FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Singh, JA Alpert, MD Kerr, G AF Singh, Jasvinder A. Alpert, Michael D. Kerr, Gail TI A National Survey of Veterans Affairs Rheumatologists for Relevance of Quality of Care Indicators for Gout Management SO ARTHRITIS CARE & RESEARCH LA English DT Article ID HYPERURICEMIA; ALLOPURINOL; ADHERENCE AB Objective. To determine the relevance of current gout quality indicators (QIs). Methods. Members of the Veterans Affairs (VA) Rheumatology Consortium were invited to participate in an online survey and provide opinions (rank 0-10) regarding existing gout QIs. Opinions sought on each QI were 1) relevance to US veterans, 2) likelihood to improve gout care, and 3) ease of electronic capture. Participants were also asked to rank their top 3 gout QIs. Results. Participating VA rheumatologists were mainly men, with a mean age of 51.3 years, and experienced in the management of gout. All 10 gout QIs were considered relevant, with a score of 8.2 or higher. The initiation of urate-lowering therapy, monitoring of urate levels after initiation of urate-lowering therapy, and treatment of acute gout with antiinflammatory agents scored the highest with regard to likelihood of improving gout care, with the first 2 QIs also thought to be the most relevant. Adjustment of initial allopurinol dosing in patients with renal impairment and in those receiving concurrent azathioprine/6-mercaptopurine were perceived as the QIs most amenable to electronic capture. The top-ranked QIs were initiation of urate-lowering therapy with frequent gout attacks, serum urate monitoring after initiation of urate-lowering therapy, and adjustment of initial allopurinol dose to renal function. Conclusion. In a national survey of VA rheumatologists, most gout QIs were thought to be highly relevant. QIs related to initiation of urate-lowering therapy, serum urate monitoring, and initial dosing of allopurinol were ranked the most important for veterans with gout. C1 [Singh, Jasvinder A.] Univ Alabama, Birmingham, AL 35294 USA. [Singh, Jasvinder A.] Birmingham VA Med Ctr, Birmingham, AL USA. [Singh, Jasvinder A.] Mayo Clin, Sch Med, Rochester, MN USA. [Alpert, Michael D.] Yale Univ, Sch Med, New Haven, CT USA. [Alpert, Michael D.; Kerr, Gail] Howard Univ Hosp, Washington, DC USA. RP Singh, JA (reprint author), Univ Alabama, Fac Off Tower 805B,510 20th St S, Birmingham, AL 35294 USA. EM Jasvinder.md@gmail.com OI singh, jasvinder/0000-0003-3485-0006 FU NIH [1-KL2-RR024151-01]; Abbott; Amgen; Centocor; Savient; URL Pharmaceuticals; Allergan; Takeda; Wyeth; Bristol-Myers Squibb FX Supported by the NIH Clinical and Translational Science Award (1-KL2-RR024151-01) to the Mayo Clinic Center for Clinical and Translational Research. The VA Rheumatology Consortium has received unrestricted educational grants from Abbott, Amgen, Centocor, and Savient.; Dr. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Savient, and URL Pharmaceuticals, and has received research and travel grants from Allergan, Takeda, Savient, Wyeth, and Amgen. Dr. Kerr has received speaking fees and/or honoraria (less than $10,000 each) from Abbott, Amgen, and Bristol-Myers Squibb, and has received research grants from Abbott, Amgen, and Savient. NR 15 TC 2 Z9 2 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 2151-464X J9 ARTHRIT CARE RES JI Arthritis Care Res. PD SEP PY 2010 VL 62 IS 9 BP 1306 EP 1311 DI 10.1002/acr.20192 PG 6 WC Rheumatology SC Rheumatology GA 651FY UT WOS:000281913400015 PM 20235197 ER PT J AU Gros, DF Simms, LJ Antony, MM AF Gros, Daniel F. Simms, Leonard J. Antony, Martin M. TI Psychometric Properties of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) in Friendship Dyads SO BEHAVIOR THERAPY LA English DT Article ID SELF-OTHER AGREEMENT; SOCIAL PHOBIA INVENTORY; BELIEFS SCALE; QUESTIONNAIRE; THOUGHTS; PERSONALITY; SIMILARITY; MATRIX; SAMPLE AB Recently, Gros, Antony, Simms, and McCabe (2007) demonstrated support for the psychometric properties of a new measure of state and trait anxiety, the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA). In the present study, we further investigated the STICSA-Trait Version in 127 friendship dyads with a self-report from one participant (target) and an other-report of the target from a friend (informant). Consistent with previous research, confirmatory factor analyses supported the 2-factor structure of the STICSA-Trait in the target and informant reports. Moreover, the STICSA-Trait Cognitive and Somatic Anxiety subscales showed acceptable convergent and discriminant validity with related measures of anxiety. In addition, the STICSA-Trait subscales demonstrated adequate internal consistency and self-other agreement across the target and informant reports. Together, these findings provide additional support for the STICSA-Trait subscales as reliable and valid measures of cognitive and somatic anxiety. C1 [Gros, Daniel F.] Ralph H Johnson Vet Adm Med Ctr, Mental Hlth Serv 116, Charleston, SC 29401 USA. [Gros, Daniel F.] Med Univ S Carolina, Charleston, SC 29425 USA. [Simms, Leonard J.] SUNY Buffalo, Buffalo, NY 14260 USA. [Antony, Martin M.] Ryerson Univ, Toronto, ON, Canada. RP Gros, DF (reprint author), Ralph H Johnson Vet Adm Med Ctr, Mental Hlth Serv 116, 109 Bee St, Charleston, SC 29401 USA. EM grosd@musc.edu RI Antony, Martin/K-1991-2012 OI Antony, Martin/0000-0002-3508-377X FU NIMH NIH HHS [R01 MH080086] NR 33 TC 18 Z9 18 U1 11 U2 21 PU ASSOC ADV BEHAVIOR THERAPY PI NEW YORK PA 305 7TH AVE #16A, NEW YORK, NY 10001-6008 USA SN 0005-7894 J9 BEHAV THER JI Behav. Therapy PD SEP PY 2010 VL 41 IS 3 BP 277 EP 284 PG 8 WC Psychology, Clinical SC Psychology GA 612JA UT WOS:000278892500002 PM 20569777 ER PT J AU Prabhu, SL Molinari, V Bowers, T Lomax, J AF Prabhu, Sheila Lobo Molinari, Victor Bowers, Theron Lomax, James TI Role of the family in suicide prevention: An attachment and family systems perspective SO BULLETIN OF THE MENNINGER CLINIC LA English DT Article ID COMMUNITY RESILIENCE; PROTECTIVE FACTORS; CONTROLLED-TRIAL; THERAPY; RISK; ADOLESCENTS; STRATEGIES; DISORDER; IDEATION; BEHAVIOR AB Suicide can be an act of despair, anger, or escape from intolerable pain associated with prior bonding disturbances within the family system, interpersonal loss, and current perceived lack of social support. Using a variety of online databases, the authors examined the research on the family's role in preventing suicide from an attachment and family systems perspective. They found relevant articles describing how to make use of family support in suicide prevention. From a study of the literature, the authors outline three new family concepts in suicide prevention: family cohesion, family adhesion, and formation of a new family. Therapists should use every familial resource to avoid premature closure and to expand perception of support options. The authors suggest specific practice recommendations to successfully involve families in suicide prevention based on the outlined family conceptual framework, and they recommend research investigation to determine empirical validation of these tentative formulations. (Bulletin of the Menninger Clinic, 74[4], 301-327) C1 [Prabhu, Sheila Lobo; Bowers, Theron; Lomax, James] Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. [Prabhu, Sheila Lobo; Bowers, Theron] Baylor Coll Med, Michael E DeBakey Dept Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Prabhu, SL (reprint author), Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, 6655 Travis, Houston, TX 77030 USA. EM SheilaM.Loboprabhu@med.va.gov NR 59 TC 9 Z9 9 U1 4 U2 10 PU GUILFORD PUBLICATIONS INC PI NEW YORK PA 72 SPRING STREET, NEW YORK, NY 10012 USA SN 0025-9284 J9 B MENNINGER CLIN JI Bull. Menninger Clin. PD FAL PY 2010 VL 74 IS 4 BP 301 EP 327 DI 10.1521/bumc.2010.74.4.301 PG 27 WC Psychiatry; Psychology, Psychoanalysis SC Psychiatry; Psychology GA 699MX UT WOS:000285668600003 ER PT J AU Karoor, V Le, M Merrick, D Dempsey, EC Miller, YE AF Karoor, Vijaya Le, Mysan Merrick, Daniel Dempsey, Edward C. Miller, York E. TI Vascular Endothelial Growth Factor Receptor 2-Targeted Chemoprevention of Murine Lung Tumors SO CANCER PREVENTION RESEARCH LA English DT Article ID SQUAMOUS-CELL CARCINOMA; TRANSGENIC MICE; CANCER; ANGIOGENESIS; INHIBITION; EXPRESSION; RISK; ADENOCARCINOMAS; OVEREXPRESSION; INDUCTION AB No clinically effective chemoprevention for lung cancer has been found. Angiogenesis is an early feature of both adenocarcinoma and squamous cell lung cancer. We investigated the effects of vascular endothelial growth factor (VEGF) receptor-2 (VEGFR-2) inhibition on lung carcinogenesis in a murine model of adenocarcinoma. The VEGFR-2 tyrosine kinase inhibitor, vandetanib, was given to FVB/N mice in chow for 7 days at varying doses to show pharmacologic activity by inhibition of VEGF-mediated VEFGR-2 and ERK phosphorylation. Plasma levels corroborated adequate dosage. For chemoprevention experiments, mice were injected i.p. with 1 mg/g of urethane, a carcinogen found in tobacco smoke. Chow containing vandetanib, 75 mg/kg/d, or control chow was given to mice, starting 7 days after urethane administration. Sixteen weeks after urethane injection, mice were sacrificed, tumors enumerated and measured. Vandetanib resulted in reductions in tumor multiplicity (6.5 +/- 0.86 versus 1.0 +/- 0.30, P = 0.001) and average tumor volume (0.85 +/- 0.10 versus 0.15 +/- 0.09 mm(3), P = 0.001), but not incidence (71% versus 100%, P = ns), compared with control. As vandetanib has other activities besides VEGFR-2 tyrosine kinase inhibition, we gave the anti-VEGFR-2 monoclonal antibody, DC101, for weeks 11 to 15 of a urethane carcinogenesis protocol with an arrest in tumor volume increase, but no change in multiplicity or incidence. Further investigation of the chemopreventive effect of vandetanib and other VEGF signaling inhibitors is needed. Cancer Prev Res; 3(9); 1141-7. (C) 2010 AACR. C1 [Miller, York E.] Univ Colorado, Denver Vet Affairs Med Ctr, Ctr Canc, Denver, CO 80220 USA. [Karoor, Vijaya; Dempsey, Edward C.; Miller, York E.] Univ Colorado, Dept Med, Denver, CO 80220 USA. [Merrick, Daniel] Univ Colorado, Dept Pathol, Denver, CO 80220 USA. [Le, Mysan; Merrick, Daniel; Dempsey, Edward C.; Miller, York E.] Dept Vet Affairs Med Ctr, Denver, CO USA. RP Miller, YE (reprint author), Univ Colorado, Denver Vet Affairs Med Ctr, Ctr Canc, Pulm 111A,1055 Clermont St, Denver, CO 80220 USA. EM york.miller@ucdenver.edu FU Department of Veterans Affairs; NCI [P50 CA58187]; NHLBI [RO1 HL078929]; PPG [HL14985] FX Department of Veterans Affairs Merit Review and NCI P50 CA58187 (Y.E. Miller), NHLBI RO1 HL078929, and PPG HL14985 (V. Karoor and E. C. Dempsey). NR 30 TC 8 Z9 8 U1 0 U2 5 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1940-6207 J9 CANCER PREV RES JI Cancer Prev. Res. PD SEP PY 2010 VL 3 IS 9 BP 1141 EP 1147 DI 10.1158/1940-6207.CAPR-10-0005 PG 7 WC Oncology SC Oncology GA 646KH UT WOS:000281538400013 PM 20647338 ER PT J AU Wu, PC Wang, Q Dong, ZM Chu, E Roberson, RS Ivanova, IC Wu, DY AF Wu, P. C. Wang, Q. Dong, Z. M. Chu, E. Roberson, R. S. Ivanova, I. C. Wu, D. Y. TI Expression of coxsackie and adenovirus receptor distinguishes transitional cancer states in therapy-induced cellular senescence SO CELL DEATH & DISEASE LA English DT Article DE cellular senescence; coxsackie and adenovirus receptor; transition state; biomarker ID MEDIATED GENE-TRANSFER; HUMAN TUMOR-CELLS; REPLICATIVE SENESCENCE; BARRETTS-ESOPHAGUS; FUNCTIONAL P53; GROWTH ARREST; HUMAN LUNG; P16(INK4A); FIBROBLASTS; SUPPRESSION AB Therapy-induced cellular senescence describes the phenomenon of cell cycle arrest that can be invoked in cancer cells in response to chemotherapy. Sustained proliferative arrest is often overcome as a contingent of senescent tumor cells can bypass this cell cycle restriction. The mechanism regulating cell cycle re-entry of senescent cancer cells remains poorly understood. This is the first report of the isolation and characterization of two distinct transitional states in chemotherapy-induced senescent cells that share indistinguishable morphological senescence phenotypes and are functionally classified by their ability to escape cell cycle arrest. It has been observed that cell surface expression of coxsackie and adenovirus receptor (CAR) is downregulated in cancer cells treated with chemotherapy. We show the novel use of surface CAR expression and adenoviral transduction to differentiate senescent states and also show in vivo evidence of CAR downregulation in colorectal cancer patients treated with neoadjuvant chemoradiation. This study suggests that CAR is a candidate biomarker for senescence response to antitumor therapy, and CAR expression can be used to distinguish transitional states in early senescence to study fundamental regulatory events in therapy-induced senescence. Cell Death and Disease (2010) 1, e70; doi:10.1038/cddis.2010.47; published online 2 September 2010 C1 [Wu, P. C.] Univ Washington, Dept Surg, Seattle, WA 98108 USA. [Wu, P. C.; Chu, E.] VA Puget Sound Hlth Care Syst, Dept Surg, Seattle, WA USA. [Wang, Q.; Roberson, R. S.; Ivanova, I. C.; Wu, D. Y.] VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. [Dong, Z. M.] VA Puget Sound Hlth Care Syst, Dept Pathol, Seattle, WA USA. [Wu, D. Y.] Univ Washington, Div Oncol, Dept Med, Seattle, WA 98108 USA. [Wu, D. Y.] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. RP Wu, PC (reprint author), Univ Washington, Dept Surg, 1660 S Columbian Way S-112, Seattle, WA 98108 USA. EM pcwu@u.washington.edu FU Veteran Affairs Office of Research & Development Medical Research Service; National Cancer Institute [R01-CA113892-01] FX This material is based on work supported by the Veteran Affairs Office of Research & Development Medical Research Service (Biomedical Laboratory R&D Career Development Award-2 to PCW) and National Cancer Institute (R01-CA113892-01 to DYW). We thank Dr. Liu Yang for his critical reading of our manuscript and his insightful suggestions. NR 38 TC 9 Z9 10 U1 0 U2 2 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 2041-4889 J9 CELL DEATH DIS JI Cell Death Dis. PD SEP PY 2010 VL 1 AR e70 DI 10.1038/cddis.2010.47 PG 10 WC Cell Biology SC Cell Biology GA 656UA UT WOS:000282361700002 PM 21364674 ER PT J AU Teodorescu, M Polomis, DA Hall, SV Teodorescu, MC Gangnon, RE Peterson, AG Xie, AL Sorkness, CA Jarjour, NN AF Teodorescu, Mihaela Polomis, David A. Hall, Stephanie V. Teodorescu, Mihai C. Gangnon, Ronald E. Peterson, Andrea G. Xie, Ailiang Sorkness, Christine A. Jarjour, Nizar N. TI Association of Obstructive Sleep Apnea Risk With Asthma Control in Adults SO CHEST LA English DT Article ID POSITIVE AIRWAY PRESSURE; BODY-MASS INDEX; TO-TREAT ASTHMA; CONTROL QUESTIONNAIRE; NOCTURNAL ASTHMA; HYPOXIA SUPPRESSES; BREATH CONDENSATE; INFLAMMATION; OBESITY; POPULATION AB Background: Unrecognized obstructive sleep apnea (OSA) may lead to poor asthma control despite optimal therapy. Our objective was to evaluate the relationship between OSA risk and asthma control in adults. Methods: Patients with asthma seen routinely at tertiary-care clinic visits completed the validated Sleep Apnea Scale of the Sleep Disorders Questionnaire (SA-SDQ) and Asthma Control Questionnaire (ACQ). An ACQ score of >= 1.5 defined not-well-controlled asthma, and an SA-SDQ score of >= 36 for men and >= 32 for women defined high OSA risk. Logistic regression was used to model associations of high OSA risk with not-well-controlled asthma (ACQ full version and short versions). Results: Among 472 subjects with asthma, the mean +/- SD ACQ (full version) score was 0.87 +/- 0.90, and 80 (17%) subjects were not well controlled. Mean SA-SDQ score was 27 +/- 7, and 109 (23%) subjects met the definition of high OSA risk. High OSA risk was associated, on average, with 2.87-times higher odds for not-well-controlled asthma (ACQ full version) (95% CI, 1.54-5.32; P = .0009) after adjusting for obesity and other factors known to worsen asthma control. Similar independent associations were seen when using the short ACQ versions. Conclusions: High OSA risk is significantly associated with not-well-controlled asthma independent of known asthma aggravators and regardless of the ACQ version used. Patients who have difficulty achieving adequate asthma control should be screened for OSA. CHEST 2010; 138(3):543-550 C1 [Teodorescu, Mihaela; Polomis, David A.; Hall, Stephanie V.; Peterson, Andrea G.; Xie, Ailiang; Sorkness, Christine A.; Jarjour, Nizar N.] Univ Wisconsin, Sch Med & Publ Hlth, Sect Allergy Pulm & Crit Care Med, Madison, WI 53792 USA. [Teodorescu, Mihaela; Teodorescu, Mihai C.] Univ Wisconsin, Sch Med & Publ Hlth, Wisconsin Sleep Inst, Madison, WI 53792 USA. [Teodorescu, Mihai C.] Univ Wisconsin, Sch Med & Publ Hlth, Sect Geriatr & Gerontol, Madison, WI 53792 USA. [Gangnon, Ronald E.] Univ Wisconsin, Sch Med & Publ Hlth, Dept Biostat & Med Informat & Populat Hlth Sci, Madison, WI 53792 USA. [Sorkness, Christine A.] Univ Wisconsin, Sch Pharm, Madison, WI 53792 USA. [Teodorescu, Mihaela; Teodorescu, Mihai C.] William S Middleton Mem Vet Adm Med Ctr, Med Serv, Madison, WI USA. RP Teodorescu, M (reprint author), Univ Wisconsin, Sch Med & Publ Hlth, Sect Allergy Pulm & Crit Care Med, K4-910 CSC 9988,600 Highland Ave, Madison, WI 53792 USA. EM mt3@medicine.wisc.edu FU University of Wisconsin School of Medicine and Public Health, Department of Medicine, and Medical Education and Research Committee-New Investigator [1UL1RR025011]; National Center for Research Resources, National Institutes of Health; Novartis; Merck; Asthmatx; National Institutes of Health; GlaxoSmith Kline; Medimmune; Genentech FX Funding/Support: This work was performed at the University of Wisconsin-Madison and was funded by the University of Wisconsin School of Medicine and Public Health, Department of Medicine, and Medical Education and Research Committee-New Investigator Award; 1UL1RR025011 from the Clinical and Translational Science Award program of the National Center for Research Resources, National Institutes of Health; and additional resources from the William S. Middleton Memorial Veterans Hospital, Madison, WI (to Dr M. Teodorescu).; Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Sorkness is on the advisory board for GlaxoSmithKline (<$10,000). Dr Jarjour is on the advisory board for GlaxoSmithKline and received speaker honoraria (each <$10,000) from Novartis and Merck and consulting fees (> $10,000) from Asthmatx. He received funding support from the National Institutes of Health, GlaxoSmith Kline, Medimmune, and Genentech. Drs M. Teodorescu, Polomis, M. C. Teodorescu, Gangnon, and Xie and Mss Hall and Peterson have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article. NR 50 TC 46 Z9 50 U1 3 U2 8 PU AMER COLL CHEST PHYSICIANS PI GLENVIEW PA 2595 PATRIOT BLVD, GLENVIEW, IL 60026 USA SN 0012-3692 J9 CHEST JI Chest PD SEP PY 2010 VL 138 IS 3 BP 543 EP 550 DI 10.1378/chest.09-3066 PG 8 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 659IZ UT WOS:000282561500017 PM 20495105 ER PT J AU Slatore, CG Cecere, LM Reinke, LF Ganzini, L Udris, EM Moss, BR Bryson, CL Curtis, JR Au, DH AF Slatore, Christopher G. Cecere, Laura M. Reinke, Lynn F. Ganzini, Linda Udris, Edmunds M. Moss, Brianna R. Bryson, Chris L. Curtis, J. Randall Au, David H. TI Patient-Clinician Communication Associations With Important Health Outcomes Among Veterans With COPD SO CHEST LA English DT Article ID OBSTRUCTIVE PULMONARY-DISEASE; PRIMARY-CARE PHYSICIANS; QUALITY-OF-LIFE; SINGLE-ITEM; QUESTIONNAIRE; MANAGEMENT; RECOMMENDATIONS; PREDICTION; MORTALITY; IMPROVE AB Background: High quality patient-clinician communication is widely advocated, but little is known about which health outcomes are associated with communication for patients with COPD. Methods: Using a cross-sectional study of 342 veterans enrolled in a randomized controlled trial, we evaluated the association of communication, measured with the quality of communication (QOC) instrument, with subject-reported quality of clinician care, breathing problem confidence, and general self-rated health. We measured these associations using general estimating equations and adjusted odds ratios (OR) of patient-reported outcomes associated with one-point changes in QOC scores. Results: Nearly one-half of the subjects reported receiving the best imaginable care (47%), whereas fewer reported being confident with their breathing problems all the time (29%) or in very good or excellent health (15%). General communication was associated with best-imagined quality of care (OR, 4.29; 95% CI, 2.84-6.48; P <.001) and confidence in dealing with breathing problems all the time (OR, 1.74; 95% CI, 1.34-2.25; P <.001) but not general self-rated health (OR, 1.19; 95% CI, 0.92-1.55; P =.19). Specific clinician behaviors with larger associations with higher quality care included listening, caring, and attentiveness. The associations between general communication and quality care increased over time (P for interaction .03). Conclusions: Communication between patients and clinicians is associated with quality of care and confidence in dealing with breathing problems, and this association may change over time. Attention to specific communication strategies may lead to improvements in the care of patients with COPD. CHEST 2010; 138(3):628-634 C1 [Slatore, Christopher G.; Ganzini, Linda] Portland VA Med Ctr, Hlth Serv Res & Dev, Portland, OR 97239 USA. [Slatore, Christopher G.] Oregon Hlth & Sci Univ, Div Pulm & Crit Care Med, Portland, OR 97201 USA. [Cecere, Laura M.; Reinke, Lynn F.; Udris, Edmunds M.; Moss, Brianna R.; Bryson, Chris L.; Au, David H.] Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA USA. [Cecere, Laura M.; Bryson, Chris L.; Curtis, J. Randall; Au, David H.] Univ Washington, Dept Med, Seattle, WA USA. RP Slatore, CG (reprint author), Portland VA Med Ctr, Hlth Serv Res & Dev, 3710 SW US Vet Hosp Rd,R&D 66, Portland, OR 97239 USA. EM slatore@ohsu.edu OI Slatore, Christopher/0000-0003-0958-8122 FU Health Services Research and Development, Department of Veterans Affairs [IIR 02-292]; National Institute of Health [CA130328]; National Institutes of Health-National Heart, Lung, and Blood Institute; Department of Veterans Affairs; American Lung Association; Gilead Science, Inc. FX This work was supported by the Health Services Research and Development, Department of Veterans Affairs [IIR 02-292), and Dr Slatore was supported by funding from the National Institute of Health [CA130328].; The authors have reported to CHEST the following conflicts of interest: Dr Au has received research funding from the National Institutes of Health-National Heart, Lung, and Blood Institute, the Department of Veterans Affairs, the American Lung Association, and Gilead Science, Inc. Drs Slatore, Cecere; Reinke, Ganzini, Bryson, Curtis, and Au; Mr Udris; and Ms Moss have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article. NR 37 TC 24 Z9 25 U1 0 U2 8 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 2010 VL 138 IS 3 BP 628 EP 634 DI 10.1378/chest.09-2328 PG 7 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 659IZ UT WOS:000282561500027 PM 20299633 ER PT J AU Castriotta, RJ Eldadah, BA Foster, WM Halter, JB Hazzard, WR Kiley, JP King, TE Horne, FM Nayfield, SG Reynolds, HY Schmader, KE Toews, GB High, KP AF Castriotta, Richard J. Eldadah, Basil A. Foster, W. Michael Halter, Jeffrey B. Hazzard, William R. Kiley, James P. King, Talmadge E., Jr. Horne, Frances McFarland Nayfield, Susan G. Reynolds, Herbert Y. Schmader, Kenneth E. Toews, Galen B. High, Kevin P. TI Workshop on Idiopathic Pulmonary Fibrosis in Older Adults SO CHEST LA English DT Article ID ENDOPLASMIC-RETICULUM STRESS; INTERSTITIAL LUNG-DISEASE; ALVEOLAR EPITHELIAL-CELLS; GASTROESOPHAGEAL-REFLUX DISEASE; GENE-EXPRESSION PROFILES; PLACEBO-CONTROLLED TRIAL; MESENCHYMAL STEM-CELLS; ARTERIAL-HYPERTENSION; ACUTE EXACERBATIONS; DIABETES-MELLITUS AB Idiopathic pulmonary fibrosis (IPF), a heterogeneous disease with respect to clinical presentation and rates of progression, disproportionately affects older adults. The diagnosis of IPF is descriptive, based on clinical, radiologic, and histopathologic examination, and definitive diagnosis is hampered by poor interobserver agreement and lack of a consensus definition. There are no effective treatments. Cellular, molecular, genetic, and environmental risk factors have been identified for IPF, but the initiating event and the characteristics of preclinical stages are not known. IPF is predominantly a disease of older adults, and the processes underlying normal aging might significantly influence the development of IPF. Yet, the biology of aging and the principles of medical care for this population have been typically ignored in basic, translational, or clinical IPF research. In August 2009, the Association of Specialty Professors, in collaboration with the American College of Chest Physicians, the American Geriatrics Society, the National Institute on Aging, and the National Heart, Lung, and Blood Institute, held a workshop, summarized herein, to review what is known, to identify research gaps at the interface of aging and IPF, and to suggest priority areas for future research. Efforts to answer the questions identified will require the integration of geriatrics, gerontology, and pulmonary, research, but these efforts have great potential to improve care for patients with IPF. CHEST 2010; 138(3):693-703 C1 [High, Kevin P.] Wake Forest Univ, Bowman Gray Sch Med, Infect Dis Sect, Winston Salem, NC 27157 USA. [Castriotta, Richard J.] Univ Texas Hlth Sci Ctr Houston, Houston, TX USA. [Eldadah, Basil A.] NIA, Bethesda, MD 20892 USA. [Foster, W. Michael] Duke Univ, Sch Med, Durham, NC USA. [Halter, Jeffrey B.; Toews, Galen B.] Univ Michigan, Sch Med, Ann Arbor, MI USA. [Hazzard, William R.] Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. [Kiley, James P.; Reynolds, Herbert Y.] NHLBI, Bethesda, MD 20892 USA. [King, Talmadge E., Jr.] Univ Calif San Francisco, San Francisco Sch Med, San Francisco, CA USA. [Horne, Frances McFarland] Assoc Specialty Prof, Washington, DC USA. [Nayfield, Susan G.] Univ Florida, Sch Med, Gainesville, FL USA. [Schmader, Kenneth E.] Duke Univ, Med Ctr, Durham, NC USA. [Schmader, Kenneth E.] GRECC Durham VA Med Ctr, Durham, NC USA. RP High, KP (reprint author), Wake Forest Univ, Bowman Gray Sch Med, Infect Dis Sect, Med Ctr Blvd, Winston Salem, NC 27157 USA. EM khigh@wfubmc.edu OI Castriotta, Richard/0000-0003-3502-4558 FU John A. Hartford Foundation [2006-0239]; Cephalon, Inc.; Merck; Wyeth; Pfizer; Optimer; Chimerix; Afexa Life Sciences FX This workshop was supported by a grant from the John A. Hartford Foundation to the Association of Specialty Professors [Grant 2006-0239].; The authors have reported to CHEST the following conflicts of interest: Dr Castriotta is a consultant for Blue Cross and Blue Shield of Texas and has received past research support from Cephalon, Inc. Dr Eldadah is a federal employee with the National Institutes of Health. Dr King serves as a consultant to the following pharmaceutical or medical device companies: Actelion, AstraZeneca, Boehringer Ingelheim, Centocor, Chronoger, CV Therapeutics, Domantis Limited, FibroGen, Genzyme, Human Genome Sciences, Huya Bioscience, InterMune, Millennium Pharmaceuticals, Merck, GlaxoSmithKline, Gilead, Novartis, Hoffman-La Roche, Inc., and Serono. He also serves on the advisory committees for Actelion and InterMune and on the data safety monitoring boards for Centocor and GlaxoSmithKline. Dr Nayfield is a federal employee with the National Institutes of Health. Dr Reynolds is a federal employee with the National Institutes of Health. Dr Schmader has received grant support from Merck and Wyeth and serves as a consultant for Merck and GlaxoSmithKline. Dr High has received grant support from Merck, Pfizer, Optimer, Chimerix, and Afexa Life Sciences, and serves as a consultant for Optimer and GlaxoSmithKline. Drs Foster, Halter, Hazzard, Kiley, McFarland Home, and Toews have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article. NR 106 TC 25 Z9 25 U1 1 U2 9 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 2010 VL 138 IS 3 BP 693 EP 703 DI 10.1378/chest.09-3006 PG 11 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 659IZ UT WOS:000282561500035 PM 20822991 ER PT J AU Magid, DJ Shetterly, SM Margolis, KL Tavel, HM O'Connor, PJ Selby, JV Ho, PM AF Magid, David J. Shetterly, Susan M. Margolis, Karen L. Tavel, Heather M. O'Connor, Patrick J. Selby, Joe V. Ho, P. Michael TI Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors Versus beta-Blockers as Second-Line Therapy for Hypertension SO CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES LA English DT Article DE hypertension; comparative effectiveness; diuretics; cardiovascular diseases ID JOINT NATIONAL COMMITTEE; HIGH BLOOD-PRESSURE; CARDIOVASCULAR EVENTS; RANDOMIZED-TRIALS; PROPENSITY SCORE; 7TH REPORT; OUTCOMES; RISK; AMLODIPINE; PREVENTION AB Background-Trials comparing hypertension monotherapies have found either no difference or modest differences in blood pressure (BP) and cardiovascular events. However, no trial has assessed the comparative effectiveness of 2nd-line therapy in patients whose BP was not controlled with a thiazide diuretic. Methods and Results-This was an observational study conducted with a hypertension registry of adults enrolled in 3 large integrated health care delivery systems from 2002 to 2007. Patients newly started on thiazide monotherapy whose BP remained uncontrolled were observed after addition of either an angiotensin-converting enzyme (ACE) inhibitor or beta-blocker for subsequent BP control and cardiovascular events. Patients for whom either add-on drug was indicated or contraindicated were excluded. After adjustment for patient characteristics and study year, BP control during the subsequent 6 to 18 months was comparable for the 2 agents (70.5% ACE, 69.0% beta-blockers; P=0.09). Rates of incident myocardial infarction (hazard ratio, 1.05; 95% confidence interval, 0.69 to 1.58) and stroke (hazard ratio, 1.01; 95% confidence interval, 0.68 to 1.52) were also similar for the ACE inhibitor and beta-blocker groups during an average of 2.3 years of follow-up. There were also no differences in heart failure or renal function. Conclusions-ACE inhibitors and beta-blockers are equally effective in lowering BP and preventing cardiovascular events for patients whose BP is not controlled with a thiazide diuretic alone and who have no compelling indication for a specific 2nd-line agent. (Circ Cardiovasc Qual Outcomes. 2010; 3:453-458.) C1 [Magid, David J.; Shetterly, Susan M.; Tavel, Heather M.; Ho, P. Michael] Kaiser Permanente, Inst Hlth Res, Denver, CO USA. [Magid, David J.; Ho, P. Michael] Univ Colorado, Denver, CO 80202 USA. [Margolis, Karen L.; O'Connor, Patrick J.] Hlth Partners Res Fdn, Minneapolis, MN USA. [Selby, Joe V.] Kaiser Permanente No Calif, Oakland, CA USA. [Ho, P. Michael] Denver VA Med Ctr, Denver, CO USA. RP Magid, DJ (reprint author), KPCO IHR, 10065 E Harvard Ave,Suite 300, Denver, CO 80231 USA. EM David.J.Magid@kp.org FU Agency for Healthcare Research and Quality, US Department of Health and Human Services [290-2005-0033] FX This project was funded under Contract No. 290-2005-0033 from the Agency for Healthcare Research and Quality, US Department of Health and Human Services as part of the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) program. The authors of this report are responsible for its content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality or the US Department of Health and Human Services. NR 25 TC 6 Z9 7 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1941-7713 J9 CIRC-CARDIOVASC QUAL JI Circ.-Cardiovasc. Qual. Outcomes PD SEP PY 2010 VL 3 IS 5 BP 453 EP 458 DI 10.1161/CIRCOUTCOMES.110.940874 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 680UW UT WOS:000284262100005 PM 20716714 ER PT J AU Bernheim, SM Grady, JN Lin, ZQ Wang, Y Wang, YF Savage, SV Bhat, KR Ross, JS Desai, MM Merrill, AR Han, LF Rapp, MT Drye, EE Normand, SLT Krumholz, HM AF Bernheim, Susannah M. Grady, Jacqueline N. Lin, Zhenqiu Wang, Yun Wang, Yongfei Savage, Shantal V. Bhat, Kanchana R. Ross, Joseph S. Desai, Mayur M. Merrill, Angela R. Han, Lein F. Rapp, Michael T. Drye, Elizabeth E. Normand, Sharon-Lise T. Krumholz, Harlan M. TI National Patterns of Risk-Standardized Mortality and Readmission for Acute Myocardial Infarction and Heart Failure Update on Publicly Reported Outcomes Measures Based on the 2010 Release SO CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES LA English DT Article DE mortality; myocardial infarction; heart failure; performance measurement; readmission ID PROFILING HOSPITAL PERFORMANCE; RATES; TRIAL; CARE AB Background-Patient outcomes provide a critical perspective on quality of care. The Centers for Medicare and Medicaid Services (CMS) is publicly reporting hospital 30-day risk-standardized mortality rates (RSMRs) and risk-standardized readmission rates (RSRRs) for patients hospitalized with acute myocardial infarction (AMI) and heart failure (HF). We provide a national perspective on hospital performance for the 2010 release of these measures. Methods and Results-The hospital RSMRs and RSRRs are calculated from Medicare claims data for fee-for-service Medicare beneficiaries, 65 years or older, hospitalized with AMI or HF between July 1, 2006, and June 30, 2009. The rates are calculated using hierarchical logistic modeling to account for patient clustering, and are risk-adjusted for age, sex, and patient comorbidities. The median RSMR for AMI was 16.0% and for HF was 10.8%. Both measures had a wide range of hospital performance with an absolute 5.2% difference between hospitals in the 5th versus 95th percentile for AMI and 5.0% for HF. The median RSRR for AMI was 19.9% and for HF was 24.5% (3.9% range for 5th to 95th percentile for AMI, 6.7% for HF). Distinct regional patterns were evident for both measures and both conditions. Conclusions-High RSRRs persist for AMI and HF and clinically meaningful variation exists for RSMRs and RSRRs for both conditions. Our results suggest continued opportunities for improvement in patient outcomes for HF and AMI. (Circ Cardiovasc Qual Outcomes. 2010; 3:459-467.) C1 [Bernheim, Susannah M.; Grady, Jacqueline N.; Lin, Zhenqiu; Wang, Yun; Wang, Yongfei; Savage, Shantal V.; Bhat, Kanchana R.; Desai, Mayur M.; Drye, Elizabeth E.; Krumholz, Harlan M.] Yale New Haven Hlth Serv Corp, Ctr Outcomes Res & Evaluat, New Haven, CT USA. [Desai, Mayur M.] Yale Univ, Sch Publ Hlth, Sect Chron Dis Epidemiol, New Haven, CT USA. [Wang, Yun; Wang, Yongfei; Drye, Elizabeth E.; Krumholz, Harlan M.] Yale Univ, Sch Med, Sect Cardiovasc Med, New Haven, CT USA. [Krumholz, Harlan M.] Robert Wood Johnson Clin Scholars Program, New Haven, CT USA. [Ross, Joseph S.] Mt Sinai Sch Med, Dept Geriatr, New York, NY USA. [Ross, Joseph S.] Mt Sinai Sch Med, Dept Adult Dev & Med, New York, NY USA. [Ross, Joseph S.] James J Peters Vet Adm Med Ctr, HSR&D Targeted Res Enhancement Program, Bronx, NY USA. [Ross, Joseph S.] James J Peters Vet Adm Med Ctr, Geriatr Res Educ & Clin Ctr, Bronx, NY USA. [Merrill, Angela R.] Math Policy Res Inc, Cambridge, MA USA. [Han, Lein F.; Rapp, Michael T.] Ctr Medicare & Medicaid Serv, Baltimore, MD USA. [Rapp, Michael T.] George Washington Univ, Sch Med & Hlth Sci, Sect Emergency Med, Washington, DC 20052 USA. [Normand, Sharon-Lise T.] Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA. [Normand, Sharon-Lise T.] Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. RP Bernheim, SM (reprint author), Yale YNHH Ctr Outcomes Res & Evaluat, 1 Church St,Suite 200, New Haven, CT 06510 USA. EM susannah.bernheim@yale.edu FU CMS, Department of Health and Human Services [HHSM-500-2008-0025I (0001), HHSM-500-2008-00020I (0001)]; National Institute on Aging [K08 AG032886]; American Federation of Aging Research; CMS FX The analyses on which this publication is based were performed under Contract No. HHSM-500-2008-0025I (0001), entitled "Measure and Instrument Development and Support (MIDS)-Development and Re-evaluation of the CMS Hospital Outcomes and Efficiency Measures," and HHSM-500-2008-00020I (0001), entitled " Production and Implementation of Hospital Outcome and Efficiency Measures" funded by the CMS, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services. The authors assume full responsibility for the accuracy and completeness of the ideas presented. Dr Ross is currently supported by the National Institute on Aging (K08 AG032886) and by the American Federation of Aging Research through the Paul B. Beeson Career Development Award.; Dr Bernheim, Jacqueline Grady, Zhenqiu Lin, Yun Wang, Yongfei Wang, Shantal V. Savage, Kanchana R. Bhat, Elizabeth Drye, and Harlan Krumholz all work under contract with CMS to develop and maintain performance measures. Dr Merrill works under contract with CMS to produce and implement the outcomes measures. Dr Han and Dr Rapp are employed by CMS. NR 17 TC 98 Z9 99 U1 2 U2 11 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1941-7713 J9 CIRC-CARDIOVASC QUAL JI Circ.-Cardiovasc. Qual. Outcomes PD SEP PY 2010 VL 3 IS 5 BP 459 EP 467 DI 10.1161/CIRCOUTCOMES.110.957613 PG 9 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 680UW UT WOS:000284262100006 PM 20736442 ER PT J AU Handforth, A Bordelon, Y Frucht, SJ Quesada, A AF Handforth, Adrian Bordelon, Yvette Frucht, Steven J. Quesada, Arnulfo TI A Pilot Efficacy and Tolerability Trial of Memantine for Essential Tremor SO CLINICAL NEUROPHARMACOLOGY LA English DT Article DE essential tremor; memantine; clinical trial ID HARMALINE-INDUCED TREMOR; AMINO-ACIDS; ACTIVATION; EXPRESSION; RECEPTORS; BRAIN; BLIND; NMDA; RATS; MICE AB Objective: We studied the potential efficacy and tolerance of memantine for essential tremor in an open-treatment trial. Methods: Participants with upper-limb tremor were titrated to no more than 40 mg/d memantine, as monotherapy or as adjunct to stable antitremor medication, followed by a 12-week extension phase. Tremor was assessed in study 1 with accelerometry and in study 2 by blinded ratings of videotaped Washington Heights Inwood Genetic Essential Tremor (WHIGET) rating scale items. Subjects also rated their tremor treatment response and tremor-associated impairment on the Functional Disabilities scale. Results: In study 1, average accelerometry-measured tremor at last titration visit (average dose, 30.3 mg/d) did not change from baseline, but 2 of 9 subjects, taking 40 mg/d, had greater than 70% accelerometry tremor reduction. In study 2, 13 of 16 provided evaluable data. Average blinded rater-evaluated WHIGET scores were significantly different from baseline scores among those taking 20 mg/d (-12.7%; P<0.05), but not at last titration visit (-8.4%; average dose, 30.4 mg/d), 40 mg/d (-14.1%), or at end-of-extension visit (-18.2%). Raters judged WHIGET scores as greater than 30% improved in 2 subjects. Unblinded subjects rated Functional Disabilities significantly improved at 30 to 40 but not at 10 to 20 mg/d, and tremor treatment response was positive at all doses. Adverse events were more common at higher doses and included dizziness, somnolence, and poor energy. Conclusions: These pilot results with small samples indicate that the average effect of memantine on tremor is mild or not significant. However, in a small subset of patients, memantine may confer meaningful tremor benefit. C1 [Handforth, Adrian] Univ Calif Los Angeles, Dept Neurol, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. [Bordelon, Yvette] Univ Calif Los Angeles, Dept Neurol, David Geffen Sch Med, Los Angeles, CA 90024 USA. [Frucht, Steven J.] Columbia Univ, Dept Neurol, Med Ctr, New York, NY USA. [Quesada, Arnulfo] Univ Calif Los Angeles, Res Serv, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. [Quesada, Arnulfo] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90024 USA. RP Handforth, A (reprint author), VA Greater Los Angeles, Neurol Serv W127, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM charles.handforth@va.gov FU Forest Laboratories; Veterans Affairs FX Supported by Forest Laboratories and by Veterans Affairs. NR 27 TC 4 Z9 4 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0362-5664 J9 CLIN NEUROPHARMACOL JI Clin. Neuropharmacol. PD SEP-OCT PY 2010 VL 33 IS 5 BP 223 EP 226 DI 10.1097/WNF.0b013e3181ebd109 PG 4 WC Clinical Neurology; Pharmacology & Pharmacy SC Neurosciences & Neurology; Pharmacology & Pharmacy GA 653YL UT WOS:000282134400002 PM 20838216 ER PT J AU O'Glasser, AY Scott, DL Corless, CL Zaman, A Sasaki, A Gopal, DV Rayhill, SC Orloff, SL Ham, JM Rabkin, JM Flora, K Davies, CH Broberg, CS Schwartz, JM AF O'Glasser, Avital Y. Scott, David L. Corless, Christopher L. Zaman, Atif Sasaki, Anna Gopal, Deepak V. Rayhill, Stephen C. Orloff, Susan L. Ham, John M. Rabkin, John M. Flora, Ken Davies, Crispin H. Broberg, Craig S. Schwartz, Jonathan M. TI Hepatic and cardiac iron overload among patients with end-stage liver disease referred for liver transplantation SO CLINICAL TRANSPLANTATION LA English DT Article DE hemochromatosis; hemosiderosis; liver transplantation ID HEREDITARY HEMOCHROMATOSIS; HEPCIDIN TRANSCRIPTION; SURVIVAL; PATHOGENESIS; EXPRESSION; LEVEL; METABOLISM; CIRRHOSIS; REGISTRY; FAILURE AB Background: Iron overload is associated with fatal cardiovascular events following liver transplantation. Myocardial iron deposits were observed post-mortem in patients who died of cardiac events after transplantation at our institution. This observation prompted testing to exclude cardiac iron in subsequent transplant candidates. Aims: To assess the results of testing for iron overload in liver transplant candidates at our institution. Methods: Ferritin, TIBC, and serum iron were measured in cirrhotics referred for transplantation. Patients with transferrin saturation >= 50% and ferritin >= 250 ng/mL underwent liver biopsy graded for iron. Patients with 3-4+ hepatic iron deposits underwent HFE mutation analysis and endomyocardial biopsy with iron staining. Results: Eight hundred and fifty-six patients were evaluated for liver transplantation between January 1997 and March 2005. Two hundred and eighty-seven patients (34%) had transferrin saturation >= 50% and ferritin >= 250 ng/mL. Patients with markers of iron overload had more advanced liver disease than those with normal iron indices. One hundred and fifty-three patients underwent liver biopsy. Twenty-six patients (17%) had 3-4+ hepatic iron staining. One patient was a C282Y heterozygote. Endomyocardial biopsy was performed in 14 patients of whom nine had cardiac iron deposition. Conclusions: Non-HFE-related cardiac iron overload can occur in advanced liver disease We therefore recommend screening for cardiac iron prior to liver transplantation. C1 [O'Glasser, Avital Y.; Zaman, Atif; Sasaki, Anna; Schwartz, Jonathan M.] Oregon Hlth & Sci Univ, Div Gastroenterol & Hepatol, Dept Med, Portland, OR 97219 USA. [O'Glasser, Avital Y.; Zaman, Atif; Sasaki, Anna; Rayhill, Stephen C.; Orloff, Susan L.; Ham, John M.; Schwartz, Jonathan M.] Portland VA Med Ctr, Portland, OR 97219 USA. [Rayhill, Stephen C.; Orloff, Susan L.; Ham, John M.] Oregon Hlth & Sci Univ, Div Liver Pancreas Transplantat, Dept Surg, Portland, OR 97219 USA. [Corless, Christopher L.] Oregon Hlth & Sci Univ, Dept Pathol, Portland, OR 97219 USA. [Gopal, Deepak V.] Univ Wisconsin, Sch Med & Publ Hlth, Dept Med, Sect Gastroenterol & Hepatol, Madison, WI USA. [Rabkin, John M.] Calif Pacific Med Ctr, San Francisco, CA USA. [Flora, Ken] Oregon Clin, Portland, OR USA. [Davies, Crispin H.; Broberg, Craig S.] Oregon Hlth & Sci Univ, Div Cardiol, Dept Med, Portland, OR 97219 USA. RP Schwartz, JM (reprint author), Oregon Hlth & Sci Univ, Div Gastroenterol & Hepatol, Dept Med, 3181 Sam Jackson Pk Rd,L461, Portland, OR 97219 USA. EM schwajon@ohsu.edu NR 39 TC 4 Z9 4 U1 0 U2 2 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0902-0063 J9 CLIN TRANSPLANT JI Clin. Transplant. PD SEP-OCT PY 2010 VL 24 IS 5 BP 643 EP 651 DI 10.1111/j.1399-0012.2009.01136.x PG 9 WC Surgery; Transplantation SC Surgery; Transplantation GA 659MJ UT WOS:000282570300023 PM 19925473 ER PT J AU Weisbord, SD Shields, AM Mor, MK Sevick, MA Homer, M Peternel, J Porter, P Rollman, BL Palevsky, PM Arnold, RM Fine, MJ AF Weisbord, Steven D. Shields, Anne Marie Mor, Maria K. Sevick, Mary Ann Homer, Marcia Peternel, Janet Porter, Patricia Rollman, Bruce L. Palevsky, Paul M. Arnold, Robert M. Fine, Michael J. TI Methodology of a randomized clinical trial of symptom management strategies in patients receiving chronic hemodialysis: The SMILE study SO CONTEMPORARY CLINICAL TRIALS LA English DT Article DE Symptoms; Hemodialysis; Pain; Sexual dysfunction; Erectile dysfunction; Depression ID STAGE RENAL-DISEASE; QUALITY-OF-LIFE; MAINTENANCE HEMODIALYSIS; ERECTILE DYSFUNCTION; DEPRESSED-PATIENTS; DIALYSIS PATIENTS; SEXUAL FUNCTION; MINI-COG; PAIN; PREVALENCE AB Despite the high prevalence of pain, sexual dysfunction, and depression in patients on chronic hemodialysis, these symptoms are often unrecognized and under-treated by renal providers. This report describes the rationale and methodology of the SMILE study (Symptom Management Involving End-Stage Renal Disease), a multi-center, randomized clinical trial comparing the effectiveness of two strategies for implementing treatment for these symptoms in patients receiving chronic hemodialysis. Approximately 250 patients from nine outpatient dialysis units will participate. Over a 2-12 month observational phase, participants complete monthly surveys characterizing their pain, sexual dysfunction, and depression. Following this observational period, subjects are randomized to one of two study arms to receive a 12-month intervention. In one study arm (feedback intervention), patients continue to complete the same three symptom surveys, and the presence and severity of the symptoms reported on these surveys is mailed to the patient's renal provider along with evidence-based algorithms outlining treatment options for these symptoms. Decisions on treatment are left at the discretion of the provider. Patients randomized to the other study arm (management intervention) also continue to complete the same monthly symptom surveys and are evaluated by a symptom management nurse trained in the management of these symptoms. This nurse then discusses the patient's symptoms with the renal provider, provides specific recommendations for treatment, and facilitates the implementation of treatment. The primary endpoints are changes in scores on pain, erectile dysfunction, and depression surveys. This report describes the rationale and methodology of this clinical trial. Published by Elsevier Inc. C1 [Weisbord, Steven D.; Palevsky, Paul M.] VA Pittsburgh Healthcare Syst, Med Specialty Serv Line, Renal Sect, Pittsburgh, PA 15240 USA. [Weisbord, Steven D.; Shields, Anne Marie; Mor, Maria K.; Sevick, Mary Ann; Homer, Marcia; Peternel, Janet; Porter, Patricia; Fine, Michael J.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. [Weisbord, Steven D.; Palevsky, Paul M.] Univ Pittsburgh, Sch Med, Dept Med, Renal Electrolyte Div, Pittsburgh, PA USA. [Mor, Maria K.] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Pittsburgh, PA 15261 USA. [Sevick, Mary Ann; Rollman, Bruce L.; Arnold, Robert M.; Fine, Michael J.] Univ Pittsburgh, Sch Med, Div Gen Internal Med, Pittsburgh, PA USA. [Arnold, Robert M.] Univ Pittsburgh, Sch Med, Div Palliat Care, Pittsburgh, PA USA. [Sevick, Mary Ann] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Behav & Community Hlth Sci, Pittsburgh, PA USA. [Sevick, Mary Ann] VA Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA 15240 USA. RP Weisbord, SD (reprint author), VA Pittsburgh Healthcare Syst, Med Specialty Serv Line, Renal Sect, 7E Room 120,111F-U, Pittsburgh, PA 15240 USA. EM weisbordsd@upmc.edu OI Palevsky, Paul/0000-0002-7334-5400 FU Department of Veterans Affairs Health Services Research and Development [IIR 07-190] FX This work was supported by a Department of Veterans Affairs Health Services Research and Development Merit Review award (IIR 07-190). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. NR 42 TC 20 Z9 20 U1 1 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1551-7144 EI 1559-2030 J9 CONTEMP CLIN TRIALS JI Contemp. Clin. Trials PD SEP PY 2010 VL 31 IS 5 BP 491 EP 497 DI 10.1016/j.cct.2010.06.005 PG 7 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 657CX UT WOS:000282391000019 PM 20601163 ER PT J AU Weiss, JW Thorp, ML O'Hare, AM AF Weiss, Jessica W. Thorp, Micah L. O'Hare, Ann M. TI Renin-angiotensin system blockade in older adults with chronic kidney disease: a review of the literature SO CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION LA English DT Review DE aging; angiotensin-converting enzyme inhibitor; angiotensin receptor blocker; chronic kidney disease; elderly ID CONVERTING-ENZYME-INHIBITION; RANDOMIZED CONTROLLED-TRIAL; CORONARY-ARTERY-DISEASE; HIGH-RISK PATIENTS; CARDIOVASCULAR EVENTS; BLOOD-PRESSURE; RENAL OUTCOMES; HYPERTENSIVE PATIENTS; MORTALITY RISK; DOUBLE-BLIND AB Purpose of review We have reviewed the literature examining the benefits and harms of renin-angiotensin system (RAS) blockade in older adults, using studies which included patients with chronic kidney disease (CKD) as well as those which included a broader patient population. Recent findings We review the results of key trials which evaluate the impact of RAS blockade on renal outcomes, and those which address the impact of RAS blockade on more global outcomes (cardiovascular events and mortality). Many trials examining renal outcomes of RAS blockade excluded older patients or did not present age-stratified results, whereas trials which examined global outcomes often excluded patients with CKD. Most older patients with CKD have nonproteinuric nondiabetic CKD, thus differing from participants in trials which examined renal outcomes, which often included only patients with diabetes or proteinuria. Most studies did not address alternate outcomes which may carry greatest import for older patients, such as worsening comorbid illness or changes in functional status. Summary The role of RAS inhibition for older patients with CKD remains unclear. Information on age-specific effects of RAS blockade on a range of different outcomes among older patients with CKD would improve our ability to assess the benefits and harms of RAS inhibition in this population. C1 [Weiss, Jessica W.] Oregon Hlth & Sci Univ, Div Nephrol & Hypertens, Dept Med, Portland, OR 97239 USA. [Thorp, Micah L.] Kaiser Permanente NW, Dept Nephrol, Lake Rd Nephrol Ctr, Milwaukie, OR USA. [O'Hare, Ann M.] Univ Washington, Dept Med, Div Nephrol, VA Puget Sound Healthcare Syst, Seattle, WA 98195 USA. RP Weiss, JW (reprint author), Oregon Hlth & Sci Univ, Div Nephrol & Hypertens, Dept Med, 3314 SW US Vet Hosp Rd Mail Code PP 262, Portland, OR 97239 USA. EM weinstje@ohsu.edu FU AHRQ [HS017582]; National Institute on Aging FX J.W.W. was supported by a AHRQ T32 training grant HS017582. A.M.O'H. was supported by a Beeson Career Development Award from the National Institute on Aging. She receives royalties from UpToDate. NR 40 TC 5 Z9 5 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1062-4821 EI 1473-6543 J9 CURR OPIN NEPHROL HY JI Curr. Opin. Nephrol. Hypertens. PD SEP PY 2010 VL 19 IS 5 BP 413 EP 419 DI 10.1097/MNH.0b013e32833b8d6b PG 7 WC Urology & Nephrology; Peripheral Vascular Disease SC Urology & Nephrology; Cardiovascular System & Cardiology GA 640YW UT WOS:000281091300001 PM 20539228 ER PT J AU Tong, J Prigeon, RL Davis, HW Bidlingmaier, M Kahn, SE Cummings, DE Tschop, MH D'Alessio, D AF Tong, Jenny Prigeon, Ronald L. Davis, Harold W. Bidlingmaier, Martin Kahn, Steven E. Cummings, David E. Tschoep, Matthias H. D'Alessio, David TI Ghrelin Suppresses Glucose-Stimulated Insulin Secretion and Deteriorates Glucose Tolerance in Healthy Humans SO DIABETES LA English DT Article ID GROWTH-HORMONE; RAT ISLETS; BETA-CELLS; GLUCAGON-SECRETION; PANCREATIC-ISLETS; RELEASE; RESISTANCE; ENDOCRINE; RECEPTOR; HOMEOSTASIS AB OBJECTIVE-The orexigenic gut hormone ghrelin and its receptor are present in pancreatic islets. Although ghrelin reduces insulin secretion in rodents, its effect on insulin secretion in humans has not been established. The goal of this study was to test the hypothesis that circulating ghrelin suppresses glucose-stimulated insulin secretion in healthy subjects. RESEARCH DESIGN AND METHODS-Ghrelin (0.3, 0.9 and 1.5 nmol/kg/h) or saline was infused for more than 65 min in 12 healthy patients (8 male/4 female) on 4 separate occasions in a counterbalanced fashion. An intravenous glucose tolerance test was performed during steady state plasma ghrelin levels. The acute insulin response to intravenous glucose (AIRg) was calculated from plasma insulin concentrations between 2 and 10 min after the glucose bolus. Intravenous glucose tolerance was measured as the glucose disappearance constant (Kg) from 10 to 30 min. RESULTS-The three ghrelin infusions raised plasma total ghrelin concentrations to 4-, 15-, and 23-fold above the fasting level, respectively. Ghrelin infusion did not alter fasting plasma insulin or glucose, but compared with saline, the 0.3, 0.9, and 1.5 nmol/kg/h doses decreased AIRg (2,152 +/- 448 vs. 1,478 +/- 2,889, 1,419 +/- 275, and 1,120 +/- 174 pmol/l) and Kg (0.3 and 1.5 nmol/kg/h doses only) significantly (P < 0.05 for all). Ghrelin infusion raised plasma growth hormone and serum cortisol concentrations significantly (P < 0.001 for both), but had no effect on glucagon, epinephrine, or norepinephrine levels (P = 0.44, 0.74, and 0.48, respectively). CONCLUSIONS-This is a robust proof-of-concept study showing that exogenous ghrelin reduces glucose-stimulated insulin secretion and glucose disappearance in healthy humans. Our findings raise the possibility that endogenous ghrelin has a role in physiologic insulin secretion, and that ghrelin antagonists could improve beta-cell function. Diabetes 59:2145-2151, 2010 C1 [Tong, Jenny; Davis, Harold W.; Tschoep, Matthias H.; D'Alessio, David] Univ Cincinnati, Dept Med, Div Endocrinol Diabet & Metab, Cincinnati, OH 45221 USA. [Prigeon, Ronald L.] Univ Maryland, Sch Med, Vet Affairs Med Ctr, Baltimore, MD 21201 USA. [Bidlingmaier, Martin] Univ Munich, Med Klin Innenstadt, D-8000 Munich, Germany. [Kahn, Steven E.; Cummings, David E.] VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA USA. [Kahn, Steven E.; Cummings, David E.] Univ Washington, Seattle, WA 98195 USA. [D'Alessio, David] Cincinnati VA Med Ctr, Cincinnati, OH USA. RP Tong, J (reprint author), Univ Cincinnati, Dept Med, Div Endocrinol Diabet & Metab, Cincinnati, OH 45221 USA. EM jenny.tong@uc.edu RI Tschoep, Matthias/I-5443-2014 OI Bidlingmaier, Martin/0000-0002-4681-6668; Kahn, Steven/0000-0001-7307-9002; Tschoep, Matthias/0000-0002-4744-371X FU NIH/NIDDK [5K23DK-80081, R0157900]; Department of Veterans Affairs FX Funding for this research was provided by NIH/NIDDK (5K23DK-80081 to J.T. and R0157900 to D.D.) and the Department of Veterans Affairs. M.H.T. is a scientific advisory board member and stockholder of Marcadia Biotech, Acylin Pharmaceutical, and Ambrx Inc. NR 49 TC 137 Z9 140 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD SEP PY 2010 VL 59 IS 9 BP 2145 EP 2151 DI 10.2337/db10-0504 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 647IN UT WOS:000281612000009 PM 20584998 ER PT J AU van Melle, JP Bot, M De Jonge, P De Boer, RA van Veldhuisen, DJ Whooley, MA AF van Melle, Joost P. Bot, Marisica De Jonge, Peter De Boer, Rudolf A. van Veldhuisen, Dirk J. Whooley, Mary A. TI Diabetes, Glycemic Control, and New-Onset Heart Failure in Patients With Stable Coronary Artery Disease Data from the Heart and Soul Study SO DIABETES CARE LA English DT Article ID GLUCOSE-LEVELS; NATRIURETIC PEPTIDE; EUROPEAN-SOCIETY; OF-CARDIOLOGY; RISK-FACTOR; TASK-FORCE; ASSOCIATION; GUIDELINES; DIAGNOSIS; ADULTS AB OBJECTIVE- Diabetes is a predictor of both coronary artery disease (CAD) and heart failure. It is unknown to what extent the association between diabetes and heart failure is influenced by other risk factors for heart failure. RESEARCH DESIGN AND METHODS- We evaluated the association of diabetes and A1C with incident heart failure in outpatients with stable CAD and no history of heart failure (average follow-up 4.1 years). RESULTS- Of 839 participants, 200 had diabetes (23.8%). Compared with patients who did not have diabetes, those with diabetes had an increased risk of heart failure (hazard ratio [HR] 2.17 [95% CI 1.37-3.44]). Adjustment for risk factors for CAD (age, sex, race, smoking, physical inactivity, obesity, blood pressure, and LDL cholesterol), interim myocardial infarction, and myocardial ischemia did not alter the strength of the association between diabetes and heart failure. After inclusion also of other risk factors for heart failure (left ventricular ejection fraction, diastolic dysfunction, and C-reactive protein) and medication use, diabetes remained an independent predictor of heart failure (HR 3.34 [95% Cl 1.65-6.76]; P = 0.001). Each 1% increase in A1C concentration was associated with a 36% increased HR of heart failure hospitalization (HR 1.36 [95% Cl 1.17-1.58]). CONCLUSIONS- In patients with stable CAD who are free from heart failure at baseline, diabetes and glycemic control are independent risk factors for new-onset heart failure. The mechanisms by which diabetes and hyperglycemia lead to heart failure deserve further study, as the association is independent of baseline functional assessment of ischemia, systolic and diastolic function, and interim myocardial infarction. C1 [van Melle, Joost P.; De Boer, Rudolf A.; van Veldhuisen, Dirk J.] Univ Groningen, Dept Cardiol, Thoraxcenter, Univ Med Ctr Groningen, Groningen, Netherlands. [Bot, Marisica; De Jonge, Peter] Tilburg Univ, Dept Med Psychol, Ctr Res Psychol Somat Dis, NL-5000 LE Tilburg, Netherlands. [De Jonge, Peter] Univ Med Ctr Groningen, Dept Psychiat, NL-9713 AV Groningen, Netherlands. [Whooley, Mary A.] San Francisco VA Med Ctr, San Francisco, CA USA. [Whooley, Mary A.] Univ Calif San Francisco, San Francisco, CA 94143 USA. RP van Melle, JP (reprint author), Univ Groningen, Dept Cardiol, Thoraxcenter, Univ Med Ctr Groningen, Groningen, Netherlands. EM j.p.van.melle@thorax.umcg.nl RI Max, Mad/E-5238-2010; de Jonge, peter/L-6395-2013; van Veldhuisen, Dirk Jan/E-8967-2014 OI Max, Mad/0000-0001-6966-6829; de Jonge, peter/0000-0002-0866-6929; NR 26 TC 19 Z9 19 U1 0 U2 6 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 2010 VL 33 IS 9 BP 2084 EP 2089 DI 10.2337/dc10-0286 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 659IN UT WOS:000282560300037 PM 20805280 ER PT J AU Home, PD Kahn, SE Jones, NP Noronha, D Beck-Nielsen, H Viberti, G AF Home, P. D. Kahn, S. E. Jones, N. P. Noronha, D. Beck-Nielsen, H. Viberti, G. CA ADOPT Study Grp RECORD Steering Comm TI Experience of malignancies with oral glucose-lowering drugs in the randomised controlled ADOPT (A Diabetes Outcome Progression Trial) and RECORD (Rosiglitazone Evaluated for Cardiovascular Outcomes and Regulation of Glycaemia in Diabetes) clinical trials SO DIABETOLOGIA LA English DT Article DE Cancer; Diabetes mellitus; Metformin; Rosiglitazone; Sulfonylureas; Thiazolidinediones ID METFORMIN; CANCER; RISK; COMPLICATIONS; INSULIN AB Aims/hypothesis Observational and mechanistic studies have suggested a possible relationship between treatment with metformin and decreased incidence of cancer in participants with type 2 diabetes. We extracted data for malignancies from the ADOPT (A Diabetes Outcome Progression Trial) and RECORD (Rosiglitazone Evaluated for Cardiovascular Outcomes and Regulation of Glycaemia in Diabetes) randomised controlled clinical trials, in which the efficacy and/or safety of metformin was assessed in comparison with sulfonylureas and rosiglitazone. Methods Neoplasm occurrences were collected as adverse events in these studies. We reviewed and re-analysed the individual participant data in both studies for serious adverse events, malignancies reported as adverse events and related neoplasms of special interest. Results In ADOPT, 50 participants (3.4%) on metformin and 55 (3.8%) on each of rosiglitazone and glibenclamide (known as glyburide in the USA and Canada) developed serious adverse event malignancies (excluding non-melanoma skin cancers). This corresponds to 1.03, 1.12 and 1.31 per 100 person-years, giving hazard ratios for metformin of 0.92 (95% CI 0.63-1.35) vs rosiglitazone and 0.78 (0.53-1.14) vs glibenclamide. In RECORD, on a background of sulfonylurea, 69 (6.1%) participants developed malignant neoplasms in the metformin group, compared with 56 (5.1%) in the rosiglitazone group (HR 1.22 [0.86-1.74]). On a background of metformin, 74 (6.7%) participants in the sulfonylurea group developed malignant neoplasms, compared with 57 (5.1%) in the rosiglitazone group (HR 1.33 [0.94-1.88]). Conclusions/interpretation The malignancy rates in these two randomised controlled clinical trials do not support a view that metformin offers any particular protection against malignancy compared with rosiglitazone. However, they do not refute the possibility of a difference compared with sulfonylureas. C1 [Home, P. D.] Newcastle Univ, Sch Med, ICM Diabet, Newcastle Upon Tyne NE2 4HH, Tyne & Wear, England. [Kahn, S. E.] Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA USA. [Kahn, S. E.] Univ Washington, Seattle, WA 98195 USA. [Jones, N. P.] GlaxoSmithKline Res & Dev Ltd, Harlow, Essex, England. [Noronha, D.] GlaxoSmithKline Res & Dev Ltd, Greenford, Middx, England. [Beck-Nielsen, H.] Univ So Denmark, Endocrinol Res Unit, Odense, Denmark. [Viberti, G.] Kings Coll London, Metab Med Unit, Sch Med, London WC2R 2LS, England. RP Home, PD (reprint author), Newcastle Univ, Sch Med, ICM Diabet, Framlington Pl, Newcastle Upon Tyne NE2 4HH, Tyne & Wear, England. EM philip.home@newcastle.ac.uk FU GlaxoSmithKline (GSK) FX The authors or institutions connected with them have received funding from GlaxoSmithKline (GSK) and other oral glucose-lowering drug manufacturers in connection with advisory, educational and research activities, including those relating to rosiglitazone. N. P. Jones and D. Noronha are employees of GSK. NR 15 TC 68 Z9 73 U1 1 U2 8 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD SEP PY 2010 VL 53 IS 9 BP 1838 EP 1845 DI 10.1007/s00125-010-1804-y PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 639YD UT WOS:000281012200006 PM 20532476 ER PT J AU Garvey, WT Troupin, B Day, WW AF Garvey, W. T. Troupin, B. Day, W. W. TI Once-daily, low-dose, controlled-release phentermine/topiramate results in significant clinical improvements in overweight/obese patients with type 2 diabetes SO DIABETOLOGIA LA English DT Meeting Abstract CT 46th Annual Meeting of the European-Association-for-the- Study-of-Diabetes (EASD) CY SEP 20-24, 2010 CL Stockholm, SWEDEN SP European Assoc Study Diabetes C1 [Garvey, W. T.] Univ Alabama, Birmingham VA Med Ctr, Birmingham, AL USA. [Troupin, B.; Day, W. W.] VIVUS Inc, Mountain View, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD SEP PY 2010 VL 53 SU 1 MA 774 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 635XA UT WOS:000280689701217 ER PT J AU Goedecke, JH Adams, K Hayes, P Evans, J Dave, J Levitt, NS Lambert, EV Kahn, SE Olsson, T AF Goedecke, J. H. Adams, K. Hayes, P. Evans, J. Dave, J. Levitt, N. S. Lambert, E. V. Kahn, S. E. Olsson, T. TI Defects in glutaeal adipogenesis are associated with obesity-related insulin resistance in black South African women SO DIABETOLOGIA LA English DT Meeting Abstract CT 46th Annual Meeting of the European-Association-for-the- Study-of-Diabetes (EASD) CY SEP 20-24, 2010 CL Stockholm, SWEDEN SP European Assoc Study Diabetes C1 [Goedecke, J. H.] S African MRC, Cape Town, South Africa. [Goedecke, J. H.; Evans, J.; Lambert, E. V.] Univ Cape Town, Dept Human Biol, ZA-7700 Rondebosch, South Africa. [Adams, K.; Hayes, P.; Dave, J.; Levitt, N. S.] Univ Cape Town, Dept Med, ZA-7700 Rondebosch, South Africa. [Kahn, S. E.] VA Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, Seattle, WA USA. [Kahn, S. E.] Univ Washington, Seattle, WA 98195 USA. [Olsson, T.] Umea Univ, Dept Med, S-90187 Umea, Sweden. RI Goedecke, Julia/J-8628-2013; Goedecke, Julia/E-1820-2016 OI Goedecke, Julia/0000-0001-6795-4771; Goedecke, Julia/0000-0001-6795-4771 NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD SEP PY 2010 VL 53 SU 1 MA 603 PG 2 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 635XA UT WOS:000280689701046 ER PT J AU Van Gaal, LF Garvey, WT Troupin, B Day, WW AF Van Gaal, L. F. Garvey, W. T. Troupin, B. Day, W. W. TI Phentermine/topiramate combination therapy significantly improves glucose impairment in overweight/obese patients SO DIABETOLOGIA LA English DT Meeting Abstract CT 46th Annual Meeting of the European-Association-for-the- Study-of-Diabetes (EASD) CY SEP 20-24, 2010 CL Stockholm, SWEDEN SP European Assoc Study Diabetes C1 [Van Gaal, L. F.] Univ Antwerp Hosp, Antwerp, Belgium. [Garvey, W. T.] Univ Alabama, Birmingham VA Med Ctr, Birmingham, AL USA. [Troupin, B.; Day, W. W.] VIVUS Inc, Mountain View, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD SEP PY 2010 VL 53 SU 1 MA 773 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 635XA UT WOS:000280689701216 ER PT J AU Papachristou, GI Muddana, V Papachristou, DJ Stello, K Whitcomb, DC AF Papachristou, Georgios I. Muddana, Venkata Papachristou, Dionysios J. Stello, Kim Whitcomb, David C. TI Epidermal Growth Factor Serum Levels and the 61 G/A Polymorphism in Patients with Acute Pancreatitis SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE EGF; Acute pancreatitis; Polymorphism; Serum; Severity ID CERULEIN-INDUCED PANCREATITIS; EGF GENE; FUNCTIONAL POLYMORPHISM; BINDING; RELEASE; DISEASE; FAMILY; DAMAGE; RATS AB Epidermal growth factor (EGF) binds to pancreatic acinar cells and facilitates recovery from acute pancreatitis (AP). In animal models, EGF protects against pancreatic injury and prevents septic complications. The role of EGF in human AP is unknown. The aim of this study was to assess EGF serum levels in AP patients and whether the EGF +61 G/A single nucleotide polymorphism (SNP) affects susceptibility and/or severity of AP. Hospitalized AP patients were prospectively enrolled. Demographics, clinical features, DNA and early serum samples were collected when available. Patients were classified into mild (79%) and severe AP (21%) based on organ failure for a parts per thousand yen48 h. Early serum samples were quantitatively assayed for EGF levels. The EGF +61 G/A SNP was evaluated by restriction fragment length polymorphism analysis. There were 179 patients ascertained with AP. EGF levels were measured in a subgroup of 60 patients with early serum samples (17 severe) and in serum from 58 healthy controls. Serum EGF levels within 48 h from the onset of pain were significantly lower in AP patients (mean 13.5 pg/ml) compared to controls (25.2 pg/ml; P = 0.015). Furthermore, EGF levels were significantly lower in severe patients when compared to mild (7.8 vs. 14.3 pg/ml; P = 0.026). DNA from all 179 patients and 189 healthy controls was sequenced. The EGF +61 G/A SNP did not affect susceptibility to or severity of AP. EGF serum levels are decreased early in the course of AP and are further suppressed in severe AP. The EGF +61 G/A polymorphism has no effect on AP. C1 [Papachristou, Georgios I.; Muddana, Venkata; Stello, Kim; Whitcomb, David C.] Univ Pittsburgh, Med Ctr, Dept Med, Div Gastroenterol Hepatol & Nutr, Pittsburgh, PA 15213 USA. [Papachristou, Georgios I.] Vet Affairs Pittsburgh Hlth Syst, Div Gastroenterol, Pittsburgh, PA USA. [Papachristou, Dionysios J.] Univ Pittsburgh, Sch Med, Dept Pathol, Pittsburgh, PA 15213 USA. [Whitcomb, David C.] Univ Pittsburgh, Sch Med, Dept Cell Biol & Physiol, Pittsburgh, PA 15213 USA. [Whitcomb, David C.] Univ Pittsburgh, Sch Med, Dept Human Genet, Pittsburgh, PA 15213 USA. RP Papachristou, GI (reprint author), Univ Pittsburgh, Med Ctr, Dept Med, Div Gastroenterol Hepatol & Nutr, M2 C Wing,200 Lothrop St, Pittsburgh, PA 15213 USA. EM papachri@pitt.edu FU VA Stars; Stripes Healthcare Network 2007 Competitive Pilot Project Fund FX Georgios Papachristou, MD was supported by the VA Stars and Stripes Healthcare Network 2007 Competitive Pilot Project Fund. NR 28 TC 0 Z9 0 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 SEP PY 2010 VL 55 IS 9 BP 2676 EP 2680 DI 10.1007/s10620-010-1129-1 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 634PN UT WOS:000280595500035 PM 20127414 ER PT J AU Malandraki, GA Sutton, BP Perlman, AL Karampinos, DC AF Malandraki, Georgia A. Sutton, Bradley P. Perlman, Adrienne L. Karampinos, Dimitrios C. TI Age-Related Differences in Laterality of Cortical Activations in Swallowing SO DYSPHAGIA LA English DT Article DE Neuroimaging; Swallowing; fMRI; Lateralization; Neurophysiology; Aging; Deglutition; Deglutition disorders ID PRIMARY SOMATOSENSORY CORTEX; TONGUE MOVEMENT; FUNCTIONAL MRI; INTERINDIVIDUAL VARIABILITY; HEMISPHERIC ACTIVATION; LESION LOCALIZATION; STROKE PATIENTS; MOTOR FUNCTION; AREAS 3A; FMRI AB The present study examined age differences in neural lateralization patterns during swallowing and three related tasks, using functional magnetic resonance imaging (fMRI). Ten healthy right-handed young adults (mean age = 21.7 years, SD = 2.1 years) and nine healthy elders (mean age = 70.2 years, SD = 3.9 years) were scanned in a 3-T MRI head scanner. Participants were visually cued to "prepare to swallow," "swallow," "tap your tongue," and "clear your throat" in randomized order. Laterality preference for each task was examined within and between groups using region-of-interest (ROI) analyses in seven areas of the left and right primary sensorimotor and premotor cortices. Results of the within-group comparisons verified a more active role of the left premotor cortex in motor-cognitive planning of deglutition in both young and older adults and a more active role of selected areas of the right hemisphere during swallowing in young adults. Greater variability was seen during tongue tapping and throat clearing in both groups. Finally, as people age the cortical hemispheric control of swallowing seems to start becoming more symmetrical/bilateral, which may indicate neural compensatory mechanisms of the aging brain commonly seen for other motor and cognitive functions. C1 [Malandraki, Georgia A.] William S Middleton Mem Vet Adm Med Ctr, GRECC, Madison, WI 53705 USA. [Malandraki, Georgia A.] Univ Wisconsin, Dept Med, Madison, WI USA. [Sutton, Bradley P.] Univ Illinois, Dept Bioengn, Urbana, IL 61801 USA. [Perlman, Adrienne L.] Univ Illinois, Dept Speech & Hearing Sci, Champaign, IL 61820 USA. [Karampinos, Dimitrios C.] Univ Illinois, Dept Mech Sci & Engn, Urbana, IL 61801 USA. RP Malandraki, GA (reprint author), William S Middleton Mem Vet Adm Med Ctr, GRECC, 2500 Overlook Terrace,11G, Madison, WI 53705 USA. EM gmaland@medicine.wisc.edu RI Karampinos, Dimitrios/A-5994-2011; Sutton, Bradley/A-4801-2008 OI Karampinos, Dimitrios/0000-0003-4922-3662; Sutton, Bradley/0000-0002-8443-0408 FU College of Applied Health Sciences; Campus Research Board of the University of Illinois at Urbana-Champaign FX This work was performed at the Biomedical Imaging Center of the Beckman Institute at the University of Illinois at Urbana-Champaign. This work was partially supported by the Mary Jane Neer Research Fund Award of the College of Applied Health Sciences and by the Campus Research Board of the University of Illinois at Urbana-Champaign. NR 47 TC 15 Z9 18 U1 0 U2 2 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0179-051X J9 DYSPHAGIA JI Dysphagia PD SEP PY 2010 VL 25 IS 3 BP 238 EP 249 DI 10.1007/s00455-009-9250-z PG 12 WC Otorhinolaryngology SC Otorhinolaryngology GA 644RB UT WOS:000281396100010 PM 19760457 ER PT J AU Baskin, DG Kim, F Gelling, RW Russell, BJ Schwartz, MW Morton, GJ Simhan, HN Moralejo, DH Blevins, JE AF Baskin, Denis G. Kim, Francis Gelling, Richard W. Russell, Brian J. Schwartz, Michael W. Morton, Gregory J. Simhan, Hyagriv N. Moralejo, Daniel H. Blevins, James E. TI A New Oxytocin-Saporin Cytotoxin for Lesioning Oxytocin-Receptive Neurons in the Rat Hindbrain SO ENDOCRINOLOGY LA English DT Article ID BRAIN-STEM NUCLEI; FOOD-INTAKE; CHOLECYSTOKININ; INHIBITION; EXPRESSION; LEPTIN AB Evidence suggests that release of oxytocin in the nucleus tractus solitarius (NTS) of the hindbrain from descending projections that originate in the paraventricular nucleus can inhibit food intake by amplifying the satiety response to cholecystokinin (CCK). To further evaluate this mechanism in rats, we used a novel cytotoxin, saporin conjugated to oxytocin (OXY-SAP), a compound designed to destroy cells that express oxytocin receptors (OXYr). OXY-SAP was injected directly into the NTS to lesion neurons that express OXYr and that are implicated in potentiating CCK's satiety effects. The control consisted of injection of saporin conjugated to a nonsense peptide. We found that OXY-SAP was cytotoxic to human uterine smooth muscle cells in vitro, demonstrating that OXY-SAP can lesion cells that express OXYr. Using laser capture microdissection and real-time quantitative PCR, we demonstrated that OXYr mRNA levels were reduced in the NTS after OXY-SAP administration. Moreover, we found that OXY-SAP attenuated the efficacy of CCK-8 to reduce food intake and blocked the actions of an OXYr antagonist to stimulate food intake. The findings suggest that OXY-SAP is an effective neurotoxin for in vivo elimination of cells that express OXYr and is potentially useful for studies to analyze central nervous system mechanisms that involve the action of oxytocin on food intake and other physiological processes. (Endocrinology 151: 4207-4213, 2010) C1 [Baskin, Denis G.; Blevins, James E.] Dept Vet Affairs Med Ctr, Vet Affairs Puget Sound Hlth Care Syst, Off Res & Dev, Med Res Serv, Seattle, WA 98108 USA. [Baskin, Denis G.; Schwartz, Michael W.; Morton, Gregory J.; Blevins, James E.] Univ Washington, Sch Med, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. [Kim, Francis] Univ Washington, Sch Med, Div Cardiol, Dept Med, Seattle, WA 98195 USA. [Baskin, Denis G.] Univ Washington, Sch Med, Dept Biol Struct, Seattle, WA 98195 USA. [Moralejo, Daniel H.] Univ Washington, Sch Med, Dept Comparat Med, Seattle, WA 98195 USA. [Russell, Brian J.] Adv Targeting Syst, San Diego, CA 92121 USA. [Gelling, Richard W.] Lilly Singapore Ctr Drug Discovery, Singapore 138648, Singapore. [Simhan, Hyagriv N.] Univ Pittsburgh, Dept Obstet Gynecol & Reprod Sci, Pittsburgh, PA 15213 USA. RP Blevins, JE (reprint author), Vet Adm Med Ctr, 1660 S Columbian Way, Seattle, WA 98108 USA. EM jeblevin@u.washington.edu RI Schwartz, Michael/H-9950-2012 FU Office of Research and Development, Medical Research Service, Department of Veterans Affairs; Department of Veterans Affairs; National Institutes of Health (NIH) Diabetes Endocrinology Research Center; NIH Clinical Nutrition Research Unit at the University of Washington; University of Washington NIH Clinical Nutrition Research Unit; NIH [DK17047, P30 DK035816, P30 DK017047, PO1 DK068384] FX This work was supported by resources from the Office of Research and Development, Medical Research Service, Department of Veterans Affairs, including the Department of Veterans Affairs Career Development Program, Merit Review Research Program, and the Career Scientist Program. D. G. B. is the recipient of a Department of Veterans Affairs Senior Research Career Scientist Award at the Veterans Affairs Puget Sound Health Care System. The research was also supported by the biomedical research core programs, particularly the Cellular and Molecular Imagine Core of the National Institutes of Health (NIH) Diabetes Endocrinology Research Center and the NIH Clinical Nutrition Research Unit at the University of Washington. The research in our laboratory has been supported by a Pilot and Feasibility grant from the University of Washington NIH Clinical Nutrition Research Unit, NIH Grants DK17047, P30 DK035816, P30 DK017047, and PO1 DK068384. NR 22 TC 35 Z9 36 U1 0 U2 4 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD SEP PY 2010 VL 151 IS 9 BP 4207 EP 4213 DI 10.1210/en.2010-0295 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 642WP UT WOS:000281252000017 PM 20610562 ER PT J AU Stengel, A Coskun, T Goebel, M Wang, LX Craft, L Alsina-Fernandez, J Rivier, J Tache, Y AF Stengel, Andreas Coskun, Tamer Goebel, Miriam Wang, Lixin Craft, Libbey Alsina-Fernandez, Jorge Rivier, Jean Tache, Yvette TI Central Injection of the Stable Somatostatin Analog ODT8-SST Induces a Somatostatin(2) Receptor-Mediated Orexigenic Effect: Role of Neuropeptide Y and Opioid Signaling Pathways in Rats SO ENDOCRINOLOGY LA English DT Article ID CENTRAL-NERVOUS-SYSTEM; MELANIN-CONCENTRATING HORMONE; FOOD-INTAKE; ENERGY-EXPENDITURE; GROWTH-HORMONE; DIURNAL-VARIATIONS; FEEDING-BEHAVIOR; BARREL ROTATION; ARCUATE NUCLEUS; MEAL PATTERNS AB Somatostatin and octreotide injected into the brain have been reported to modulate food intake. However, little is known regarding the underlying mechanisms. The stable oligosomatostatin analog, des-AA(1,2,4,5,12,13)-[DTrp(8)]-somatostatin (ODT8-SST), like somatostatin, binds to all five somatostatin receptors (sst(1-5)). We characterized the effects of ODT8-SST injected intracerebroventricularly (icv) on food consumption and related mechanisms of action in freely fed rats. ODT8-SST (0.3 and 1 mu g per rat, icv) injected during the light or dark phase induced an early onset (within 1 h) and long-lasting (4 h) increase in food intake in nonfasted rats. By contrast, ip injection (0.3-3 mg/kg) or icv injection of selective sst(1) or sst(4) agonists (1 mu g per rat) had no effect. The 2 h food intake response during the light phase was blocked by icv injection of a sst(2) antagonist, the neuropeptide Y (NPY)Y-1 receptor antagonist, BIBP-3226, and ip injection of the mu-opioid receptor antagonist, naloxone, and not associated with changes in plasma ghrelin levels. ODT8-SST (1 mu g per rat, icv) stimulated gastric emptying of a solid meal which was also blocked by naloxone. The increased food intake was accompanied by a sustained increase in respiratory quotient, energy expenditure, and drinking as well as mu-opioid receptor-independent grooming behavior and hyperthermia, while ambulatory movements were not altered after ODT8-SST (1 mu g per rat, icv). These data show that ODT8-SST acts primarily through brain sst(2) receptors to induce a long-lasting orexigenic effect that involves the activation of Y-1 and opiate-receptors, accompanied by enhanced gastric transit and energy expenditure suggesting a modulation of NPYergic and opioidergic orexigenic systems by brain sst(2) receptors. (Endocrinology 151: 4224-4235, 2010) C1 [Tache, Yvette] Vet Affairs Greater Los Angeles Healthcare Syst, Ctr Ulcer Res & Educ, Ctr Neurobiol Stress, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Ctr Ulcer Res & Educ, Ctr Neurobiol Stress, Dept Med,Digest Dis Res Ctr,Digest Dis Div, Los Angeles, CA 90073 USA. [Coskun, Tamer; Craft, Libbey; Alsina-Fernandez, Jorge] Eli Lilly & Co, Biotechnol Discovery Res, Indianapolis, IN 46285 USA. [Rivier, Jean] Salk Inst Biol Studies, Peptide Biol Labs, La Jolla, CA 92037 USA. RP Tache, Y (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Ctr Ulcer Res & Educ, Ctr Neurobiol Stress, Bldg 115,Room 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM ytache@mednet.ucla.edu FU German Research Foundation [STE 1765/1-1, GO 1718/1-1]; National Institutes of Health (NIH) [R01 DK-33061]; NIH Center [DK-41301]; Veterans Affairs Research Career Scientist award FX This work was supported by German Research Foundation Grants STE 1765/1-1 (to A. S.) and GO 1718/1-1 (to M.G.), National Institutes of Health (NIH) Grant R01 DK-33061, NIH Center Grant DK-41301 (Animal Core), and Veterans Affairs Research Career Scientist award (to Y.T.). J.R. is the Dr. Frederik Paulsen Chair in Neurosciences Professor. NR 81 TC 18 Z9 18 U1 0 U2 0 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD SEP PY 2010 VL 151 IS 9 BP 4224 EP 4235 DI 10.1210/en.2010-0195 PG 12 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 642WP UT WOS:000281252000019 PM 20610566 ER PT J AU Bosso, JA Mauldin, PD Salgado, CD AF Bosso, J. A. Mauldin, P. D. Salgado, C. D. TI The association between antibiotic use and resistance: the role of secondary antibiotics SO EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES LA English DT Article ID LACTAMASE-PRODUCING ENTEROBACTERIACEAE; PSEUDOMONAS-AERUGINOSA; FLUOROQUINOLONE USE; SUSCEPTIBILITY; HOSPITALS; ANTIMICROBIALS; SURVEILLANCE; KLEBSIELLA; PATHOGENS; HEALTH AB Using susceptibility rates of Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae over time as markers, we assessed the significance of the change of susceptibility rates to imipenem, ceftriaxone, cefepime, piperacillin/tazobactam, and ciprofloxacin over time and the relationship to antibiotic use for the period 2000-2006. Antibiotic use-susceptibility relationships were assessed using longitudinal regression analysis. The variables "time" and define daily doses (DDD)/1,000 patient days for the specific drug related to the susceptibility rates of that particular model's dependent variable were considered as the main effects, with significance determined at the 0.05 level. Decreases in susceptibility of the target organisms were common over the period of observation. Decreasing susceptibility trends over time were not statistically associated with the primary drug (e.g., organism susceptibility rate to imipenem with imipenem usage). However, secondary drug use was associated with susceptibility rates (e.g., susceptibility of E. cloacae to cefepime with piperacillin/tazobactam usage). These results suggest that antibiotic use-resistance relationships are influenced by the use of secondary antibiotics. Thus, a resistance problem may not be adequately addressed by simply altering the utilization of the primary antibiotic. C1 [Bosso, J. A.; Mauldin, P. D.] S Carolina Coll Pharm, Dept Clin Pharm & Outcome Sci, Charleston, SC 29425 USA. [Mauldin, P. D.] Ralph H Johnson Vet Adm Med Ctr, Charleston, SC USA. [Bosso, J. A.; Salgado, C. D.] Med Univ S Carolina, Coll Med, Dept Med, Div Infect Dis, Charleston, SC 29425 USA. RP Bosso, JA (reprint author), S Carolina Coll Pharm, Dept Clin Pharm & Outcome Sci, MUSC Campus,280 Calhoun St,MSC 140, Charleston, SC 29425 USA. EM bossoja@musc.edu FU AstraZeneca Pharmaceuticals FX This work was supported, in part, by an investigator-initiated research grant from AstraZeneca Pharmaceuticals. NR 18 TC 8 Z9 9 U1 0 U2 2 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0934-9723 J9 EUR J CLIN MICROBIOL JI Eur. J. Clin. Microbiol. Infect. Dis. PD SEP PY 2010 VL 29 IS 9 BP 1125 EP 1129 DI 10.1007/s10096-010-0972-5 PG 5 WC Infectious Diseases; Microbiology SC Infectious Diseases; Microbiology GA 637UP UT WOS:000280844500011 PM 20535624 ER PT J AU Kinkel, RP Simon, J O'Connor, PW Foulds, P You, X Pace, A Hyde, R AF Kinkel, R. P. Simon, J. O'Connor, P. W. Foulds, P. You, X. Pace, A. Hyde, R. CA CHAMPIONS Study Grp TI Early MRI activity on IM IFN beta-1a predicts disease activity at 10 years SO EUROPEAN JOURNAL OF NEUROLOGY LA English DT Meeting Abstract CT 14th Congress of European-Federation-of-Neurological-Societies CY SEP, 2010 CL Geneva, SWITZERLAND SP European Federat Neurol Soc C1 [Kinkel, R. P.] Beth Israel Deaconess Med Ctr, Multiple Sclerosis Ctr, Boston, MA 02215 USA. [Simon, J.] Portland VA Med Ctr, Portland, OR USA. [O'Connor, P. W.] St Michaels Hosp, Div Neurol, Toronto, ON M5B 1W8, Canada. [Foulds, P.; You, X.; Pace, A.; Hyde, R.] Biogen Idec Inc, Cambridge, MA 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 1351-5101 J9 EUR J NEUROL JI Eur. J. Neurol. PD SEP PY 2010 VL 17 SU 3 SI SI BP 221 EP 221 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 800BD UT WOS:000293331100423 ER PT J AU Ducharme, N Banks, WA Morley, JE Robinson, SM Niehoff, ML Mattern, C AF Ducharme, Nicole Banks, William A. Morley, John E. Robinson, Sandra M. Niehoff, Michael L. Mattern, Claudia TI Brain distribution and behavioral effects of progesterone and pregnenolone after intranasal or intravenous administration SO EUROPEAN JOURNAL OF PHARMACOLOGY LA English DT Article DE Intranasal; Neurosteroid; Pregnenolone; Progesterone; Memory; Anxiety ID RECEPTOR ISOFORMS EXPRESSION; FEMALE MICE; RAT-BRAIN; NEUROSTEROIDS; SULFATE; METABOLISM; INFUSION; STEROIDS; HORMONES AB Neurosteroids hold great promise for the treatment of diseases of the central nervous system (CNS). We compared the uptake by 11 brain regions and appearance in blood of tritium-labeled pregnenolone and progesterone after intranasal and intravenous (IV) injection. Both neurosteroids appeared in blood and brain after either method of administration, but with important differences in uptake. Bioavailability based on appearance in arterial serum showed that about 23% and 14% of the intranasal administered doses of pregnenolone and progesterone, respectively, entered the blood. Brain levels were about two fold lower after intranasal administration for the two neurosteroids. With intranasal administration, brain levels of the two steroids did not vary over time (2-120 min), whereas brain levels were higher early (10 min or less) after i.v. administration. With iv. administration, uptake by brain regions did not vary, whereas the olfactory bulb, hippocampus, and hypothalamus had high uptake rates after intranasal administration. Intranasal administration of prenenolone improved memory, whereas progesterone decreased anxiety, thus demonstrating that therapeutic levels of neurosteroids can be delivered to the brain by intranasal administration. The neurosteroids were rapidly degraded after i.v. or intranasal delivery, but pregnenolone was more resistant to degradation in the brain after intranasal administration and in serum after iv. administration. These results show that either the iv. or intranasal routes of administration can deliver neurosteroids to blood and brain, but that the two routes have significant differences with intranasal administration favoring some brain regions. Published by Elsevier B.V. C1 [Ducharme, Nicole; Morley, John E.; Robinson, Sandra M.; Niehoff, Michael L.] Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, St Louis, MO USA. [Ducharme, Nicole; Banks, William A.; Morley, John E.; Robinson, Sandra M.; Niehoff, Michael L.] St Louis Univ, Sch Med, Dept Internal Med, Div Geriatr, St Louis, MO USA. [Banks, William A.] Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. [Mattern, Claudia] M&P Pharma AG, CH-6370 Stans, Switzerland. RP Banks, WA (reprint author), WAB, Bldg 1,Rm 810A,1600 Columbian Way, Seattle, WA USA. EM wabanks1@uw.edu RI morley, john/F-9177-2011 OI morley, john/0000-0001-6444-2965 FU Mattern Pharmaceutical [NSR01 051334] FX Supported by Mattern Pharmaceutical and NSR01 051334. NR 33 TC 15 Z9 15 U1 0 U2 5 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 1 PY 2010 VL 641 IS 2-3 BP 128 EP 134 DI 10.1016/j.ejphar.2010.05.033 PG 7 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 625OU UT WOS:000279905500009 PM 20570588 ER PT J AU Katiyar, SK Sampath, A Bihari, S Mamtani, M Kulkarni, H AF Katiyar, S. K. Sampath, A. Bihari, S. Mamtani, M. Kulkarni, H. TI Using a whole-blood interferon-gamma assay to improve diagnosis of tuberculous pleural effusion SO EUROPEAN RESPIRATORY JOURNAL LA English DT Letter ID ANTIGEN; TOOLS; TESTS C1 [Katiyar, S. K.; Sampath, A.] Ganesh Shankar Vidyarthi Mem Med Coll, Dept TB & Resp Dis, Kanpur, Uttar Pradesh, India. [Sampath, A.; Bihari, S.; Mamtani, M.; Kulkarni, H.] Lata Med Res Fdn, Nagpur, Maharashtra, India. [Mamtani, M.; Kulkarni, H.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Mamtani, M.; Kulkarni, H.] S Texas Vet Hlth Care Syst, Vet Adm Res Ctr AIDS & Infect HIV 1, San Antonio, TX USA. RP Kulkarni, H (reprint author), 12023 Waterway Rdg, San Antonio, TX 78249 USA. EM hemant_kulkarnius@yahoo.com NR 14 TC 1 Z9 1 U1 0 U2 1 PU EUROPEAN RESPIRATORY SOC JOURNALS LTD PI SHEFFIELD PA 442 GLOSSOP RD, SHEFFIELD S10 2PX, ENGLAND SN 0903-1936 J9 EUR RESPIR J JI Eur. Resp. J. PD SEP PY 2010 VL 36 IS 3 BP 679 EP 681 DI 10.1183/09031936.00001110 PG 3 WC Respiratory System SC Respiratory System GA 658DI UT WOS:000282470000032 PM 20930202 ER PT J AU Santillan, AA Zager, JS AF Santillan, Alfredo A. Zager, Jonathan S. TI Isolated limb infusion for melanoma: a less morbid alternative to hyperthermic isolated limb perfusion in the US SO EXPERT OPINION ON DRUG METABOLISM & TOXICOLOGY LA English DT Editorial Material DE melanoma; melphalan; regional arterial infusion; toxicity ID ACUTE REGIONAL TOXICITY; TUMOR-NECROSIS-FACTOR; MELPHALAN; EXPERIENCE; CHEMOTHERAPY; EXTREMITY; TRIAL C1 [Santillan, Alfredo A.] Univ Texas Hlth Sci Ctr San Antonio, Sect Surg Oncol, Dept Surg, Audie L Murphy Vet Affairs Hosp, San Antonio, TX 78229 USA. [Zager, Jonathan S.] Univ S Florida, Dept Oncol Sci & Surg, Tampa, FL 33612 USA. EM jonathan.zager@moffitt.org NR 22 TC 1 Z9 1 U1 0 U2 0 PU INFORMA HEALTHCARE PI LONDON PA TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND SN 1742-5255 J9 EXPERT OPIN DRUG MET JI Expert Opin. Drug Metab. Toxicol. PD SEP PY 2010 VL 6 IS 9 BP 1033 EP 1037 DI 10.1517/17425250903559881 PG 5 WC Biochemistry & Molecular Biology; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Pharmacology & Pharmacy GA 651XP UT WOS:000281961200001 PM 20078252 ER PT J AU Furuta, T Graham, DY AF Furuta, Takahisa Graham, David Y. TI Pharmacologic Aspects of Eradication Therapy for Helicobacter pylori Infection SO GASTROENTEROLOGY CLINICS OF NORTH AMERICA LA English DT Article DE CYP2C19; Helicobacter pylon; Pharmacogenomics; Proton pump inhibitor; Rapid metabolizer; Intermediate metabolizer; Poor metabolizer ID PROTON PUMP INHIBITOR; 23S RIBOSOMAL-RNA; EARLY GASTRIC-CANCER; DOUBLE-BLIND TRIAL; TRIPLE THERAPY; CYP2C19 GENOTYPE; PEPTIC-ULCER; CURE RATES; DUAL THERAPY; CLARITHROMYCIN RESISTANCE AB The commonly used regimens for the eradication of Helicobacter pylori infection consist of administration of proton pump inhibitors (PPIs) and 1 to 3 antimicrobial agents such as amoxicillin clarithromycin metronidazole fluoroquinolone or tetracycline Each agent has its own pharmacologic characteristics PPIs are metabolized by cytochrome P450 2C19 (CYP2C19) which is polymorphic CYP2C19 genotypic differences in the pharmacokinetics and pharmacodynamics of PPIs influence the eradication rates of H pylori infection by PPI-containing regimens Amoxicillin is a time-dependent antibiotic, whereas clarithromycin metronidazole, tetracycline and fluoroquinolone are not The plasma half-life of antimicrobial agents also differs among these antibiotics To achieve consistently high eradication rates the eradication regimens must be designed based on a good understanding of the resistance patterns of the bacteria and the pharmacologic characteristics of the agents used for H pylori eradication therapy C1 [Furuta, Takahisa] Hamamatsu Univ Sch Med, Clin Res Ctr, Higashi Ku, Hamamatsu, Shizuoka 4313192, Japan. [Graham, David Y.] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Furuta, T (reprint author), Hamamatsu Univ Sch Med, Clin Res Ctr, Higashi Ku, 1 20 1 Handayama, Hamamatsu, Shizuoka 4313192, Japan. FU Office of Research and Development, Medical Research Service, Department of Veterans Affairs, Public Health Service [DK56338, R21DK067366] FX Dr Graham is supported in part by the Office of Research and Development, Medical Research Service, Department of Veterans Affairs, Public Health Service grant DK56338, which funds the Texas Medical Center Digestive Diseases Center and R21DK067366 The contents are solely the responsibility of the authors and do not necessarily represent the official views of the Department of Veterans Affairs or National Institutes of Health Dr Graham is an unpaid consultant for Novartis in relation to vaccine development for treatment or prevention of Helicobacter pylon infection Dr Graham is also a paid consultant for Otsuka Pharmaceuticals regarding diagnostic testing, and until July 2007, he was a member of the Board of Directors of Meretek Diagnostics, the manufacturer of the 13C-urea breath test Until November 2009, Dr Graham received royalties on the Baylor College of Medicine patent covering materials related to 13C-urea breath test Dr Furuta declares no conflicts NR 68 TC 36 Z9 42 U1 0 U2 6 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 2010 VL 39 IS 3 BP 465 EP + DI 10.1016/j.gtc.2010.08.007 PG 18 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 681DP UT WOS:000284291900005 PM 20951912 ER PT J AU Dismuke, CE Egede, LE AF Dismuke, Clara E. Egede, Leonard E. TI Association between major depression, depressive symptoms and personal income in US adults with diabetes SO GENERAL HOSPITAL PSYCHIATRY LA English DT Article ID FUNCTIONAL DISABILITY; COMORBID DEPRESSION; CARE USE; INDIVIDUALS; EMPLOYMENT; SAMPLE; PREVALENCE; COMMUNITY; AMERICANS; MORTALITY AB Objective: Although the association between diabetes and depression outcomes has been well studied, very little is known about the association between depression and personal income in adults with diabetes. We examined the association between major depression, number of depressive symptoms and personal income among individuals with diabetes. Methods: We used the two-stage Heckman procedure to estimate adjusted personal income by major depression status and number of depressive symptoms for 1818 adults with diabetes from the nationally representative 2006 Medical Expenditure Panel Survey. STATA V.10 was used for statistical analysis to account for the complex survey design. Results: In a fully adjusted model with major depression as a binary variable, major depression was associated with $2838 lower personal income. In a separate model with depressive symptoms as a continuous variable, each additional symptom was associated with $1235 lower personal income. Compared with being white/non-Hispanic, being black/non-Hispanic (-$4640) was associated with decreased personal income. Compared with excellent health status, fair health status (-$12,172) and poor health status (-$13,835) were associated with lower income. Relative to private insurance, public insurance only (-$8413) and being uninsured (-$9600) were associated with decreased income. Conclusions: Among adults with diabetes, major depression and depressive symptoms are associated with lower personal income, after adjusting for relevant confounders. This finding suggests that aggressively diagnosing and treating depression as well as keeping people free of depressive symptoms can have huge human capital savings over the employment lifetime of individuals with diabetes and depression. (C) 2010 Elsevier Inc. All rights reserved. C1 [Egede, Leonard E.] Med Univ S Carolina, Dept Med, Ctr Hlth Dispar Res, Charleston, SC 29425 USA. [Dismuke, Clara E.] Med Univ S Carolina, Dept Clin Pharm & Outcome Sci, Charleston, SC 29425 USA. [Dismuke, Clara E.; Egede, Leonard E.] Ralph H Johnson VA Med Ctr, Ctr Dis Prevent & Hlth Intervent Diverse Populat, Charleston, SC 29401 USA. RP Egede, LE (reprint author), Med Univ S Carolina, Dept Med, Ctr Hlth Dispar Res, Charleston, SC 29425 USA. EM egedel@musc.edu NR 37 TC 16 Z9 17 U1 2 U2 3 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 2010 VL 32 IS 5 BP 484 EP 491 DI 10.1016/j.genhosppsych.2010.06.004 PG 8 WC Psychiatry SC Psychiatry GA 657CT UT WOS:000282390500005 PM 20851268 ER PT J AU Schofield, JW Hausmann, LRM Ye, FF Woods, RL AF Schofield, Janet Ward Hausmann, Leslie R. M. Ye, Feifei Woods, Rochelle L. TI Intergroup friendships on campus: Predicting close and casual friendships between White and African American first-year college students SO GROUP PROCESSES & INTERGROUP RELATIONS LA English DT Article DE intergroup friendships; contact theory ID INTERRACIAL ROOMMATE RELATIONSHIPS; COMMON INGROUP IDENTITY; CROSS-GROUP FRIENDSHIPS; BLACK-AND-WHITE; CONTACT HYPOTHESIS; RACIAL-ATTITUDES; ETHNIC-ATTITUDES; PEER INTERACTION; MEDIATING ROLE; PREJUDICE AB Intergroup friendships have been linked to important outcomes such as reduced prejudice, increased empathy for outgroups, and lower intergroup anxiety. However, little is known about the factors facilitating such friendships. This longitudinal study therefore examined factors associated with the development of friendships between White and African American freshmen at a predominantly White university. African American (vs. White) and male (vs. female) students had more intergroup friendships at the end of freshman year. Friendships between African American and White freshmen were also associated with more direct and indirect intergroup contact during high school, less prejudice upon entering college, having an outgroup roommate (White or African American), having any roommate, and having more contact with outgroup members during the academic year. C1 [Hausmann, Leslie R. M.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA 15206 USA. [Schofield, Janet Ward] Univ Pittsburgh, Dept Psychol, Pittsburgh, PA 15260 USA. [Schofield, Janet Ward] Univ Pittsburgh, Learning Res & Dev Ctr, Pittsburgh, PA 15260 USA. [Ye, Feifei] Univ Pittsburgh, Dept Educ Psychol, Pittsburgh, PA 15260 USA. [Woods, Rochelle L.] Univ Michigan, Off Acad Multicultural Initiat, Ann Arbor, MI 48109 USA. RP Hausmann, LRM (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, 7180 Highland Dr 151C-H, Pittsburgh, PA 15206 USA. EM leslie.hausmann@gmail.com NR 59 TC 14 Z9 15 U1 2 U2 11 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 1368-4302 J9 GROUP PROCESS INTERG JI Group Process Intergroup Relat. PD SEP PY 2010 VL 13 IS 5 BP 585 EP 602 DI 10.1177/1368430210362437 PG 18 WC Psychology, Social SC Psychology GA 651SZ UT WOS:000281948700004 ER PT J AU Werner, R Stuart, E Polsky, D AF Werner, Rachel Stuart, Elizabeth Polsky, Daniel TI Public Reporting Drove Quality Gains At Nursing Homes SO HEALTH AFFAIRS LA English DT Article ID NEW-YORK-STATE; REPORT CARDS; OF-CARE; INFORMATION; SURGERY; OUTCOMES; CHOICE; TRENDS; IMPACT; MARKET AB Public reporting of the quality of care delivered in hospitals and nursing homes is thought to foster improvements in care. When information is available, consumers may choose high-quality providers. That choice, in turn, may stimulate providers to improve quality as a way to attract a larger share of the market. However, these assumptions have gone largely untested. We examined short-stay care provided at 8,137 nursing homes after the Nursing Home Compare public reporting requirements went into effect in 2002. We found that quality improved both because consumers chose higher-quality nursing homes and because providers improved the care they delivered. These findings support the continued use of public reporting to improve quality. C1 [Werner, Rachel] Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. [Polsky, Daniel] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. [Werner, Rachel] Vet Affairs Med Ctr, Philadelphia, PA USA. [Stuart, Elizabeth] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA. RP Werner, R (reprint author), Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. EM rwerner@upenn.edu OI Stuart, Elizabeth/0000-0002-9042-8611 FU Agency for Healthcare Research and Quality [R01 HS016478-01]; Veterans Affairs Health Services Research and Development Career Development Award FX This material was presented at the AcademyHealth Annual Research Meeting in June 2009, in Chicago, Illinois. This research was funded by a grant from the Agency for Healthcare Research and Quality (R01 HS016478-01). Rachel Werner's work is funded in part by a Veterans Affairs Health Services Research and Development Career Development Award. The contents of this article do not represent the views of the Department of Veterans Affairs or the United States government. NR 30 TC 15 Z9 15 U1 1 U2 9 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 SEP PY 2010 VL 29 IS 9 BP 1706 EP 1713 DI 10.1377/hlthaff.2009.0556 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 647ET UT WOS:000281601300023 PM 20820030 ER PT J AU Alia, I de la Cal, MA Esteban, A Ferrer, R Molina, F Piner, R Anzueto, A AF Alia, I. de la Cal, M. A. Esteban, A. Ferrer, R. Molina, F. Piner, R. Anzueto, A. TI EVALUATION OF THE EFFICACY OF CORTICOSTEROIDS IN PATIENTS WITH AN ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE RECEIVING VENTILATORY SUPPORT: A PROSPECTIVE, INTERNATIONAL, RANDOMIZED DOUBLE BLIND CLINICAL TRIAL SO INTENSIVE CARE MEDICINE LA English DT Meeting Abstract CT 23rd Annual Meeting of the European-Society-of-Intensive-Care-Medicine CY OCT 09-13, 2010 CL Barcelona, SPAIN SP European Soc Intens Care Med C1 [Alia, I.; de la Cal, M. A.; Esteban, A.] Hosp Univ Getafe, Intens Care Unit, Getafe, Spain. [Ferrer, R.] Hosp Parc Tauli Sabadell, Intens Care Unit, Barcelona, Spain. [Molina, F.] Clin Univ Bolivariana, Intens Care Unit, Medellin, Colombia. [Piner, R.] Hosp Clin Barcelona, Intens Care Unit, Barcelona, Spain. [Anzueto, A.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0342-4642 J9 INTENS CARE MED JI Intensive Care Med. PD SEP PY 2010 VL 36 SU 2 MA 0474 BP S205 EP S205 PG 1 WC Critical Care Medicine SC General & Internal Medicine GA 648GS UT WOS:000281679500475 ER PT J AU Steinhauer, SR Siegle, GJ Condray, R Chakraborty, BH AF Steinhauer, Stuart R. Siegle, Greg J. Condray, Ruth Chakraborty, Beatrice H. TI Working memory deficits in schizophrenia are reflected by deficits in pupillary dilation SO INTERNATIONAL JOURNAL OF PSYCHOPHYSIOLOGY LA English DT Meeting Abstract CT 15th World Congress of Psychophysiology CY SEP 01-04, 2010 CL Budapest, HUNGARY SP Int Org Psychophysiol C1 [Steinhauer, Stuart R.; Siegle, Greg J.; Condray, Ruth; Chakraborty, Beatrice H.] Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA 15260 USA. [Chakraborty, Beatrice H.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-8760 J9 INT J PSYCHOPHYSIOL JI Int. J. Psychophysiol. PD SEP PY 2010 VL 77 IS 3 SI SI BP 254 EP 255 DI 10.1016/j.ijpsycho.2010.06.071 PG 2 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 644BA UT WOS:000281344200132 ER PT J AU Barth, KS Becker, WC Wiedemer, NL Mavandadi, S Oslin, DW Meghani, SH Gallagher, RM AF Barth, Kelly S. Becker, William C. Wiedemer, Nancy L. Mavandadi, Shahrzad Oslin, David W. Meghani, Salimah H. Gallagher, Rollin M. TI Association Between Urine Drug Test Results and Treatment Outcome in High-Risk Chronic Pain Patients on Opioids SO JOURNAL OF ADDICTION MEDICINE LA English DT Article DE urine drug testing; aberrant behavior; opioid pharmacotherapy ID CHRONIC NONCANCER PAIN; METHADONE-MAINTENANCE; SUBSTANCE-ABUSE; PRIMARY-CARE; THERAPY; COCAINE; MANAGEMENT; PREDICTORS; BEHAVIORS; MEDICINE AB Objective: How to best use urine drug test (UDT) results in the management of opioid pharmacotherapy has not been elucidated. The purpose of this study was to describe how the results of UDTs gathered from a group of chronic pain patients in a high-risk monitored opioid pharmacotherapy program apply to treatment outcome. Methods: Retrospective review of the medical records of 335 primary care patients on chronic opioids more than 22 months. Results: Patients with a UDT containing unprescribed opioids were more likely to demonstrate resolution of aberrant behavior (P = 0.02) and less likely to be discharged from treatment (P = 0.04). Patients with cocaine, alone or in combination, in the UDT were less likely to resolve aberrant behavior (P = 0.007 and 0.001), and were more likely to be electively or administratively discharged from treatment (P = 0.012 and 0.001). Discussion: In this group of high-risk pain patients on chronic opioids, information gained from UDT results can be used to predict treatment outcomes and inform appropriate interventions. Patients on chronic opioids who have a UDT positive for an illicit opioid or unprescribed opioids alone are more likely to respond to monitored opioid pharmacotherapy. Patients with a UDT positive for cocaine, alone or in combination, are less likely to resolve aberrant behavior within the structure of a monitored opioid pharmacotherapy program and are more likely to be discharged electively or administratively from the program without significant transition to addiction treatment. Further studies are needed to investigate which patient responded best to structured opioid pharmacotherapy programs and how to appropriately handle abnormal UDT results to improve the management and engagement in appropriate treatment for this population. C1 [Barth, Kelly S.] Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. [Becker, William C.] Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06510 USA. [Wiedemer, Nancy L.; Oslin, David W.; Gallagher, Rollin M.] Philadelphia VA Med Ctr, Philadelphia, PA USA. [Mavandadi, Shahrzad; Oslin, David W.; Gallagher, Rollin M.] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. [Gallagher, Rollin M.] Univ Penn, Dept Anesthesia, Philadelphia, PA 19104 USA. [Meghani, Salimah H.] Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA. RP Barth, KS (reprint author), Med Univ S Carolina, Dept Psychiat & Behav Sci, 67 President St,POB 250861, Charleston, SC 29425 USA. EM stephen@musc.edu OI Becker, William/0000-0002-0788-1467 FU VISN-4 Competitive Pilot Project FX Supported by VISN-4 Competitive Pilot Project Funding (to N.S.L.). NR 32 TC 2 Z9 2 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1932-0620 J9 J ADDICT MED JI J. Addict. Med. PD SEP PY 2010 VL 4 IS 3 BP 167 EP 173 DI 10.1097/ADM.0b013e3181c379ed PG 7 WC Substance Abuse SC Substance Abuse GA 642RP UT WOS:000281234900008 PM 21769031 ER PT J AU Huang, SL Shen, QA Duong, TQ AF Huang, Shiliang Shen, Qiang Duong, Timothy Q. TI Artificial neural network prediction of ischemic tissue fate in acute stroke imaging SO JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM LA English DT Article DE ANN; DWI; ischemic penumbra; perfusion-diffusion mismatch; predictive model; PWI ID POSITRON-EMISSION-TOMOGRAPHY; FOCAL CEREBRAL-ISCHEMIA; BRAIN-INJURY; QUANTITATIVE PERFUSION; FUNCTIONAL MRI; DIFFUSION; PENUMBRA; OXYGEN; TIME; CONSUMPTION AB Multimodal magnetic resonance imaging of acute stroke provides predictive value that can be used to guide stroke therapy. A flexible artificial neural network (ANN) algorithm was developed and applied to predict ischemic tissue fate on three stroke groups: 30-, 60-minute, and permanent middle cerebral artery occlusion in rats. Cerebral blood flow (CBF), apparent diffusion coefficient (ADC), and spin-spin relaxation time constant (T2) were acquired during the acute phase up to 3 hours and again at 24 hours followed by histology. Infarct was predicted on a pixel-by-pixel basis using only acute (30-minute) stroke data. In addition, neighboring pixel information and infarction incidence were also incorporated into the ANN model to improve prediction accuracy. Receiver-operating characteristic analysis was used to quantify prediction accuracy. The major findings were the following: (1) CBF alone poorly predicted the final infarct across three experimental groups; (2) ADC alone adequately predicted the infarct; (3) CBF + ADC improved the prediction accuracy; (4) inclusion of neighboring pixel information and infarction incidence further improved the prediction accuracy; and (5) prediction was more accurate for permanent occlusion, followed by 60- and 30-minute occlusion. The ANN predictive model could thus provide a flexible and objective framework for clinicians to evaluate stroke treatment options on an individual patient basis. Journal of Cerebral Blood Flow & Metabolism (2010) 30, 1661-1670; doi:10.1038/jcbfm.2010.56; published online 28 April 2010 C1 [Huang, Shiliang; Shen, Qiang; Duong, Timothy Q.] UT Hlth Sci San Antonio, Res Imaging Inst, San Antonio, TX 78229 USA. [Shen, Qiang; Duong, Timothy Q.] UT Hlth Sci San Antonio, Dept Ophthalmol, San Antonio, TX 78229 USA. [Duong, Timothy Q.] UT Hlth Sci San Antonio, Dept Radiol, San Antonio, TX 78229 USA. [Duong, Timothy Q.] UT Hlth Sci San Antonio, Dept Physiol, San Antonio, TX 78229 USA. [Duong, Timothy Q.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Duong, TQ (reprint author), UT Hlth Sci San Antonio, Res Imaging Inst, 8403 Floyd Curl Dr, San Antonio, TX 78229 USA. EM duongt@uthscsa.edu RI Duong, Timothy/B-8525-2008; Shen, Qiang/B-8784-2008; Huang, Shiliang/F-3143-2010 OI Shen, Qiang/0000-0002-4287-3403; FU NIH [R01-NS45879]; American Heart Association [SDG-0430020N, SDG-0830293N] FX This work was supported by the NIH (R01-NS45879) and the American Heart Association (SDG-0430020N and SDG-0830293N). NR 36 TC 13 Z9 14 U1 0 U2 6 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0271-678X J9 J CEREBR BLOOD F MET JI J. Cereb. Blood Flow Metab. PD SEP PY 2010 VL 30 IS 9 BP 1661 EP 1670 DI 10.1038/jcbfm.2010.56 PG 10 WC Endocrinology & Metabolism; Hematology; Neurosciences SC Endocrinology & Metabolism; Hematology; Neurosciences & Neurology GA 646SF UT WOS:000281562300013 PM 20424631 ER PT J AU Bliziotes, M AF Bliziotes, Michael TI Update in Serotonin and Bone SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID RECEPTOR-RELATED PROTEIN-5; SYSTEM-ACTIVE MEDICATIONS; NURSING-HOME RESIDENTS; REUPTAKE INHIBITOR USE; MINERAL DENSITY; DEPRESSIVE SYMPTOMS; OLDER MEN; POSTMENOPAUSAL WOMEN; HIP FRACTURE; RISK-FACTOR AB Context: Serotonin (5-HT) may be an important regulatory agent in bone, and agents that modify 5-HT signaling, such as selective serotonin reuptake inhibitors (SSRIs), are in widespread clinical use. Evidence Acquisition: Evidence was obtained by PubMed search and the author's knowledge of the field. Evidence Synthesis: Recent data suggest that gut-derived 5-HT may mediate the skeletal effects of LDL receptor-related protein 5, stimulating intense interest in a novel mechanism for regulating bone mass. However, the specific biochemical nature of serotonergic pathways influencing bone and their direct and/or indirect effects on bone metabolism are still unclear. The weight of epidemiological evidence suggests that SSRIs are associated with reduced bone mass, increased bone loss, and increased risk of fractures. Interpretation of these studies is complicated by the confounding effects of depression, the usual indication for treatment with SSRIs. The mechanisms for putative SSRI-induced deleterious effects on the skeleton are unknown, and are likely multifactorial. Conclusions: 5-HT may have regulatory effects on bone. Initial preclinical data suggest that its effects may be deleterious and may be regulated by low-density lipoprotein receptor-related protein 5. These studies need confirmation, as well as elucidation, of the biochemical pathways utilized and the feedback loops involved among bone, gut, and perhaps brain. Paradoxically, targeting of 5-HT synthesis and/or signaling in selective tissues may hold promise as an anabolic intervention for bone. Epidemiological data suggest that clinicians should be vigilant about detection of bone disease in patients who are using SSRIs. (J Clin Endocrinol Metab 95: 4124-4132, 2010) C1 [Bliziotes, Michael] Oregon Hlth & Sci Univ, Dept Med, Portland, OR 97239 USA. [Bliziotes, Michael] Portland VA Med Ctr, Portland, OR 97239 USA. RP Bliziotes, M (reprint author), 3710 SW Vet Rd,P3-ENDO, Portland, OR 97239 USA. EM bliziote@ohsu.edu FU National Institutes of Health [AR-052018] FX This work was supported by National Institutes of Health Grant AR-052018 (to M.B.). NR 74 TC 36 Z9 36 U1 2 U2 7 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD SEP PY 2010 VL 95 IS 9 BP 4124 EP 4132 DI 10.1210/jc.2010-0861 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 647SU UT WOS:000281640300024 PM 20823465 ER PT J AU Wu, BA Haigh, PI Hwang, R Ituarte, PHG Liu, ILA Hahn, TJ Yeh, MW AF Wu, Bian Haigh, Philip I. Hwang, Roy Ituarte, Philip H. G. Liu, In-Lu Amy Hahn, Theodore J. Yeh, Michael W. TI Underutilization of Parathyroidectomy in Elderly Patients with Primary Hyperparathyroidism SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM; CLINICAL-TRIAL; SURGERY; DIAGNOSIS; DISEASE; OLDER; NONAGENARIANS; OCTOGENARIANS; EPIDEMIOLOGY; PERSPECTIVE AB Context: Primary hyperparathyroidism (PHPT) disproportionately affects older patients, who may face higher thresholds for surgical intervention compared to young patients. Objective: The aim was to examine for differences in the utilization of parathyroidectomy attributable to age. Design: We conducted a retrospective cohort study. Participants: Patients with biochemically diagnosed PHPT during the years 1995-2008 were identified within an integrated health care delivery system in Southern California encompassing approximately 3 million individuals. Main Outcome Measures: The outcome measures were parathyroidectomy (PTx) and time interval to surgery. Results: We found 3388 patients with PHPT, 964 (28%) of whom underwent PTx. Patients aged 60+ yr comprised 60% of the study cohort. The likelihood of PTx decreased linearly among patients aged 60+ when compared to patients aged 50-59, an effect that persisted in multivariate analysis: odds ratio 0.68 for ages 60-69 (P < 0.05); 0.41 for ages 70-79 (P < 0.0001), and 0.11 for age 80+ (P < 0.0001). The PTx rate for patients aged 70+ was 14%. Among patients meeting 2002 consensus criteria for surgical treatment, 45% of those aged 60-69 and 24% of those aged 70+ underwent PTx. A Cox proportional hazards model showed that patients aged 60+ experienced significantly longer delays from diagnosis to surgery compared to young patients (P < 0.0001). Conclusions: PHPT is undertreated in the elderly. We observed a progressive age-related decline in PTx rate that renders patients aged 70+ unlikely to have definitive treatment, irrespective of comorbidity and eligibility for surgery. (J Clin Endocrinol Metab 95: 4324-4330, 2010) C1 [Wu, Bian; Ituarte, Philip H. G.; Yeh, Michael W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Endocrine Surg Unit, Los Angeles, CA 90095 USA. [Haigh, Philip I.] Kaiser Permanente Los Angeles Med Ctr, Dept Surg, Los Angeles, CA 90027 USA. [Hwang, Roy] Cleveland Clin Lerner Coll Med, Cleveland, OH 44195 USA. [Liu, In-Lu Amy] Kaiser Permanente Reg Off, Ctr Res & Evaluat, Pasadena, CA 91101 USA. [Hahn, Theodore J.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Hahn, Theodore J.] Geriatr Res Educ & Clin Ctr, Los Angeles, CA 90073 USA. RP Haigh, PI (reprint author), Kaiser Permanente Los Angeles Med Ctr, Dept Surg, 4760 Sunset Blvd, Los Angeles, CA 90027 USA. EM Philip.I.Haigh@kp.org FU University of California-Los Angeles Older Americans Independence Center, National Institutes of Health (NIH)/National Institute on Aging (NIA) [P30-AG028748] FX M.W.Y. received support from the University of California-Los Angeles Older Americans Independence Center, National Institutes of Health (NIH)/National Institute on Aging (NIA) Grant P30-AG028748. The content does not necessarily represent the official views of the NIA or the NIH. NR 36 TC 26 Z9 27 U1 0 U2 2 PU ENDOCRINE SOC PI WASHINGTON PA 2055 L ST NW, SUITE 600, WASHINGTON, DC 20036 USA SN 0021-972X EI 1945-7197 J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD SEP PY 2010 VL 95 IS 9 BP 4324 EP 4330 DI 10.1210/jc.2009-2819 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 647SU UT WOS:000281640300048 PM 20610600 ER PT J AU Bloch, MJ Basile, JN AF Bloch, Michael J. Basile, Jan N. TI Meta-Analysis Concludes Angiotensin Receptor Blocker Use Increases the Risk of Developing Cancer: Concerns About the Science and the Message SO JOURNAL OF CLINICAL HYPERTENSION LA English DT Editorial Material C1 [Bloch, Michael J.] St Marys Reg Med Ctr, Risk Reduct Ctr, Reno, NV 89503 USA. [Bloch, Michael J.] Univ Nevada, Sch Med, Div Gen Internal Med, Div Cardiol, Reno, NV 89557 USA. [Basile, Jan N.] Ralph H Johnson VA Med Ctr, Primary Care Serv Line, Charleston, SC USA. [Basile, Jan N.] Univ S Carolina, Div Gen Internal Med Geriatr, Charleston, SC USA. RP Bloch, MJ (reprint author), St Marys Reg Med Ctr, Risk Reduct Ctr, 645 N Arlington St,Suite 460, Reno, NV 89503 USA. EM mbloch@aol.com NR 3 TC 1 Z9 1 U1 0 U2 0 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1524-6175 J9 J CLIN HYPERTENS JI J. Clin. Hypertens. PD SEP PY 2010 VL 12 IS 9 BP 661 EP 663 DI 10.1111/j.1751-7176.2010.00369.x PG 3 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 646QM UT WOS:000281557100001 PM 20883225 ER PT J AU Menzies, BE AF Menzies, Barbara E. TI Axillary Abscess Due to Yersinia enterocolitica SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID SUPPURATIVE LYMPHADENITIS; ANTIBIOTIC-TREATMENT; CHITTERLINGS; INFECTION AB Yersinia enterocolitica rarely causes extraintestinal disease. A 54-year-old construction worker with chronic hepatitis C developed an axillary abscess following an injury to his finger. An aspirate from the axillary mass grew Y. enterocolitica. Direct inoculation is proposed as the mode of transmission of this classically enteric pathogen. C1 [Menzies, Barbara E.] VA Puget Sound Hlth Care Syst, Infect Dis Sect, Seattle, WA 98108 USA. [Menzies, Barbara E.] Univ Washington, Div Allergy & Infect Dis, Seattle, WA 98195 USA. RP Menzies, BE (reprint author), VA Puget Sound Hlth Care Syst, Infect Dis Sect, S-111 ID,1660 S Columbian Way, Seattle, WA 98108 USA. EM bmenzies@u.washington.edu NR 14 TC 2 Z9 2 U1 0 U2 1 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 2010 VL 48 IS 9 BP 3438 EP 3439 DI 10.1128/JCM.00829-10 PG 2 WC Microbiology SC Microbiology GA 645QZ UT WOS:000281480400076 PM 20631098 ER PT J AU Kunik, ME Snow, AL Davila, JA Steele, AB Balasubramanyam, V Doody, RS Schulz, PE Kalavar, JS Morgan, RO AF Kunik, Mark E. Snow, A. Lynn Davila, Jessica A. Steele, Avila B. Balasubramanyam, Valli Doody, Rachelle S. Schulz, Paul E. Kalavar, Jagadeesh S. Morgan, Robert O. TI Causes of Aggressive Behavior in Patients With Dementia SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID NURSING-HOME RESIDENTS; ALZHEIMERS-DISEASE; NEUROPSYCHIATRIC SYMPTOMS; GERIATRIC PSYCHIATRY; CONTROLLED-TRIAL; CACHE COUNTY; CHRONIC PAIN; DEPRESSION; INTERVENTIONS; COMMUNITY AB Objective: To examine factors predicting development of aggression. Method: Community-dwelling patients over 60 years of age in a Veterans Affairs Medical Center who had a documented ICD-9-CM code for dementia within 12 months of screening and no other dementia codes recorded for 2 preceding years but no aggressive behavior during the 12 months preceding study initiation were assessed every 4 months for 24 months for aggression, depression, pain, patient/caregiver relationship quality (mutuality), involvement in pleasant events, and caregiver burden. The study was conducted from September 5, 2003, to June 10, 2005. Results: Of 215 patients, 89 (41%) developed aggression. In individual models, high baseline mutuality decreased risk of aggression; high burden and pain increased risk. Increases in depression and pain and declines in total mutuality also increased risk. In a full model and step-wise model, high levels of baseline caregiver burden, worst pain, and decline in mutuality over time increased risk of aggression. Conclusions: Many dementia patients become aggressive. Higher levels of worst pain, caregiver burden, and declining mutuality over time increase risk of aggression. J Clin Psychiatry 2010;71(9):1145-1152 Copyright (C) 2010 Physicians Postgraduate Press, Inc. C1 [Kunik, Mark E.] Baylor Coll Med, Hlth Serv Res & Dev Serv, Houston Ctr Qual Care & Utilizat Studies, Michael E DeBakey VAMC 152, Houston, TX 77030 USA. [Kunik, Mark E.; Davila, Jessica A.; Steele, Avila B.; Balasubramanyam, Valli; Kalavar, Jagadeesh S.] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Kunik, Mark E.; Steele, Avila B.] Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. [Kunik, Mark E.; Kalavar, Jagadeesh S.] Baylor Coll Med, Dept Med, Houston, TX 77030 USA. [Doody, Rachelle S.; Schulz, Paul E.] Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. [Kunik, Mark E.] Univ Texas Sch Publ Hlth, Vet Affairs S Cent Mental Illness Res Educ & Clin, Houston, TX USA. [Morgan, Robert O.] Univ Texas Sch Publ Hlth, Div Management Policy & Community Hlth, Houston, TX USA. [Snow, A. Lynn] Univ Alabama, Ctr Mental Hlth & Aging, Tuscaloosa, AL USA. [Snow, A. Lynn] Univ Alabama, Dept Psychol, Tuscaloosa, AL 35487 USA. [Snow, A. Lynn] Tuscaloosa Vet Affairs Med Ctr, Tuscaloosa, AL USA. RP Kunik, ME (reprint author), Baylor Coll Med, Hlth Serv Res & Dev Serv, Houston Ctr Qual Care & Utilizat Studies, Michael E DeBakey VAMC 152, 2002 Holcombe, Houston, TX 77030 USA. EM mkunik@bcm.tmc.edu FU Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (VA HSR&D), Washington, DC [IIR 01-159-2]; Houston Center for Quality of Care and Utilization Studies (Houston VA HSR&D Center of Excellence) [HFP90-020] FX This study was conducted at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, and was supported by grant #IIR 01-159-2 from the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (VA HSR&D), Washington, DC. It was also supported in part by the Houston Center for Quality of Care and Utilization Studies (Houston VA HSR&D Center of Excellence [HFP90-020]), Michael E. DeBakey VA Medical Center, Houston, Texas. NR 56 TC 46 Z9 46 U1 4 U2 15 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PD SEP PY 2010 VL 71 IS 9 BP 1145 EP 1152 DI 10.4088/JCP.08m04703oli PG 8 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 661EF UT WOS:000282705700006 PM 20361896 ER PT J AU Nicklas, BJ McEneaney, PA Lichniak, JE Baron, RL Brownell, BA AF Nicklas, Bonnie J. McEneaney, Patrick A. Lichniak, James E. Baron, Robert L. Brownell, Benjamin A. TI Surgical Repair of Abductor Hallucis Muscle Herniation: A Case Report SO JOURNAL OF FOOT & ANKLE SURGERY LA English DT Article DE foot; hernia; rupture; surgery; trauma ID COMPARTMENT SYNDROME; TIBIALIS ANTERIOR; MESH AB Herniation of the abductor hallucis muscle has rarely been reported in the literature. This condition causes localized pain, especially while weight bearing, as a result of a complex cascade of biomechanical events directly related to loss of integrity of the medial wall of the foot. The authors present a case of a flexor retinaculum tear with subsequent herniation of the abductor hallucis muscle. When conservative treatment options failed to provide significant relief, surgical intervention was performed, which revealed ischemic muscle tissue and a partial flexor retinaculum tear. The nonviable muscle was surgically debrided and the fascial defect was repaired with a polypropylene nonabsorbable synthetic surgical mesh. This herniorrhaphy reestablished medial compartment support, thus allowing the patient to return to pain-free ambulation. (C) 2010 by the American College of Foot and Ankle Surgeons. All rights reserved. C1 [McEneaney, Patrick A.] Thorek Mem Hosp, Weil Foot & Ankle Inst, Chicago, IL 60613 USA. [Nicklas, Bonnie J.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Lichniak, James E.] Ohio Coll Podiatr Med, Dept Podiatr Biomech & Orthoped, Independence, OH USA. [Lichniak, James E.] Cuyahoga Community Coll, Parma, OH USA. [Baron, Robert L.] Franklin Univ Med & Sci, Dept Radiol, William M Scholl Coll Podiatr Med Rosalind, N Chicago, IL USA. [Brownell, Benjamin A.] Vet Affairs Med Ctr, Cent Calif Dept, Fresno, CA USA. RP McEneaney, PA (reprint author), Thorek Mem Hosp, Weil Foot & Ankle Inst, 850 W Irving Pk Rd, Chicago, IL 60613 USA. EM mceneaneydpm@hotmail.com NR 26 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 1067-2516 J9 J FOOT ANKLE SURG JI J. Foot Ankle Surg. PD SEP-OCT PY 2010 VL 49 IS 5 DI 10.1053/j.jfas.2010.06.020 PG 5 WC Orthopedics; Surgery SC Orthopedics; Surgery GA 642LQ UT WOS:000281215600019 ER PT J AU Hausmann, LRM Mor, M Hanusa, BH Zickmund, S Cohen, PZ Grant, R Kresevic, DM Gordon, HS Ling, BS Kwoh, CK Ibrahim, SA AF Hausmann, Leslie R. M. Mor, Maria Hanusa, Barbara H. Zickmund, Susan Cohen, Peter Z. Grant, Richard Kresevic, Denise M. Gordon, Howard S. Ling, Bruce S. Kwoh, C. Kent Ibrahim, Said A. TI The Effect of Patient Race on Total Joint Replacement Recommendations and Utilization in the Orthopedic Setting SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE healthcare disparities; total joint replacement; orthopedic surgery; osteoarthritis; patient preference ID FUNCTIONAL HEALTH LITERACY; TOTAL KNEE REPLACEMENT; TOTAL HIP-ARTHROPLASTY; SURVEY NHANES-I; ETHNIC-DIFFERENCES; RACIAL DISPARITIES; AFRICAN-AMERICAN; NATIONAL-HEALTH; OSTEOARTHRITIS; ARTHRITIS AB The extent to which treatment recommendations in the orthopedic setting contribute to well-established racial disparities in the utilization of total joint replacement (TJR) in the treatment of advanced knee/hip osteoarthritis has not been explored. To examine whether orthopedic surgeons are less likely to recommend TJR to African-American patients compared to white patients with similar clinical indications, and whether there are racial differences in the receipt of TJR within six months of study enrollment. Prospective, observational study. African-American (AA; n = 120) and white (n = 337) patients seeking treatment for knee or hip osteoarthritis in Veterans Affairs orthopedic clinics. Patients completed surveys that assessed socio-demographic and clinical variables that could influence osteoarthritis treatment. Orthopedic surgeons' notes were reviewed to determine whether patients had been recommended for TJR and whether they underwent the procedure within 6 months of study enrollment. Rate of TJR recommendation was 19.5%. Odds of receiving a TJR recommendation were lower for AA than white patients of similar age and disease severity (OR = 0.46, 95% CI = 0.26-0.83; P = 0.01). However, this difference was not significant after adjusting for patient preference for TJR (OR = 0.69, 95% CI = 0.36-1.31, P = 0.25). Overall, 10.3% of patients underwent TJR within 6 months. TJR was less likely for AA patients than for white patients of similar age and disease severity (OR = 0.41, 95% CI = 0.16-1.05, P = 0.06), but this difference was reduced after adjusting for whether patients had received a recommendation for the procedure at the index visit (OR = 0.57, 95% CI = 0.21-1.54, P = 0.27). In this study, race differences in patient preferences for TJR appeared to underlie race differences in TJR recommendations, which led to race differences in utilization of the procedure. Our findings suggest that patient treatment preferences play an important role in racial disparities in TJR utilization in the orthopedic setting. C1 [Hausmann, Leslie R. M.; Mor, Maria; Hanusa, Barbara H.; Zickmund, Susan; Ling, Bruce S.; Kwoh, C. Kent] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15206 USA. [Mor, Maria] Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA. [Hanusa, Barbara H.] Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA. [Grant, Richard; Kresevic, Denise M.] Louis Stokes DVA Med Ctr, Cleveland, OH USA. [Grant, Richard; Kresevic, Denise M.] Univ Hosp Case Med Ctr, Cleveland, OH USA. [Gordon, Howard S.] Jesse Brown VA Med Ctr, Ctr Complex Chron Care, Chicago, IL USA. [Gordon, Howard S.] Univ Illinois, Coll Med, Chicago, IL USA. [Ibrahim, Said A.] Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. [Ibrahim, Said A.] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Hausmann, LRM (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, 7180 Highland Dr 151C-H, Pittsburgh, PA 15206 USA. EM leslie.hausmann@gmail.com RI Gordon, Howard/E-4420-2010 OI Gordon, Howard/0000-0002-6712-5954 FU Department of Veterans Affairs; Veterans Health Administration; Office of Research and Development; Health Services Research and Development Service [IIR 04-137]; Veterans Affairs Health Services Research and Development [RCD 06-287, ER 0280-1]; VA Health Services; Harold Amos Robert Wood Johnson Scholar Award; National Institutes of Musculoskeletal and Skin Disorders [1K24AR055259-01] FX This study was supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development Service (IIR 04-137, PI: Said A. Ibrahim). Dr. Hausmann's effort was supported by the Veterans Affairs Health Services Research and Development Career Development Program (RCD 06-287 and ER 0280-1). Dr. Ibrahim is a previous recipient of a VA Health Services Research Career Development Award and the Harold Amos Robert Wood Johnson Scholar Award. Dr. Ibrahim is also supported by a K24 Award (1K24AR055259-01) from the National Institutes of Musculoskeletal and Skin Disorders. The views expressed here are those of the authors and do not represent those of the Department of Veterans Affairs or the United States Government. The authors would like to thank project coordinator Margaret Kerr and members of the research staff: Elizabeth Flatley, Michael Hannon, Laura Johnson, Renee McDade, Matthew McShane, Rebecca Meiksin, Christine Schneider, Rebecca Siders, Lisa Stewart, and Sandra Truax. The authors would also like to thank Kim Hansen and Hilary Peterson for editorial input on this manuscript. NR 47 TC 29 Z9 29 U1 1 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 SEP PY 2010 VL 25 IS 9 BP 982 EP 988 DI 10.1007/s11606-010-1399-5 PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 636JL UT WOS:000280728300022 PM 20509053 ER PT J AU Pierce, RG Wong, M Skalet, AB AF Pierce, Read G. Wong, Melisa Skalet, Alison B. TI More to Mutton than Meets the Eye SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material DE panuveitis; conjunctival injection; slit lamp; tuberculosis AB A 64-year-old Mexican fisherman with a history of syphilis is diagnosed with panuveitis of the right eye after presenting with unilateral blurry vision, redness, and pain. A PPD was 35X30mm, and chest X-ray suggested tuberculosis. The patient's pain and vision improved with 4-drug anti-tuberculous therapy, topical steroids, and cycloplegic eye drops. C1 [Pierce, Read G.; Wong, Melisa; Skalet, Alison B.] UCSF Internal Med & Ophthalmol, San Francisco VA Med Ctr, San Francisco, CA 94121 USA. RP Pierce, RG (reprint author), UCSF Internal Med & Ophthalmol, San Francisco VA Med Ctr, 4150 Clement St,Rm 1A-81,Bldg 203, San Francisco, CA 94121 USA. EM read.pierce@ucsf.edu NR 0 TC 1 Z9 1 U1 0 U2 0 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 SEP PY 2010 VL 25 IS 9 BP 989 EP 989 DI 10.1007/s11606-010-1406-x PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 636JL UT WOS:000280728300023 PM 20532658 ER PT J AU Singh, PP Newton, DP Estrada, CA AF Singh, Preet Paul Newton, David P. Estrada, Carlos A. TI An Uncommon Cause of Headache SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material C1 [Singh, Preet Paul; Newton, David P.; Estrada, Carlos A.] Univ Alabama, Dept Med, Birmingham, AL 35294 USA. [Estrada, Carlos A.] Birmingham Vet Affairs Med Ctr, Vet Affairs Natl Qual Scholars Program, Birmingham, AL USA. [Estrada, Carlos A.] Birmingham Vet Affairs Med Ctr, Ctr Surg Med Acute Care Res & Transit C SMART, Birmingham, AL USA. RP Estrada, CA (reprint author), 732 Fac Off Tower,510 20th St S, Birmingham, AL 35294 USA. EM cestrada@uab.edu OI Singh, Preet Paul/0000-0001-8936-8191 NR 0 TC 0 Z9 0 U1 0 U2 0 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 SEP PY 2010 VL 25 IS 9 BP 990 EP 990 DI 10.1007/s11606-010-1366-1 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 636JL UT WOS:000280728300024 PM 20467828 ER PT J AU King, L Mancini, M Priest, K Wilhelm, J Kaul, M Rinehart, K Karl, A Mader, S Horak, F AF King, Laurie Mancini, Martina Priest, Kelsey Wilhelm, Jenny Kaul, Matt Rinehart, Katie Karl, Andrea Mader, Scott Horak, Fay TI Instrumented Tests of Postural Control for Mild TBI SO JOURNAL OF HEAD TRAUMA REHABILITATION LA English DT Meeting Abstract C1 [King, Laurie; Mancini, Martina; Priest, Kelsey; Wilhelm, Jenny; Horak, Fay] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Kaul, Matt; Karl, Andrea; Mader, Scott] Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0885-9701 EI 1550-509X J9 J HEAD TRAUMA REHAB JI J. Head Trauma Rehabil. PD SEP-OCT PY 2010 VL 25 IS 5 BP 403 EP 403 PG 1 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 649JR UT WOS:000281765400064 ER PT J AU Lee, MH Hammad, SM Semler, AJ Luttrell, LM Lopes-Virella, MF Klein, RL AF Lee, Mi-Hye Hammad, Samar M. Semler, Andrea J. Luttrell, Louis M. Lopes-Virella, Maria F. Klein, Richard L. TI HDL3, but not HDL2, stimulates plasminogen activator inhibitor-1 release from adipocytes: the role of sphingosine-1-phosphate SO JOURNAL OF LIPID RESEARCH LA English DT Article DE plasminogen activator inhibitor-1; fibrinolysis; lipoprotein; high-density lipoprotein ID SPHINGOSINE 1-PHOSPHATE RECEPTORS; DENSITY-LIPOPROTEIN BINDING; CORONARY-ARTERY-DISEASE; VEIN ENDOTHELIAL-CELLS; NITRIC-OXIDE SYNTHASE; SCAVENGER RECEPTOR; BIOLOGICAL-ACTIVITIES; GENE-EXPRESSION; ADIPOSE-TISSUE; CLASS-B AB Sphingosine-1-phosphate (S1P) is a bioactive lysophospholipid that regulates numerous key cardiovascular functions. High-density lipoproteins (HDLs) are the major plasma lipoprotein carriers of S1P. Fibrinolysis is a physiological process that allows fibrin clot dissolution, and decreased fibrinolytic capacity may result from increased circulating levels of plasminogen activator inhibitor-1 (PAI-1). We examined the effect of S1P associated with HDL sub-fractions on PAI-1 secretion from 3T3 adipocytes. S1P concentration in HDL3 averaged twice that in HDL2. Incubation of adipocytes with increasing concentrations of S1P in HDL3, but not HDL2, or with S1P complexed to albumin stimulated PAI-I secretion in a concentration-dependent manner. Quantitative RT-PCR revealed that S1P(1-3) are expressed in 3T3 adipocytes, with S1P(2) expressed in the greatest amount. Treatment of adipocytes with the S1P(1) and S1P(3) antagonist VPC23019 did not block PAI-1 secretion. Inhibiting S1P(2) with JTE-013 or reducing the expression of the gene coding for S1P(2) using silencing RNA (siRNA) technology blocked PAI-1 secretion, suggesting that the S1P(2) receptor mediates PAI-1 secretion from adipocytes exposed to HDL3 or S1P. Treatment with the phospholipase C (PLC) inhibitor U73122, the protein kinase C (PKC) inhibitor RO-318425, or the Rho-associated protein kinase (ROCK) inhibitor Y27632 all significantly inhibited HDL3- and S1P-mediated PAI-1 release, suggesting that HDL3- and/or S1P-stimulated PAI-1 secretion from 3T3 cells is mediated by activation of multiple, downstream signaling pathways of S1P(2).-Lee, M-H., S. M. Hammad, A. J. Semler, L M. Luttrell, M. F. Lopes-Virella, and R. L. Klein. HDL3, but not HDL2, stimulates plasminogen activator inhibitor-1 release from adipocytes: the role of sphingosine-1-phosphate. J. Lipid Res. 2010. 51: 2619-2628. C1 [Lee, Mi-Hye; Semler, Andrea J.; Luttrell, Louis M.; Lopes-Virella, Maria F.; Klein, Richard L.] Med Univ S Carolina, Div Endocrinol Metab & Med Genet, Charleston, SC 29425 USA. [Hammad, Samar M.] Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. [Hammad, Samar M.] Med Univ S Carolina, Dept Regenerat Med & Cell Biol, Charleston, SC 29425 USA. [Luttrell, Louis M.; Lopes-Virella, Maria F.; Klein, Richard L.] Ralph H Johnson Dept Vet Affairs Med Ctr, Res Serv, Charleston, SC USA. RP Klein, RL (reprint author), Med Univ S Carolina, Div Endocrinol Metab & Med Genet, Charleston, SC 29425 USA. EM kleinrl@musc.edu FU National Institutes of Health [P01 HL-55782, DK-081352, HL-079274]; Department of Veterans Affairs; National Center for Research Resources (NCRR) [P20 RR-17677]; Medical University of South Carolina FX This work was supported by National Institutes of Health Grants P01 HL-55782 (M.L.V), DK-081352 (M.L.V.), and HL-079274 (S.M.H.). This work was also supported by the Merit Review Program of the Department of Veterans Affairs (R.L.K. and M.L.V.), the South Carolina COBRE in Lipidomics and Pathobiology (P20 RR-17677 from the National Center for Research Resources (NCRR) (S.M.H.), and the Lipidomics Core Facility at the Medical University of South Carolina. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health or other granting agencies. NR 51 TC 21 Z9 21 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0022-2275 J9 J LIPID RES JI J. Lipid Res. PD SEP PY 2010 VL 51 IS 9 BP 2619 EP 2628 DI 10.1194/jlr.M003988 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 637FA UT WOS:000280800200013 PM 20522601 ER PT J AU Dovydaitis, T AF Dovydaitis, Tiffany TI Human Trafficking: The Role of the Health Care Provider SO JOURNAL OF MIDWIFERY & WOMENS HEALTH LA English DT Article DE case study; human trafficking; immigrant; sex trafficking; women's health care AB Human trafficking is a major public health problem, both domestically and internationally. Health care providers are often the only professionals to interact with trafficking victims who are still in captivity. The expert assessment and interview skills of providers contribute to their readiness to identify victims of trafficking. The purpose of this article is to provide clinicians with knowledge on trafficking and give specific tools that they may use to assist victims in the clinical setting. Definitions, statistics, and common health care problems of trafficking victims are reviewed. The role of the health care provider is outlined through a case study and clinical practice tools are provided. Suggestions for future research are also briefly addressed. J Midwifery Womens Health 2010; 55: 462-467 (C) 2010 by the American College of Nurse-Midwives. C1 Univ Penn, Sch Nursing, Ctr Hlth Equ Res, Philadelphia, PA 19104 USA. RP Dovydaitis, T (reprint author), Univ Penn, Sch Nursing, Ctr Hlth Equ Res, Claire M Fagin Hall,418 Curie Blvd,Floor 2L, Philadelphia, PA 19104 USA. EM dtiffany@nursing.upenn.edu FU NINR NIH HHS [T32 NR007100, T32 NR007100-13] NR 28 TC 25 Z9 25 U1 3 U2 39 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1526-9523 J9 J MIDWIFERY WOM HEAL JI J. Midwifery Women Health PD SEP-OCT PY 2010 VL 55 IS 5 BP 462 EP 467 DI 10.1016/j.jmwh.2009.12.017 PG 6 WC Nursing SC Nursing GA 641PV UT WOS:000281142200011 PM 20732668 ER PT J AU Pasinetti, GM Ksiezak-Reding, H Santa-Maria, I Wang, J Ho, L AF Pasinetti, Giulio Maria Ksiezak-Reding, Hanna Santa-Maria, Ismael Wang, Jun Ho, Lap TI Development of a grape seed polyphenolic extract with anti-oligomeric activity as a novel treatment in progressive supranuclear palsy and other tauopathies SO JOURNAL OF NEUROCHEMISTRY LA English DT Review DE botanical medicine; grape seed polyphenolic extract; neurodegeneration; progressive supranuclear palsy; tau ID PAIRED HELICAL FILAMENTS; ALZHEIMERS-DISEASE; TAU-PROTEIN; NEURODEGENERATIVE TAUOPATHIES; CORTICOBASAL DEGENERATION; IN-VITRO; EXON 10; AGGREGATION; ISOFORMS; PHOSPHORYLATION AB A diverse group of neurodegenerative diseases - including progressive supranuclear palsy (PSP), corticobasal degeneration and Alzheimer's disease among others, collectively referred to as tauopathies - are characterized by progressive, age-dependent intracellular formations of misfolded protein aggregates that play key roles in the initiation and progression of neuropathogenesis. Recent studies from our laboratory reveal that grape seed-derived polyphenolic extracts (GSPE) potently prevent tau fibrillization into neurotoxic aggregates and therapeutically promote the dissociation of preformed tau aggregates [J. Alzheimer's Dis. (2009) vol. 16, pp. 433]. Based on our extensive bioavailability, bioactivity and functional preclinical studies, combined with the safety of GSPE in laboratory animals and in humans, we initiated a series of studies exploring the role of GSPE (Meganatural-Az (R) GSPE) as a potential novel botanical drug for the treatment of certain forms of tauopathies including PSP, a neurodegenerative disorder involving the accumulation and deposition of misfolded tau proteins in the brain characterized, in part, by abnormal intracellular tau inclusions in specific anatomical areas involving astrocytes, oligodendrocytes and neurons [J. Neuropathol. Exp. Neurol. (2002) vol. 61, pp. 33]. In this mini-review article, we discuss the biochemical characterization of GSPE in our laboratory and its potential preventative and therapeutic role in model systems of abnormal tau processing pertinent to PSP and related tauopathies. C1 [Pasinetti, Giulio Maria; Ksiezak-Reding, Hanna; Santa-Maria, Ismael; Wang, Jun; Ho, Lap] Mt Sinai Sch Med, Ctr Excellence Novel Approaches Neurodiagnost & N, Ctr Excellence Res Complementary & Alternat Med A, Brain Inst,Dept Neurol, New York, NY 10029 USA. [Pasinetti, Giulio Maria] James J Peters Vet Affairs Med Ctr, Geriatr Res Educ & Clin Ctr, Bronx, NY USA. RP Pasinetti, GM (reprint author), Mt Sinai Sch Med, Ctr Excellence Novel Approaches Neurodiagnost & N, Ctr Excellence Res Complementary & Alternat Med A, Brain Inst,Dept Neurol, 1 Gustave L Levy Pl,Box 1137, New York, NY 10029 USA. EM giulio.pasinetti@mssm.edu FU NIH [P01AT004511-01] FX Supported by NIH P01AT004511-01 to GMP. NR 49 TC 11 Z9 11 U1 2 U2 10 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD SEP PY 2010 VL 114 IS 6 BP 1557 EP 1568 DI 10.1111/j.1471-4159.2010.06875.x PG 12 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 646NQ UT WOS:000281549600003 PM 20569300 ER PT J AU Bao, L Patel, JC Walker, RH Shashidharan, P Rice, ME AF Bao, Li Patel, Jyoti C. Walker, Ruth H. Shashidharan, Pullanipally Rice, Margaret E. TI Dysregulation of striatal dopamine release in a mouse model of dystonia SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE acetylcholine; basal ganglia; brain slices; early-onset dystonia; voltammetry ID NICOTINIC ACETYLCHOLINE-RECEPTORS; IDIOPATHIC TORSION DYSTONIA; FAMILIAL PARKINSONS-DISEASE; EXERCISE-INDUCED DYSTONIA; DYT1 DYSTONIA; BASAL GANGLIA; MIDBRAIN DOPAMINE; NUCLEUS-ACCUMBENS; NEURONAL-ACTIVITY; HUMAN BRAIN AB Dystonia is a neurological disorder characterized by involuntary movements. We examined striatal dopamine (DA) function in hyperactive transgenic (Tg) mice generated as a model of dystonia. Evoked extracellular DA concentration was monitored with carbon-fiber microelectrodes and fast-scan cyclic voltammetry in striatal slices from non-Tg mice, Tg mice with a positive motor phenotype, and phenotype-negative Tg litter-mates. Peak single-pulse evoked extracellular DA concentration was significantly lower in phenotype-positive mice than in non-Tg or phenotype-negative mice, but indistinguishable between non-Tg and phenotype-negative mice. Phenotype-positive mice also had higher functional D2 DA autoreceptor sensitivity than non-Tg mice, which would be consistent with lower extracellular DA concentration in vivo. Multiple-pulse (phasic) stimulation (five pulses, 10-100 Hz) revealed an enhanced frequency dependence of evoked DA release in phenotype-positive versus non-Tg or phenotype-negative mice, which was exacerbated when extracellular Ca(2+) concentration was lowered. Enhanced sensitivity to phasic stimulation in phenotype-positive mice was reminiscent of the pattern seen with antagonism of nicotinic acetylcholine receptors. Consistent with a role for altered cholinergic regulation, the difference in phasic responsiveness among groups was lost when nicotinic receptors were blocked by mecamylamine. Together, these data implicate compromised DA release regulation, possibly from cholinergic dysfunction, in the motor symptoms of this dystonia model. C1 [Bao, Li; Rice, Margaret E.] NYU, Sch Med, Dept Physiol & Neurosci, New York, NY 10016 USA. [Bao, Li; Patel, Jyoti C.; Rice, Margaret E.] NYU, Sch Med, Dept Neurosurg, New York, NY 10016 USA. [Walker, Ruth H.] James J Peters Vet Affairs Med Ctr, Dept Neurol, Bronx, NY USA. [Walker, Ruth H.; Shashidharan, Pullanipally] Mt Sinai Sch Med, Dept Neurol, New York, NY USA. RP Rice, ME (reprint author), NYU, Sch Med, Dept Physiol & Neurosci, 550 1st Ave, New York, NY 10016 USA. EM margaret.rice@nyu.edu OI Patel, Jyoti/0000-0003-0295-6180; Rice, Margaret/0000-0003-1793-2798 FU Bachmann-Strauss Dystonia and Parkinson Foundation; NIH/NINDS [NS036362, NS043038] FX This work was supported by the Bachmann-Strauss Dystonia and Parkinson Foundation (M. E. R. and P. S.), and by NIH/NINDS grants NS036362 (M. E. R) and NS043038 (P. S.). The authors declare no conflicts of interest. NR 90 TC 14 Z9 14 U1 0 U2 5 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD SEP PY 2010 VL 114 IS 6 BP 1781 EP 1791 DI 10.1111/j.1471-4159.2010.06890.x PG 11 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 646NQ UT WOS:000281549600023 PM 20626557 ER PT J AU Farrell, SR Raymond, ID Foote, M Brecha, NC Barnes, S AF Farrell, Spring R. Raymond, Iona D. Foote, Michael Brecha, Nicholas C. Barnes, Steven TI Modulation of Voltage-Gated Ion Channels in Rat Retinal Ganglion Cells Mediated by Somatostatin Receptor Subtype 4 SO JOURNAL OF NEUROPHYSIOLOGY LA English DT Article ID CALCIUM INFLUX; MOUSE RETINA; SST(2) RECEPTORS; RABBIT RETINA; NITRIC-OXIDE; NEURONS; EXPRESSION; CURRENTS; ROD AB Farrell SR, Raymond ID, Foote M, Brecha NC, Barnes S. Modulation of voltage-gated ion channels in rat retinal ganglion cells mediated by somatostatin receptor subtype 4. J Neurophysiol 104: 1347-1354, 2010. First published June 23, 2010; doi:10.1152/jn.00098.2010. Somatostatin (somatotropin release-inhibiting factor [SRIF]) is known to modulate the excitability of retinal ganglion cells, but the membrane mechanisms responsible and the extent to which intracellular calcium signaling is affected have not been determined. We show that somatostatin receptor subtype 4 (sst(4)) is expressed specifically in rat ganglion cells and that the generation of repetitive action potentials by isolated ganglion cells is reduced in the presence of L-803,087, a selective sst(4) agonist (10 nM). Under voltage clamp, L-803,087 increased outward K+ currents by 51.1 +/- 13.1% at 0 mV and suppressed Ca2+ channel currents by 32.5 +/- 9.4% at -10 mV in whole cell patch-clamped ganglion cells. The N-type Ca2+ channel blocker omega-conotoxin GVIA (CTX, 1 mu M) reduced L-type Ca2+ current (I Ca) in ganglion cells by 43.5 +/- 7.2% at -10 mV, after which addition of L-803,087 further reduced I Ca by 28.0 +/- 16.0%. In contrast, ganglion cells treated first with nifedipine (NIF, 10 mu M), which blocked 46.1 +/- 3.5% of the control current at -10 mV, did not undergo any further reduction in I Ca in the presence of L-803,087 (-3.5 +/- 3.8% vs. NIF), showing that stimulation of sst(4) reduces Ca2+ influx through L-type Ca2+ channels. To assess the effects of sst(4) stimulation on intracellular Ca2+ levels ([Ca2+](i)) in ganglion cells, fura-2 was used to measure changes in [Ca2+](i) in response to depolarization induced by elevated [K+](o). [Ca2+](i) was increased to a lesser extent (86%) in the presence of L-803,087 compared with recordings made in the absence of the sst(4) agonist and this effect was blocked by NIF (10 mu M). Suppression of spiking and Ca2+ signaling via sst(4) may contribute to the reported neuroprotective actions of somatostatin and promote ganglion cell survival following ischemia and axonal trauma. C1 [Farrell, Spring R.; Foote, Michael; Barnes, Steven] Dalhousie Univ, Dept Physiol & Biophys, Halifax, NS B3H 4H7, Canada. [Farrell, Spring R.; Foote, Michael; Barnes, Steven] Dalhousie Univ, Inst Neurosci, Halifax, NS B3H 4H7, Canada. [Barnes, Steven] Dalhousie Univ, Dept Ophthalmol & Visual Sci, Halifax, NS B3H 4H7, Canada. [Raymond, Iona D.; Brecha, Nicholas C.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. [Brecha, Nicholas C.] Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Barnes, S (reprint author), Dalhousie Univ, Dept Physiol & Biophys, Halifax, NS B3H 4H7, Canada. EM sbarnes@dal.ca FU Plum Foundation; National Eye Institute [EY-15573]; Veterans Administration; Canadian Institutes for Health Research [MT-10968] FX This work was supported by a Plum Foundation grant to S. Barnes and N. Brecha, National Eye Institute Grant EY-15573 to N. Brecha, a Veterans Administration Senior Career Scientist Award to N. Brecha, and Canadian Institutes for Health Research Grant MT-10968 to S. Barnes. NR 29 TC 12 Z9 13 U1 0 U2 7 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-3077 EI 1522-1598 J9 J NEUROPHYSIOL JI J. Neurophysiol. PD SEP PY 2010 VL 104 IS 3 BP 1347 EP 1354 DI 10.1152/jn.00098.2010 PG 8 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 651FH UT WOS:000281910600014 PM 20573967 ER PT J AU Brochmann, EJ Simon, RJ Jawien, J Behnam, K Sintuu, C Wang, JC Murray, SS AF Brochmann, Elsa J. Simon, Robert J. Jawien, Janusz Behnam, Keyvan Sintuu, Chananit Wang, Jeffrey C. Murray, Samuel S. TI Carboxy Terminus of Secreted Phosphoprotein-24 kDa (spp24) Is Essential for Full Inhibition of BMP-2 Activity SO JOURNAL OF ORTHOPAEDIC RESEARCH LA English DT Article DE bone morphogenetic proteins; BMP-binding proteins; surface plasmon resonance; spp24 ID BONE MORPHOGENETIC PROTEINS; BINDING PEPTIDE; ANTAGONISTS; SEQUENCE; GENE AB Secreted phosphoprotein-24 kDa (spp24) is a bone morphogenetic protein (BMP)-binding protein isolated from bone. It exists in a number of size forms and is hypothesized to function as a BMP latency protein and/or a "slow release" mechanism for BMPs involved in bone turnover and repair. We have examined the hypothesis that proteolytic modification of the C-terminus of spp24 affects its BMP-2-binding properties and bioactivity in the BMP-2-stimulated ectopic bone forming bioassay. Three different size forms of recombinant spp24 that correspond to predicted 18.1 kDa, 16.0 kDa, and 14.5 kDa proteolytic products were compared to full-length (fl) spp24. One of these forms (spp18.1) we hypothesize to be the protein which Urist initially, but apparently inaccurately, called "BMP." Only full-length spp24 completely inhibited BMP-2-induced bone formation. The 18.1 kD a truncated isoform of spp24 which we hypothesize to be Urist's protein did not. The inhibitory capacity of the proteins was correlated with their kinetic constants, assessed by surface plasmon resonance. At the highest, inhibitory, dose of spp24 and its derivatives, k(d) ("stability") best predicted the extent of ectopic bone formation whereas at the lowest dose, which was not inhibitory, k(a) ("recognition") best predicted the extent of ectopic bone formation. We conclude that proteolytic processing of spp24 affects the interaction of this protein with BMP-2 and this affects the function of the protein. (C) 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:1200-1207, 2010 C1 [Brochmann, Elsa J.; Murray, Samuel S.] VA Greater Los Angeles Hlth Care Syst, VA Med Ctr, Geriatr Res Educ & Clin Ctr 11 E, Sepulveda, CA 91343 USA. [Brochmann, Elsa J.; Murray, Samuel S.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. [Simon, Robert J.; Jawien, Janusz; Behnam, Keyvan; Sintuu, Chananit] VA Greater Los Angeles Hlth Care Syst, Res Serv, Sepulveda, CA 91343 USA. [Behnam, Keyvan] Lanx Inc, Broomfield, CO 80021 USA. [Sintuu, Chananit; Wang, Jeffrey C.] Univ Calif Los Angeles, Dept Orthopaed Surg, Los Angeles, CA 90024 USA. [Sintuu, Chananit; Wang, Jeffrey C.; Murray, Samuel S.] Univ Calif Los Angeles, Biomed Engn Interdept Program, Los Angeles, CA 90024 USA. RP Murray, SS (reprint author), VA Greater Los Angeles Hlth Care Syst, VA Med Ctr, Geriatr Res Educ & Clin Ctr 11 E, 16111 Plummer St, Sepulveda, CA 91343 USA. EM Samuel.Murray@va.gov FU Department of Veteran Affairs; Lanx, Inc. FX This work was supported by the Department of Veteran Affairs and Lanx, Inc. NR 20 TC 13 Z9 13 U1 0 U2 7 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0736-0266 J9 J ORTHOP RES JI J. Orthop. Res. PD SEP PY 2010 VL 28 IS 9 BP 1200 EP 1207 DI 10.1002/jor.21102 PG 8 WC Orthopedics SC Orthopedics GA 638LT UT WOS:000280897100013 PM 20162696 ER PT J AU Chapman, CR Lipschitz, DL Angst, MS Chou, R Denisco, RC Donaldson, GW Fine, PG Foley, KM Gallagher, RM Gilson, AM Haddox, JD Horn, SD Inturrisi, CE Jick, SS Lipman, AG Loeser, JD Noble, M Porter, L Rowbotham, MC Schoelles, KM Turk, DC Volinn, E Von Korff, MR Webster, LR Weisner, CM AF Chapman, C. Richard Lipschitz, David L. Angst, Martin S. Chou, Roger Denisco, Richard C. Donaldson, Gary W. Fine, Perry G. Foley, Kathleen M. Gallagher, Rollin M. Gilson, Aaron M. Haddox, J. David Horn, Susan D. Inturrisi, Charles E. Jick, Susan S. Lipman, Arthur G. Loeser, John D. Noble, Meredith Porter, Linda Rowbotham, Michael C. Schoelles, Karen M. Turk, Dennis C. Volinn, Ernest Von Korff, Michael R. Webster, Lynn R. Weisner, Constance M. TI Opioid Pharmacotherapy for Chronic Non-Cancer Pain in the United States: A Research Guideline for Developing an Evidence-Base SO JOURNAL OF PAIN LA English DT Article DE Opioid pharmacotherapy; chronic pain; evidence-based medicine; guideline; effectiveness; efficacy ID CHRONIC NONMALIGNANT PAIN; LOW-BACK-PAIN; CLINICAL-PRACTICE GUIDELINE; PRIMARY-CARE PHYSICIANS; DRUG-RELATED BEHAVIORS; TORSADES-DE-POINTES; INDUCED HYPERALGESIA; MORPHINE REQUIREMENTS; WORKERS-COMPENSATION; RANDOMIZED-TRIALS AB This document reports the consensus of an interdisciplinary panel of research and clinical experts charged with reviewing the use of opioids for chronic noncancer pain (CNCP) and formulating guidelines for future research. Prescribing opioids for chronic noncancer pain has recently escalated in the United States. Contrasting with increasing opioid use are: 1) The lack of evidence supporting long-term effectiveness; 2) Escalating misuse of prescription opioids including abuse and diversion; and 3) Uncertainty about the incidence and clinical salience of multiple, poorly characterized adverse drug events (ADEs) including endocrine dysfunction, immunosuppression and infectious disease, opioid-induced hyperalgesia and xerostomia, overdose, falls and fractures, and psychosocial complications. Chief among the limitations of current evidence are: 1) Sparse evidence on long-term opioid effectiveness in chronic pain patients due to the short-term time frame of clinical trials; 2) Insufficiently comprehensive outcome assessment; and 3) Incomplete identification and quantification of ADEs. The panel called for a strategic interdisciplinary approach to the problem domain in which basic scientists and clinicians cooperate to resolve urgent issues and generate a comprehensive evidence base. It offered 4 recommendations in 3 areas: 1) A research strategy for studying the effectiveness of long-term opioid pharmacotherapy; 2) Improvements in evidence-generation methodology; and 3) Potential research topics for generating new evidence. Perspective: Prescribing opioids for CNCP has outpaced the growth of scientific evidence bearing on the benefits and harms of these interventions. The need for a strong evidence base is urgent. This guideline offers a strategic approach to creating a comprehensive evidence base to guide safe and effective management of CNCP. (C) 2010 by the American Pain Society C1 [Chapman, C. Richard] Univ Utah, Pain Res Ctr, Dept Anesthesiol, Sch Med, Salt Lake City, UT 84108 USA. [Angst, Martin S.] Stanford Univ, Dept Anesthesiol, Palo Alto, CA 94304 USA. [Chou, Roger] Oregon Hlth & Sci Univ, Sch Med, Portland, OR 97201 USA. [Denisco, Richard C.] Natl Inst Drug Abuse, Div Epidemiol Serv & Prevent Res, NIH, Bethesda, MD USA. [Foley, Kathleen M.; Inturrisi, Charles E.] Mem Sloan Kettering Canc Ctr, Pain & Palliat Care Serv, New York, NY 10021 USA. [Gallagher, Rollin M.] Univ Penn, Sch Med, Dept Psychiat, Penn Pain Med Ctr, Philadelphia, PA 19104 USA. [Gallagher, Rollin M.] Univ Penn, Sch Med, Dept Anesthesiol & Crit Care, Penn Pain Med Ctr, Philadelphia, PA 19104 USA. [Gallagher, Rollin M.] Philadelphia VA Med Ctr, Philadelphia, PA USA. [Gilson, Aaron M.] Univ Wisconsin, Sch Med & Publ Hlth, Madison, WI USA. [Inturrisi, Charles E.] Cornell Univ, Dept Pharmacol, Joan & Sanford I Weill Med Sch, New York, NY 10021 USA. [Haddox, J. David] Purdue Pharma, Risk Management & Hlth Policy, Stamford, CT USA. [Jick, Susan S.] Boston Univ, Dept Epidemiol, Boston, MA 02215 USA. [Horn, Susan D.] Univ Utah, Sch Med, Dept Med Informat, ICOR, Salt Lake City, UT 84108 USA. [Horn, Susan D.] Univ Utah, Sch Med, Dept Med Informat, Int Sever Informat Syst Inc, Salt Lake City, UT 84108 USA. [Lipman, Arthur G.] Univ Utah, Dept Pharmacotherapy, LS Skaggs Pharm, Salt Lake City, UT 84108 USA. [Loeser, John D.] Univ Washington, Dept Neurol Surg, Seattle, WA 98195 USA. [Porter, Linda] Natl Inst Neurol Disorders & Stroke Syst & Cognit, NIH, Bethesda, MD USA. [Rowbotham, Michael C.] Univ Calif San Francisco, Pain Clin Res Ctr, San Francisco, CA 94143 USA. [Noble, Meredith; Schoelles, Karen M.] ECRI Inst, Plymouth Meeting, PA USA. [Turk, Dennis C.] Univ Washington, Dept Anesthesiol, Seattle, WA 98195 USA. [Von Korff, Michael R.] Ctr Hlth Studies Grp Hlth Cooperat, Seattle, WA USA. [Webster, Lynn R.] Lifetree Pain Clin, Salt Lake City, UT USA. [Weisner, Constance M.] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. RP Chapman, CR (reprint author), Univ Utah, Pain Res Ctr, Dept Anesthesiol, Sch Med, 615 Arapeen Dr,Suite 200, Salt Lake City, UT 84108 USA. EM crc20@utah.edu RI Inturrisi, Charles/E-7365-2013 OI Jick, Susan/0000-0002-2215-1067 FU Milbank Foundation; Mayday Fund FX Supported by a grant to the first author from the Milbank Foundation. A grant from The Mayday Fund supported the work necessary for this document. NR 143 TC 80 Z9 82 U1 3 U2 14 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 1526-5900 J9 J PAIN JI J. Pain PD SEP PY 2010 VL 11 IS 9 BP 807 EP 829 DI 10.1016/j.jpain.2010.02.019 PG 23 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 652TW UT WOS:000282033900001 PM 20430701 ER PT J AU Williams, EC Achtmeyer, CE Kivlahan, DR Greenberg, D Merrill, JO Wickizer, TM Koepsell, TD Heagerty, PJ Bradley, KA AF Williams, Emily C. Achtmeyer, Carol E. Kivlahan, Daniel R. Greenberg, Diane Merrill, Joseph O. Wickizer, Thomas M. Koepsell, Thomas D. Heagerty, Patrick J. Bradley, Katharine A. TI Evaluation of an Electronic Clinical Reminder to Facilitate Brief Alcohol-Counseling Interventions in Primary Care SO JOURNAL OF STUDIES ON ALCOHOL AND DRUGS LA English DT Article ID DECISION-SUPPORT-SYSTEMS; HEALTH-CARE; PROBLEM DRINKING; AUDIT-C; BARRIERS; IMPLEMENTATION; PERFORMANCE; OUTCOMES; PATIENT; TRIALS AB Objective: Brief intervention for patients with unhealthy alcohol use is a prevention priority in the United States, but most eligible patients do not receive it. This study evaluated an electronic alcohol-counseling clinical reminder at a single Veterans Affairs general medicine clinic. Method: The systems-level intervention evaluated in this study consisted of making the clinical reminder, which facilitated medical record documentation of brief intervention among patients who screened positive for unhealthy alcohol use, available to providers on one (of two) randomly selected hallways. Secondary electronic data were extracted for all patients who visited the clinic (October 1, 2002, to September 30, 2005). The proportion of patients with clinical-reminder use was evaluated among patients who screened positive for unhealthy drinking and were assigned to intervention hallway providers ("descriptive cohort"). Adjusted logistic regression evaluated the association between the intervention and resolution of unhealthy drinking at follow-up among all screen-positive patients who completed a second Alcohol Use Disorders Identification Test Consumption questionnaire 18 months or longer after the first ("outcomes cohort"). Results: Eligible patients (N = 22,863) included 10,392 controls and 12,471 in the intervention group. Fifteen percent (398 of 2,640) of descriptive cohort patients with unhealthy drinking had clinical-reminder use, which varied by severity (14% [n = 302 of 2,165] with mild/moderate and 20% [n = 96 of 475] with severe unhealthy drinking, p = .001). Only 39% (156 of 398) of patients with clinical-reminder use had documented brief intervention; advice to abstain was most common. Access to the clinical reminder was not significantly associated with resolution of unhealthy drinking in 1,358 patients in the outcomes cohort. Conclusions: Availability of a clinical reminder to facilitate brief intervention did not, alone, result in substantial use of the clinical reminder. More active implementation efforts may be needed to get brief interventions onto the agenda of busy primary care providers. (J. Stud. Alcohol Drugs, 71, 720-725, 2010) C1 [Williams, Emily C.] Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98101 USA. [Williams, Emily C.; Bradley, Katharine A.] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. [Achtmeyer, Carol E.; Bradley, Katharine A.] Vet Affairs Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA 98101 USA. [Kivlahan, Daniel R.] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Bradley, Katharine A.] Univ Washington, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Ctr Excellence Subst Abuse Treatment & Educ, Seattle, WA 98101 USA. RP Williams, EC (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM emily.williams3@va.gov FU National Institute on Alcohol Abuse and Alcoholism [K23AA00313]; Veterans Affairs (VA) Substance Use Disorders Quality Enhancement Research Initiative (SUD QuERI); VA's Northwest Center of Excellence for Health Services Research and Development FX Dr. Bradley was a Robert Wood Johnson Generalist Physician Faculty Scholar and supported by a National Institute on Alcohol Abuse and Alcoholism career development award (K23AA00313) at the time this research was initiated. This study was also supported by the Veterans Affairs (VA) Substance Use Disorders Quality Enhancement Research Initiative (SUD QuERI) and the VA's Northwest Center of Excellence for Health Services Research and Development. Views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs, the University of Washington, the National Institute on Alcohol Abuse and Alcoholism, or the Robert Wood Johnson Foundation. Preliminary versions of this work were presented at the Annual Scientific Meeting of the Research Society on Alcoholism, Washington, DC, June 28-July 2, 2008, and included in the dissertation of Emily C. Williams that was submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy from the University of Washington. NR 30 TC 10 Z9 10 U1 1 U2 3 PU ALCOHOL RES DOCUMENTATION INC CENT ALCOHOL STUD RUTGERS UNIV PI PISCATAWAY PA C/O DEIRDRE ENGLISH, 607 ALLISON RD, PISCATAWAY, NJ 08854-8001 USA SN 1937-1888 J9 J STUD ALCOHOL DRUGS JI J. Stud. Alcohol Drugs PD SEP PY 2010 VL 71 IS 5 BP 720 EP 725 PG 6 WC Substance Abuse; Psychology SC Substance Abuse; Psychology GA 645UE UT WOS:000281490900010 PM 20731977 ER PT J AU Del Prete, JC Bakaeen, FG Dao, TK Huh, J LeMaire, SA Coselli, JS Chu, D AF Del Prete, Jennifer C. Bakaeen, Faisal G. Dao, Tam K. Huh, Joseph LeMaire, Scott A. Coselli, Joseph S. Chu, Danny TI The Impact of Obesity on Long-term Survival After Coronary Artery Bypass Grafting SO JOURNAL OF SURGICAL RESEARCH LA English DT Article; Proceedings Paper CT 5th Annual Academic-Surgical Congress CY JAN-FEB -, 2010 CL San Antonio, TX DE body mass index; coronary artery bypass grafting; obesity; outcomes; survival ID BODY-MASS INDEX; AMERICAN-HEART-ASSOCIATION; CARDIAC-SURGERY; CARDIOVASCULAR-DISEASE; SECONDARY PREVENTION; EXTREME OBESITY; EARLY OUTCOMES; VALVE SURGERY; UNITED-STATES; MORTALITY AB Background. Obesity is a well-known risk factor for coronary artery disease. The objective of our study was to examine the impact of obesity on long-term survival after coronary artery bypass grafting (CABG). Materials and Methods. Using prospectively gathered data, we reviewed records of 1163 consecutive patients who underwent isolated primary CABG between 1997 and 2007. We compared outcomes of obese patients (body mass index [BMI] >= 30 kg/m(2); n = 472) and non-obese patients (BMI < 30 kg/m(2); n = 691). Long-term survival was assessed by using Kaplan-Meier curves generated by log-rank tests and adjusted for confounding factors with Cox logistic regression analysis. Results. Obese patients were slightly younger (60 +/- 8 versus 63 +/- 9y; P < 0.0001), were less likely to be current tobacco smokers (30% versus 41%; P < 0.0001), had a higher incidence of diabetes (51% versus 33%; P < 0.0001), and had a lower incidence of cerebral vascular disease (18% versus 24%; P = 0.009) than non-obese patients. The two groups of patients had similar 30-d rates of mortality (1.3% versus 1.5%; P = 0.8) and major adverse cardiac events (2.3% versus 2.5%; P = 0.9). Adjusted Cox regression survival curves were also similar between the two groups of patients (adjusted hazard ratio, 1.2; 95% confidence interval, 0.8-1.8; P = 0.28). Conclusions. Obese patients who underwent CABG had 30-d mortality rates and early outcomes similar to those of non-obese patients. Long-term survival was also similar between these two groups of patients after adjustment for confounding variables. Published by Elsevier Inc. C1 [Chu, Danny] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Del Prete, Jennifer C.; Huh, Joseph; LeMaire, Scott A.; Coselli, Joseph S.] St Lukes Episcopal Hosp, Texas Heart Inst, Houston, TX USA. [Dao, Tam K.] Univ Houston, Houston, TX USA. RP Chu, D (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, 2002 Holcombe Blvd,OCL 112, Houston, TX 77030 USA. EM dchumd@gmail.com NR 29 TC 8 Z9 8 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 0022-4804 J9 J SURG RES JI J. Surg. Res. PD SEP PY 2010 VL 163 IS 1 BP 7 EP 11 DI 10.1016/j.jss.2010.02.014 PG 5 WC Surgery SC Surgery GA 640TT UT WOS:000281076300002 PM 20452615 ER PT J AU Ortmann, AJ Palmer, CV Prattt, SR AF Ortmann, Amanda J. Palmer, Catherine V. Prattt, Sheila R. TI Impact of Spectrally Asynchronous Delays on Consonant Voicing Perception SO JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY LA English DT Article DE Assistive listening devices; hearing aids; speech perception ID HEARING-AID DELAYS; SPEECH PRODUCTION; IMPAIRED SUBJECTS; STOP CONSONANTS; LIMITS; IDENTIFICATION; RECOGNITION; SENTENCES; ENGLISH; ADULTS AB Background: A possible voicing cue used to differentiate voiced and voiceless cognate pairs is envelope onset asynchrony (EOA). EOA is the time between the onsets of two frequency bands of energy (in this study one band was high-pass filtered at 3000 Hz, the other low-pass filtered at 350 Hz). This study assessed the perceptual impact of manipulating EOA on voicing perception of initial stop consonants, and whether normal-hearing and hearing-impaired listeners were sensitive to changes in EOA as a cue for voicing. Purpose: The purpose of this study was to examine the effect of spectrally asynchronous auditory delay on the perception of voicing associated with initial stop consonants by normal-hearing and hearing-impaired listeners. Research Design: Prospective experimental study comparing the perceptual differences of manipulating the EOA cues for two groups of listeners. Study Sample: Thirty adults between the ages of 21 and 60yr completed the study: 17 listeners with normal hearing and 13 listeners with mild-moderate sensorineural hearing loss. Data Collection and Analysis: The participants listened to voiced and voiceless stop consonants within a consonant-vowel syllable structure. The EOA of each syllable was varied along a continuum, and identification and discrimination tasks were used to determine if the EOA manipulation resulted in categorical shifts in voicing perception. In the identification task the participants identified the consonants as belonging to one of two categories (voiced or voiceless cognate). They also completed a same-different discrimination task with the same set of stimuli. Categorical perception was confirmed with a d-prime sensitivity measure by examining how accurately the results from the identification task predicted the discrimination results. The influence of EOA manipulations on the perception of voicing was determined from shifts in the identification functions and discrimination peaks along the EOA continuum. The two participant groups were compared in order to determine the impact of EOA on voicing perception as a function of syllable and hearing status. Results: Both groups of listeners demonstrated a categorical shift in voicing perception with manipulation of EOA for some of the syllables used in this study. That is, as the temporal onset asynchrony between low-and high-frequency bands of speech was manipulated, the listeners' perception of consonant voicing changed between voiced and voiceless categories. No significant differences were found between listeners with normal hearing and listeners with hearing loss as a result of the EOA manipulation. Conclusions: The results of this study suggested that both normal-hearing and hearing-impaired listeners likely use spectrally asynchronous delays found in natural speech as a cue for voicing distinctions. While delays in modern hearing aids are less than those used in this study, possible implications are that additional asynchronous delays from digital signal processing or open-fitting amplification schemes might cause listeners with hearing loss to misperceive voicing cues. C1 [Ortmann, Amanda J.; Palmer, Catherine V.; Prattt, Sheila R.] Univ Pittsburgh, Dept Commun Sci & Disorders, Pittsburgh, PA 15260 USA. [Prattt, Sheila R.] VA Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA. RP Ortmann, AJ (reprint author), Washington Univ, Sch Med, Dept Otolaryngol, Campus Box 8115,660 S Euclid Ave, St Louis, MO 63110 USA. EM ortmanna@ent.wustl.edu FU Veterans Affairs; University of Pittsburgh School of Health; Rehabilitation Sciences Research Development Fund FX The primary author was funded through a Veterans Affairs predoctoral traineeship. This study was supported in part by the University of Pittsburgh School of Health and Rehabilitation Sciences Research Development Fund. NR 27 TC 1 Z9 1 U1 0 U2 1 PU AMER ACAD AUDIOLOGY PI RESTON PA 11730 PLAZA DR, STE 300, RESTON, VA 20190 USA SN 1050-0545 J9 J AM ACAD AUDIOL JI J. Am. Acad. Audiol. PD SEP PY 2010 VL 21 IS 8 BP 493 EP 511 DI 10.3766/jaaa.21.8.2 PG 19 WC Audiology & Speech-Language Pathology; Otorhinolaryngology SC Audiology & Speech-Language Pathology; Otorhinolaryngology GA 674AK UT WOS:000283705300002 PM 21034697 ER PT J AU Ereso, AQ Garcia, P Tseng, E Gauger, G Kim, H Dua, MM Victorino, GP Guy, TS AF Ereso, Alexander Q. Garcia, Pablo Tseng, Elaine Gauger, Grant Kim, Hubert Dua, Monica M. Victorino, Gregory P. Guy, T. Sloane TI Live Transference of Surgical Subspecialty Skills Using Telerobotic Proctoring to Remote General Surgeons SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Article ID COLORECTAL SURGERY; OPERATING-ROOM AB BACKGROUND: Certain clinical environments, including military field hospitals or rural medical centers, lack readily available surgical subspecialists. We hypothesized that telementoring by a surgical sub-specialist using a robotic platform is feasible and can convey subspecialty knowledge and skill to a remotely located general surgeon. STUDY DESIGN: Eight general surgery residents evaluated the effect of remote surgical telementoring by performing 3 operative procedures, first unproctored and then again when teleproctored by a surgical subspecialist. The clinical scenarios consisted of a penetrating right ventricular injury requiring suture repair, an open tibial fracture requiring external fixation, and a traumatic subdural hematoma requiring craniectomy. A robotic platform consisting of a pan-and-tilt camera with laser pointer attached to an overhead surgical light with integrated audio allowed surgical subspecialists the ability to remotely teleproctor residents. Performance was evaluated using an Operative Performance Scale. Satisfaction surveys were given after performing the scenario unproctored and again after proctoring. RESULTS: Overall mean performance scores were superior in all scenarios when residents were proctored than when they were not (4.30 +/- 0.25 versus 2.43 +/- 0.20; p < 0.001). Mean performance scores for individual metrics, including tissue handling, instrument handling, speed of completion, and knowledge of anatomy, were all superior when residents were proctored (p < 0.001). Satisfaction surveys showed greater satisfaction and comfort among residents when proctored. Proctored residents believed the robotic platform facilitated learning and would be feasible if used clinically. CONCLUSIONS: This study supports the use of surgical teleproctoring in guiding remote general surgeons by a surgical subspecialist in the care of a wounded patient in need of an emergency subspecialty operation. (J Am Coll Surg 2010;211:400-411. (C) 2010 by the American College of Surgeons) C1 [Victorino, Gregory P.] Univ Calif, Dept Surg, Oakland, CA 94602 USA. [Garcia, Pablo] SRI Int, Menlo Pk, CA 94025 USA. [Tseng, Elaine; Gauger, Grant; Kim, Hubert; Guy, T. Sloane] Univ Calif San Francisco, Dept Surg, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. RP Victorino, GP (reprint author), Univ Calif, Dept Surg, 1411 E 31st St, Oakland, CA 94602 USA. EM gregory.victorino@ucsfmedctr.org FU US Army Medical Research and Materiel Command under MIPR [7K036M7082] FX This work was supported by the US Army Medical Research and Materiel Command under MIPR No.7K036M7082. NR 16 TC 25 Z9 25 U1 1 U2 3 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 2010 VL 211 IS 3 BP 400 EP 411 DI 10.1016/j.jamcollsurg.2010.05.014 PG 12 WC Surgery SC Surgery GA 648QH UT WOS:000281708500014 PM 20800198 ER PT J AU Chitsaz, S Jaussaud, N Chau, E Azadani, AN Guy, TS Ratcliffe, MB Tseng, EE AF Chitsaz, Sam Jaussaud, Nicolas Chau, Edward Azadani, Ali N. Guy, T. Sloane Ratcliffe, Mark B. Tseng, Elaine E. TI Veteran patients with severe aortic stenosis: Outcomes with and without aortic valve replacement SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Meeting Abstract CT Annual Clinical Congress of American-College-of-Surgeons CY 2010 CL Chicago, IL SP Amer Coll Surg C1 [Chitsaz, Sam; Jaussaud, Nicolas; Chau, Edward; Azadani, Ali N.; Guy, T. Sloane; Ratcliffe, Mark B.; Tseng, Elaine E.] San Francisco VA Med Ctr, San Francisco, CA USA. RI Chitsaz, Sam/C-4586-2008 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 2010 VL 211 IS 3 SU S BP S30 EP S30 PG 1 WC Surgery SC Surgery GA 648QI UT WOS:000281708600050 ER PT J AU Qureshi, SU Kimbrell, T Pyne, JM Magruder, KM Hudson, TJ Petersen, NJ Yu, HJ Schulz, PE Kunik, ME AF Qureshi, Salah U. Kimbrell, Timothy Pyne, Jeffrey M. Magruder, Kathy M. Hudson, Teresa J. Petersen, Nancy J. Yu, Hong-Jen Schulz, Paul E. Kunik, Mark E. TI Greater Prevalence and Incidence of Dementia in Older Veterans with Posttraumatic Stress Disorder SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE posttraumatic stress disorder; dementia; veterans ID ALZHEIMERS-DISEASE; RISK-FACTORS; AFFAIRS; MEMORY; PTSD; CARE; EDUCATION; INJURY; IRAQ AB OBJECTIVES To explore the association between posttraumatic stress disorder (PTSD) and dementia in older veterans. DESIGN Administrative database study of individuals seen within one regional division of the Veterans Affairs healthcare network. SETTING Veterans Integrated Service Network 16. PARTICIPANTS Veterans aged 65 and older who had a diagnosis of PTSD or who were recipients of a Purple Heart (PH) and a comparison group of the same age with no PTSD diagnosis or PH were divided into four groups: those with PTSD and no PH (PTSD+/PH-, n=3,660), those with PH and no PTSD (PTSD-/PH+, n=1,503), those with PTSD and a PH (PTSD+/PH+, n=153), and those without PTSD or a PH (PTSD-/PH-, n=5,165). MEASUREMENTS Incidence and prevalence of dementia after controlling for confounding factors in multivariate logistic regression. RESULTS The PTSD+/PH- group had a significantly higher incidence and prevalence of dementia than the groups without PTSD with or without a PH. The prevalence and incidence of a dementia diagnosis remained two times as high in the PTSD+/PH- group as in the PTSD-/PH+ or PTSD-/PH- group after adjusting for the confounding factors. There were no statistically significant differences between the other groups. CONCLUSION The incidence and prevalence of dementia is greater in veterans with PTSD. It is unclear whether this is due to a common risk factor underlying PTSD and dementia or to PTSD being a risk factor for dementia. Regardless, this study suggests that veterans with PTSD should be screened more closely for dementia. Because PTSD is so common in veterans, this association has important implications for veteran care. C1 [Qureshi, Salah U.; Petersen, Nancy J.; Yu, Hong-Jen; Kunik, Mark E.] Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Serv, Houston, TX 77030 USA. [Qureshi, Salah U.; Schulz, Paul E.] Michael E DeBakey VA Med Ctr, Houston, TX USA. [Qureshi, Salah U.; Schulz, Paul E.] Baylor Coll Med, Neurosensory Ctr, Houston, TX 77030 USA. [Qureshi, Salah U.; Schulz, Paul E.] Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. [Petersen, Nancy J.; Kunik, Mark E.] Baylor Coll Med, Dept Med, Houston, TX 77030 USA. [Kunik, Mark E.] Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. [Qureshi, Salah U.; Kimbrell, Timothy; Kunik, Mark E.] Cent Arkansas Vet Healthcare Syst, Vet Affairs S Cent Mental Illness Res Educ & Clin, Little Rock, AR USA. [Kimbrell, Timothy; Pyne, Jeffrey M.; Hudson, Teresa J.] Cent Arkansas Vet Healthcare Syst, Ctr Mental Hlth & Outcomes Res, Little Rock, AR USA. [Kimbrell, Timothy; Pyne, Jeffrey M.; Hudson, Teresa J.] Univ Arkansas Med Sci, Dept Psychiat, Coll Med, Little Rock, AR 72205 USA. [Magruder, Kathy M.] Med Univ S Carolina, Dept Psychiat & Behav Sci, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. RP Kunik, ME (reprint author), Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Serv, Michael DeBakey VAMC 152,2002 Holcombe, Houston, TX 77030 USA. EM mkunik@bcm.tmc.edu FU Houston Center for Quality of Care and Utilization Studies [HFP90-020] FX This work was supported in part by the Houston Center for Quality of Care and Utilization Studies (Houston VA Health Services Research and Development Center of Excellence [HFP90-020]). NR 31 TC 46 Z9 46 U1 4 U2 7 PU WILEY-BLACKWELL PUBLISHING, INC 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 SEP PY 2010 VL 58 IS 9 BP 1627 EP 1633 DI 10.1111/j.1532-5415.2010.02977.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 646NM UT WOS:000281549000001 PM 20863321 ER PT J AU Ishii, S Streim, JE Saliba, D AF Ishii, Shinya Streim, Joel E. Saliba, Debra TI Potentially Reversible Resident Factors Associated with Rejection of Care Behaviors SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE rejection of care; nursing home; modifiable characteristics ID NURSING-HOME RESIDENTS; CONFUSION ASSESSMENT METHOD; LONG-TERM-CARE; AGGRESSIVE-BEHAVIOR; PSYCHOLOGICAL SYMPTOMS; ALZHEIMERS-DISEASE; DEMENTIA; DELIRIUM; DEPRESSION; AGITATION AB OBJECTIVES To identify the potentially modifiable resident-level factors associated with rejection of care in nursing home (NH) residents. DESIGN Secondary analysis of a 3.0 national field test to revise the Minimum Data Set (MDS). SETTING Seventy-one NHs in eight states. PARTICIPANTS Three thousand two hundred thirty NH residents scheduled for MDS assessments from September 2006 through February 2007. MEASUREMENTS The potentially mutable characteristics assessed were mood (Patient Health Questionnaire-9), delirium (Confusion Assessment Method), delusions, hallucinations or illusions, hearing impairment, vision impairment, pain severity, and infection diagnoses. Characteristics considered as covariates were cognition, communication abilities, and impairment in activities of daily living. RESULTS Of 3,230 residents assessed, 312 (9.7%) had demonstrated rejection of care in the preceding 5 days. In multiple regression analysis adjusted for covariates, rejection of care was associated with delusions (odds ratio (OR)=3.9; 95% confidence interval (CI)=2.5-6.0), delirium (OR=1.8, 95% CI=1.3-2.4), minor (OR=2.1, 95% CI=1.5-2.8) and major (OR=2.3, 95% CI=1.5-3.4) depression, and severe to horrible pain (OR=1.6, 95% CI=1.1-2.3). Infection diagnoses were not significant in bivariate analysis. Hallucinations or illusions, mild to moderate pain, and hearing and vision impairment were not significant in multiple regression analysis. CONCLUSION In this population, delirium, delusions, depression, and severe pain were associated with rejection of care, suggesting that some care rejection behaviors may resolve with appropriate interventions for the identified target conditions if the associations observed are causal. C1 [Ishii, Shinya; Saliba, Debra] VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Los Angeles, CA 90073 USA. [Streim, Joel E.] Mental Illness Res Educ & Clin Ctr, Vet Integrated Serv Network 4, Philadelphia, PA USA. [Streim, Joel E.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. [Streim, Joel E.] Univ Penn, Dept Psychiat, Geriatr Psychiat Sect, Philadelphia, PA 19104 USA. [Saliba, Debra] Hlth Serv Res & Dev Ctr Excellence Study Healthca, Dept Vet Affairs, Los Angeles, CA USA. [Saliba, Debra] Univ Calif Los Angeles, Jewish Home Borun Ctr Gerontol Res, Los Angeles, CA USA. [Saliba, Debra] RAND, Santa Monica, CA USA. RP Ishii, S (reprint author), VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, 11301 Wilshire Blvd,Bldg 220,Room 302 11G, Los Angeles, CA 90073 USA. EM sishii@mednet.ucla.edu FU U.S. Department of Veterans Affairs; Veterans Health Administration; VA Health Services Research and Development (HSRD) [SDR 03-217] FX This work was funded by the U.S. Department of Veterans Affairs, Veterans Health Administration, VA Health Services Research and Development (HSR&D) Service through the VA Greater Los Angeles HSR&D Center of Excellence (Project SDR 03-217), the VA Office of Academic Affairs, and the Centers for Medicare and Medicaid Services and supported by the University of California at Los Angeles/Jewish Home Borun Center for Gerontological Research. NR 54 TC 9 Z9 9 U1 0 U2 1 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 SEP PY 2010 VL 58 IS 9 BP 1693 EP 1700 DI 10.1111/j.1532-5415.2010.03020.x PG 8 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 646NM UT WOS:000281549000010 PM 20863329 ER PT J AU Cherubini, A Del Signore, S Ouslander, J Semla, T Michel, JP AF Cherubini, Antonio Del Signore, Susanna Ouslander, Joe Semla, Todd Michel, Jean-Pierre TI Fighting Against Age Discrimination in Clinical Trials SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE older participant; clinical trial; regulatory agency; geriatric medicine; exclusion ID ISOLATED SYSTOLIC HYPERTENSION; RANDOMIZED CONTROLLED-TRIALS; FRAIL OLDER PERSONS; HEART-FAILURE; RESEARCH PARTICIPATION; PEOPLE; SPIRONOLACTONE; GUIDELINES; MORTALITY; BARRIERS AB At the American Geriatrics Society 2008 Annual Meeting, representatives of two geriatric societies, the European Union Geriatric Medicine Societies and the American Geriatrics Society, and two regulatory agencies, the U.S. Food and Drug Administration and the European Medicine Agency, conducted a roundtable discussion aimed at reviewing the participation of older people in clinical trials. This article summarizes the important issues discussed at the meeting. Historically, regulatory agencies started to promote the inclusion of older participants in clinical trials in the late 1980s. The identification of the causes of delay in including older participants in clinical trials, as well as of the ongoing bias against including older participants with multiple comorbidities, is important to help geriatricians fight against age discrimination in clinical trials. To overcome this problem, geriatrics societies and regulatory agencies must work together to propose new definitions, study designs, and technologies aimed at improving the evaluation of drugs in older people with multiple comorbidities and polypharmacy. C1 [Cherubini, Antonio] Univ Perugia, Sch Med, Policlin Santa Maria Misericordia, Inst Gerontol & Geriatr, I-06156 Perugia, Italy. [Del Signore, Susanna] Sanofi Aventis Rech & Dev, Massy, France. [Ouslander, Joe] Univ Miami, Miller Sch Med, Div Gerontol & Geriatr Med, Miami, FL 33136 USA. [Semla, Todd] US Dept Vet Affairs, Pharm Benefit Management Serv, Washington, DC USA. [Semla, Todd] Northwestern Univ, Dept Med, Div Geriatr Med, Feinberg Sch Med, Chicago, IL 60611 USA. [Michel, Jean-Pierre] Geneva Sch Med, Dept Rehabil & Geriatr, Geneva, Switzerland. [Michel, Jean-Pierre] Univ Hosp Geneva, Geneva, Switzerland. RP Cherubini, A (reprint author), Univ Perugia, Sch Med, Policlin Santa Maria Misericordia, Inst Gerontol & Geriatr, Piazzale Menghini 1, I-06156 Perugia, Italy. EM cherubin_9@yahoo.com OI Cherubini, Antonio/0000-0003-0261-9897 NR 27 TC 57 Z9 59 U1 0 U2 12 PU WILEY-BLACKWELL PUBLISHING, INC 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 SEP PY 2010 VL 58 IS 9 BP 1791 EP 1796 DI 10.1111/j.1532-5415.2010.03032.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 646NM UT WOS:000281549000024 PM 20863340 ER PT J AU Joseph, WS Lipsky, BA AF Joseph, Warren S. Lipsky, Benjamin A. TI Medical Therapy of Diabetic Foot Infections SO JOURNAL OF THE AMERICAN PODIATRIC MEDICAL ASSOCIATION LA English DT Article ID STAPHYLOCOCCUS-AUREUS; CLASSIFICATION-SYSTEM; VALIDATION; DIAGNOSIS; RISK AB Diabetic foot infections are a common and often serious problem, accounting for more hospital bed days than any other complication of diabetes. Despite advances in antibiotic drug therapy and surgical management, these infections continue to be a major risk factor for amputations of the lower extremity. Although a variety of wound size and depth classification systems have been adapted for use in codifying diabetic foot ulcerations, none are specific to infection. In 2003, the International Working Group on the Diabetic Foot developed guidelines for managing diabetic foot infections, including the first severity scale specific to these infections. The following year, the Infectious Diseases Society of America published their diabetic foot infection guidelines. Herein, we review some of the critical points from the Executive Summary of the Infectious Diseases Society of America document and provide a commentary following each issue to update the reader on any pertinent changes that have occurred since publication of the original document in 2004. The importance of a multidisciplinary limb salvage team, apropos of this special issue jointly published by the American Podiatric Medical Association and the Society for Vascular Surgery, cannot be overstated. (J Am Podiatr Med Assoc 100(5): 395-400, 2010) C1 [Joseph, Warren S.] Roxborough Mem Hosp, Philadelphia, PA USA. [Lipsky, Benjamin A.] Univ Washington, Seattle, WA 98195 USA. [Lipsky, Benjamin A.] VA Puget Sound HCS, Primary Care Clin, Seattle, WA USA. RP Joseph, WS (reprint author), Amer Podiatr Med Assoc, 1109 Old Ford Rd, Huntingdon Valley, PA 19006 USA. EM wsjoseph@comcast.net OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 17 TC 5 Z9 5 U1 0 U2 0 PU AMER PODIATRIC MED ASSOC PI BETHESDA PA 9312 OLD GEORGETOWN ROAD, BETHESDA, MD 20814-1621 USA SN 8750-7315 J9 J AM PODIAT MED ASSN JI J. Am. Podiatr. Med. Assoc. PD SEP-OCT PY 2010 VL 100 IS 5 BP 395 EP 400 PG 6 WC Orthopedics SC Orthopedics GA 655LF UT WOS:000282250800010 PM 20847353 ER PT J AU Ellis, C Zhao, YM Egede, LE AF Ellis, Charles Zhao, Yumin Egede, Leonard E. TI Racial/Ethnic Disparities in Poststroke Outpatient Rehabilitation Among Veterans SO JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION LA English DT Article DE stroke; rehabilitation; race/ethnicity ID INPATIENT STROKE REHABILITATION; HEALTH-CARE SYSTEM; RACIAL DISPARITIES; UNITED-STATES; ETHNIC-DIFFERENCES; OUTCOMES; SERVICES; MORTALITY; SEVERITY; AFFAIRS AB Objective: To examine racial/ethnic differences in the use of poststroke outpatient rehabilitation in veterans. Methods: We examined data from 4115 veterans with a diagnosis of stroke who were seen at a VA Medical Center in the southeastern United States. We compared the receipt of physical therapy (PT) and occupational therapy (OT) evaluations, visits, and procedures among 3 racial/ethnic groups. Multiple logistic regression was used to assess the independent effect of race/ethnicity on the receipt of a PT or OT evaluation and Poisson regression to estimate the effect of race/ethnicity on treatment visits and procedures received. Results: In univariate comparisons, a higher proportion of blacks received PT and OT evaluations than whites and others. Similarly, blacks received a higher mean number of PT/OT treatments than whites and others. In multivariate logistic models with whites as reference, blacks were more likely to receive PT evaluations (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.24-1.74) and OT evaluations (OR, 1.23; 95% CI, 1.01-1.51). In multivariate Poisson models with whites as reference, blacks received more PT/OT visits (OR, 7.22; 95% CI, 5.95-8.76) than non-Hispanic whites (OR, 5.28; 95% CI, 4.41-6.33), while others received fewer visits (OR, 4.39; 95% CI, 3.58-5.39) than the reference group. No significant differences were observed across groups in the number of procedures completed during each treatment visit. Conclusions: In an equal-access system, blacks were more likely to receive outpatient PT/OT evaluations and higher mean number of PT/OT treatments. Future studies need to examine sociodemographic and disease-specific factors that account for these differences. C1 [Ellis, Charles] Med Univ S Carolina, Dept Hlth Sci & Res, Charleston, SC 29425 USA. [Zhao, Yumin; Egede, Leonard E.] Med Univ S Carolina, Dept Med, Ctr Hlth Dispar Res, Charleston, SC 29425 USA. [Egede, Leonard E.] Ralph H Johnson VA Med Ctr, Ctr Dis Prevent & Hlth Intervent Diverse Populat, Charleston, SC USA. RP Ellis, C (reprint author), Med Univ S Carolina, Dept Hlth Sci & Res, 77 President St, Charleston, SC 29425 USA. EM ellisc@musc.edu FU Charleston, South Carolina, Veterans Administration Health Services Research and Development [REA 08-261]; Veterans Administration Health Services Research and Development [CDA 07-012-3] FX The contents of this paper are the result of work supported by the use of facilities at the Charleston, South Carolina, Veterans Administration Health Services Research and Development-funded Center for Disease Prevention and Health Interventions for Diverse Populations (REA 08-261). Dr Ellis is supported by a career development award (CDA 07-012-3) from the Veterans Administration Health Services Research and Development program. NR 31 TC 1 Z9 1 U1 1 U2 3 PU NATL MED ASSOC PI WASHINGON PA 1012 10TH ST, N W, WASHINGON, DC 20001 USA SN 0027-9684 J9 J NATL MED ASSOC JI J. Natl. Med. Assoc. PD SEP PY 2010 VL 102 IS 9 BP 817 EP 822 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 670XK UT WOS:000283463100008 PM 20922926 ER PT J AU Denlinger, CE Ikonomidis, JS Reed, CE Spinale, FG AF Denlinger, Chadrick E. Ikonomidis, John S. Reed, Carolyn E. Spinale, Francis G. TI Epithelial to mesenchymal transition: The doorway to metastasis in human lung cancers SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Review ID BREAST-CANCER; TUMOR PROGRESSION; MATRIX-METALLOPROTEINASE; PROTEIN EXPRESSION; BETA-CATENIN; CELLS; CARCINOMA; CADHERIN; INVASION; RECEPTOR C1 Univ S Carolina, Charleston, SC USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Denlinger, CE (reprint author), 25 Courtenay Dr,Suite 7018, Charleston, SC 29425 USA. EM denlinge@musc.edu NR 49 TC 23 Z9 23 U1 0 U2 3 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 SEP PY 2010 VL 140 IS 3 BP 505 EP 513 DI 10.1016/j.jtcvs.2010.02.061 PG 9 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 641HS UT WOS:000281116000003 PM 20723721 ER PT J AU Dao, TK Chu, D Springer, J Gopaldas, RR Menefee, DS Anderson, T Hiatt, E Nguyen, Q AF Dao, Tam K. Chu, Danny Springer, Justin Gopaldas, Raja R. Menefee, Deleene S. Anderson, Thomas Hiatt, Emily Nguyen, Quang TI Clinical depression, posttraumatic stress disorder, and comorbid depression and posttraumatic stress disorder as risk factors for in-hospital mortality after coronary artery bypass grafting surgery SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article ID HEART-RATE-VARIABILITY; PLASMA NOREPINEPHRINE; ADMINISTRATIVE DATABASES; DISEASE; INDEX; MORBIDITY; CABG AB Objective: The goal of this study was to examine the effect of clinical depression, posttraumatic stress disorder, and comorbid depression and posttraumatic stress disorder on in-hospital mortality after a coronary artery bypass grafting surgery. It is hypothesized that depression, posttraumatic stress disorder, and comorbid depression and posttraumatic stress disorder will independently contribute to an increased risk for in-hospital mortality rates after coronary artery bypass grafting surgery. Methods: We performed a retrospective analysis of the 2006 Nationwide Inpatient Sample database. The Nationwide Inpatient Sample database provides information on approximately 8 million US inpatient stays from about 1000 hospitals. We performed c 2 and unpaired t tests to evaluate potential confounding group demographic and medical variables. Hierarchic logistic regression was used with forced order entry of depression, posttraumatic stress disorder, and comorbid depression and posttraumatic stress disorder. Results: Deceased patients were more likely to have had depression (alive, 24.8%; deceased, 60.3%; P < .001), posttraumatic stress disorder (alive, 13.4%; deceased, 56.1%; P < .001), and cormorbid depression and posttraumatic stress disorder (alive, 7.8%; deceased, 48.5%; P < .001). After adjusting for potential confounding factors, patients with depression (odds ratio, 1.24; 95% confidence interval, 1.02-1.50), posttraumatic stress disorder (odds ratio, 2.09; 95% confidence interval, 1.65-2.64), and comorbid depression and posttraumatic stress disorder (odds ratio, 4.66; 95% confidence interval, 3.46-6.26) had an increased likelihood of in-hospital mortality compared with that seen in patients who were alive. Conclusions: Two findings were noteworthy. First, depression, posttraumatic stress disorder, and comorbid depression and posttraumatic stress disorder are prevalent in patients undergoing coronary artery bypass grafting procedures. Second, depression, posttraumatic stress disorder, and comorbid depression and posttraumatic stress disorder increase the risk of death by magnitudes comparable with well-established physical health risk factors after coronary artery bypass grafting surgery. The implications for clinical practice and future directions are discussed. (J Thorac Cardiovasc Surg 2010;140:606-10) C1 [Dao, Tam K.; Hiatt, Emily] Univ Houston, Baylor Coll Med, Houston, TX 77030 USA. [Dao, Tam K.; Chu, Danny; Springer, Justin; Menefee, Deleene S.; Anderson, Thomas; Nguyen, Quang] Baylor Coll Med, Dept Educ Psychol, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Dao, Tam K.; Springer, Justin; Menefee, Deleene S.; Anderson, Thomas; Nguyen, Quang] Baylor Coll Med, Mental Hlth Serv Line, Houston, TX 77030 USA. [Chu, Danny] Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. [Gopaldas, Raja R.] Baylor Coll Med, Div Cardiothorac Surg, Houston, TX 77030 USA. St Lukes Episcopal Hosp, Texas Heart Inst, USA Sect Adult Cardiac Surg, Houston, TX USA. RP Dao, TK (reprint author), Univ Houston, Baylor Coll Med, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM tdao@mail.coe.uh.edu FU Mental Illness Research, Education, and Clinical Center FX Supported by the Mental Illness Research, Education, and Clinical Center. NR 23 TC 13 Z9 14 U1 0 U2 3 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 SEP PY 2010 VL 140 IS 3 BP 606 EP 610 DI 10.1016/j.jtcvs.2009.10.046 PG 5 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 641HS UT WOS:000281116000017 PM 20074753 ER PT J AU Jones, JA Zavadzkas, JA Chang, EI Sheats, N Koval, C Stroud, RE Spinale, FG Ikonomidis, JS AF Jones, Jeffrey A. Zavadzkas, Juozas A. Chang, Eileen I. Sheats, Nina Koval, Christine Stroud, Robert E. Spinale, Francis G. Ikonomidis, John S. TI Cellular phenotype transformation occurs during thoracic aortic aneurysm development SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article ID MATRIX METALLOPROTEINASES; MURINE MODEL; ASCENDING AORTA; UP-REGULATION; EXPRESSION; INHIBITORS; PATTERNS; VALVES; CELLS AB Objective: Thoracic aortic aneurysms result from dysregulated remodeling of the vascular extracellular matrix, which may occur as a result of altered resident cellular function. The present study tested the hypothesis that aortic fibroblasts undergo a stable change in cellular phenotype during thoracic aortic aneurysm formation. Methods: Primary murine aortic fibroblasts were isolated from normal and thoracic aortic aneurysm-induced aortas (4 weeks post induction with 0.5 mol/L CaCl(2) 15 minutes) by the outgrowth method. Normal and thoracic aortic aneurysm cultures were examined using a focused polymerase chain reaction array to determine fibroblast-specific changes in gene expression in the absence and presence of biological stimulation (endothelin-1, phorbol-12-myristate-13-acetate, angiotensin-II). The relative expression of 38 genes, normalized to 4 housekeeping genes, was determined, and genes displaying a minimum 2-fold increase/decrease or genes with significantly different normalized cycle threshold values were considered to have altered expression. Results: At steady state, thoracic aortic aneurysm fibroblasts revealed elevated expression of several matrix metalloproteinases (Mmp2, Mmp11, Mmp14), collagen genes/elastin (Col1a1, Col1a2, Col3a1, Eln), and other matrix proteins, as well as decreased expression of Mmp3, Timp3, and Ltbp1. Moreover, gene expression profiles in thoracic aortic aneurysm fibroblasts were different than normal fibroblasts after equivalent biological stimuli. Conclusions: This study demonstrated for the first time that isolated primary aortic fibroblasts from thoracic aortic aneurysm-induced mice possess a unique and stable gene expression profile, and when challenged with biological stimuli, induce a transcriptional response that is different from normal aortic fibroblasts. Together, these data suggest that aortic fibroblasts undergo a stable phenotypic change during thoracic aortic aneurysm development, which may drive the enhancement of extracellular matrix proteolysis in thoracic aortic aneurysm progression. (J Thorac Cardiovasc Surg 2010;140:653-9) C1 [Jones, Jeffrey A.] Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Div Cardiothorac Surg, Dept Surg, Charleston, SC 29425 USA. RP Jones, JA (reprint author), Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Div Cardiothorac Surg, Dept Surg, Strom Thurmond Res Bldg,114 Doughty St,Suite 625,, Charleston, SC 29425 USA. EM jonesja@musc.edu OI Chang, Eileen/0000-0002-3444-7260 FU National Institutes of Health/National Health, Lung, and Blood Institute [R01 HL075488, R01 HL81692]; Department of Veterans Affairs [BLRD-CDA-2] FX This work was supported by the National Institutes of Health/National Health, Lung, and Blood Institute R01 HL075488 (to J.S.I.) and R01 HL81692 (to F. G. S.), and by the Department of Veterans Affairs through a Career Development Award to J.A.J. (BLRD-CDA-2) and a Merit Award to F. G. S. NR 27 TC 11 Z9 13 U1 0 U2 1 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 SEP PY 2010 VL 140 IS 3 BP 653 EP 659 DI 10.1016/j.jtcvs.2009.12.033 PG 7 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 641HS UT WOS:000281116000024 PM 20219212 ER PT J AU Kilpatrick, LA Ornitz, E Ibrahimovic, H Hubbard, CS Rodriguez, LV Mayer, EA Naliboff, BD AF Kilpatrick, Lisa Ann Ornitz, Edward Ibrahimovic, Hana Hubbard, Catherine S. Rodriguez, Larissa V. Mayer, Emeran A. Naliboff, Bruce D. TI Gating of Sensory Information Differs in Patients With Interstitial Cystitis/Painful Bladder Syndrome SO JOURNAL OF UROLOGY LA English DT Article DE urinary bladder; cystitis, interstitial; startle reaction; female; sensory gating ID PREPULSE INHIBITION; STARTLE; STRESS; SENSORIMOTOR; MODULATION; BRAIN; MEN AB Purpose: Altered sensory processing in interstitial cystitis/painful bladder syndrome cases may result from a deficiency of the central nervous system to adequately filter incoming visceral afferent information. We used prepulse inhibition as an operational measure of sensorimotor gating to examine early pre-attentive stages of information processing in females with interstitial cystitis/painful bladder syndrome and healthy controls. Materials and Methods: We assessed prepulse inhibition in 14 female patients with interstitial cystitis/painful bladder syndrome and 17 healthy controls at 60 and 120-millisecond prepulse-to-startle stimulus intervals. We evaluated group differences in prepulse inhibition, and relationships between prepulse inhibition, neuroticism and acute stress ratings. Results: Patients showed significantly decreased prepulse inhibition at 60 and 120-millisecond prepulse intervals. The prepulse inhibition deficit was related to acute stress ratings in the patients. However, increased neuroticism appeared to mitigate the prepulse inhibition deficit in those with interstitial cystitis/painful bladder syndrome, possibly reflecting greater vigilance. Conclusions: Compared to healthy controls, female patients with interstitial cystitis/painful bladder syndrome had decreased ability to adequately filter incoming information and perform appropriate sensorimotor gating. These results suggest that a possible mechanism for altered interoceptive information processing in interstitial cystitis/painful bladder syndrome cases may be a general deficit in filtering mechanisms due to altered pre-attentive processing. C1 [Rodriguez, Larissa V.] Univ Calif Los Angeles, Dept Urol, Los Angeles, CA 90024 USA. [Ornitz, Edward; Mayer, Emeran A.] Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90095 USA. [Kilpatrick, Lisa Ann; Hubbard, Catherine S.; Mayer, Emeran A.] Univ Calif Los Angeles, Dept Physiol & Med, Div Digest Dis, Los Angeles, CA 90095 USA. [Ornitz, Edward; Mayer, Emeran A.; Naliboff, Bruce D.] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. [Kilpatrick, Lisa Ann; Ornitz, Edward; Ibrahimovic, Hana; Hubbard, Catherine S.; Mayer, Emeran A.; Naliboff, Bruce D.] Univ Calif Los Angeles, Ctr Neurobiol Stress, Los Angeles, CA 90095 USA. [Hubbard, Catherine S.; Naliboff, Bruce D.] Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Rodriguez, LV (reprint author), Univ Calif Los Angeles, Dept Urol, Los Angeles, CA 90024 USA. EM naliboff@ucla.edu RI Kilpatrick, Lisa/E-6995-2015 OI Hubbard, Catherine/0000-0002-9139-2198 FU National Institutes of Health [NR007768, P50 DK64539, R24 AT002681]; Veterans Affairs Medical Research, National Institutes of Health [T32-DK07180-34]; Astellas FX Supported by National Institutes of Health Grants NR007768, P50 DK64539 and R24 AT002681, Veterans Affairs Medical Research, National Institutes of Health GI Training Grant T32-DK07180-34 and a gift from the Virginia Friedhofer Charitable Trust.; Financial interest and/or other relationship with Astellas. NR 30 TC 15 Z9 15 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 SEP PY 2010 VL 184 IS 3 BP 958 EP 963 DI 10.1016/j.juro.2010.04.083 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 636IP UT WOS:000280725600039 PM 20643444 ER PT J AU Joseph, WS Lipsky, BA AF Joseph, Warren S. Lipsky, Benjamin A. TI Medical therapy of diabetic foot infections SO JOURNAL OF VASCULAR SURGERY LA English DT Article ID STAPHYLOCOCCUS-AUREUS; CLASSIFICATION-SYSTEM; VALIDATION; DIAGNOSIS; RISK AB Diabetic foot infections are a common and often serious problem, accounting for a greater number of hospital bed days than any other complication of diabetes. Despite advances in both antibiotic therapy and surgical management, these infections continue to be a major risk factor for amputations of the lower extremity. Although a number of wound size and depth classification systems have been adapted for use in codifying diabetic foot ulcerations, none are specific for infection. In 2003, the International Working Group on the Diabetic Foot developed guidelines for managing diabetic foot infections, including the first severity scale specific for these infections. The following year, the Infectious Diseases Society of America (IDSA) published their Diabetic Foot Infection Guidelines. In this article, we review some of the critical points from the Executive Summary of the IDSA document and provide a commentary following each issue to update the reader on any pertinent changes that have occurred since the publication of the original document in 2004. The importance of a multidisciplinary limb salvage team, apropos this special joint issue of the American Podiatric Medical Association and the Society for Vascular Surgery, cannot be overstated. (J Vase Surg 2010;52:67S-71S.) C1 [Joseph, Warren S.] Roxborough Mem Hosp, Philadelphia, PA USA. Univ Washington, Seattle, WA 98195 USA. [Lipsky, Benjamin A.] VA Puget Sound HCS, Primary Care Clin, Seattle, WA 98195 USA. RP Joseph, WS (reprint author), 1109 Old Ford Rd, Huntingdon Valley, PA 19006 USA. EM wsjoseph@comcast.net OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 16 TC 9 Z9 10 U1 0 U2 5 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 2010 VL 52 SU S BP 67S EP 71S DI 10.1016/j.jvs.2010.06.010 PG 5 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 646VC UT WOS:000281570200010 PM 20804935 ER PT J AU Choi, AI Li, YM Parikh, C Volberding, PA Shlipak, MG AF Choi, Andy I. Li, Yongmei Parikh, Chirag Volberding, Paul A. Shlipak, Michael G. TI Long-term clinical consequences of acute kidney injury in the HIV-infected SO KIDNEY INTERNATIONAL LA English DT Article DE acute kidney injury; cardiovascular disease; end-stage renal disease; HIV; mortality ID ACUTE-RENAL-FAILURE; ACUTE MYOCARDIAL-INFARCTION; OF-VETERANS-AFFAIRS; T-CELL-ACTIVATION; PERITUBULAR CAPILLARIES; ANTIRETROVIRAL THERAPY; CARDIOVASCULAR EVENTS; SERUM CREATININE; DEATH; OUTCOMES AB To evaluate the long-term consequences of acute kidney injury (AKI) in human immunodeficiency virus (HIV)-infected persons, we studied 17,325 patients in a national HIV registry during their first hospitalization. We determined the association of AKI with risk for heart failure, cardiovascular events, end-stage renal disease (ESRD), and mortality beginning 90 days after discharge. Based on AKI Network criteria, 2453 had stage 1; 273 had stage 2 or 3; and 334 had dialysis-requiring AKI. Over a mean follow-up period of 5.7 years, 333 had heart failure, 673 had cardiovascular diseases (CVDs), 348 developed ESRD, and 8405 deaths occurred. In multivariable-adjusted analyses, AKI stage 1 was associated with death and ESRD, but not heart failure or other CVD. Dialysis-requiring AKI had much stronger and significant associations with increased risk for long-term ESRD, and death in addition to heart failure and cardiovascular events. When AKI was reclassified to account for recovery, stage 1 with recovery was still associated with death, but not ESRD. Thus, in this national sample of HIV-infected persons, we found the clinical repercussions of AKI appear to extend beyond the hospital setting contributing to excess cardiovascular risks, ESRD, and mortality. Additionally, AKI affected almost one of six patients with HIV who survived at least 90 days following discharge. Kidney International (2010) 78, 478-485; doi: 10.1038/ki.2010.171; published online 2 June 2010 C1 [Choi, Andy I.; Li, Yongmei; Volberding, Paul A.; Shlipak, Michael G.] San Francisco VA Med Ctr, Dept Med, San Francisco, CA 94121 USA. [Choi, Andy I.; Shlipak, Michael G.] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. [Parikh, Chirag] Yale Univ, New Haven, CT USA. RP Choi, AI (reprint author), San Francisco VA Med Ctr, Dept Med, Box 111J,4150 Clement St, San Francisco, CA 94121 USA. EM andy.choi@ucsf.edu FU National Institutes of Health [K23DK080645-01A1, K23AI65244, R01 DK066488-01]; National Center for Research Resources [KL2 RR024130]; American Heart Association; VA Public Health Strategic Health Care Group FX This study was supported by the National Institutes of Health (K23DK080645-01A1, K23AI65244, R01 DK066488-01), the National Center for Research Resources (KL2 RR024130), the American Heart Association Early Investigator Award, and the VA Public Health Strategic Health Care Group. These funding sources had no involvement in the design or execution of this study. NR 42 TC 54 Z9 56 U1 1 U2 3 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD SEP PY 2010 VL 78 IS 5 BP 478 EP 485 DI 10.1038/ki.2010.171 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 637YX UT WOS:000280856200009 PM 20520594 ER PT J AU Astolfi, A Nannini, M Pantaleo, MA Di Battista, M Heinrich, MC Santini, D Catena, F Corless, CL Maleddu, A Saponara, M Lolli, C Di Scioscio, V Formica, S Biasco, G AF Astolfi, Annalisa Nannini, Margherita Pantaleo, Maria Abbondanza Di Battista, Monica Heinrich, Michael C. Santini, Donatella Catena, Fausto Corless, Christopher L. Maleddu, Alessandra Saponara, Maristella Lolli, Cristian Di Scioscio, Valerio Formica, Serena Biasco, Guido TI A molecular portrait of gastrointestinal stromal tumors: an integrative analysis of gene expression profiling and high-resolution genomic copy number SO LABORATORY INVESTIGATION LA English DT Article DE gastrointestinal stromal tumors; gene expression profiling; SNPs array ID POTENTIAL THERAPEUTIC TARGET; PROGNOSTIC IMPLICATIONS; CHROMOSOME 14; MUTATIONS; GISTS; 22Q; AGGRESSIVENESS; ABERRATIONS; DELETIONS; IMATINIB AB In addition to KIT and PDGFRA mutations, sequential accumulation of other genetic events is involved in the development and progression of gastrointestinal stromal tumors (GISTs). Until recently, the significance of these other alterations has not been thoroughly investigated. We report the first study that integrates gene expression profiling and high-resolution genomic copy number analyses in GIST. Fresh tissue specimens from 25 patients with GIST were collected, and gene expression profiling and high-resolution genomic copy number analyses were performed, using Affymetrix U133Plus and SNP array 6.0. We found that all 21 mutant GIST patients showed both macroscopic cytogenetic alterations and cryptic microdeletions or amplifications, whereas 75% (three of four) of wild-type patients with GIST did not show genomic imbalances. The most frequently observed chromosomal alterations in patients with mutant GIST included 14q complete or partial deletion (17 of 25), 1p deletion (14 of 25) and 22q deletion (10 of 25). Genetic targets of the chromosomal aberrations were selected by integrated analysis of copy number and gene expression data. We detected the involvement of known oncogenes and tumor suppressors including KRAS in chr 12p amplification and KIF1B, PPM1A, NF2 in chr 1p, 14q and 22p deletions, respectively. The genomic segment most frequently altered in mutated samples was the 14q23.1 region, which contains potentially novel tumor suppressors, including DAAM1, RTN1 and DACT1. siRNA-mediated RTN1 downregulation showed evidence for the potential role in GIST pathogenesis. The combination of gene expression profiling and high-resolution genomic copy number analysis offers a detailed molecular portrait of GISTs, providing an essential comprehensive knowledge necessary to guide the discovery of novel target genes involved in tumor development and progression. Laboratory Investigation (2010) 90, 1285-1294; doi:10.1038/labinvest.2010.110; published online 14 June 2010 C1 [Nannini, Margherita; Pantaleo, Maria Abbondanza; Di Battista, Monica; Maleddu, Alessandra; Saponara, Maristella; Lolli, Cristian; Biasco, Guido] Univ Bologna, S Orsola Malpighi Hosp, Dept Hematol & Oncol Sci LA Seragnoli, I-40138 Bologna, Italy. [Astolfi, Annalisa; Pantaleo, Maria Abbondanza; Formica, Serena; Biasco, Guido] Univ Bologna, Interdept Ctr Canc Res G Prodi, I-40138 Bologna, Italy. [Heinrich, Michael C.] Oregon Hlth & Sci Univ, Dept Med, Portland VA Med Ctr, Portland, OR 97201 USA. [Heinrich, Michael C.; Corless, Christopher L.] Oregon Hlth & Sci Univ, Knight Canc Inst, Portland, OR 97201 USA. [Santini, Donatella] Univ Bologna, S Orsola Malpighi Hosp, Pathol Unit, I-40138 Bologna, Italy. [Catena, Fausto] Univ Bologna, S Orsola Malpighi Hosp, Emergency Surg & Transplant Dept, I-40138 Bologna, Italy. [Corless, Christopher L.] Oregon Hlth & Sci Univ, Dept Pathol, Portland VA Med Ctr, Portland, OR 97201 USA. [Di Scioscio, Valerio] Univ Bologna, Univ Hosp S Orsola Malpighi, Div Pneumonefro, Dept Radiol, I-40138 Bologna, Italy. RP Pantaleo, MA (reprint author), Univ Bologna, S Orsola Malpighi Hosp, Dept Hematol & Oncol Sci, Via Massarenti 9, I-40138 Bologna, Italy. EM maria.pantaleo@unibo.it RI Saponara, Maristella/J-9904-2016; nannini, margherita/J-9866-2016 OI Saponara, Maristella/0000-0003-0715-171X; PANTALEO, MARIA ABBONDANZA/0000-0002-0177-6957; NANNINI, MARGHERITA/0000-0002-2103-1960; astolfi, annalisa/0000-0002-2732-0747 FU Fondazione Cassa di Risparmio of Bologna (CARISBO); Fondazione Giuseppe Alazio, Palermo; Vanini-Cavagnino; VA; Life Raft Group FX Research programs on GISTs are supported by Fondazione Cassa di Risparmio of Bologna (CARISBO), Fondazione Giuseppe Alazio, Palermo, and Vanini-Cavagnino grant. This research was also supported in part by A VA Merit Review grant (MCH) and funding from the Life Raft Group (MCH). NR 35 TC 45 Z9 47 U1 0 U2 3 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0023-6837 J9 LAB INVEST JI Lab. Invest. PD SEP PY 2010 VL 90 IS 9 BP 1285 EP 1294 DI 10.1038/labinvest.2010.110 PG 10 WC Medicine, Research & Experimental; Pathology SC Research & Experimental Medicine; Pathology GA 645NN UT WOS:000281467800002 PM 20548289 ER PT J AU Phipps, AI Ichikawa, L Bowles, EJA Carney, PA Kerlikowske, K Miglioretti, DL Buist, DSM AF Phipps, Amanda I. Ichikawa, Laura Bowles, Erin J. A. Carney, Patricia A. Kerlikowske, Karla Miglioretti, Diana L. Buist, Diana S. M. TI Defining menopausal status in epidemiologic studies: A comparison of multiple approaches and their effects on breast cancer rates SO MATURITAS LA English DT Article DE Menopause; Breast cancer; Incidence; Concordance ID MENSTRUAL FACTORS; RISK; TRANSITION; WOMEN AB Objectives: Menopausal status is a common covariate in epidemiologic studies. Still, there are no standard definitions for menopausal status using observational data. This study assesses distinctions between menopausal status definitions using commonly collected epidemiologic data, and explores their impact on study outcomes using breast cancer rates as an example. Study design: Using survey data from 227,700 women aged 40-64 who received screening mammograms from the Breast Cancer Surveillance Consortium, we classified menopausal status under five different definitions: one complex definition combining multiple variables, two definitions using age as a proxy for menopausal status, one based only on menstrual period status, and one based on age and menstrual period status. Main outcome measures: We compared the distribution of menopausal status and menopausal status-specific breast cancer incidence and detection rates across definitions for menopausal status. Results: Overall, 36% and 29% of women were consistently classified as postmenopausal and premenopausal, respectively, across all definitions. Menopausal status-specific breast cancer incidence and detection rates were similar across definitions. Rates were unchanged when information regarding natural menopause, bilateral oophorectomy, hormone therapy, and timing of last menstrual period were sequentially added to definitions of postmenopausal status. Conclusions: Distinctions in menopausal status definitions contribute to notable differences in how women are classified, but translate to only slight differences in menopausal status-specific breast cancer rates. (C) 2010 Elsevier Ireland Ltd. All rights reserved. C1 [Phipps, Amanda I.; Buist, Diana S. M.] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. [Ichikawa, Laura; Bowles, Erin J. A.; Miglioretti, Diana L.; Buist, Diana S. M.] Grp Hlth Res Inst, Seattle, WA 98101 USA. [Carney, Patricia A.] Oregon Hlth & Sci Univ, Dept Family Med, Portland, OR 97239 USA. [Carney, Patricia A.] Oregon Hlth & Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97239 USA. [Kerlikowske, Karla] Univ Calif San Francisco, Dept Med, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. [Kerlikowske, Karla] Univ Calif San Francisco, Dept Epidemiol, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. [Kerlikowske, Karla] Univ Calif San Francisco, Dept Biostat, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. [Miglioretti, Diana L.] Univ Washington, Dept Biostat, Seattle, WA 98195 USA. RP Phipps, AI (reprint author), Univ Washington, Dept Epidemiol, 1959 NE Pacific St,Hlth Sci Bldg F-262,Box 357236, Seattle, WA 98195 USA. EM aiphipps@u.washington.edu FU National Cancer Institute (NCI), NIH [T32 CA09168]; NCI [U01CA63740, U01CA86076, U01CA86082, U01CA63736, U01CA70013, U01CA69976, U01CA63731, U01CA70040] FX Data collection for this work was supported by a NCI-funded Breast Cancer Surveillance Consortium co-operative agreement (U01CA63740, U01CA86076, U01CA86082, U01CA63736, U01CA70013, U01CA69976, U01CA63731, U01CA70040). This publication was supported by grant number T32 CA09168 from the National Cancer Institute (NCI), NIH. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCI, NIH. NR 16 TC 27 Z9 27 U1 0 U2 1 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0378-5122 J9 MATURITAS JI Maturitas PD SEP PY 2010 VL 67 IS 1 BP 60 EP 66 DI 10.1016/j.maturitas.2010.04.015 PG 7 WC Geriatrics & Gerontology; Obstetrics & Gynecology SC Geriatrics & Gerontology; Obstetrics & Gynecology GA 651QU UT WOS:000281943000013 PM 20494530 ER PT J AU Schwarz, EB Longo, LS Zhao, XH Stone, RA Cunningham, F Good, CB AF Schwarz, Eleanor Bimla Longo, Lisa S. Zhao, Xinhua Stone, Roslyn A. Cunningham, Francesca Good, Chester B. TI Provision of Potentially Teratogenic Medications to Female Veterans of Childbearing Age SO MEDICAL CARE LA English DT Article DE women; preconception counseling; medication safety; contraception ID UNITED-STATES; BIRTH-DEFECTS; CARE; PREGNANCY; HEALTH; WOMEN; PRECONCEPTION; PRESCRIPTION AB Background: Certain medications increase the risk of birth defects whether used during pregnancy or immediately preconception. Objectives: To describe dispensing of potentially teratogenic medications (Food and Drug Administration classes D or X) to female Veterans treated by the Veterans Affairs (VA) Healthcare System, and assess whether documented provision of family planning services is more common when potentially teratogenic medications are prescribed. Research Design: We examined all 2,634,441 prescriptions filled in fiscal year 2007 or 2008 by 78,232 female Veterans, aged 18 to 45, who made >= 2 visits to VA clinics within the year prior to medication dispensing from VA pharmacies. Measures: Medications dispensed, contraceptive counseling, and pregnancy testing. Results: Prescriptions for potentially teratogenic medications were filled by 48.8% of female Veterans who received medications from a VA pharmacy. Women who filled prescriptions for potentially teratogenic medications were only slightly more likely to have documented family planning services (eg, contraception, contraceptive counseling, or pregnancy testing) than women who filled class C, but not class D or X, prescriptions (55.7% vs. 51.8%). Women filling only class A or B prescriptions were least likely to have documented family planning services (35.9%). Among women dispensed potentially teratogenic medications, family planning services were significantly more likely to be documented for women who were >= 25 years (odds ratio [OR], 2.82; 95% confidence interval [CI], 2.57-3.11), unmarried (OR, 1.30; 95% CI, 1.23-1.35), non-White (OR, 1.17; 95% CI, 1.09-1.26), seen at a women's clinic (OR, 1.96; 95% CI, 1.88-2.05), received a retinoid medication (OR, 7.72; 95% CI, 3.02- 19.7), or had serious mental illness (OR, 1.26; 95% CI, 1.18-1.34). Conclusions: Medications that may cause birth defects if used during pregnancy are dispensed frequently to female Veterans by VA pharmacies without documented receipt of contraceptive counseling or pregnancy testing. C1 [Schwarz, Eleanor Bimla] Univ Pittsburgh, Ctr Res Hlth Care, Dept Obstet, Pittsburgh, PA 15213 USA. [Schwarz, Eleanor Bimla] Univ Pittsburgh, Dept Gynecol, Pittsburgh, PA 15213 USA. [Schwarz, Eleanor Bimla] Univ Pittsburgh, Dept Reprod Sci, Pittsburgh, PA 15213 USA. [Schwarz, Eleanor Bimla; Stone, Roslyn A.] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15213 USA. [Schwarz, Eleanor Bimla; Good, Chester B.] Univ Pittsburgh, Dept Med, Pittsburgh, PA 15213 USA. [Longo, Lisa S.] Vet Affairs Pharm Benefits Management Serv, Pittsburgh, PA USA. [Zhao, Xinhua; Stone, Roslyn A.; Good, Chester B.] Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Cunningham, Francesca] Vet Affairs Pharm Benefits Management Serv, Vet Affairs Ctr Medicat Safety, Hines, IL USA. RP Schwarz, EB (reprint author), Univ Pittsburgh, Ctr Res Hlth Care, Dept Obstet, 230 McKee Pl,Suite 600, Pittsburgh, PA 15213 USA. EM schwarzeb@upmc.edu OI Schwarz, Eleanor Bimla/0000-0002-9912-8236 FU National Institute of Child Health and Development [K23HD051585]; Department of Veterans Affairs (VA Pittsburgh Healthcare System, Pittsburgh, PA; VA Hospital, Hines, IL FX Supported by a career development award from the National Institute of Child Health and Development, K23HD051585. Also supported in part by the Department of Veterans Affairs (VA Pittsburgh Healthcare System, Pittsburgh, PA and Edward Hines, Jr. VA Hospital, Hines, IL). NR 22 TC 17 Z9 17 U1 0 U2 1 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 SEP PY 2010 VL 48 IS 9 BP 834 EP 842 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 641JZ UT WOS:000281122800011 PM 20706159 ER PT J AU Sun, HY Alexander, BD Lortholary, O Dromer, F Forrest, GN Lyon, GM Somani, J Gupta, KL Del Busto, R Pruett, TL Sifri, CD Limaye, AP John, GT Klintmalm, GB Pursell, K Stosor, V Morris, MI Dowdy, LA Munoz, P Kalil, AC Garcia-Diaz, J Orloff, SL House, AA Houston, SH Wray, D Huprikar, S Johnson, LB Humar, A Razonable, RR Fisher, RA Husain, S Wagener, MM Singh, N AF Sun, Hsin-Yun Alexander, Barbara D. Lortholary, Olivier Dromer, Francoise Forrest, Graeme N. Lyon, G. Marshall Somani, Jyoti Gupta, Krishan L. Del Busto, Ramon Pruett, Timothy L. Sifri, Costi D. Limaye, Ajit P. John, George T. Klintmalm, Goran B. Pursell, Kenneth Stosor, Valentina Morris, Michele I. Dowdy, Lorraine A. Munoz, Patricia Kalil, Andre C. Garcia-Diaz, Julia Orloff, Susan L. House, Andrew A. Houston, Sally H. Wray, Dannah Huprikar, Shirish Johnson, Leonard B. Humar, Atul Razonable, Raymund R. Fisher, Robert A. Husain, Shahid Wagener, Marilyn M. Singh, Nina CA CRYPTOCOCCAL COLLABORATIVE TI Cutaneous cryptococcosis in solid organ transplant recipients SO MEDICAL MYCOLOGY LA English DT Article DE Cryptococcus; transplants; fungal infections ID IMMUNE RECONSTITUTION SYNDROME; RENAL-ALLOGRAFT RECIPIENT; HEMATOPOIETIC STEM-CELL; NEOFORMANS INFECTION; CLINICAL-RELEVANCE; CELLULITIS; TUBERCULOSIS; THERAPY; MYCOSES AB Clinical manifestations, treatment, and outcomes of cutaneous cryptococcosis in solid organ transplant (SOT) recipients are not fully defined. In a prospective cohort comprising 146 SOT recipients with cryptococcosis, we describe the presentation, antifungal therapy, and outcome of cutaneous cryptococcal disease. Cutaneous cryptococcosis was documented in 26/146 (17.8%) of the patients and manifested as nodular/mass (34.8%), maculopapule (30.4%), ulcer/pustule/abscess (30.4%), and cellulitis (30.4%) with 65.2% of the skin lesions occurred in the lower extremities. Localized disease developed in 30.8% (8/26), and disseminated disease in 69.2% (18/26) with involvement of the central nervous system (88.9%, 16/18), lung (33.3%, 6/18), or fungemia (55.6%, 10/18). Fluconazole (37.5%) was employed most often for localized and lipid formulations of amphotericin B (61.1%) for disseminated disease. Overall mortality at 90 days was 15.4% (4/26) with 16.7% in disseminated and 12.5% in localized disease (P = 0.78). SOT recipients who died were more likely to have renal failure (75.0% vs. 13.6%, P = 0.028), longer time to onset of disease after transplantation (87.5 vs. 22.6 months, P = 0.023), and abnormal mental status (75% vs. 13.6%, P = 0.028) than those who survived. Cutaneous cryptococcosis represents disseminated disease in most SOT recipients and preferentially involves the extremities. Outcomes with appropriate management were comparable between SOT recipients with localized and disseminated cryptococcosis. C1 [Singh, Nina] VA Pittsburgh Healthcare Syst, Infect Dis Sect, Pittsburgh, PA 15240 USA. [Sun, Hsin-Yun] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei 100, Taiwan. [Sun, Hsin-Yun] Natl Taiwan Univ, Coll Med, Taipei 10764, Taiwan. [Alexander, Barbara D.] Duke Univ, Med Ctr, Durham, NC USA. [Lortholary, Olivier; Dromer, Francoise] Inst Pasteur, Paris, France. [Lortholary, Olivier] Hop Necker Enfants Malad, Fac Med Paris Descartes, Paris, France. [Forrest, Graeme N.] Univ Maryland, Sch Med, Baltimore, MD 21201 USA. [Lyon, G. Marshall; Somani, Jyoti] Emory Univ, Atlanta, GA 30322 USA. [Gupta, Krishan L.] Postgrad Inst Med Educ & Res, Chandigarh 160012, India. [Del Busto, Ramon] Henry Ford Hosp, Detroit, MI 48202 USA. [Pruett, Timothy L.; Sifri, Costi D.] Univ Virginia, Charlottesville, VA USA. [Limaye, Ajit P.] Univ Washington, Seattle, WA 98195 USA. [John, George T.] Christian Med Coll & Hosp, Vellore, Tamil Nadu, India. [Klintmalm, Goran B.] Baylor Univ, Med Ctr, Dallas, TX USA. [Pursell, Kenneth] Univ Chicago, Chicago, IL 60637 USA. [Stosor, Valentina] Northwestern Univ, Chicago, IL 60611 USA. [Morris, Michele I.; Dowdy, Lorraine A.] Univ Miami, Miller Sch Med, Miami, FL 33136 USA. [Munoz, Patricia] Hosp Gen Univ Gregorio Maranon, Madrid, Spain. [Munoz, Patricia] CIBER Enfermedades Respiratorias CIBERES, Madrid, Spain. [Kalil, Andre C.] Univ Nebraska, Omaha, NE 68182 USA. [Garcia-Diaz, Julia] Ochsner Clin & Alton Ochsner Med Fdn, Orleans, LA USA. [Orloff, Susan L.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [House, Andrew A.] Univ Western Ontario, London, ON, Canada. [Houston, Sally H.] Tampa Gen Hosp, Tampa, FL 33606 USA. [Wray, Dannah] Med Univ S Carolina, Charleston, SC 29425 USA. [Huprikar, Shirish] Mt Sinai Med Ctr, New York, NY 10029 USA. [Johnson, Leonard B.] St Johns Hosp, Detroit, MI USA. [Humar, Atul] Toronto Gen Hosp, Univ Hlth Network, Toronto, ON, Canada. [Razonable, Raymund R.] Mayo Clin, Rochester, MN USA. [Fisher, Robert A.] Virginia Commonwealth Univ, Richmond, VA USA. [Husain, Shahid; Wagener, Marilyn M.; Singh, Nina] Univ Pittsburgh, Pittsburgh, PA USA. RP Singh, N (reprint author), VA Pittsburgh Healthcare Syst, Infect Dis Sect, Univ Dr C, Pittsburgh, PA 15240 USA. EM nis5@pitt.edu RI khan, raja/B-5726-2012; Garcia-Diaz, Julia/D-3555-2011 OI SUN, HSIN-YUN/0000-0003-0074-7721; Munoz Garcia, Patricia Carmen/0000-0001-5706-5583 FU National Institutes of Health; National Institute of Allergy and Infectious Diseases [R01 AI 054719-01] FX National Institutes of Health, National Institute of Allergy and Infectious Diseases (R01 AI 054719-01 to Nina Singh). NR 26 TC 17 Z9 17 U1 0 U2 0 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1369-3786 J9 MED MYCOL JI Med. Mycol. PD SEP PY 2010 VL 48 IS 6 BP 785 EP 791 DI 10.3109/13693780903496617 PG 7 WC Infectious Diseases; Mycology; Veterinary Sciences SC Infectious Diseases; Mycology; Veterinary Sciences GA 654WA UT WOS:000282200500001 PM 20100136 ER PT J AU Kirkpatrick, WR Zimmerman, JD Haikal, FP Broker, MJ Brockway, E Fothergill, AW McCarthy, DI Patterson, TF Redding, SW AF Kirkpatrick, William R. Zimmerman, Joseph D. Haikal, Fadi P. Broker, Michael J. Brockway, Erin Fothergill, Annette W. McCarthy, Dora I. Patterson, Thomas F. Redding, Spencer W. TI Screening for drug-resistant Candida yeasts with chromogenic agar SO MEDICAL MYCOLOGY LA English DT Article DE Candida; resistance; echinocandin; azole ID PATIENTS RECEIVING RADIATION; DISK DIFFUSION METHODS; IN-VITRO ACTIVITIES; ANTIFUNGAL SUSCEPTIBILITY; ORAL COLONIZATION; SEPSIS SECONDARY; AMPHOTERICIN-B; NECK-CANCER; CASPOFUNGIN; GLABRATA AB We examined the utility of agar dilution to screen yeasts for reduced susceptibility to several newer antifungal drugs including echinocandins and azoles. We compared agar dilution susceptibility screening with the Clinical and Laboratory Standards Institute (CLSI) method for Candida isolates. We added echinocandins and azoles to CHROMagar Candida medium prior to its solidification. Assessment of resistance was based on growth characteristics, wherein decreased colony size in the presence of antifungal drugs was used as an indicator of susceptibility. Clinical Candida isolates of C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, C. guilliermondii, C. lusitaniae, C. rugosa and C. dubliniensis were screened for drug susceptibility. Overall, antifungal susceptibility of the yeasts to anidulafungin, caspofungin, micafungin, posaconazole and voriconazole, determined using CHROMagar agar dilution, were shown to be 96, 80, 94, 90 and 97% as accurate, respectively, as those determined by the CLSI method, i.e., within one tube dilution of CLSI MICs. Categorical errors by percentage had a broader range. Major errors noted with anidulafungin, caspofungin and micafungin were 3, 6 and 0%, respectively, while very major errors were 15, 55 and 38%, respectively. Major errors with posaconazole and voriconazole were 12 and 0%, respectively, while very major errors were 0 and 22%, respectively, compared to CLSI standards. Most of the assessment errors were found with C. glabrata and C. parapsilosis. Agar dilution screening for drug susceptibility with the current panel of antifungal drugs is rapid, accurate and effective. However, the determination of resistance or non-susceptibility in yeasts may be more problematic, and may be species dependent. C1 [Zimmerman, Joseph D.; Haikal, Fadi P.; Broker, Michael J.; Redding, Spencer W.] Univ Texas Hlth Sci Ctr San Antonio, Dept Dent Diagnost Sci, San Antonio, TX 78229 USA. [Kirkpatrick, William R.; Brockway, Erin; Patterson, Thomas F.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. [Fothergill, Annette W.; McCarthy, Dora I.; Patterson, Thomas F.] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. [Redding, Spencer W.] S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Redding, SW (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Dent Diagnost Sci, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM redding@uthscsa.edu FU National Institute of Dental and Craniofacial Research; National Institutes of Health NIH [DE14318, NIH NIDCR 5R01-DE018096] FX This project was funded in part by federal funds from the National Institute of Dental and Craniofacial Research, National Institutes of Health, under Contract No. NIH NIDCR 5R01-DE018096 and NIH Grant #DE14318 for the COSTAR Program. NR 21 TC 2 Z9 2 U1 0 U2 1 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1369-3786 J9 MED MYCOL JI Med. Mycol. PD SEP PY 2010 VL 48 IS 6 BP 807 EP 816 DI 10.3109/13693780903514542 PG 10 WC Infectious Diseases; Mycology; Veterinary Sciences SC Infectious Diseases; Mycology; Veterinary Sciences GA 654WA UT WOS:000282200500004 PM 20109095 ER PT J AU Palacio-Bedoya, F Cadena, JA Thompson, GR Sutton, DA Owens, AD Patterson, TF AF Palacio-Bedoya, Federico Cadena, Jose A. Thompson, George R., III Sutton, Deanna A. Owens, Aaron D. Patterson, Thomas F. TI A noninvasive renal fungus ball caused by Rhizopus - a previously unreported manifestation of zygomycosis SO MEDICAL MYCOLOGY LA English DT Article DE zygomycetes; Rhizopus; fungus ball; renal; mucormycosis ID SALVAGE THERAPY; POSACONAZOLE; ASPERGILLUS; MANAGEMENT; CANDIDIASIS; DISEASE AB We describe the first reported case of renal zygomycosis presenting as an isolated fungus ball (bezoar) without renal parenchymal invasion. Since all previous descriptions of renal involvement have discussed tissue invasion, our case is unique in that the infection was confined solely in the renal pelvis and extended to the distal ureter without signs of contiguous renal infection. Our patient later developed renal insufficiency while receiving amphotericin B Lipid Complex (ABLC). The therapy was changed to posaconazole with subsequent clinical, mycologic, and radiographic improvement and the patient has remained free of recurrence 5 years after diagnosis. C1 [Thompson, George R., III] Univ Calif Davis, Dept Internal Med, Div Infect Dis, Sacramento, CA 95817 USA. [Palacio-Bedoya, Federico; Owens, Aaron D.] Univ Texas Hlth Sci Ctr San Antonio, Dept Internal Med, Div Hosp Med, San Antonio, TX USA. [Palacio-Bedoya, Federico; Cadena, Jose A.; Thompson, George R., III; Owens, Aaron D.; Patterson, Thomas F.] Univ Texas Hlth Sci Ctr San Antonio, Dept Internal Med, Div Infect Dis, San Antonio, TX USA. [Sutton, Deanna A.] Univ Texas Hlth Sci Ctr San Antonio, Dept Microbiol, Fungus Testing Lab, San Antonio, TX USA. [Palacio-Bedoya, Federico; Cadena, Jose A.; Thompson, George R., III; Patterson, Thomas F.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Thompson, GR (reprint author), Univ Calif Davis, Dept Internal Med, Div Infect Dis, 4150 V St, Sacramento, CA 95817 USA. EM george.thompson@ucdmc.ucdavis.edu FU Basilea; Merck; Pfizer FX G.R.T. has served as a consultant for Basilea. T.F.P. has received research support from Basilea, Merck, Pfizer, and Schering-Plough, has received speaking fees from Merck and Pfizer, and as a consultant for Basilea, Merck, Nektar, Pfizer, and Toyama. NR 20 TC 2 Z9 2 U1 0 U2 1 PU INFORMA HEALTHCARE PI LONDON PA TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND SN 1369-3786 EI 1460-2709 J9 MED MYCOL JI Med. Mycol. PD SEP PY 2010 VL 48 IS 6 BP 866 EP 869 DI 10.3109/13693781003694796 PG 4 WC Infectious Diseases; Mycology; Veterinary Sciences SC Infectious Diseases; Mycology; Veterinary Sciences GA 654WA UT WOS:000282200500014 PM 20353310 ER PT J AU Goedecke, JH Utzschneider, K Faulenbach, MV Rizzo, M Berneis, K Spinas, GA Dave, JA Levitt, NS Lambert, EV Olsson, T Kahn, SE AF Goedecke, Julia H. Utzschneider, Kristina Faulenbach, Mirjam V. Rizzo, Manfredi Berneis, Kaspar Spinas, Giatgen A. Dave, Joel A. Levitt, Naomi S. Lambert, Estelle V. Olsson, Tommy Kahn, Steven E. TI Ethnic differences in serum lipoproteins and their determinants in South African women SO METABOLISM-CLINICAL AND EXPERIMENTAL LA English DT Article ID INSULIN-RESISTANCE; METABOLIC SYNDROME; RISK-FACTORS; MYOCARDIAL-INFARCTION; TRIGLYCERIDE LEVELS; FAT DISTRIBUTION; ADIPOSE-TISSUE; CHOLESTEROL; OBESITY; LIPASE AB The objective of the study was to characterize ethnic differences in lipid levels and low-density lipoprotein (LDL) particle size and subclasses in black and white South African women and to explore the associations with insulin sensitivity (S-1), body composition, and lifestyle factors Fasting scrum lipids and LDL size and subclasses, body composition (dual-energy x-ray absorptiometry), and S-1 (frequently sampled intravenous glucose tolerance test) were measured in normal-weight (body mass index <25 kg/m(2)) black (n = 15) and white (n = 15), and obese (body mass index >30 kg/m(2)) black (n = 13) and white (n = 13) women. Normal-weight and obese black women had lower triglycerides (0 59 +/- 0 09 and 0 77 +/- 0 10 vs 0.89 +/- 0 09 and 0.93 +/- 0 10 mmol/L, P < 05) and high-density lipoprotein cholesterol (1 2 +/- 0 1 and 1 1 +/- 0.1 vs 1 7 +/- 0 1 and 1 6 +/- 0 3 mmol/L, P < 01) than white women. The LDL particle size was not different, but obese black women had more LDL subclass IV (17 3% +/- 1 0% vs 12 5% +/- 1.0%, P < 01) In white women, triglycerides and LDL particle size correlated with S-1 (P < 01), whereas cholesterol levels correlated with body fat (P < .05) Low socioeconomic status, low dietary protein intake, and injectable contraceptive use were the major determinants of unfavorable lipid profiles in black women Black women had lower triglyceride and high-density lipoprotein cholesterol levels and more small dense LDL particles than white women The major determinants of serum lipids in black women were socioeconomic status and lifestyle factors, whereas in white women, S-1 and body composition most closely correlated with scrum lipids (C) 2010 Elsevier Inc All rights reserved C1 [Goedecke, Julia H.; Lambert, Estelle V.] Univ Cape Town, Dept Human Biol, UCT MRC Res Unit Exercise Sci & Sports Med, ZA-7700 Rondebosch, South Africa. [Goedecke, Julia H.] S African MRC, Cape Town, South Africa. [Utzschneider, Kristina; Faulenbach, Mirjam V.; Kahn, Steven E.] Univ Washington, Seattle, WA 98195 USA. [Utzschneider, Kristina; Faulenbach, Mirjam V.; Kahn, Steven E.] VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA USA. [Rizzo, Manfredi] Univ Palermo, Dept Clin Med & Emerging Dis, I-90133 Palermo, Italy. [Berneis, Kaspar; Spinas, Giatgen A.] Univ Zurich Hosp, Div Endocrinol Diabet & Clin Nutr, Zurich, Switzerland. [Berneis, Kaspar] Zurich Ctr Integrat Human Physiol, Zurich, Switzerland. [Dave, Joel A.; Levitt, Naomi S.] Univ Cape Town, Dept Med, Endocrine Unit, ZA-7700 Rondebosch, South Africa. [Olsson, Tommy] Umea Univ, Dept Med, S-90187 Umea, Sweden. RP Goedecke, JH (reprint author), Univ Cape Town, UCT MRC Res Unit Exercise Sci & Sports Med, 3rd Floor Sports Sci Inst S Africa,POB 115, ZA-7725 Newlands, South Africa. RI Goedecke, Julia/J-8628-2013; Goedecke, Julia/E-1820-2016 OI Goedecke, Julia/0000-0001-6795-4771; Goedecke, Julia/0000-0001-6795-4771; Olsson, Tommy/0000-0001-7768-1076; RIZZO, Manfredi/0000-0002-9549-8504; Kahn, Steven/0000-0001-7307-9002 FU Medical Research Council of South Africa; International Atomic Energy Agency; National Research Foundation of South Africa; Royal Society SA-UK; University of Cape Town; United States Department of Veterans Affairs FX This study was funded by the Medical Research Council of South Africa, the International Atomic Energy Agency, the National Research Foundation of South Africa and Royal Society SA-UK Science Networks Programme, the University of Cape Town, and the United States Department of Veterans Affairs. There are no conflicts of interest. NR 36 TC 21 Z9 21 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 0026-0495 EI 1532-8600 J9 METABOLISM JI Metab.-Clin. Exp. PD SEP PY 2010 VL 59 IS 9 BP 1341 EP 1350 DI 10.1016/j.metabol.2009.12.018 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 645SY UT WOS:000281487700015 PM 20096899 ER PT J AU Szymczak, JE Brooks, JV Volpp, KG Bosk, CL AF Szymczak, Julia E. Brooks, Joanna Veazey Volpp, Kevin G. Bosk, Charles L. TI To Leave or to Lie? Are Concerns about a Shift-Work Mentality and Eroding Professionalism as a Result of Duty-Hour Rules Justified? SO MILBANK QUARTERLY LA English DT Article DE Internship; residency; duty-hour regulations; professionalism ID HOURS REFORM; RESIDENTS; REGULATIONS; MORTALITY; RESTRICTIONS; ATTITUDES; EDUCATION; MEDICINE; SURGEONS; LIMITS AB Methods: In 2008, we conducted three months of ethnographic observation of internal medicine and general surgery residents as they went about their everyday work in two hospitals affiliated with the same training program, as well as in-depth interviews with seventeen residents. Field notes and interview transcripts were analyzed for perceptions and behaviors in regard to beginning and leaving work, reporting duty hours, and expressing opinions about DHR. Findings: The respondents did not exhibit a "shift work" mentality in relation to their work. We found that residents: (1) occasionally stay in the hospital in order to complete patient care tasks even when, according to the clock, they are required to leave, because the organizational culture stresses performing work thoroughly, (2) do not blindly embrace noncompliance with DHR but are thoughtful about the tradeoffs inherent in the regulations, and (3) express nuanced and complex reasons for erroneously reporting duty hours, suggesting that reporting hours worked is not a simple issue of lying or truth telling. Conclusions: Concerns about DHR and the erosion of resident professionalism resulting from the development of a "shift work" mentality likely have been overstated. Instead, the influence of DHR on professionalism is more complex than the conventional wisdom suggests and requires additional assessment. C1 [Bosk, Charles L.] Univ Penn, Dept Sociol, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Bosk, CL (reprint author), Univ Penn, Dept Sociol, 3718 Locust Walk,Suite 113, Philadelphia, PA 19104 USA. EM cbosk@sas.upenn.edu FU U.S. Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development [SHP 08-178]; Robert Wood Johnson Health Investigator Award FX This work was supported by the U.S. Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development (SHP 08-178). Charles L. Bosk received additional support from a Robert Wood Johnson Health Investigator Award. We thank Jacob Avery and Keri Monahan for their substantial data collection efforts. Without their commitment, we would have offered only a thin, rather than a thick, description. Mary Dixon-Woods of the University of Leicester anticipated one of our reviewers' objections, which speeded up the revision. Finally, we would like to thank the editor and reviewers of The Milbank Quarterly for their insightful comments and suggestions. NR 40 TC 26 Z9 26 U1 1 U2 8 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0887-378X J9 MILBANK Q JI Milbank Q. PD SEP PY 2010 VL 88 IS 3 BP 350 EP 381 PG 32 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 654QA UT WOS:000282181900004 PM 20860575 ER PT J AU Yao, JK Dougherty, GG Reddy, RD Keshavan, MS Montrose, DM Matson, WR Rozen, S Krishnan, RR McEvoy, J Kaddurah-Daouk, R AF Yao, J. K. Dougherty, G. G., Jr. Reddy, R. D. Keshavan, M. S. Montrose, D. M. Matson, W. R. Rozen, S. Krishnan, R. R. McEvoy, J. Kaddurah-Daouk, R. TI Altered interactions of tryptophan metabolites in first-episode neuroleptic-naive patients with schizophrenia SO MOLECULAR PSYCHIATRY LA English DT Article DE Trp; N-acetylserotonin; 5-hydroxyindoleacetic acid; schizophrenia; first-episode neuroleptic naive; targeted metabolomics ID PERFORMANCE LIQUID-CHROMATOGRAPHY; PLATELET SEROTONIN CONCENTRATION; ENDOGENOUS KYNURENIC ACID; CEREBROSPINAL-FLUID; LIPID-PEROXIDATION; N-ACETYLSEROTONIN; 5-HYDROXYINDOLEACETIC ACID; METABOLOMIC ANALYSIS; DIETARY TRYPTOPHAN; OXIDATIVE DAMAGE AB Schizophrenia is characterized by complex and dynamically interacting perturbations in multiple neurochemical systems. In the past, evidence for these alterations has been collected piecemeal, limiting our understanding of the interactions among relevant biological systems. Earlier, both hyper- and hyposerotonemia were variously associated with the longitudinal course of schizophrenia, suggesting a disturbance in the central serotonin (5-hydroxytryptamine (5-HT)) function. Using a targeted electrochemistry-based metabolomics platform, we compared metabolic signatures consisting of 13 plasma tryptophan (Trp) metabolites simultaneously between first-episode neuroleptic-naive patients with schizophrenia (FENNS, n = 25) and healthy controls (HC, n = 30). We also compared these metabolites between FENNS at baseline (BL) and 4 weeks (4w) after antipsychotic treatment. N-acetylserotonin was increased in FENNS-BL compared with HC (P = 0.0077, which remained nearly significant after Bonferroni correction). N-acetylserotonin/Trp and melatonin (Mel)/serotonin ratios were higher, and Mel/N-acetylserotonin ratio was lower in FENNS-BL (all P-values < 0.0029), but not after treatment, compared with HC volunteers. All three groups had highly significant correlations between Trp and its metabolites, Mel, kynurenine, 3-hydroxykynurenine and tryptamine. However, in the HC, but in neither of the FENNS groups, serotonin was highly correlated with Trp, Mel, kynurenine or tryptamine, and 5-hydroxyindoleacetic acid (5HIAA) was highly correlated with Trp, Mel, kynurenine or 3-hydroxykynurenine. A significant difference between HC and FENNS-BL was further shown only for the Trp-5HIAA correlation. Thus, some metabolite interactions within the Trp pathway seem to be altered in the FENNS-BL patients. Conversion of serotonin to N-acetylserotonin by serotonin N-acetyltransferase may be upregulated in FENNS patients, possibly related to the observed alteration in Trp-5HIAA correlation. Considering N-acetylserotonin as a potent antioxidant, such increases in N-acetylserotonin might be a compensatory response to increased oxidative stress, implicated in the pathogenesis of schizophrenia. Molecular Psychiatry (2010) 15, 938-953; doi:10.1038/mp.2009.33;published online 28 April 2009 C1 [Yao, J. K.] VA Pittsburgh Healthcare Syst, Neurochem & Psychopharmacol Lab, Pittsburgh, PA 15206 USA. [Yao, J. K.; Dougherty, G. G., Jr.; Reddy, R. D.; Keshavan, M. S.; Montrose, D. M.] Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat, Med Ctr, Pittsburgh, PA 15213 USA. [Yao, J. K.] Univ Pittsburgh, Sch Pharm, Dept Pharmaceut Sci, Pittsburgh, PA 15261 USA. [Keshavan, M. S.] Wayne State Univ, Dept Psychiat & Behav Neurosci, Detroit, MI USA. [Keshavan, M. S.] Beth Israel Deaconess Med Ctr, Dept Psychiat, Boston, MA 02215 USA. [Keshavan, M. S.] Harvard Univ, Boston, MA 02115 USA. [Matson, W. R.] Bedford VA Med Ctr, Bedford, MA USA. [Rozen, S.] Whitehead Inst Biomed Res, Cambridge, MA 02142 USA. [Krishnan, R. R.; McEvoy, J.; Kaddurah-Daouk, R.] Duke Univ, Med Ctr, Durham, NC USA. RP Yao, JK (reprint author), VA Pittsburgh Healthcare Syst, Neurochem & Psychopharmacol Lab, Bldg 13,151R2-H,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM jkyao@pitt.edu OI Rozen, Steven G./0000-0002-4288-0056 FU Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Biomedical Laboratory RD; Senior Research Career Scientist Award; VA Pittsburgh Healthcare System; National Institute of Health [MH58141, MH64118, MH45203, R24 GM078233, UL1 RR024153]; NIH/NCRR/GCRC [M01 RR00056]; Metabolomics Research Network; Stanley Medical Research Institute; NARSAD FX This material is based on work supported in part by the grants from the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Biomedical Laboratory R&D (Merit Reviews (JKY) and Senior Research Career Scientist Award (JKY)), VA Pittsburgh Healthcare System (JKY, GGD, RDR), National Institute of Health (MH58141 (JKY), MH64118 (RDR), MH45203 (MSK), R24 GM078233 (RKD), c UL1 RR024153 and NIH/NCRR/GCRC Grant M01 RR00056), Metabolomics Research Network (RKD); Stanley Medical Research Institute (RKD), and NARSAD (RKD). The authors are grateful to Drs Nina Schooler, Cameron Carter and Gretchen Haas, and the clinical core staff of the Center for the Neuroscience of Mental Disorders (MH45156, David Lewis MD, Director) for their assistance in diagnostic and psychopathological assessments, and to P Cheng, C Korbanic and J Haflett for their technical assistance. NR 94 TC 45 Z9 47 U1 2 U2 18 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 SEP PY 2010 VL 15 IS 9 BP 938 EP 953 DI 10.1038/mp.2009.33 PG 16 WC Biochemistry & Molecular Biology; Neurosciences; Psychiatry SC Biochemistry & Molecular Biology; Neurosciences & Neurology; Psychiatry GA 648EB UT WOS:000281672100009 PM 19401681 ER PT J AU Maestrini, E Pagnamenta, AT Lamb, JA Bacchelli, E Sykes, NH Sousa, I Toma, C Barnby, G Butler, H Winchester, L Scerri, TS Minopoli, F Reichert, J Cai, G Buxbaum, JD Korvatska, O Schellenberg, GD Dawson, G de Bildt, A Minderaa, RB Mulder, EJ Morris, AP Bailey, AJ Monaco, AP AF Maestrini, E. Pagnamenta, A. T. Lamb, J. A. Bacchelli, E. Sykes, N. H. Sousa, I. Toma, C. Barnby, G. Butler, H. Winchester, L. Scerri, T. S. Minopoli, F. Reichert, J. Cai, G. Buxbaum, J. D. Korvatska, O. Schellenberg, G. D. Dawson, G. de Bildt, A. Minderaa, R. B. Mulder, E. J. Morris, A. P. Bailey, A. J. Monaco, A. P. CA IMGSAC TI High-density SNP association study and copy number variation analysis of the AUTS1 and AUTS5 loci implicate the IMMP2L-DOCK4 gene region in autism susceptibility SO MOLECULAR PSYCHIATRY LA English DT Article DE autistic disorder; disease susceptibility; single nucleotide polymorphisms; linkage disequilibrium; chromosome 7; chromosome 2 ID LINKED MENTAL-RETARDATION; PERVASIVE DEVELOPMENTAL DISORDERS; MULTILOCUS GENOTYPE DATA; CANDIDATE GENES; SPECTRUM DISORDERS; LINKAGE ANALYSES; CHROMOSOME 7Q; ARRAY-CGH; GENOME; MUTATIONS AB Autism spectrum disorders are a group of highly heritable neurodevelopmental disorders with a complex genetic etiology. The International Molecular Genetic Study of Autism Consortium previously identified linkage loci on chromosomes 7 and 2, termed AUTS1 and AUTS5, respectively. In this study, we performed a high-density association analysis in AUTS1 and AUTS5, testing more than 3000 single nucleotide polymorphisms (SNPs) in all known genes in each region, as well as SNPs in non-genic highly conserved sequences. SNP genotype data were also used to investigate copy number variation within these regions. The study sample consisted of 127 and 126 families, showing linkage to the AUTS1 and AUTS5 regions, respectively, and 188 gender-matched controls. Further investigation of the strongest association results was conducted in an independent European family sample containing 390 affected individuals. Association and copy number variant analysis highlighted several genes that warrant further investigation, including IMMP2L and DOCK4 on chromosome 7. Evidence for the involvement of DOCK4 in autism susceptibility was supported by independent replication of association at rs2217262 and the finding of a deletion segregating in a sib-pair family. Molecular Psychiatry (2010) 15, 954-968; doi:10.1038/mp.2009.34; published online 28 April 2009 C1 [Pagnamenta, A. T.; Lamb, J. A.; Sykes, N. H.; Sousa, I.; Barnby, G.; Butler, H.; Winchester, L.; Scerri, T. S.; Morris, A. P.] Univ Oxford, Wellcome Trust Ctr Human Genet, Oxford OX3 7BN, England. [Maestrini, E.; Bacchelli, E.; Toma, C.; Minopoli, F.] Univ Bologna, Dept Biol, I-40126 Bologna, Italy. [Lamb, J. A.] Univ Manchester, Ctr Integrated Genom Med Res, Manchester, Lancs, England. [Reichert, J.; Cai, G.; Buxbaum, J. D.] Mt Sinai Sch Med, Seaver Autism Res Ctr, Dept Psychiat, New York, NY USA. [Korvatska, O.] Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, Geriatr Res Educ & Clin Ctr, Seattle, WA USA. [Schellenberg, G. D.] Univ Penn, Sch Med, Dept Pathol, Philadelphia, PA 19104 USA. [Schellenberg, G. D.] Univ Penn, Sch Med, Lab Med, Philadelphia, PA 19104 USA. [Dawson, G.] Autism Speaks, New York, NY USA. [Dawson, G.] Univ Washington, Dept Psychol, Seattle, WA 98195 USA. [de Bildt, A.; Minderaa, R. B.; Mulder, E. J.] Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat, NL-9713 AV Groningen, Netherlands. [Bailey, A. J.] Univ Dept Psychiat, Warneford Hosp, Oxford, England. RP Monaco, AP (reprint author), Univ Oxford, Wellcome Trust Ctr Human Genet, S Parks Rd, Oxford OX3 7BN, England. EM Anthony.Bailey@psych.ox.ac.uk; anthony.monaco@well.ox.ac.uk RI Monaco, Anthony/A-4495-2010; Bolton, Patrick/E-8501-2010; Maestrini, Elena/K-7508-2012; Bailey, Anthony/J-2860-2014; Toma, Claudio/L-7853-2014 OI Monaco, Anthony/0000-0001-7480-3197; Bolton, Patrick/0000-0002-5270-6262; Bailey, Anthony/0000-0003-4257-972X; Toma, Claudio/0000-0003-3901-7507; Girao Meireles de Sousa, Ines/0000-0001-6983-8870; Buxbaum, Joseph/0000-0001-8898-8313 FU UK Medical Research Council; Wellcome Trust; BIOMED 2 [CT-97-2759]; EC [QLG2-CT-1999-0094]; Deutsche Forschungsgemeinschaft; Fondation France Telecom; Conseil Regional Midi-Pyrenees; Child Mental Health Research of Copenhagen; Danish Natural Science Research Council [9802210]; National Institutes of Health [U19 HD35482, MO1 RR06022, K05 MH01196, K02 MH01389]; Fondazione Telethon FX We thank all the families who have participated in the study and the professionals who made this study possible. We also thank John Broxholme for bioinformatics support, Joseph Trakalo and Chris Allan at the WTCHG core genomics facility for Illumina and Sequenom genotyping, respectively. We especially thank Professor Giovanni Romeo at the Medical Genetics Unit, S Orsola-Malpighi Hospital, University of Bologna for his generous provision of laboratory space and equipment to EM, EB and CT. The CPEA (Collaborative Program of Excellence in Autism) thank Jeffery Munson, and Raphael Bernier and Annette Estes. This work was funded by the Nancy Lurie Marks Family Foundation; the Simons Foundation; the EC Sixth FP AUTISM MOLGEN, TelethonItaly; the Korczak Foundation for Autism and Related Disorders; the Netherlands Organization for Scientific Research (NWO). The IMGSAC was funded by UK Medical Research Council, Wellcome Trust, BIOMED 2 (CT-97-2759), EC Fifth Framework (QLG2-CT-1999-0094), Deutsche Forschungsgemeinschaft, Fondation France Telecom, Conseil Regional Midi-Pyrenees, trice Surovell Haskells Fund for Child Mental Health Research of Copenhagen, Danish Natural Science Research Council (9802210) and National Institutes of Health (U19 HD35482, MO1 RR06022, K05 MH01196, K02 MH01389). AJ Bailey is the Cheryl and Reece Scott Professor of Psychiatry. AP Monaco is a Wellcome Trust principal research fellow. NR 62 TC 52 Z9 52 U1 2 U2 10 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1359-4184 EI 1476-5578 J9 MOL PSYCHIATR JI Mol. Psychiatr. PD SEP PY 2010 VL 15 IS 9 BP 954 EP 968 DI 10.1038/mp.2009.34 PG 15 WC Biochemistry & Molecular Biology; Neurosciences; Psychiatry SC Biochemistry & Molecular Biology; Neurosciences & Neurology; Psychiatry GA 648EB UT WOS:000281672100010 PM 19401682 ER PT J AU Hamza, TH Zabetian, CP Tenesa, A Laederach, A Montimurro, J Yearout, D Kay, DM Doheny, KF Paschall, J Pugh, E Kusel, VI Collura, R Roberts, J Griffith, A Samii, A Scott, WK Nutt, J Factor, SA Payami, H AF Hamza, Taye H. Zabetian, Cyrus P. Tenesa, Albert Laederach, Alain Montimurro, Jennifer Yearout, Dora Kay, Denise M. Doheny, Kimberly F. Paschall, Justin Pugh, Elizabeth Kusel, Victoria I. Collura, Randall Roberts, John Griffith, Alida Samii, Ali Scott, William K. Nutt, John Factor, Stewart A. Payami, Haydeh TI Common genetic variation in the HLA region is associated with late-onset sporadic Parkinson's disease SO NATURE GENETICS LA English DT Article ID GENOME-WIDE ASSOCIATION; SUBSTANTIA-NIGRA; RISK-FACTORS; REACTIVE MICROGLIA; ALPHA-SYNUCLEIN; T-CELLS; POPULATION; PATHOGENESIS; METAANALYSIS; EXPRESSION AB Parkinson's disease is a common disorder that leads to motor and cognitive disability. We performed a genome-wide association study of 2,000 individuals with Parkinson's disease (cases) and 1,986 unaffected controls from the NeuroGenetics Research Consortium (NGRC)(1-5). We confirmed associations with SNCA(2,6-8) and MAPT(3,7-9), replicated an association with GAK9 (using data from the NGRC and a previous study(9), P = 3.2 x 10(-9)) and detected a new association with the HLA region (using data from the NGRC only, P = 2.9 x 10(-8)), which replicated in two datasets (meta-analysis P = 1.9 x 10(-10)). The HLA association was uniform across all genetic and environmental risk strata and was strong in sporadic (P = 5.5 x 10(-10)) and late-onset (P = 2.4 x 10(-8)) disease. The association peak we found was at rs3129882, a noncoding variant in HLA-DRA. Two studies have previously suggested that rs3129882 influences expression of HLA-DR and HLA-DQ(10,11). The brains of individuals with Parkinson's disease show upregulation of DR antigens and the presence of DR-positive reactive microglia(12), and nonsteroidal anti-inflammatory drugs reduce Parkinson's disease risk(4,13). The genetic association with HLA supports the involvement of the immune system in Parkinson's disease and offers new targets for drug development. C1 [Hamza, Taye H.; Laederach, Alain; Montimurro, Jennifer; Yearout, Dora; Kay, Denise M.; Kusel, Victoria I.; Collura, Randall; Payami, Haydeh] Wadsworth Ctr, New York State Dept Hlth, Albany, NY USA. [Zabetian, Cyrus P.; Yearout, Dora; Samii, Ali] Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. [Zabetian, Cyrus P.; Yearout, Dora; Samii, Ali] Univ Washington, Dept Neurol, Seattle, WA 98195 USA. [Tenesa, Albert] Univ Edinburgh, Inst Genet & Mol Med, Edinburgh, Midlothian, Scotland. [Doheny, Kimberly F.; Pugh, Elizabeth] Johns Hopkins Univ, Sch Med, CIDR, Baltimore, MD USA. [Paschall, Justin] NIH, Natl Ctr Biotechnol Informat, Natl Lib Med, Bethesda, MD 20892 USA. [Roberts, John] Virginia Mason Med Ctr, Seattle, WA 98101 USA. [Griffith, Alida] Evergreen Hosp Med Ctr, Booth Gardner Parkinsons Care Ctr, Washington, DC USA. [Scott, William K.] Univ Miami, Dr John T Macdonald Fdn, Dept Human Genet, Miami, FL USA. [Scott, William K.] Univ Miami, John P Hussman Inst Human Genom, Miami, FL USA. [Nutt, John] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. [Factor, Stewart A.] Emory Univ, Sch Med, Dept Neurol, Atlanta, GA 30322 USA. RP Payami, H (reprint author), Wadsworth Ctr, New York State Dept Hlth, Albany, NY USA. EM hpayami@wadsworth.org OI Kay, Denise/0000-0002-9928-2698; Zabetian, Cyrus/0000-0002-7739-4306; Laederach, Alain/0000-0002-5088-9907 FU National Institute of Neurological Disorders and Stroke [R01NS36960]; Michael J. Fox Foundation for Parkinson's Disease Research; Department of Veterans Affairs [1I01BX000531]; National Institutes of Aging [P30AG08017]; National Institute of Mental Health [R21MH087336]; Office of Research and Development, Clinical Sciences Research and Development Service, Department of Veteran Affairs; US National Institutes of Health (NIH) at the National Library of Medicine; NIH [HHSN268200782096C, AG027944, NS039764] FX We would like to acknowledge the individuals with Parkinson's disease, their families and the healthy volunteers who participated in this study. We thank T. L. Edwards, J.M. Vance, E. R. Martin, J.L. Haines and M. A. Pericak-Vance for sharing their GWAS data with us; R. H. Myers, J.F. Gusella, T. Foroud and N. Pankratz for making their data public via dbGaP; and J. Degner for assistance with the eQTL data repository website at University of Chicago. We acknowledge M. Adams, M. Zilka and the staff of CIDR for excellent genotyping service, M. Palumbo, C. S. Carmack and the staff of the Computational Biology and Statistics Core of Wadsworth Center for computing support and C. Lambert and G. L. Peterson for developing the randomized plate layout. This project was supported by Award Number R01NS36960 from the National Institute of Neurological Disorders and Stroke. Additional support was provided by an Edmond J. Safra Global Genetic Consortium Grant from the Michael J. Fox Foundation for Parkinson's Disease Research, Merit Review Award from the Department of Veterans Affairs (1I01BX000531), National Institutes of Aging (P30AG08017), National Institute of Mental Health (R21MH087336), Office of Research and Development, Clinical Sciences Research and Development Service, Department of Veteran Affairs, The Intramural Research Program of the US National Institutes of Health (NIH) at the National Library of Medicine and the Close to the Cure Foundation. Genotyping services were provided by CIDR, which is fully funded through a federal contract from the NIH to Johns Hopkins University, contract number HHSN268200782096C. The work described in ref. 8, whose data were used for replication, was funded by NIH grants AG027944 and NS039764. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. NR 35 TC 271 Z9 276 U1 3 U2 21 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 1061-4036 J9 NAT GENET JI Nature Genet. PD SEP PY 2010 VL 42 IS 9 BP 781 EP U75 DI 10.1038/ng.642 PG 6 WC Genetics & Heredity SC Genetics & Heredity GA 644OM UT WOS:000281388400015 PM 20711177 ER PT J AU Bartzokis, G Lu, PH Tingus, K Mendez, MF Richard, A Peters, DG Oluwadara, B Barrall, KA Finn, JP Villablanca, P Thompson, PM Mintz, J AF Bartzokis, George Lu, Po H. Tingus, Kathleen Mendez, Mario F. Richard, Aurore Peters, Douglas G. Oluwadara, Bolanle Barrall, Katherine A. Finn, J. Paul Villablanca, Pablo Thompson, Paul M. Mintz, Jim TI Lifespan trajectory of myelin integrity and maximum motor speed SO NEUROBIOLOGY OF AGING LA English DT Article DE Age; Processing speed; Motor; White matter; Oligodendrocyte; Breakdown; Cognition; Dementia; Risk; Neurodegeneration; Alzheimer; Onset; Frontal lobe; Treatment; Prevention ID INDUCED INTRAMYELINIC EDEMA; DEMYELINATED NERVE-FIBERS; REITAN NEUROPSYCHOLOGICAL TESTS; MATTER STRUCTURAL INTEGRITY; PRIMATE CEREBRAL-CORTEX; WHITE-MATTER; COGNITIVE DECLINE; RHESUS-MONKEY; HUMAN BRAIN; ALZHEIMERS-DISEASE AB Objective Myelination of the human brain results in roughly quadratic trajectories of myelin content and integrity, reaching a maximum in mid-life and then declining in older age This trajectory is most evident in vulnerable later myelinating association regions such as frontal lobes and may be the biological substrate for similar trajectories of cognitive processing speed Speed of movement, such as maximal finger tapping speed (FTS), requires high-frequency action potential (AP) bursts and is associated with myelin integrity We tested the hypothesis that the age-related trajectory of FTS is related to brain myelin integrity Methods A sensitive in VIVO MRI biomarker of myelin integrity (calculated transverse relaxation rates (R(2))) of frontal lobe white matter (FLwm) was measured in a sample of very healthy males (N=72) between 23 and 80 years of age To assess specificity. R, of a contrasting early-myelinating region (splenium of the corpus callosum) was also measured Results FLwm R(2) and FTS measures were significantly correlated (r=45, p<0001) with no association noted in the early-myelinating region (splenium) Both FLwm R(2) and FTS had significantly quadratic lifespan trajectories that were virtually indistinguishable and both reached a peak at 39 years of age and declined with an accelerating trajectory thereafter Conclusions The results suggest that in this very healthy male sample, maximum motor speed requiring high-frequency AP burst may depend on brain myelin integrity To the extent that the FLwm changes assessed by R(2) contribute to an age-related reduction in AP burst frequency, it is possible that other brain functions dependent on AP bursts may also he affected Non-invasive measures of myelin integrity together with testing of basic measures of processing speed may aid in developing and targeting anti-aging treatments to mitigate age-related functional declines (C) 2008 Elsevier Inc All rights reserved C1 [Bartzokis, George; Richard, Aurore; Peters, Douglas G.; Oluwadara, Bolanle] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. [Bartzokis, George; Thompson, Paul M.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Lab Neuroimaging,Div Brain Mapping, Los Angeles, CA 90095 USA. [Bartzokis, George; Mendez, Mario F.; Barrall, Katherine A.] Greater Los Angeles VA Healthcare Syst, Dept Psychiat, Los Angeles, CA 90073 USA. [Finn, J. Paul; Villablanca, Pablo] Univ Calif Los Angeles, David Geffen Sch Med, Dept Radiol, Los Angeles, CA 90095 USA. [Mintz, Jim] Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat, San Antonio, TX 78229 USA. RP Bartzokis, G (reprint author), 300 UCLA Med Plaza,Suite 2200, Los Angeles, CA 90095 USA. RI Bartzokis, George/K-2409-2013 FU NIH [MH066029, AG027342, EB008281, P50 AG 16570, U54 RR021813]; RCS Alzheimer's Foundation; Sidell-Kagan Foundation; Department of Veterans Affairs FX This work was supported in part by NIH grants (MH066029; AG027342; EB008281, P50 AG 16570; U54 RR021813). the RCS Alzheimer's Foundation, Sidell-Kagan Foundation; and the Department of Veterans Affairs. NR 88 TC 83 Z9 84 U1 1 U2 15 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD SEP PY 2010 VL 31 IS 9 BP 1554 EP 1562 DI 10.1016/j.neurobiolaging.2008.08.015 PG 9 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 632UO UT WOS:000280454700006 PM 18926601 ER PT J AU Kay, DM Stevens, CF Hamza, TH Montimurro, JS Zabetian, CP Factor, SA Samii, A Griffith, A Roberts, JW Molho, ES Higgins, DS Gancher, S Moses, L Zareparsi, S Poorkaj, P Bird, T Nutt, J Schellenberg, GD Payami, H AF Kay, D. M. Stevens, C. F. Hamza, T. H. Montimurro, J. S. Zabetian, C. P. Factor, S. A. Samii, A. Griffith, A. Roberts, J. W. Molho, E. S. Higgins, D. S. Gancher, S. Moses, L. Zareparsi, S. Poorkaj, P. Bird, T. Nutt, J. Schellenberg, G. D. Payami, H. TI A comprehensive analysis of deletions, multiplications, and copy number variations in PARK2 SO NEUROLOGY LA English DT Article ID ONSET PARKINSONS-DISEASE; RECESSIVE JUVENILE PARKINSONISM; DEPENDENT PROBE AMPLIFICATION; ALPHA-SYNUCLEIN; GENE; MUTATIONS; ASSOCIATION; HETEROZYGOSITY; SUSCEPTIBILITY; REARRANGEMENTS AB Objectives: To perform a comprehensive population genetic study of PARK2. PARK2 mutations are associated with juvenile parkinsonism, Alzheimer disease, cancer, leprosy, and diabetes mellitus, yet ironically, there has been no comprehensive study of PARK2 in control subjects; and to resolve controversial association of PARK2 heterozygous mutations with Parkinson disease (PD) in a well-powered study. Methods: We studied 1,686 control subjects (mean age 66.1 +/- 13.1 years) and 2,091 patients with PD (mean onset age 58.3 +/- 12.1 years). We tested for PARK2 deletions/multiplications/copy number variations (CNV) using semiquantitative PCR and multiplex ligation-dependent probe amplification, and validated the mutations by real-time quantitative PCR. Subjects were tested for point mutations previously. Association with PD was tested as PARK2 main effect, and in combination with known PD risk factors: SNCA, MAPT, APOE, smoking, and coffee intake. Results: A total of 0.95% of control subjects and 0.86% of patients carried a heterozygous CNV mutation. CNV mutations found in 16 control subjects were all in exons 1-4, sparing exons that encode functionally critical protein domains. Thirteen patients had 2 CNV mutations, 5 had 1 CNV and 1 point mutation, and 18 had 1 CNV mutation. Mutations found in patients spanned exons 2-9. In whites, having 1 CNV was not associated with increased risk (odds ratio 1.05, p = 0.89) or earlier onset of PD (64.7 +/- 8.6 heterozygous vs 58.5 +/- 11.8 normal). Conclusions: This comprehensive population genetic study in control subjects fills the void for a PARK2 reference dataset. There is no compelling evidence for association of heterozygous PARK2 mutations, by themselves or in combination with known risk factors, with PD. Neurology (R) 2010; 75: 1189-1194 C1 [Payami, H.] New York State Dept Hlth, Genom Inst, Wadsworth Ctr, Albany, NY 12201 USA. [Zabetian, C. P.; Samii, A.] VA Puget Sound Hlth Care Syst, Res Educ & Clin Ctr, Seattle, WA USA. [Factor, S. A.] Emory Univ, Sch Med, Dept Neurol, Atlanta, GA 30322 USA. [Factor, S. A.; Molho, E. S.; Higgins, D. S.] Albany Med Ctr, Parkinsons Dis & Movement Disorders Ctr, Albany, NY USA. [Griffith, A.] Evergreen Hosp, Med Ctr, Booth Gardner Parkinsons Care Ctr, Kirkland, WA USA. [Roberts, J. W.] Virginia Mason Med Ctr, Seattle, WA 98101 USA. [Higgins, D. S.] Vet Affairs Med Ctr, Neurol Serv, Albany, NY USA. [Poorkaj, P.] Univ Washington, Dept Psychiat, Seattle, WA 98195 USA. [Poorkaj, P.] Univ Washington, Dept Behav Sci, Seattle, WA 98195 USA. [Zabetian, C. P.; Samii, A.; Bird, T.] Univ Washington, Dept Neurol, Seattle, WA 98195 USA. [Gancher, S.] Kaiser Permanente, Portland, OR USA. [Zareparsi, S.] W Virginia Univ, Dept Ophthalmol, Morgantown, WV 26506 USA. [Nutt, J.] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. [Schellenberg, G. D.] Univ Penn, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA. RP Payami, H (reprint author), New York State Dept Hlth, Genom Inst, Wadsworth Ctr, POB 22002, Albany, NY 12201 USA. EM hpayami@wadsworth.org OI Kay, Denise/0000-0002-9928-2698 FU National Institutes of Health [NS R01-36960]; National Institutes of Neurologic Disease and Stroke (NINDS); Veterans Affairs Research Funds; Riley Family Chair in Parkinson's Disease; NIH National Institutes of Aging [AG 08017]; Swedish Medical Center; American Parkinson Disease Association; Portland Veterans Affairs Research Foundation; NIH (NINDS) [R01 NS065070-01 [PI], NINDS P50 NS062684-01 [PI Project 3], NINDSR01 NS036960-09, NINDS R01 NS057567-01, NIA R01 AG033398-01]; US Department of Veterans Affairs; Parkinson's Disease Foundation FX Supported by National Institutes of Health grant NS R01-36960 from the National Institutes of Neurologic Disease and Stroke (NINDS; H. P.); Veterans Affairs Research Funds (T. B., C. P. Z.); and the Riley Family Chair in Parkinson's Disease (E. S. M.). A subset of control subjects were acquired through the Indiana University National Cell Repository for Alzheimer's Disease, and NIH National Institutes of Aging grant AG 08017 (Jeffrey Kaye). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.; Dr. Kay, Dr. Stevens, Dr. Hamza, and J. S. Montimurro report no disclosures. Dr. Zabetian has received speaker honoraria from the Swedish Medical Center, the American Parkinson Disease Association, and the Portland Veterans Affairs Research Foundation; receives research support from the NIH (NINDS R01 NS065070-01 [PI], NINDS P50 NS062684-01 [PI Project 3], NINDSR01 NS036960-09 [coinvestigator], NINDS R01 NS057567-01 [coinvestigator], and NIA R01 AG033398-01 [coinvestigator]), the US Department of Veterans Affairs, the Parkinson's Disease Foundation, and the American Parkinson Disease Association. Dr. Factor serves as a Section Editor for Current Treatment Options in Neurology; receives royalties from the publication of Parkinson's Disease Diagnosis and Clinical Management (Demos, 2008) and Drug Induced Movement Disorders (Blackwell Futura, 2005); serves as a consultant for Allergan, Inc., UCB, and Lundbeck Inc.; receives research support from Teva Pharmaceutical Industries Ltd., Ipsen, UCB, and ScheringPlough Corp.; and has served as an expert witness on behalf of Boehringer Ingelheim. Dr. Samii has received funding for travel and speaker honoraria from Teva Pharmaceutical Industries Ltd., Boehringer Ingelheim, and Ipsen. Dr. Griffith has served on a scientific advisory board for and received speaker honoraria from Teva Pharmaceutical Industries Ltd.; and serves on speakers' bureaus for Teva Pharmaceutical Industries Ltd. and Novartis. Dr. Roberts has received speaker honoraria from Teva Pharmaceutical Industries Ltd. Dr. Molho has served on scientific advisory boards for Allergan, Inc., Ipsen, and Merz Pharmaceuticals, LLC; has served on speakers' bureaus for Allergan, Inc., Boehringer Ingelheim, and Teva Pharmaceutical Industries Ltd.; and receives research support from Teva Pharmaceutical Industries Ltd., IMPAX Laboratories, Inc., Allergan, Inc., the NIH [NINDS 1 UO1 NS50324-01A1] [site investigator]), and Molecular Biometrics, Inc. Dr. Higgins has served on speakers' bureaus for GlaxoSmithKline and Boehringer Ingelheim and has received research support from Acadia Pharmaceuticals and Schwarz Pharma. Dr. Gancher, L. Moses, and Dr. Zareparsi report no disclosures. Dr. Poorkaj has received research support from the NIH (NIA 5K01AG024329-02 [PI]) and the University of Washington. Dr. Bird serves on scientific advisory boards for the Association for Frontotemporal Dementia and CharcotMarie- Tooth Association; serves on the speakers' bureau for and has received funding for travel and a speaker honoraria from Athena Diagnostics, Inc.; serves on the editorial boards of Brain and Neurology Today; has received license fee payments from Athena Diagnostics, Inc. for patents re: Mutations In PKC ~ : are the cause for spinocerebellar ataxia, and Mutations associated with a human demyelinating neuropathy (Charcot-Marie-Tooth Disease Type 1C); receives royalties from the publication of Human Genetics: Principles and Approaches, 4th ed (SpringerVerlag GmbH Biomedical Sciences, 2010); and receives research support from the US Department of Veterans Affairs. Dr. Nutt has received funding for travel from Novartis and Teva Pharmaceutical Industries Ltd.; has received speaker honoraria from Novartis and Teva; has served as a consultant for XenoPort Inc., IMPAX Laboratories, Inc., Neurogen Inc., Synosia Therapeutics, NeuroDerm, Ltd.; , Merck, Lilly-Medtronics, Elan and Lundbeck; and has received research support from Schering-Plough Corp, the NIH (NINDS R01 NS 21062 [PI] and UL1-RR024140 [PI]), the Veterans Administration (PADRECC [Co-PI]), and the Nationl Parkinson Foundation. Dr. Schellenberg serves on a scientific advisory board and receives honoraria from the American Health Assistance Foundation; has served as a consultant for and received funding for travel from IntegraGen; serves on the editorial boards of the American Journal of Alzheimer's Disease and Other Dementias, Neurodegenerative Diseases, Current Alzheimer Research, and Pathology and Laboratory Medicine International; holds/ has filed patents re: Chromosome 14 and familial Alzheimer's disease genetic markers and assays, Chromosome 1 gene and gene products related to Alzheimer's disease, and Genetic basis of Alzheimer's disease and diagnosis and treatment thereof; and receives/ has received research support from the NIH (NIA R01 AG 11762 [PI], NIA R01 AG 21544 [PI], NHGRI ADD GRANT NUMBER [co-PI], NIA UO1AG032984 [PI], NIA RC2AG036528 [PI], and NIMH R01 MH089004 [PI]), the Autism Genome Project, Autism Speaks, the PSP Genetics Consortium, and CurePSP. Dr. Payami receives research support from the NIH (NINDS NS R01-36960 [PI]) and the New York Attorney General's Office. NR 32 TC 40 Z9 42 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD SEP PY 2010 VL 75 IS 13 BP 1189 EP 1194 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 655CD UT WOS:000282219300015 PM 20876472 ER PT J AU Sonnen, JA Larson, EB Walker, RL Haneuse, S Crane, PK Gray, SL Breitner, JCS Montine, TJ AF Sonnen, J. A. Larson, E. B. Walker, R. L. Haneuse, S. Crane, P. K. Gray, S. L. Breitner, J. C. S. Montine, T. J. TI Nonsteroidal anti-inflammatory drugs are associated with increased neuritic plaques SO NEUROLOGY LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; ALZHEIMERS-DISEASE; COGNITIVE IMPAIRMENT; PARKINSONS-DISEASE; DEMENTIA; RISK; PATHOLOGY; ROFECOXIB; NEUROPATHOLOGY; METAANALYSIS AB Objectives: Observational and experimental studies suggest that nonsteroidal anti-inflammatory drugs (NSAIDs) may protect against Alzheimer disease (AD); however, clinical trials and other observational studies, including the Adult Changes in Thought (ACT) study, show no protection or promotion of AD. The objective of this study is to determine the relationship between common dementia-associated pathologies and mid-to late-life NSAID exposure. Methods: We examined the association of mid-to late-life NSAID use with neuropathologic findings on 257 autopsies from ACT, a population-based study of brain aging and incident dementia. Cumulative standard daily doses (SDD) of nonselective NSAIDs were determined from >= 10 years of computerized pharmacy dispensing data. Analyses were adjusted for selection bias to broaden generalizability of results to 3,026 eligible participants in the ACT cohort. Seven pathologic indices were evaluated: intermediate or frequent score for neuritic plaques, Braak stages V or VI for neurofibrillary tangles, >2 cerebral microinfarcts, the presence of any neocortical Lewy bodies, any macroscopic infarcts, any amyloid angiopathy, and moderate or severe atherosclerosis. Results: Of the neuropathologic indices evaluated, only neuritic plaque score was significantly increased in participants with greater use of nonselective NSAIDs (p = 0.065), specifically in those with high levels of cumulative use: 1,000-2,000 SDD (adjusted relative risk [RR] 2.16, 95% confidence interval [CI] 1.02-4.25, compared to light/nonuse [ <60 SDD]) and >2,000 SDD (adjusted RR 2.37, 95% CI 1.24-4.67). Conclusions: Increased neuritic plaque accumulation may explain the association between heavy use of nonselective NSAIDs and increased risk of dementia among ACT participants. Neurology (R) 2010; 75: 1203-1210 C1 [Sonnen, J. A.; Montine, T. J.] Univ Washington, Dept Pathol, Seattle, WA 98104 USA. [Crane, P. K.] Univ Washington, Dept Med, Seattle, WA 98104 USA. [Gray, S. L.] Univ Washington, Dept Pharm, Seattle, WA 98104 USA. [Breitner, J. C. S.] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98104 USA. [Larson, E. B.; Walker, R. L.; Haneuse, S.] Grp Hlth Res Inst, Grp Hlth Cooperat, Seattle, WA USA. [Breitner, J. C. S.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Sonnen, JA (reprint author), Univ Washington, Dept Pathol, 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 NIH/NIA [AG05136, U01AG06781, AG02380, AG19349, AG06781, AG 06781 [PI], AG23801, AG000258]; Nancy and Buster Alvord Endowment; US Department of Veterans Affairs; NCI [AG05136, CA63740, U01CA86076, U01CA86082, U01CA63736, U01CA70013, U01CA69976, U01CA63731] FX Supported by the NIH/NIA(AG05136, AG23801, AG000258, and U01AG06781), the Nancy and Buster Alvord Endowment, and the US Department of Veterans Affairs.; Dr. Sonnen serves as an Associate Editor of the Journal of Alzheimer's Disease; receives royalties from the publication of Molecular Pathology (Elsevier, 2009) and Essentials of Molecular Pathology (Elsevier, 2009); serves as a consultant for the Allen Brain Institute; and receives research support from the NIH/NIA (AG02380 [coinvestigator], AG05136 [coinvestigator], AG19349 [coinvestigator], and AG06781 [coinvestigator]). Dr. Larson served as Chair of the editorial board for the Journal of General Internal Medicine; receives publishing royalties from UpToDate, Inc.; and receives research support from the NIH (AG 06781 [PI]). Mr. Walker receives research support from the NIH (AG05136 [biostatistician], AG23801 [biostatistician], AG000258 [biostatistician], AG06781 [biostatistician], NCI CA63740 [biostatistician], NCI U01CA86076 [biostatistician], NCI U01CA86082 [biostatistician], NCI U01CA63736 [biostatistician], NCI U01CA70013 [biostatistician], NCI U01CA69976 [biostatistician], NCI U01CA63731 [biostatistician], and NCI U01CA70040 [biostatistician]). Dr. Haneuse serves as an Associate Editor for the Journal of Alzheimer's Disease and the International Society for Bayesian Analysis; and receives research support from the NIH (AG05136 [biostatistician], AG23801 [biostatistician], AG000258 [biostatistician], and AG06781 [biostatistician]), and the US Department of Veterans Affairs. Dr. Crane receives research support from the NIH (AG06781 [coinvestigator], AG024180 [coinvestigator], AG 029672-01 [PI], HG004610 [coinvestigator]; AG030618 [coinvestigator], AG010220 [coinvestigator], AR057954 [PI]. Dr. Gray serves on the editorial boards of the Journal of the American Geriatrics Society, Research in Gerontological Nursing, the American Journal of Geriatric Pharmacotherapy, and the Annals of Pharmacotherapy; and has received research support from the NIH (AG06781 [coinvestigator]). Dr. Breitner serves on scientific advisory boards for the N. Bud Grossman Center for Research in Memory and Care, the Florida ADRC (NIA and State of FL), and for the Chicago Health and Aging Project; serves on the editorial boards of Alzheimer's Disease and Associated Disorders, PLOS-One, Academics, Alzheimer's and Dementia, and the American Journal of Alzheimer's Disease; receives royalties from the publication of Fast Facts-Dementia, 2nd ed. (Health Press, 2009); and receives research support from the NIH (AG15477 [PI]) and from the Minnesota Medical Foundation. Dr. Montine serves on the editorial boards of the American Journal of Pathology, Brain Pathology, and the Journal of Alzheimer's Disease; and receives research support from the NIH (NS062684 [PI], AG32984 [co-PI], ES16754 [PI], ES007032 [PI], AG031892 [PI], AG023801 [PI], AG05136 [core leader], AG05136 [project leader], GM015431 [project leader], AG10880 [coinvestigator]) and from the Nancy and Buster Alvord Endowment. NR 34 TC 33 Z9 33 U1 0 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 SEP PY 2010 VL 75 IS 13 BP 1203 EP 1210 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 655CD UT WOS:000282219300017 PM 20811000 ER PT J AU Chao, LL Rothlind, JC Cardenas, VA Meyerhoff, DJ Weiner, MW AF Chao, Linda L. Rothlind, Johannes C. Cardenas, Valerie A. Meyerhoff, Dieter J. Weiner, Michael W. TI Effects of low-level exposure to sarin and cyclosarin during the 1991 Gulf War on brain function and brain structure in US veterans SO NEUROTOXICOLOGY LA English DT Article DE Cognitive functioning; Magnetic resonance imaging; Morphometric analysis; Brain; Central nervous system; Chemical warfare agents; Sarin; Cyclosarin; Gulf War veterans ID POSTTRAUMATIC-STRESS-DISORDER; ARMY VETERANS; MULTISYMPTOM ILLNESS; HIPPOCAMPAL VOLUME; NERVOUS-SYSTEM; SYMPTOMS; HEALTH; KHAMISIYAH; ATTACK AB Background: Potentially more than 100,000 US troops may have been exposed to the organophosphate chemical warfare agents sarin (GB) and cyclosarin (GF) when a munitions dump at Khamisiyah, Iraq was destroyed during the Gulf War (GW) in 1991. Although little is known about the long-term neurobehavioral or neurophysiological effects of low-dose exposure to GB/GF in humans, recent studies of GW veterans from the Devens Cohort suggest decrements in certain cognitive domains and atrophy in brain white matter occur individuals with higher estimated levels of presumed GB/GF exposure. The goal of the current study is to determine the generalizability of these findings in another cohort of GW veterans with suspected GB/GF exposure. Methods: Neurobehavioral and imaging data collected in a study on Gulf War Illness between 2002 and 2007 were used in this study. We focused on the data of 40 GW-deployed veterans categorized as having been exposed to GB/GF at Khamisiyah, Iraq and 40 matched controls. Magnetic resonance images (MRI) of the brain were analyzed using automated and semi-automated image processing techniques that produced volumetric measurements of gray matter (GM), white matter (WM), cerebrospinal fluid (CSF) and hippocampus. Results: GW veterans with suspected GB/GF exposure had reduced total GM and hippocampal volumes compared to their unexposed peers (p <= 0.01). Although there were no group differences in measures of cognitive function or total WM volume, there were significant, positive correlations between total WM volume and measures of executive function and visuospatial abilities in veterans with suspected GB/GF exposure. Conclusions: These findings suggest that low-level exposure to GB/GF can have deleterious effects on brain structure and brain function more than decade later. (C) 2010 Elsevier Inc. All rights reserved. C1 [Chao, Linda L.; Cardenas, Valerie A.; Meyerhoff, Dieter J.; Weiner, Michael W.] San Francisco VA Med Ctr, Ctr Imaging Neurodegenerat Dis, San Francisco, CA 94121 USA. [Chao, Linda L.; Rothlind, Johannes C.; Weiner, Michael W.] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. [Chao, Linda L.; Cardenas, Valerie A.; Meyerhoff, Dieter J.; Weiner, Michael W.] Univ Calif San Francisco, Dept Radiol & Biomed Imaging, San Francisco, CA 94143 USA. RP Chao, LL (reprint author), San Francisco VA Med Ctr, Ctr Imaging Neurodegenerat Dis, 4150 Clement St,114 M, San Francisco, CA 94121 USA. EM linda.chao@ucsf.edu FU Department of Defense [DAMD17-01-1-0764]; Department of Veteran's Affairs; National Institutes of Health National Center of Research Resources [P41 RR023953] FX The opinions or assertions contained herein are the private views of the author(s) and are not to be construed as official or reflecting the views of the Army, Department of Defense, or Department of Veterans Affairs. Drs. Chao, Cardenas, Meyerhoff, and Weiner receive grant support from the Department of Defense and Dr. Weiner receives grant support from the Department of Veteran's Affairs.; This study was supported by Department of Defense grant DAMD17-01-1-0764, entitled 'Magnetic Resonance and Spectroscopy of the Human Brain in Gulf War Illness', awarded to the Northern California Institute for Research and Education from the Department of Defense Gulf War Illnesses Research Program, US Army Medical Research and Materiel Command and partially by funding from the National Institutes of Health National Center of Research Resources (P41 RR023953). This material is the result of work supported with resources and the use of facilities at the San Francisco Veterans Affairs Medical Center. The authors express their thanks for the assistance and advice of Dr. Robert Haley, University of Texas Dallas TX, who provided questionnaires and software for syndrome analysis, and Col. Karl Friedl, US Army Medical Research and Materiel Command. The authors also acknowledge Derek Flenniken for managing the database, Jennifer Hlavin and her staff for subject recruitment and neuropsychological testing, Diana Truran Sacrey and her staff for scanning the subjects and processing the MRI data, Philip Insel for assistance with statistical analyses, Drs. Norbert Schuff, Susanne Mueller, and Ron Killiany for helpful comments, and Larry Sippos, Executive Officer to the Deputy Assistant Secretary of Defense for Force Health Protection and Readiness for providing information about the presence or absence of the research participants' units in the modeled hazard areas and the cumulative estimated GB/GF exposure levels. NR 44 TC 34 Z9 34 U1 2 U2 10 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0161-813X J9 NEUROTOXICOLOGY JI Neurotoxicology PD SEP PY 2010 VL 31 IS 5 BP 493 EP 501 DI 10.1016/j.neuro.2010.05.006 PG 9 WC Neurosciences; Pharmacology & Pharmacy; Toxicology SC Neurosciences & Neurology; Pharmacology & Pharmacy; Toxicology GA 651PI UT WOS:000281939200011 PM 20580739 ER PT J AU Hansen, L Sasaki, A Zucker, B AF Hansen, Lissi Sasaki, Anna Zucker, Betsy TI End-Stage Liver Disease: Challenges and Practice Implications SO NURSING CLINICS OF NORTH AMERICA LA English DT Article DE End-stage liver disease; End of life; Palliative care; Pain ID HEPATIC-ENCEPHALOPATHY; TRANSPLANT CANDIDATES; HEPATORENAL-SYNDROME; PALLIATIVE CARE; UNITED-STATES; CIRRHOSIS; HEPATOTOXICITY; GUIDELINES; MANAGEMENT; INFECTION AB As the seventh leading cause of death among people aged 25 to 64 years, end-stage liver disease (ESLD) affects many Americans in the most productive years of their lives. Despite the increasing number of individuals who are dying of ESLD, little is documented about their end of life challenges as the disease progresses. The purpose of this article is to highlight specific challenges for people with ESLD, their families, and their implications for health care providers: ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, malnutrition, altered drug metabolism, renal insufficiency and hyponatremia, hepatocellular carcinoma, and pain. The authors also present a case study to illustrate disease progression and difficulties facing patients, family members, and providers. C1 [Hansen, Lissi] Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR 97239 USA. [Zucker, Betsy] Portland VA Med Ctr, Liver Clin DHSM, Portland, OR 97239 USA. RP Hansen, L (reprint author), Oregon Hlth & Sci Univ, Sch Nursing, SN 65,3455 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM hansenli@ohsu.edu NR 64 TC 7 Z9 7 U1 2 U2 5 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 2010 VL 45 IS 3 BP 411 EP + DI 10.1016/j.cnur.2010.03.005 PG 17 WC Nursing SC Nursing GA 655IV UT WOS:000282244300009 PM 20804886 ER PT J AU Iqbal, N Vetter, ML Moore, RH Chittams, JL Dalton-Bakes, CV Dowd, M Williams-Smith, C Cardillo, S Wadden, TA AF Iqbal, Nayyar Vetter, Marion L. Moore, Renee H. Chittams, Jesse L. Dalton-Bakes, Cornelia V. Dowd, Monique Williams-Smith, Catherine Cardillo, Serena Wadden, Thomas A. TI Effects of a Low-intensity Intervention That Prescribed a Low-carbohydrate vs. a Low-fat Diet in Obese, Diabetic Participants SO OBESITY LA English DT Article ID RANDOMIZED-TRIAL; WEIGHT-LOSS; FOLLOW-UP; REDUCTION; PROTEIN; ADVICE; ADULTS AB Low-carbohydrate diets have been associated with significant reductions in weight and HbA(1c) in obese, diabetic participants who received high-intensity lifestyle modification for 6 or 12 months. This investigation sought to determine whether comparable results to those of short-term, intensive interventions could be achieved over a 24-month study period using a low-intensity intervention that approximates what is feasible in outpatient practice. A total of 144 obese, diabetic participants were randomly assigned to a low-carbohydrate diet (<30 g/day) or to a low-fat diet (<= 30% of calories from fat with a deficit of 500 kcal/day). Participants were provided weekly group nutrition education sessions for the first month, and monthly sessions thereafter through the end of 24 months. Weight, HbA(1c), glucose, and lipids were measured at baseline and 6, 12, and 24 months. Of the 144 enrolled participants, 68 returned for the month 24 assessment visit. Weights were retrieved from electronic medical records for an additional 57 participants (total, 125 participants) at month 24. All participants with a baseline measurement and at least one of the three other measurements were included in the mixed-model analyses (n = 138). The low-intensity intervention resulted in modest weight loss in both groups at month 24. At this time, participants in the low-carbohydrate group lost 1.5 kg, compared to 0.2 kg in the low-fat group (P = 0.147). Lipids, glycemic indexes, and dietary intake did not differ between groups at month 24 (or at months 6 or 12) C1 [Iqbal, Nayyar; Vetter, Marion L.; Dalton-Bakes, Cornelia V.; Cardillo, Serena] Hosp Univ Penn, Dept Med, Div Endocrinol Diabet & Metab, Philadelphia, PA 19104 USA. [Iqbal, Nayyar; Vetter, Marion L.] Philadelphia Vet Affairs Med Ctr, Dept Med, Div Endocrinol, Philadelphia, PA USA. [Vetter, Marion L.; Moore, Renee H.; Wadden, Thomas A.] Univ Penn, Sch Med, Dept Psychiat, Ctr Weight & Eating Disorders, Philadelphia, PA 19104 USA. [Moore, Renee H.; Chittams, Jesse L.; Williams-Smith, Catherine] Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. [Dowd, Monique] Springs Hosp, Dept Food & Nutr, Springfield, PA USA. RP Iqbal, N (reprint author), Hosp Univ Penn, Dept Med, Div Endocrinol Diabet & Metab, Philadelphia, PA 19104 USA. EM nayyar.iqbal@uphs.upenn.edu FU VA Merit Review Entry Program FX This study is dedicated to the memory of Frederick F. Samaha, in recognition of his many contributions to this research. We gratefully acknowledge Rosa Kim, and Sara Ali, for assisting with study management and Jeffrey Lavenberg, for his technical assistance. Grant support: VA Merit Review Entry Program. NR 15 TC 31 Z9 32 U1 2 U2 13 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 1930-7381 J9 OBESITY JI Obesity PD SEP PY 2010 VL 18 IS 9 BP 1733 EP 1738 DI 10.1038/oby.2009.460 PG 6 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 646CE UT WOS:000281512400009 PM 20019677 ER PT J AU Utzschneider, KM Van de Lagemaat, A Faulenbach, MV Goedecke, JH Carr, DB Boyko, EJ Fujimoto, WY Kahn, SE AF Utzschneider, Kristina M. Van de Lagemaat, Anne Faulenbach, Mirjam V. Goedecke, Julia H. Carr, Darcy B. Boyko, Edward J. Fujimoto, Wilfred Y. Kahn, Steven E. TI Insulin Resistance is the Best Predictor of the Metabolic Syndrome in Subjects With a First-Degree Relative With Type 2 Diabetes SO OBESITY LA English DT Article ID BODY-MASS INDEX; CORONARY-HEART-DISEASE; CARDIOVASCULAR-DISEASE; WAIST CIRCUMFERENCE; CARDIOMETABOLIC RISK; GLUCOSE-TOLERANCE; NORMAL-WEIGHT; OBESITY; MEN; DEFINITION AB Although obesity is associated with insulin resistance and the metabolic syndrome (MetS), some obese individuals are metabolically healthy. Conversely, some lean individuals are insulin resistant (IR) and at increased cardiometabolic risk. To determine the relative importance of insulin sensitivity, BMI and waist circumference (WC) in predicting MetS, we studied these two extreme groups in a high-risk population. One thousand seven hundred and sixty six subjects with a first-degree relative with type 2 diabetes were stratified by BMI and homeostasis model assessment of insulin resistance (HOMA(IR)) into groups. IR groups had higher triglycerides, fasting glucose, and more diabetes than their BMI-group insulin sensitive (IS) counterparts. Within both IS and IR groups, obesity was associated with higher HOMA(IR) and diastolic blood pressure (BP), but no difference in other metabolic variables. MetS (Adult Treatment Panel III (ATPIII)) prevalence was higher in IR groups (P < 0.001) and more subjects met each MetS criterion (P < 0.001). Within each BMI category, HOMA(IR) independently predicted MetS (P < 0.001) whereas WC did not. Within IS and IR groups, age and WC, but not BMI, were independent determinants of MetS (P < 0.001). WC was a less meaningful predictor of MetS at higher values of HOMA(IR). HOMA(IR) was a better predictor of MetS than WC or BMI (receiver operating characteristic (ROC) area under the curve 0.76 vs. 0.65 vs. 0.59, P < 0.001). In conclusion, insulin sensitivity rather than obesity is the major predictor of MetS and is better than WC at identifying obese individuals with a healthier metabolic profile. Further, as many lean individuals with a first-degree relative with type 2 diabetes are IR and metabolically unhealthy, they may all benefit from metabolic testing. C1 [Utzschneider, Kristina M.; Boyko, Edward J.] VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. [Utzschneider, Kristina M.; Van de Lagemaat, Anne; Faulenbach, Mirjam V.; Kahn, Steven E.] Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. [Goedecke, Julia H.] Univ Cape Town, S African Med Res Council, Dept Human Biol, ZA-7925 Cape Town, South Africa. [Carr, Darcy B.] Univ Washington, Dept Obstet & Gynecol, Div Maternal Fetal Med, Seattle, WA 98195 USA. RP Utzschneider, KM (reprint author), VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. EM kutzschn@u.washington.edu RI Goedecke, Julia/J-8628-2013; Goedecke, Julia/E-1820-2016 OI Goedecke, Julia/0000-0001-6795-4771; Goedecke, Julia/0000-0001-6795-4771; Kahn, Steven/0000-0001-7307-9002; Boyko, Edward/0000-0002-3695-192X FU Department of Veterans Affairs [DK-17047]; American Diabetes Association; Dutch Diabetes Research Foundation FX We thank Brian Fish for assistance with the database. This study was supported in part by the Department of Veterans Affairs and DK-17047. The GENNID Study was supported by the American Diabetes Association. A. V. was funded by the Dutch Diabetes Research Foundation. NR 31 TC 11 Z9 13 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 1930-7381 J9 OBESITY JI Obesity PD SEP PY 2010 VL 18 IS 9 BP 1781 EP 1787 DI 10.1038/oby.2010.77 PG 7 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 646CE UT WOS:000281512400016 PM 20379148 ER PT J AU Pruitt, JA Ilsen, PF AF Pruitt, Joseph A. Ilsen, Pauline F. TI On the frontline: What an optometrist needs to know about myasthenia gravis SO OPTOMETRY-JOURNAL OF THE AMERICAN OPTOMETRIC ASSOCIATION LA English DT Article DE Myasthenia gravis; Ocular myasthenia; Myogenic ptosis; Ptosis crutch ID OCULAR MYASTHENIA; INTRAVENOUS IMMUNOGLOBULIN; ICE TEST; PTOSIS; BLEPHAROPTOSIS; THYMECTOMY; MANAGEMENT; THERAPY; THYMUS AB BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease that affects the voluntary skeletal muscles. It is characterized by transient weakness of the muscles that improves with rest. Muscle weakness involving the eyes can produce signs or symptoms of diplopia, blurred vision, ptosis, and ophthalmoplegia. Ptosis is defined as an abnormal eyelid "drooping" beyond the normal I to 2 mm of the upper limbus of the cornea. Hence, most patients with MG have ophthalmic manifestations. Among all patients with MG, up to half will have exclusively ocular symptoms. In these cases, the condition is referred to as ocular myasthenia. CASE REPORT: A 60-year-old man was referred from a neurology clinic for management of intermittent diplopia for greater than 1 year and intermittent bilateral ptosis for the prior year. He reported that he first noticed symptoms of MG at the age of 42, but did not receive the diagnosis until 1 year before his aforementioned neurology examination. He was prescribed spectacles with bilateral ptosis crutches. A diagnosis of severe seronegative MG was subsequently confirmed with neurologic examination and antibody testing. CONCLUSIONS: Because patients with undiagnosed myasthenia gravis may present initially with ocular signs or symptoms, it is important for the optometrist to be familiar with the condition and the simple "in-office" tests that can be performed to establish a tentative diagnosis and management plan. The optometrist can also participate in the management of ocular manifestations of myasthenia and should be familiar with the use of a ptosis crutch (in addition to prism spectacles or occlusion therapies if indicated) as a nonsurgical intervention for ptosis. Optometry 2010;81:454-460 C1 [Pruitt, Joseph A.] Minneapolis Vet Affairs Med Ctr, Minneapolis, MN 55417 USA. [Pruitt, Joseph A.] Univ Missouri, St Louis Coll Optometry, St Louis, MO 63121 USA. [Ilsen, Pauline F.] So Calif Coll Optometry, Fullerton, CA USA. [Ilsen, Pauline F.] W Los Angeles Vet Affairs Healthcare Ctr, Los Angeles, CA USA. RP Pruitt, JA (reprint author), Minneapolis Vet Affairs Med Ctr, 1 Vet Dr,100-77, Minneapolis, MN 55417 USA. EM Joseph.pruitt3@va.gov NR 54 TC 1 Z9 1 U1 0 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1529-1839 J9 OPTOMETRY JI Optometry PD SEP PY 2010 VL 81 IS 9 BP 454 EP 460 DI 10.1016/j.optm.2009.09.023 PG 7 WC Ophthalmology SC Ophthalmology GA 800MH UT WOS:000293364500009 PM 20655284 ER PT J AU Okun, MS Siderowf, A Nutt, JG O'Conner, GT Bloem, BR Olmstead, EM Guttman, M Simuni, T Cheng, E Cohen, EV Parashos, S Marsh, L Malaty, IA Giladi, N Schmidt, P Oberdorf, J AF Okun, Michael S. Siderowf, Andrew Nutt, John G. O'Conner, Gerald T. Bloem, Bastiaan R. Olmstead, Elaine M. Guttman, Mark Simuni, Tanya Cheng, Eric Cohen, Elaine V. Parashos, Sotirios Marsh, Laura Malaty, Irene A. Giladi, Nir Schmidt, Peter Oberdorf, Joyce TI Piloting the NPF data-driven quality improvement initiative SO PARKINSONISM & RELATED DISORDERS LA English DT Article DE Parkinson's disease; Care; Treatment; Economic; Database ID PARKINSONS-DISEASE AB Objective: To pilot a data-driven quality care program in National Parkinson Foundation (NPF) Centers of Excellence. Background: Evidence from comparative effectiveness research (CER) can be used to guide decisions regarding health care and to improve quality and efficiency of care. We propose to develop the infrastructure required to conduct CER across an extensive network of NPF Centers of Excellence. Methods: We present the staged planning for a pilot study which will demonstrate the development and implementation of the infrastructure that will be needed for a large standardized patient-centered, clinical practice database for PD. This database will support CER and drive quality improvement studies. Results: We describe the infrastructure for the ongoing pilot feasibility testing in a subset of six NPF Centers of Excellence, and we discuss the impact that the data (available in 2010) could have in guiding PD management. Conclusion: This preliminary experience will facilitate the longitudinal tracking of therapies and of outcomes in PD clinical practice. Further, we are hopeful that the information will provide insight into PD that will extend beyond the clinical trials population (the population included in most available PD databases). This prospective standardized real-world multi-center clinical practice database will aim to identify positive health outcomes associated with treatment approaches, and to identify variations in clinical outcomes that may suggest improvements in best clinical practice patterns. (C) 2010 Elsevier Ltd. All rights reserved. C1 [Okun, Michael S.; Malaty, Irene A.] Univ Florida, Dept Neurol, Natl Parkinson Fdn,Ctr Excellence, Movement Disorders Ctr,McKnight Brain Inst, Gainesville, FL 32611 USA. [Siderowf, Andrew] Univ Penn, Dept Neurol, Natl Parkinson Fdn,Ctr Excellence, Educ & Clin Ctr,NIH Udall Ctr,VA Parkinson Dis Re, Philadelphia, PA 19104 USA. [Nutt, John G.] Oregon Hlth & Sci Univ, VA Parkinson Dis Res, Natl Parkinson Fdn,Ctr Excellence, Educ & Clin Ctr, Portland Va, OR USA. [O'Conner, Gerald T.; Olmstead, Elaine M.] Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USA. [Bloem, Bastiaan R.] Radboud Univ Nijmegen, Med Ctr, Natl Parkinson Fdn,Ctr Excellence, Donders Inst Brain Cognit & Behav,Dept Neurol, Nijmegen, Netherlands. [Guttman, Mark] Univ Toronto, Dept Med, Div Neurol, Natl Parkinson Fdn,Ctr Excellence, Toronto, ON, Canada. [Simuni, Tanya] Northwestern Univ, Dept Neurol, Natl Parkinson Fdn,Ctr Excellence, Parkinsons Dis & Movement Disorders Ctr, Chicago, IL USA. [Cheng, Eric] VA Greater Los Angeles Healthcare Syst, VA Parkinsons Dis Res Educ & Clin Ctr, Los Angeles, CA USA. [Cohen, Elaine V.] NY Univ, New York Univ Pk, Natl Parkinson Fdn,Ctr Excellence, Dept Neurol, New York, NY USA. [Cohen, Elaine V.] NY Univ, Movement Disorder Ctr, New York, NY USA. [Parashos, Sotirios] Struthers Parkinsons Ctr, Natl Parkinson Fdn,Ctr Excellence, Minneapolis, MN USA. [Marsh, Laura] Menninger Dept Psychiat & Behav Sci, Houston, TX USA. [Giladi, Nir] Tel Aviv Univ, Sackler Sch Med, Tel Aviv Sourasky Med Ctr, Movement Disorders Unit,Natl Parkinson Fdn,Ctr Ex, IL-69978 Tel Aviv, Israel. [Schmidt, Peter; Oberdorf, Joyce] Natl Parkinson Fdn, Miami, FL USA. RP Okun, MS (reprint author), Univ Florida, Dept Neurol, Natl Parkinson Fdn,Ctr Excellence, Movement Disorders Ctr,McKnight Brain Inst, 100 S Newell Dr,Rm L3-101 3rd Floor Neurol, Gainesville, FL 32611 USA. EM okun@neurology.ufl.edu RI Bloem, Bastiaan/E-3812-2010; Bloem, B.R./H-8013-2014 OI Okun, Michael/0000-0002-6247-9358 FU National Parkinson Foundation FX Funding was provided for this project through the National Parkinson Foundation, and we thank Sharon Metz for organizational support. NR 12 TC 15 Z9 15 U1 0 U2 3 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1353-8020 J9 PARKINSONISM RELAT D JI Parkinsonism Relat. Disord. PD SEP PY 2010 VL 16 IS 8 BP 517 EP 521 DI 10.1016/j.parkreldis.2010.06.005 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 665FE UT WOS:000283019800007 PM 20609611 ER PT J AU Stengel, A Goebel, M Wang, LX Reeve, JR Tache, Y Lambrecht, NWG AF Stengel, Andreas Goebel, Miriam Wang, Lixin Reeve, Joseph R., Jr. Tache, Yvette Lambrecht, Nils W. G. TI Lipopolysaccharide differentially decreases plasma acyl and desacyl ghrelin levels in rats: Potential role of the circulating ghrelin-acylating enzyme GOAT SO PEPTIDES LA English DT Article DE Acyl ghrelin; Desacyl ghrelin; GOAT; LPS; RAPID method; Rat ID HELICOBACTER-PYLORI INFECTION; HORMONE SECRETAGOGUE RECEPTOR; BODY-MASS INDEX; FOOD-INTAKE; GASTRIC GHRELIN; SECRETION; STOMACH; PEPTIDE; CELLS; INSULIN AB Bacterial lipopolysaccharide (LPS) in rodents is an established model for studying innate immune responses to gram-negative bacteria and mimicking symptoms of infections including reduced food intake associated with decreased circulating total ghrelin levels. The ghrelin-acylating enzyme, ghrelin-O-acyltransferase (GOAT) involved in the formation of acyl ghrelin (AG) was recently identified. We investigated changes in circulating AG, desacyl ghrelin (DG) and GOAT induced by intraperitoneal LPS (100 mu g/kg) and associated changes in food intake. Plasma AG and total ghrelin were assessed by radioimmunoassay, GOAT protein by Western blot and mRNA by RT-OCR. DG was derived from total minus AG. Plasma AG and DG were decreased at 2,5 and 7 h (p < 0.01) post-injection compared to vehicle and recovered at 24 h. At 2 h there was a significantly greater decrease of AG (-53%) than DG (-28%) resulting in a decreased AG/DG ratio (1:5,p < 0.01), which thereafter returned to pre-injection values (1:3). This altered ratio was associated with a 38% decrease in plasma GOAT protein compared to vehicle (p < 0.001), whereas gastric GOAT protein was slightly increased by 10% (p < 0.05). GOAT mRNA expression was unchanged. Food intake was reduced by 58% measured during the 1.5-2 h period post-LPS injection. Decreased plasma AG and DG preceded the rise in rectal temperature and blood glucose that peaked at 7 h. These data indicate that LPS induces a long-lasting reduction of AG and DG levels that may have a bearing with the decrease in food intake. The faster drop in AG than DG within 2 h is associated with reduced circulating GOAT. Published by Elsevier Inc. C1 [Lambrecht, Nils W. G.] Vet Affairs Long Beach Healthcare Syst, Long Beach, CA 90822 USA. [Stengel, Andreas; Goebel, Miriam; Wang, Lixin; Reeve, Joseph R., Jr.; Tache, Yvette] Univ Calif Los Angeles, Dept Med, Div Digest Dis, CURE Digest Dis Res Ctr,Ctr Neurobiol Stress, Los Angeles, CA 90073 USA. [Stengel, Andreas; Goebel, Miriam; Wang, Lixin; Reeve, Joseph R., Jr.; Tache, Yvette] VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. RP Lambrecht, NWG (reprint author), Vet Affairs Long Beach Healthcare Syst, 5901 E 7th St,Bldg 1,Rm 200M, Long Beach, CA 90822 USA. EM Nils.Lambrecht2@va.gov OI Lambrecht, Nils/0000-0002-1275-1384 FU Department of Veterans Affairs; VA Research Career Scientist Award; NIHDK [33061, DK-41301]; German Research Foundation [STE 1765/1-1, GO 1718/1-1] FX This work was supported by Department of Veterans Affairs Merit Awards (N.W.G.L. and Y.T.) and a VA Research Career Scientist Award (Y.T.), NIHDK 33061 (Y.T.), Center grant DK-41301 (Animal Core, Y.T. and Peptidomic, Radioimmunoassay and Proteomic Core, J.R.R., Jr.) and German Research Foundation grants STE 1765/1-1 (A.S.) and GO 1718/1-1 (M.G.). We are grateful to Mrs. Honghui Liang for her excellent technical support and we thank Ms. Eugenia Hu for reviewing the manuscript. NR 42 TC 26 Z9 26 U1 0 U2 2 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 2010 VL 31 IS 9 BP 1689 EP 1696 DI 10.1016/j.peptides.2010.06.015 PG 8 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy GA 644IL UT WOS:000281368400011 PM 20599577 ER PT J AU Arar, N Seo, J Abboud, HE Parchman, M Noel, P AF Arar, Nedal Seo, Joann Abboud, Hanna E. Parchman, Michael Noel, Polly TI Providers' behavioral beliefs regarding the delivery of genomic medicine at the Veterans Health Administration SO PERSONALIZED MEDICINE LA English DT Article DE behavioral intentions; genomic medicine; genomic services; theory of planned behavior; Veterans Health Administration ID PRIMARY-CARE PHYSICIANS; FAMILY-HISTORY; PLANNED BEHAVIOR; REASONED ACTION; GENETIC TESTS; PRACTITIONERS; PERSPECTIVES; INFORMATION; CHALLENGES; INTENTION AB To examine providers' behavioral intention toward the utilization of genomic services at the Veterans Health Administration (VHA; Washington, DC, USA) through the lens of the 'Theory of Planned Behavior'. The theory of planned behavior posits that individuals' behaviors (using genomic services) are driven by their behavioral intentions. Behavioral intentions is a function of: first, behavioral beliefs; second, normative beliefs, and third; control beliefs. Materials & methods: Semi-structured interviews were conducted with 20 providers working in different units at the South Texas Veterans Health Care System (STVHCS; TX USA). The interviews focused on assessing providers' behavioral beliefs, normative beliefs and control beliefs regarding the delivery of genomic medicine at the STVHCS. Interview materials were tape recorded, transcribed and the content was analyzed using qualitative methods. Results: All participating providers perceived genomic medicine to be an important area in medicine (behavioral beliefs). They agreed that the VHA has the necessary infrastructure to foster the delivery of genomic services. The majority of participants (n = 18; 90%) agreed that primary care providers will play a major role in delivering genomic services. Providers indicated that referents' (other providers) opinions about genomic services may affect their decisions about whether to utilize genomic services (normative beliefs). However, most providers (n = 17; 85%) raised concerns about the impact of using genomic services on the process of care (control beliefs). Participants indicated that additional training for providers and patients, and decision support will facilitate the delivery of genomic services (control beliefs). Providers also identified three external barriers: first, uncertainty about genomic findings; second, coordination of care between primary care, specialists and genetic services (system level barriers); and third ethical issues associated with genomic information and services. Conclusion: Our findings highlight several opportunities and challenges related to the delivery of genomic medicine at the VHA. The results suggest that strategies to address providers' concerns in the control beliefs domain may be necessary to enhance providers' utilization of genomic services in clinical practice. C1 [Arar, Nedal; Seo, Joann; Abboud, Hanna E.; Parchman, Michael; Noel, Polly] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Div Nephrol, Audie L Murphy Mem Vet Hosp, San Antonio, TX 78229 USA. RP Arar, N (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Div Nephrol, Audie L Murphy Mem Vet Hosp, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM ararn@uthscsa.edu OI Parchman, Michael/0000-0001-7129-2889 FU VHA-HSRD FX This work was supported by the VHA-HSR&D (PI: Nedal Arar). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. NR 41 TC 4 Z9 4 U1 1 U2 6 PU FUTURE MEDICINE LTD PI LONDON PA UNITEC HOUSE, 3RD FLOOR, 2 ALBERT PLACE, FINCHLEY CENTRAL, LONDON, N3 1QB, ENGLAND SN 1741-0541 J9 PERS MED JI Pers. Med. PD SEP PY 2010 VL 7 IS 5 BP 485 EP 494 DI 10.2217/PME.10.47 PG 10 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 666HZ UT WOS:000283106800009 ER PT J AU Oyetayo, OO Rogers, CE Hofmann, PO AF Oyetayo, Ola O. Rogers, Carrie E. Hofmann, Prudence O. TI Dronedarone: A New Antiarrhythmic Agent SO PHARMACOTHERAPY LA English DT Review DE dronedarone; atrial fibrillation; atrial flutter; antiarrhythmics; amiodarone ID PERSISTENT ATRIAL-FIBRILLATION; AMIODARONE-LIKE AGENT; DE-POINTES ARRHYTHMIAS; RHYTHM-CONTROL; HEART-FAILURE; SINUS RHYTHM; COMPARATIVE EFFICACY; RANDOMIZED-TRIAL; SR-33589; MAINTENANCE AB Dronedarone is an antiarrhythmic agent recently approved by the United States Food and Drug Administration for the reduction of cardiovascular-related hospitalizations in patients with paroxysmal or persistent atrial fibrillation or atrial flutter The drug is a derivative of amiodarone and has been modified to reduce the organ toxicities frequently encountered with amiodarone. Dronedarone exerts its antiarrhythmic effects through multichannel blockade of the sodium, potassium, and calcium channels and also possesses antiadrenergic activity, thereby exhibiting pharmacologic effects of all four Vaughan Williams classes of antiarrhythmics The efficacy of dronedarone for the maintenance of sinus rhythm, ventricular rate control, and reduction in cardiovascular-related hospitalizations has been demonstrated in several randomized, placebo-controlled trials Although a high rate of gastrointestinal events (e g, nausea, vomiting, and diarrhea) has been associated with dronedarone, more serious adverse events such as thyroid, liver, or pulmonary toxicities have not been observed Because of a possible increase in mortality, dronedarone should be avoided in patients with New York Heart Association class IV or II-III heart failure with a recent decompensation Given the efficacy and safety data currently available, dronedarone represents a reasonable alternative for maintenance of sinus rhythm in appropriately selected patients C1 [Oyetayo, Ola O.; Rogers, Carrie E.; Hofmann, Prudence O.] Univ Texas Hlth Sci Ctr San Antonio, Pharmacotherapy Educ & Res Ctr, Sch Med, San Antonio, TX 78229 USA. [Oyetayo, Ola O.; Rogers, Carrie E.; Hofmann, Prudence O.] Univ Texas Austin, Coll Pharm, Austin, TX 78712 USA. [Rogers, Carrie E.; Hofmann, Prudence O.] Audie L Murphy Hosp, Dept Pharm, S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Oyetayo, OO (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Pharmacotherapy Educ & Res Ctr, Sch Med, 7703 Floyd Curl Dr,MC6220, San Antonio, TX 78229 USA. NR 52 TC 13 Z9 15 U1 0 U2 1 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 SEP PY 2010 VL 30 IS 9 BP 904 EP 915 PG 12 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 648AL UT WOS:000281662200006 PM 20795846 ER PT J AU Pinne, M Choy, HA Haake, DA AF Pinne, Marija Choy, Henry A. Haake, David A. TI The OmpL37 Surface-Exposed Protein Is Expressed by Pathogenic Leptospira during Infection and Binds Skin and Vascular Elastin SO PLOS NEGLECTED TROPICAL DISEASES LA English DT Article ID EXTRACELLULAR-MATRIX PROTEINS; OUTER-MEMBRANE PROTEINS; MONOCLONAL-ANTIBODIES; STAPHYLOCOCCUS-AUREUS; PULMONARY HEMORRHAGE; FIBRONECTIN; INTERROGANS; ADHESION; LAMININ; LIPL32 AB Pathogenic Leptospira spp. shed in the urine of reservoir hosts into freshwater can be transmitted to a susceptible host through skin abrasions or mucous membranes causing leptospirosis. The infection process involves the ability of leptospires to adhere to cell surface and extracellular matrix components, a crucial step for dissemination and colonization of host tissues. Therefore, the elucidation of novel mediators of host-pathogen interaction is important in the discovery of virulence factors involved in the pathogenesis of leptospirosis. In this study, we assess the functional roles of transmembrane outer membrane proteins OmpL36 (LIC13166), OmpL37 (LIC12263), and OmpL47 (LIC13050), which we recently identified on the leptospiral surface. We determine the capacity of these proteins to bind to host tissue components by enzyme-linked immunosorbent assay. OmpL37 binds elastin preferentially, exhibiting dose-dependent, saturating binding to human skin (K(d), 104 +/- 19 nM) and aortic elastin (K(d), 152 +/- 27 nM). It also binds fibrinogen (K(d), 244 +/- 15 nM), fibrinogen fragment D (K(d), 132 +/- 30 nM), plasma fibronectin (K(d), 359 +/- 68 nM), and murine laminin (K(d), 410 +/- 81 nM). The binding to human skin elastin by both recombinant OmpL37 and live Leptospira interrogans is specifically enhanced by rabbit antiserum for OmpL37, suggesting the involvement of OmpL37 in leptospiral binding to elastin and also the possibility that host-generated antibodies may promote rather than inhibit the adherence of leptospires to elastin-rich tissues. Further, we demonstrate that OmpL37 is recognized by acute and convalescent leptospirosis patient sera and also by Leptospira-infected hamster sera. Finally, OmpL37 protein is detected in pathogenic Leptospira serovars and not in saprophytic Leptospira. Thus, OmpL37 is a novel elastin-binding protein of pathogenic Leptospira that may be promoting attachment of Leptospira to host tissues. C1 [Pinne, Marija; Choy, Henry A.] Vet Affairs Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA USA. [Pinne, Marija; Choy, Henry A.; Haake, David A.] Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, Los Angeles, CA 90024 USA. [Haake, David A.] Vet Affairs Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA USA. [Haake, David A.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Urol, Los Angeles, CA 90095 USA. [Haake, David A.] Univ Calif Los Angeles, Dept Microbiol Immunol & Mol Genet, Los Angeles, CA USA. RP Pinne, M (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA USA. EM mpinne@ucla.edu FU National Institute of Allergy and Infectious Diseases [AI-34431]; VA Medical Research Funds FX This work was supported by Public Health Service grant AI-34431 (to D.A.H.) from the National Institute of Allergy and Infectious Diseases and by VA Medical Research Funds (to D.A.H.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 51 TC 30 Z9 30 U1 0 U2 4 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 185 BERRY ST, STE 1300, SAN FRANCISCO, CA 94107 USA SN 1935-2727 J9 PLOS NEGLECT TROP D JI Plos Neglect. Trop. Dis. PD SEP PY 2010 VL 4 IS 9 AR e815 DI 10.1371/journal.pntd.0000815 PG 12 WC Infectious Diseases; Parasitology; Tropical Medicine SC Infectious Diseases; Parasitology; Tropical Medicine GA 655TB UT WOS:000282271300018 PM 20844573 ER PT J AU Asch, DA Werner, RM AF Asch, David A. Werner, Rachel M. TI Paying for Performance in Population Health: Lessons From Health Care Settings SO PREVENTING CHRONIC DISEASE LA English DT Article AB The appeal of pay-for-performance in health care derives from the conceptual view that paying doctors and hospitals more to deliver better care will encourage them to deliver better care. What lessons can be learned from the successes and failures of pay-for-performance in health care settings that apply to pay-for-performance in population health? We argue that pay-for-performance requires conditions that are not easily met in population health settings. Pay-for-performance has focused on narrow clinical problems whose success depends on identifiable actors with the motivation and resources to change clinical processes or outcomes. In contrast, population health has broad goals, many antecedents, and no single, identifiable fiduciary (a person who holds assets in trust for a beneficiary). Nevertheless, with careful attention, conditions for successful pay-for-performance in population health might be met. C1 [Asch, David A.; Werner, Rachel M.] Univ Penn, Leonard Davis Inst Hlth Econ, Ctr Hlth Equ Res & Promot, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Asch, DA (reprint author), Univ Penn, Leonard Davis Inst Hlth Econ, Ctr Hlth Equ Res & Promot, Philadelphia Vet Affairs Med Ctr, 3641 Locust Walk, Philadelphia, PA 19104 USA. EM asch@wharton.upenn.edu FU Veterans Affairs Health Service; Robert Wood Johnson Foundation FX Rachel Werner is supported by a Veterans Affairs Health Services Research and Development Career Development Award. This manuscript was developed as part of the Mobilizing Action Toward Community Health (MATCH) project funded by the Robert Wood Johnson Foundation. NR 24 TC 1 Z9 1 U1 1 U2 3 PU CENTERS DISEASE CONTROL PI ATLANTA PA 1600 CLIFTON RD, ATLANTA, GA 30333 USA SN 1545-1151 J9 PREV CHRONIC DIS JI Prev. Chronic Dis. PD SEP PY 2010 VL 7 IS 5 AR A98 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA V20SD UT WOS:000208158800008 PM 20712946 ER PT J AU Shannon, J O'Malley, J Mori, M Garzotto, M Palma, AJ King, IB AF Shannon, J. O'Malley, J. Mori, M. Garzotto, M. Palma, A. J. King, I. B. TI Erythrocyte fatty acids and prostate cancer risk: A comparison of methods SO PROSTAGLANDINS LEUKOTRIENES AND ESSENTIAL FATTY ACIDS LA English DT Article DE Fatty acids; Prostate cancer; Principal components analysis ID ALPHA-LINOLENIC ACID; GENE-TRANSCRIPTION; BREAST-CANCER; EXPRESSION; DISEASE; PHOSPHOLIPIDS; METAANALYSIS; HYPERPLASIA; METABOLISM; LIPIDOME AB The role of fatty acids (FA) in prostate carcinogenesis is unclear. Interest in the inter-relationship among different types of FA has resulted in new analytic approaches to FA and their role in cancer development. We evaluated the association between erythrocyte FA and prostate cancer in 127 prostate cancer patients and 183 screen negative controls. We present three approaches to the analyses of the FA and prostate cancer association; (1) individual or common groups of FA, (2) biologically meaningful FA ratios and (3) principal components analysis. Monounsaturated FA and the alpha-linolenic:eicosapentaenoic ratio were associated with reduced risk of prostate cancer. However, Factor 1, which was strongly correlated with some long chain saturated FA, was associated with an increased risk of prostate cancer. We provide an example of modeling FA and their inter-relationships on the risk of prostate cancer. Comparing three approaches suggests the importance of considering the impact of the entire fatty acid profile in disease prevention. Published by Elsevier Ltd. C1 [Shannon, J.; O'Malley, J.; Mori, M.; Garzotto, M.; Palma, A. J.] Oregon Hlth & Sci Univ, Portland, OR 97239 USA. [Shannon, J.; Garzotto, M.; Palma, A. J.] Portland VA Med Ctr, Portland, OR 97239 USA. [King, I. B.] Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Seattle, WA 98101 USA. RP Shannon, J (reprint author), Oregon Hlth & Sci Univ, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM shannoja@ohsu.edu FU United States Public Health Service [5 M01 RR000334, 1 UL1 RR024120-01, K22CA94973]; Portland Veterans Affairs Medical Center FX Work Supported by: United States Public Health Service grants (5 M01 RR000334), (1 UL1 RR024120-01) and (K22CA94973) and was supported by the resources and facilities of the Portland Veterans Affairs Medical Center. Biostatistics support was provided through the Knight Cancer Institute Biostatistics Shared Resource (P30 CA069533-09) and the Oregon Clinical and Translational Research Institute (UL1 RR024140). NR 41 TC 14 Z9 14 U1 0 U2 2 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0952-3278 J9 PROSTAG LEUKOTR ESS JI Prostaglandins Leukot. Essent. Fatty Acids PD SEP PY 2010 VL 83 IS 3 BP 161 EP 169 DI 10.1016/j.plefa.2010.06.003 PG 9 WC Biochemistry & Molecular Biology; Cell Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Cell Biology; Endocrinology & Metabolism GA 657YL UT WOS:000282455200008 PM 20630734 ER PT J AU Cullen, SW Nath, SB Marcus, SC AF Cullen, Sara Wiesel Nath, Sara Bressi Marcus, Steven C. TI Toward Understanding Errors in Inpatient Psychiatry: A Qualitative Inquiry SO PSYCHIATRIC QUARTERLY LA English DT Article DE Medical error; Inpatient psychiatry; Patient safety; Error prevention ID ADVERSE EVENTS; HOSPITALIZED-PATIENTS; CARE AB While prior research has identified the impact, nature, and causes of medical error in general medical settings, little is known about errors in inpatient psychiatry. Understanding the broad range of errors that occur in inpatient psychiatry is a critical step toward improving systems of care for a vulnerable patient population. An explorative qualitative analysis of key informant interviews identified a preliminary typology of errors and the contextual factors that precipitate them in inpatient psychiatry. The types of errors and their contextual factors fall broadly within the rubric of categories identified in medicine and surgery. However, many of the specific errors and contextual factors manifest themselves differently and are shaped by the uniqueness of the inpatient psychiatric setting and patient population. Interventions geared toward improving systems of care for psychiatric patients should draw on best practices for safety in medicine and surgery, but also be complemented with new strategies specifically tailored to the inpatient psychiatric setting. C1 [Cullen, Sara Wiesel; Marcus, Steven C.] Univ Penn, Sch Social Policy & Practice, Philadelphia, PA 19104 USA. [Nath, Sara Bressi] Bryn Mawr Coll, Grad Sch Social Work & Social Res, Bryn Mawr, PA 19010 USA. [Marcus, Steven C.] Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. [Marcus, Steven C.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Marcus, SC (reprint author), Univ Penn, Sch Social Policy & Practice, 3701 Locust Walk, Philadelphia, PA 19104 USA. EM swiesel@sp2.upenn.edu; snath@brynmawr.edu; marcuss@sp2.upenn.edu NR 13 TC 1 Z9 1 U1 1 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0033-2720 J9 PSYCHIAT QUART JI Psychiatr. Q. PD SEP PY 2010 VL 81 IS 3 BP 197 EP 205 DI 10.1007/s11126-010-9129-z PG 9 WC Psychiatry SC Psychiatry GA 639YP UT WOS:000281013400002 PM 20204514 ER PT J AU Radant, AD Dobie, DJ Calkins, ME Olincy, A Braff, DL Cadenhead, KS Freedman, R Green, MF Greenwood, TA Gur, RE Gur, RC Light, GA Meichle, SP Millard, SP Mintz, J Nuechterlein, KH Schork, NJ Seidman, LJ Siever, LJ Silverman, JM Stone, WS Swerdlow, NR Tsuang, MT Turetsky, BI Tsuang, DW AF Radant, Allen D. Dobie, Dorcas J. Calkins, Monica E. Olincy, Ann Braff, David L. Cadenhead, Kristin S. Freedman, Robert Green, Michael F. Greenwood, Tiffany A. Gur, Raquel E. Gur, Ruben C. Light, Gregory A. Meichle, Sean P. Millard, Steve P. Mintz, Jim Nuechterlein, Keith H. Schork, Nicholas J. Seidman, Larry J. Siever, Larry J. Silverman, Jeremy M. Stone, William S. Swerdlow, Neal R. Tsuang, Ming T. Turetsky, Bruce I. Tsuang, Debby W. TI Antisaccade performance in schizophrenia patients, their first-degree biological relatives, and community comparison subjects: Data from the COGS study SO PSYCHOPHYSIOLOGY LA English DT Article DE Oculomotor; Endophenotype; Antisaccade; Schizophrenia; Family ID DORSOLATERAL PREFRONTAL CORTEX; SACCADIC EYE-MOVEMENTS; ADMIXTURE ANALYSIS; SMOOTH-PURSUIT; CORTICAL INHIBITION; ENDOPHENOTYPES; TASK; AGE; FAMILIES; DEFICITS AB The antisaccade task is a widely used technique to measure failure of inhibition, an important cause of cognitive and clinical abnormalities found in schizophrenia. Although antisaccade performance, which reflects the ability to inhibit prepotent responses, is a putative schizophrenia endophenotype, researchers have not consistently reported the expected differences between first-degree relatives and comparison groups. Schizophrenia participants (n=219) from the large Consortium on the Genetics of Schizophrenia (COGS) sample (n=1078) demonstrated significant deficits on an overlap version of the antisaccade task compared to their first-degree relatives (n=443) and community comparison subjects (CCS; n=416). Although mean antisaccade performance of first-degree relatives was intermediate between schizophrenia participants and CCS, a linear mixed-effects model adjusting for group, site, age, and gender found no significant performance differences between the first-degree relatives and CCS. However, admixture analyses showed that two components best explained the distributions in all three groups, suggesting two distinct doses of an etiological factor. Given the significant heritability of antisaccade performance, the effects of a genetic polymorphism is one possible explanation of our results. C1 [Radant, Allen D.; Dobie, Dorcas J.; Meichle, Sean P.; Millard, Steve P.; Tsuang, Debby W.] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Radant, Allen D.; Dobie, Dorcas J.; Meichle, Sean P.; Millard, Steve P.; Tsuang, Debby W.] Mental Illness Res Educ & Clin Ctr, Dept Vet Affairs, Seattle, WA USA. [Calkins, Monica E.; Gur, Raquel E.; Gur, Ruben C.; Turetsky, Bruce I.] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. [Olincy, Ann; Freedman, Robert] Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Aurora, CO USA. [Braff, David L.; Cadenhead, Kristin S.; Greenwood, Tiffany A.; Light, Gregory A.; Schork, Nicholas J.; Swerdlow, Neal R.; Tsuang, Ming T.] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. [Green, Michael F.; Nuechterlein, Keith H.] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, David Geffen Sch Med, Los Angeles, CA 90024 USA. [Mintz, Jim] Univ Texas Hlth Sci Ctr San Antonio, Dept Epidemiol & Biostat, San Antonio, TX 78229 USA. [Seidman, Larry J.; Stone, William S.; Tsuang, Ming T.] Harvard Univ, Sch Med, Massachusetts Mental Hlth Ctr,Dept Psychiat, Publ Psychiat Div,Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA. [Seidman, Larry J.; Stone, William S.; Tsuang, Ming T.] Harvard Inst Psychiat Epidemiol & Genet, Boston, MA USA. [Siever, Larry J.; Silverman, Jeremy M.] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. [Siever, Larry J.] James J Peters VA Med Ctr, Dept Vet Affairs, Mental Illness Res Educ & Clin Ctr, VISN 3, Bronx, NY USA. RP Radant, AD (reprint author), VAPSHCS S-116 MHC,1660 S Columbian Way, Seattle, WA 98108 USA. EM aradant@u.washington.edu RI Greenwood, Tiffany/F-6356-2012; Tsuang, Debby/L-7234-2016 OI Greenwood, Tiffany/0000-0002-6080-6503; Tsuang, Debby/0000-0002-4716-1894 FU Office of Research and Development Medical Research Service (or) Health Services R&D Service, Department of Veterans Affairs; NIMH [R01 MH65571, R01 MH65588, R01 MH65562, R01 MH65707, R01 MH65554, R01 MH65578, R01 MH65558] FX This material is based upon work supported (or supported in part) by the Office of Research and Development Medical Research Service (or) Health Services R&D Service, Department of Veterans Affairs. This study was supported by NIMH grants R01 MH65571, R01 MH65588, R01 MH65562, R01 MH65707, R01 MH65554, R01 MH65578, and R01 MH65558. NR 68 TC 25 Z9 26 U1 0 U2 3 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PD SEP PY 2010 VL 47 IS 5 BP 846 EP 856 DI 10.1111/j.1469-8986.2010.01004.x PG 11 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 635EO UT WOS:000280638600008 PM 20374545 ER PT J AU Morone, NE Weiner, DK Belnap, BH Karp, JF Mazumdar, S Houck, PR He, FY Rollman, BL AF Morone, Natalia E. Weiner, Debra K. Belnap, Bea Herbeck Karp, Jordan F. Mazumdar, Sati Houck, Patricia R. He, Fanyin Rollman, Bruce L. TI The Impact of Pain and Depression on Recovery After Coronary Artery Bypass Grafting SO PSYCHOSOMATIC MEDICINE LA English DT Article DE depression; pain; CABG; collaborative care ID POST-CABG DEPRESSION; COLLABORATIVE CARE; TREATMENT RESPONSE; SURGERY; PREDICTORS; SYMPTOMS; VALIDITY; ADULTS; SF-36; LIFE AB Objective: To describe the relationship between pain and depression on recovery after coronary artery bypass grafting (CABG). Methods: A secondary data analysis on 453 depressed and nondepressed post-CABG patients enrolled in a randomized, controlled, effectiveness trial of telephone-delivered collaborative care for depression. Outcome measures were collected from March 2004 to September 2007 and included pain, physical function, and mood symptoms. Results: Depressed patients (baseline Patient Health Questionnaire-9 score >= 10) versus those without depression reported significantly worse pain scores on the 36-Item Short Form Health Survey Bodily Pain Scale at baseline and up to 12 months post-CABG, p < .05. Among patients with depression, those who received collaborative care reported significantly better pain scores at each time point between 2 and 12 months post-CABG versus depressed patients randomized to the usual care control group, p < .05. Regardless of intervention status, depressed participants with at least moderate pain at baseline reported significantly lower functional status (measured by the Duke Activity Status Index) at 8 and 12 months versus depressed patients with none or mild pain, p < .05. Depressed patients with at least moderate pain at baseline were also significantly less likely to show improvement of depressive symptoms throughout the course of follow-up versus depressed patients with little or no pain, p < .05. These findings controlled for age, gender, education, race, comorbid conditions, and baseline pain diagnosis. Conclusions: Depression and pain seem to influence functional recovery post-CABG. The relationship between these two conditions and 12-month outcomes should be considered by clinicians when planning treatment. C1 [Morone, Natalia E.; Belnap, Bea Herbeck; Rollman, Bruce L.] Univ Pittsburgh, Div Gen Internal Med, Dept Med, Pittsburgh, PA 15260 USA. [Morone, Natalia E.; Karp, Jordan F.] Univ Pittsburgh, Clin & Translat Sci Inst, Pittsburgh, PA 15260 USA. [Weiner, Debra K.] Univ Pittsburgh, Div Geriatr Med, Dept Med, Pittsburgh, PA 15260 USA. [Weiner, Debra K.; Karp, Jordan F.; Mazumdar, Sati; Houck, Patricia R.] Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15260 USA. [Weiner, Debra K.; Karp, Jordan F.] Univ Pittsburgh, Dept Anesthesiol, Pittsburgh, PA 15260 USA. [Mazumdar, Sati; He, Fanyin] Univ Pittsburgh, Dept Biostat, Grad Sch Publ Hlth, Pittsburgh, PA 15260 USA. [Weiner, Debra K.] VA Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA. RP Morone, NE (reprint author), 230 McKee Pl,Suite 600, Pittsburgh, PA 15213 USA. EM moronene@upmc.edu FU National Institutes of Health (NIH) [R01 HL70000]; National Center for Research Resources (NCRR), NIH [KL2RR024154]; NIH Roadmap for Medical Research FX Supported by National Institutes of Health (NIH) Grant R01 HL70000 and by KL2RR024154 from the National Center for Research Resources (NCRR; a component of the NIH) and NIH Roadmap for Medical Research (to N.E.M. and J.F.K.). NR 23 TC 19 Z9 21 U1 1 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0033-3174 J9 PSYCHOSOM MED JI Psychosom. Med. PD SEP PY 2010 VL 72 IS 7 BP 620 EP 625 DI 10.1097/PSY.0b013e3181e6df90 PG 6 WC Psychiatry; Psychology; Psychology, Multidisciplinary SC Psychiatry; Psychology GA 653IY UT WOS:000282084000004 PM 20562371 ER PT J AU Morasco, BJ Loftis, JM Indest, DW Ruimy, S Davison, JW Felker, B Hauser, P AF Morasco, Benjamin J. Loftis, Jennifer M. Indest, David W. Ruimy, Samantha Davison, John W. Felker, Bradford Hauser, Peter TI Prophylactic Antidepressant Treatment in Patients With Hepatitis C on Antiviral Therapy: A Double-Blind, Placebo-Controlled Trial SO PSYCHOSOMATICS LA English DT Article ID INTERFERON-INDUCED DEPRESSION; ALPHA-INDUCED DEPRESSION; SYMPTOMS; PREVENTION; PAROXETINE; MANAGEMENT; RIBAVIRIN AB Background: Approximately one-third of patients undergoing interferon-alpha (IFN-alpha) therapy for treatment of the hepatitis C virus (HCV) develop major depression, which decreases functioning and may lead to the reduction or discontinuation of treatment. Objective: The authors examined the efficacy of citalopram in preventing IFN-alpha-induced depression in HCV patients. Method: This was a randomized, controlled trial comparing citalopram with placebo in 39 HCV patients. Results: The rate of IFN-alpha-induced depression in the sample was 15.4% (6/39). Randomization to citalopram did not decrease the statistical likelihood of developing IFN-alpha-induced depression (10.5% for citalopram vs. 20.0% for placebo). Conclusion: Citalopram does not prevent depression onset; however, an empirically-supported treatment recommendation for IFN-alpha-induced depression includes monitoring depressive symptoms throughout antiviral therapy and initiating psychiatric treatment at the initial signs of depression. (Psychosomatics 2010; 51: 401-408) C1 [Morasco, Benjamin J.] Portland VA Med Ctr, Behav Hlth & Clin Neurosci Div, Portland, OR 97239 USA. Portland VA Med Ctr, NW Hepatitis Resource Ctr C, Portland, OR 97239 USA. OR Hlth & Sci Univ, Dept Psychiat, Portland, OR USA. OR Hlth & Sci Univ, Dept Behav Neurosci, Portland, OR USA. Dept Vet Affairs, Publ Hlth Strateg Hlth Care Grp, Washington, DC USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. VISN 20 Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. OR Hlth & Sci Univ, Dept Internal Med, Portland, OR USA. RP Morasco, BJ (reprint author), Portland VA Med Ctr, Behav Hlth & Clin Neurosci Div, 3710 SW US Vet Hosp Rd R&D 99, Portland, OR 97239 USA. EM benjamin.morasco@va.gov FU Department of Veterans Affairs; National Institutes of Health [K23DA023467-01A1]; Janssen Pharmaceutica FX This material is based on work supported in part by the Office of Research Development, Clinical Sciences Research and Development Service, from the Department of Veterans Affairs. Dr. Morasco receives support from the National Institutes of Health (K23DA023467-01A1). The authors also appreciate collaboration from members of the Northwest Hepatitis C Resource Center.; Dr. Hauser has grant funding from Janssen Pharmaceutica and is currently on the speaker's bureau for AstraZeneca and Jazz Pharmaceutical. No other coauthor reports a potential conflict of interest. NR 23 TC 35 Z9 38 U1 0 U2 1 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0033-3182 J9 PSYCHOSOMATICS JI Psychosomatics PD SEP-OCT PY 2010 VL 51 IS 5 BP 401 EP 408 PG 8 WC Psychiatry; Psychology SC Psychiatry; Psychology GA 649AF UT WOS:000281736600006 PM 20833939 ER PT J AU Wieseler, KM Bhargava, P Kanal, KM Vaidya, S Stewart, BK Dighe, MK AF Wieseler, Karen M. Bhargava, Puneet Kanal, Kalpana M. Vaidya, Sandeep Stewart, Brent K. Dighe, Manjiri K. TI Imaging in Pregnant Patients: Examination Appropriateness SO RADIOGRAPHICS LA English DT Article ID ACUTE PULMONARY-EMBOLISM; AAPM/RSNA PHYSICS TUTORIAL; LOWER-QUADRANT PAIN; ACUTE APPENDICITIS; SUSPECTED APPENDICITIS; COMPUTED-TOMOGRAPHY; HELICAL CT; PERFUSION SCINTIGRAPHY; RADIATION-EXPOSURE; ABDOMINAL-PAIN AB A recurring source of contention between clinicians and radiologists continues to be examination appropriateness when imaging pregnant patients. With the multitude of references on potential radiation risks to the fetus, radiologists tend to be cautious and hesitant about exposing the fetus to radiation. This tendency is often interpreted by referring physicians as intrusion into and delay in the care of their patients. The risk burden of radiation exposure to the fetus has to be carefully weighed against the benefits of obtaining a critical diagnosis quickly and using a single tailored imaging study. In general, there is lower than expected awareness of radiation risks to the fetus from imaging pregnant patients. Modalities that do not use ionizing radiation, such as ultrasonography and magnetic resonance imaging, should be the preferred examinations for evaluating an acute condition in a pregnant patient. However, no examination should be withheld when an important clinical diagnosis is under consideration. Exposure to ionizing radiation may be unavoidable, but there is no evidence to suggest that the risk to the fetus after a single imaging study and an interventional procedure is significant. All efforts should be made to minimize the exposure, with consideration of the risk versus benefit for a given clinical scenario. (C) RSNA, 2010 . radiographics.rsna.org C1 [Wieseler, Karen M.; Bhargava, Puneet; Kanal, Kalpana M.; Vaidya, Sandeep; Stewart, Brent K.; Dighe, Manjiri K.] Univ Washington, Med Ctr, Dept Radiol, Seattle, WA 98195 USA. [Bhargava, Puneet] Vet Affairs Puget Sound Healthcare Syst, Dept Radiol, Seattle, WA USA. [Vaidya, Sandeep] Univ Washington, Harborview Med Ctr, Dept Radiol, Seattle, WA 98104 USA. RP Dighe, MK (reprint author), Univ Washington, Med Ctr, Dept Radiol, Box 357115,1959 NE Pacific St, Seattle, WA 98195 USA. EM dighe@u.washington.edu RI Bhargava, Puneet /F-1330-2011 OI Bhargava, Puneet/0000-0002-3849-9666 NR 62 TC 49 Z9 49 U1 0 U2 3 PU RADIOLOGICAL SOC NORTH AMERICA PI OAK BROOK PA 820 JORIE BLVD, OAK BROOK, IL 60523 USA SN 0271-5333 J9 RADIOGRAPHICS JI Radiographics PD SEP PY 2010 VL 30 IS 5 BP 1215 EP 1229 DI 10.1148/rg.305105034 PG 15 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 651YV UT WOS:000281966100005 PM 20833847 ER PT J AU Kuna, ST AF Kuna, Samuel T. TI Portable-Monitor Testing: An Alternative Strategy for Managing Patients With Obstructive Sleep Apnea SO RESPIRATORY CARE LA English DT Article; Proceedings Paper CT 56th International Respiratory Congress of the American-Association-for-Respiratory-Care CY DEC 06-09, 2010 CL Las Vegas, NV SP Amer Assoc Resp Care DE sleep; polysomnogram; continuous positive airway pressure; CPAP; comparative effectiveness research ID POSITIVE AIRWAY PRESSURE; SPLIT-NIGHT POLYSOMNOGRAPHY; MIDDLE-AGED MEN; CPAP TITRATION; DAYTIME SLEEPINESS; HEART HEALTH; PRACTICE PARAMETERS; TELEMONITORED POLYSOMNOGRAPHY; APNOEA/HYPOPNOEA SYNDROME; CARDIOVASCULAR OUTCOMES AB Portable-monitor testing is being used increasingly in ambulatory management pathways for the diagnosis and treatment of patients with obstructive sleep apnea. Wide varieties of portable monitors are commercially available and they range from single-channel recorders to units that record a full polysomnogram. Recent comparative effectiveness research studies have shown that clinical outcomes of patients with a high pretest probability for obstructive sleep apnea who receive ambulatory management using portable-monitor testing have similar functional outcomes and adherence to continuous positive airway pressure treatment, compared to patients managed with in-laboratory polysomnography. The cost-effectiveness of portable-monitor testing and its potential to improve patient access to diagnosis and treatment requires further investigation. C1 [Kuna, Samuel T.] Univ Penn, Sch Med, Div Pulm Allergy & Crit Care, Dept Med, Philadelphia, PA 19104 USA. [Kuna, Samuel T.] Philadelphia Vet Affairs Med Ctr, Pulm Crit Care & Sleep Sect, Philadelphia, PA USA. RP Kuna, ST (reprint author), Univ Penn, Sch Med, Div Pulm Allergy & Crit Care, Dept Med, 3624 Market St,Suite 205, Philadelphia, PA 19104 USA. EM skuna@mail.med.upenn.edu NR 123 TC 15 Z9 16 U1 0 U2 2 PU DAEDALUS ENTERPRISES INC PI IRVING PA 9425 N MAC ARTHUR BLVD, STE 100, IRVING, TX 75063-4706 USA SN 0020-1324 EI 1943-3654 J9 RESP CARE JI Respir. Care PD SEP PY 2010 VL 55 IS 9 SI SI BP 1196 EP 1215 PG 20 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 676AL UT WOS:000283882400006 PM 20800001 ER PT J AU Adams, SG Anzueto, A Briggs, DD Leimer, I Kesten, S AF Adams, Sandra G. Anzueto, Antonio Briggs, Dick D., Jr. Leimer, Inge Kesten, Steven TI Comment on tiotropium Response SO RESPIRATORY MEDICINE LA English DT Letter C1 [Adams, Sandra G.; Anzueto, Antonio] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Adams, Sandra G.; Anzueto, Antonio] S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78229 USA. [Briggs, Dick D., Jr.] Univ Alabama, Birmingham, AL 35294 USA. [Leimer, Inge; Kesten, Steven] Boehringer Ingelheim GmbH & Co KG, Ingelheim, Germany. RP Adams, SG (reprint author), Univ Texas Hlth Sci Ctr San Antonio, 7400 Merton Minter,111E, San Antonio, TX 78229 USA. EM ADAMSSG@UTHSCSA.EDU NR 0 TC 0 Z9 0 U1 0 U2 0 PU W B SAUNDERS CO LTD PI LONDON PA 32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND SN 0954-6111 J9 RESP MED JI Respir. Med. PD SEP PY 2010 VL 104 IS 9 BP 1389 EP 1389 DI 10.1016/j.rmed.2010.04.019 PG 1 WC Cardiac & Cardiovascular Systems; Respiratory System SC Cardiovascular System & Cardiology; Respiratory System GA 640WJ UT WOS:000281084400024 ER PT J AU Kasckow, J Liu, N Haas, GL Phillips, MR AF Kasckow, John Liu, Nancy Haas, Gretchen L. Phillips, Michael R. TI Case-control study of the relationship of depressive symptoms to suicide in a community-based sample of individuals with schizophrenia in China SO SCHIZOPHRENIA RESEARCH LA English DT Article DE Depression; Suicide; Schizophrenia; China; Psychological autopsy ID PSYCHOLOGICAL AUTOPSY; RISK-FACTORS; MENTAL-DISORDERS; RURAL-COMMUNITY; MAINLAND CHINA; PREVENTION; MORTALITY; TRIAL; MOOD AB Background: Suicide is the leading cause of premature death among people with schizophrenia. Most studies on suicide and schizophrenia report an associated depression history, but they are based on clinical samples from mostly western countries. Methods: We conducted a secondary analysis of 74 suicides (cases) and 24 accidental deaths (controls) among persons with schizophrenia identified in a national psychological autopsy study in mainland China using the Chinese version of the Structured Clinical Interview for DSM-IV. A 'depression symptom severity score' based on number, severity, and persistence of depressive symptoms 2 weeks before death was derived from psychiatric interviews with 2 informants; determination of a 'dysfunction due to depressive symptoms score' was based on informants' reports about effects of depressive symptoms on decedents' functioning in the month before death. In addition, the mean number of negative life events was determined along with the effect of the events on the decedent. Comparison of the measures made for cases and controls were made by univariate analysis followed by adjustments using the False Discovery Rate. Results: Compared to persons with schizophrenia who died by accident, those who died by suicide were more likely to have a recent DSM IV diagnosis of major depression, the symptom of depressed mood, thoughts of death and a prior suicide attempt. In addition, those who died by suicide were more likely to have a higher overall depression severity score and greater dysfunction due to depressive symptoms. Discussion: This community-based study of individuals with DSM-IV schizophrenia who died by suicide in a non-western culture extends findings from clinical studies in western cultures providing data on the importance of depressive symptoms as risk factors for suicide in schizophrenia in a low income rural setting. These findings underline the importance of routine screening for depressive symptoms among patients with schizophrenia. Published by Elsevier B.V. C1 [Kasckow, John; Haas, Gretchen L.] VA Pittsburgh Hlth Care Syst MIRECC, Pittsburgh, PA 15206 USA. [Kasckow, John; Haas, Gretchen L.] Behav Hlth Serv, Pittsburgh, PA 15206 USA. [Kasckow, John; Haas, Gretchen L.] Univ Pittsburgh, Western Psychiat Inst & Clin, Med Ctr, Pittsburgh, PA 15213 USA. [Liu, Nancy; Phillips, Michael R.] Beijing Hui Long Guan Hosp, WHO Collaborating Ctr Res & Training Suicide Prev, Beijing, Peoples R China. [Liu, Nancy] Univ Nebraska, Dept Psychol, Lincoln, NE 68588 USA. [Phillips, Michael R.] Columbia Univ, Dept Psychiat, New York, NY USA. [Phillips, Michael R.] Columbia Univ, Dept Epidemiol, New York, NY USA. RP Kasckow, J (reprint author), VA Pittsburgh Hlth Care Syst, Behav Hlth, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM kasckowjw@upmc.edu FU Ford Foundation; Befrienders International; University of Pittsburgh Medical Center FX This study was supported by institutional support from the University of Pittsburgh Medical Center as well as grants from the Ford Foundation, the Save the Children Fund, and Befrienders International. Participating institutions include 23 Disease Surveillance Points and four psychiatric centres (Department of Neuropsychiatry, Xijing Hospital, Xian, Shaanxi Province; Jingzhou City Psychiatric Hospital, Hubei Province; Shenyang Mental Health Centre, Liaoning Province; and Suzhou Guangji Hospital, Jiangsu Province).; This study is part of the 'Causes and Prevention of Accidental Deaths in China' project, which was supported by grants from the Ford Foundation, the Save the Children Fund, and Befrienders International. Participating institutions include 23 Disease Surveillance Points and four psychiatric centres (Department of Neuropsychiatry, Xijing Hospital, Xian, Shaanxi Province; Jingzhou City Psychiatric Hospital, Hubei Province; Shenyang Mental Health Centre, Liaoning Province; and Suzhou Guangji Hospital, Jiangsu Province). The authors thank all the institutions, investigators and respondents for their contribution to the research. NR 39 TC 9 Z9 10 U1 6 U2 8 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 2010 VL 122 IS 1-3 BP 226 EP 231 DI 10.1016/j.schres.2010.02.1056 PG 6 WC Psychiatry SC Psychiatry GA 709AH UT WOS:000286406900029 PM 20227247 ER PT J AU Messamore, E Hoffman, WF Yao, JK AF Messamore, Erik Hoffman, William F. Yao, Jeffrey K. TI Niacin sensitivity and the arachidonic acid pathway in schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE Niacin; Schizophrenia; RBC membrane; Arachidonic acid; Adrenic acid ID POLYUNSATURATED FATTY-ACID; SKIN FLUSH RESPONSE; NICOTINIC-ACID; HUMAN ERYTHROCYTES; ABSENT RESPONSE; RECEPTOR HM74A; CELL MEMBRANES; VASODILATION; PATCH AB Objective: Schizophrenia is associated with a blunted flush response to niacin. Since niacin-induced skin flushing is mediated by vasodilators derived from arachidonic acid (AA), we tested whether the blunted flush response to niacin is a marker of AA deficiency. Methods: Eight concentrations of methylnicotinate were applied to the forearms of 20 adults with schizophrenia and 20 controls. Laser Doppler measurement of blood flow responses was used to derive values for niacin sensitivity (defined as the concentration eliciting half-maximal response, i.e., EC(50) value) and efficacy (defined as the maximal evoked blood flow response). RBC membrane fatty acids were analyzed by gas chromatography. Results: Niacin sensitivity and efficacy were reduced in schizophrenia. In the control group, there was significant correlation between AA levels and niacin sensitivity as well as a trend toward correlation between AA levels and niacin efficacy. In contrast, neither sensitivity nor efficacy of niacin correlated with AA levels in schizophrenia. An expected correlation between the levels of AA and its elongation product (adrenic acid) was absent in schizophrenia. Adrenic acid levels correlated with niacin efficacy in schizophrenia. Conclusions: The schizophrenia-associated niacin response abnormality involves both diminished sensitivity and reduced efficacy. The lack of expected correlation between levels of AA and adrenic acid suggests homeostatic imbalance within the n-6 polyunsaturated fatty acid (PUFA) pathway in schizophrenia. Though AA levels were unrelated to measures of niacin response in schizophrenia, the correlation between adrenic acid and niacin efficacy in schizophrenia suggests relevance of the n-6 PUFA pathway to the blunted niacin response. Published by Elsevier B.V. C1 [Messamore, Erik; Hoffman, William F.] Portland VA Med Ctr, Behav Hlth & Clin Neurosci Div, Portland, OR 97239 USA. [Yao, Jeffrey K.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. [Yao, Jeffrey K.] Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15213 USA. [Yao, Jeffrey K.] Univ Pittsburgh, Dept Pharmaceut Sci, Pittsburgh, PA 15213 USA. RP Messamore, E (reprint author), Portland VA Med Ctr, Div Mental Hlth, P35C,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM Erik.Messamore@va.gov FU NIMH [R03 MH070434, R01 MH58141]; VA FX Funding for this study was provided by: NIMH grant R03 MH070434 (to EM); NIMH grant R01 MH58141 (JKY); and a VA Senior Research Career Scientist Award (JKY). NR 42 TC 15 Z9 15 U1 3 U2 7 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 2010 VL 122 IS 1-3 BP 248 EP 256 DI 10.1016/j.schres.2010.03.025 PG 9 WC Psychiatry SC Psychiatry GA 709AH UT WOS:000286406900032 PM 20417059 ER PT J AU Williams, B Woodby, L Drentea, P AF Williams, Beverley Woodby, Lesa Drentea, Patricia TI Ethical capital: 'What's a poor man got to leave?' SO SOCIOLOGY OF HEALTH & ILLNESS LA English DT Article DE dying; socioeconomic status; capital; legacy ID AFRICAN-AMERICAN; OLDER-ADULTS; LEGACY; DEATH; IMPACT; LIFE; PARTICIPATION; AWARENESS; ACCOUNTS; SELF AB For those of little or no means, leaving one's mark through financial assets, social connections, and human investment is difficult. Using secondary analysis of transcripts from face-to-face interviews with 33 terminally-ill patients from an outpatient clinic at a public hospital serving the disadvantaged in the southern United States, we examine the legacy participants wish to leave behind. As part of this process, participants assess life circumstances to try and generate a legacy allowing them to remain personally relevant to loved ones after death. For the low-SES terminally ill persons in this study, the desire to leave a material legacy and the means to do so are not congruous. In the absence of economic resources to bequeath loved ones, participants describe their desire to leave loved ones some form of ethical currency to facilitate interactions with others and protect them against social marginalisation. We call this concept ethical capital. We then argue ethical capital is a way for disadvantaged people to find dignity and to affirm their lives. C1 [Drentea, Patricia] Univ Alabama, Dept Sociol, Birmingham, AL 35294 USA. [Williams, Beverley; Woodby, Lesa] Birmingham VA Med Ctr, Dept Vet Affairs, Birmingham, AL USA. RP Drentea, P (reprint author), Univ Alabama, Dept Sociol, HHB 460,1530 3rd Ave S, Birmingham, AL 35294 USA. EM pdrentea@uab.edu NR 60 TC 3 Z9 3 U1 3 U2 9 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0141-9889 J9 SOCIOL HEALTH ILL JI Sociol. Health Ill. PD SEP PY 2010 VL 32 IS 6 BP 880 EP 897 DI 10.1111/j.1467-9566.2010.01246.x PG 18 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical; Sociology SC Public, Environmental & Occupational Health; Biomedical Social Sciences; Sociology GA 655EC UT WOS:000282225800004 PM 20633241 ER PT J AU Gaffey, JL Ghanayem, AJ Voronov, ML Havey, RM Carandang, G Abjornson, C Patwardhan, AG AF Gaffey, John L. Ghanayem, Alexander J. Voronov, Michael L. Havey, Robert M. Carandang, Gerard Abjornson, Celeste Patwardhan, Avinash G. TI Effect of Increasing Implant Height on Lumbar Spine Kinematics and Foraminal Size Using the ProDisc-L Prosthesis SO SPINE LA English DT Article DE lumbar spine; TDR; prosthesis height; range of motion; foramen; biomechanics ID TOTAL DISC REPLACEMENT; FOLLOW-UP; II PROSTHESIS; MOTION; OUTCOMES; FUSION; RANGE; ADJACENT; TRIAL AB Study Design. A biomechanical study using human lumbar spines. Objective. To test the hypotheses that with increasing implant height (1) the range of motion (ROM) of the implanted segment will decrease, (2) the segmental lordosis will increase, and (3) the size of the neural foramens will increase. Summary of Background Data. Little is known about the effects of the implant height on the segmental motion and foraminal size at the implanted level. Methods. Seven human lumbar spines (age, 54.4 +/- 11.4 years; L1-sacrum) were tested intact, and after discectomy at L4-L5 and sequential insertion of ProDisc-L implants (Synthes Spine, Paoli, PA) of increasing heights (10, 12, and 14 mm). The specimens were tested in flexion (8 Nm) and extension (+/- 6 Nm) with a 400 N follower preload as well as in lateral bending (+/- 6 Nm) and axial rotation (+/- 5 Nm) without preload. Three-dimensional motions were measured at L4-L5. Foraminal sizes at L4-L5 were measured in the specimen's neutral posture under a 400 N preload for the intact spine and after each implantation using finely graded cylindrical probes. Segmental lordosis was measured in the specimen's neutral posture under a 400 N preload by analyzing digital fluoroscopic images. Effects of implant height on the kinematics, foraminal size, and segmental lordosis were assessed using paired comparisons with Bonferroni correction. Results. Increasing implant height from 10 mm to 14 mm caused a significant decrease (P < 0.05) in segmental ROM by up to 37% +/- 21% in flexion/extension, 33% +/- 18% in lateral bending, and 29% +/- 28% in axial rotation. Increasing implant height also produced a significant increase in segmental lordosis (P < 0.05): from 9.7 degrees +/- 2.9 degrees at 10 mm, to 16.1 degrees +/- 5.1 degrees at 14 mm. The increase in foraminal size, while significant, was only 4.6% +/- 3.2% when comparing 10 mm to 14 mm implants. Conclusion. These results suggest that a smaller implant height should be selected to optimize the ROM of the implanted segment and maintain sagittal balance. C1 [Gaffey, John L.; Ghanayem, Alexander J.; Voronov, Michael L.; Havey, Robert M.; Patwardhan, Avinash G.] Loyola Univ, Med Ctr, Dept Orthopaed Surg & Rehabil, Maywood, IL 60153 USA. [Gaffey, John L.; Ghanayem, Alexander J.; Voronov, Michael L.; Havey, Robert M.; Carandang, Gerard; Patwardhan, Avinash G.] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. [Abjornson, Celeste] Synthes Spine, Paoli, PA USA. RP Patwardhan, AG (reprint author), Loyola Univ, Med Ctr, Dept Orthopaed Surg & Rehabil, 2160 S 1st Ave, Maywood, IL 60153 USA. EM apatwar@lumc.edu FU Department of Veterans Affairs, WA, DC; Synthes Spine, Paoli, PA FX Supported by the Department of Veterans Affairs, WA, DC and Synthes Spine, Paoli, PA. NR 23 TC 10 Z9 10 U1 4 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0362-2436 J9 SPINE JI SPINE PD SEP 1 PY 2010 VL 35 IS 19 BP 1777 EP 1782 DI 10.1097/BRS.0b013e3181ebaa4d PG 6 WC Clinical Neurology; Orthopedics SC Neurosciences & Neurology; Orthopedics GA 647YI UT WOS:000281656400006 PM 20700082 ER PT J AU Fenton, MS Marion, KM Salem, AK Hogen, R Naeim, F Hershman, JM AF Fenton, Mike S. Marion, Kenneth M. Salem, Andrew K. Hogen, Rachel Naeim, Faramarz Hershman, Jerome M. TI Sunitinib Inhibits MEK/ERK and SAPK/JNK Pathways and Increases Sodium/Iodide Symporter Expression in Papillary Thyroid Cancer SO THYROID LA English DT Article ID TYROSINE KINASE INHIBITOR; SODIUM-IODIDE SYMPORTER; UPSTREAM ENHANCER; GENE-EXPRESSION; CELL-LINES; CARCINOMA; ACTIVATION; GROWTH; TRANSCRIPTION; RECEPTOR AB Background: Sunitinib malate (Sutent (R), Pfizer, Inc.; SU11248) is a selective, multitargeted inhibitor of receptor tyrosine kinases and has been shown to inhibit receptors for VEGF, PDGF, KIT, FLT3, and RET. The objective of this study was to determine the effects of sunitinib on signal transduction pathways and on gene expression of iodide-metabolizing proteins in papillary cancer cells with the RET/PTC1 rearrangement. Methods: We investigated the effects of sunitinib on cell growth, signal transduction pathways, and thyroid-specific gene expression in papillary thyroid cancer (PTC) cell lines that had the RET/PTC1 rearrangement. Results: Sunitinib inhibited proliferation of RET/PTC1 subclones in a time-and dose-related manner. The mean 50% lethal concentration in the RET/PTC1 subclones was 1.81 mu M. Incubation of RET/PTC1 cells with 1 mu M sunitinib inhibited their migration potential and transformed their morphology. Sunitinib inhibited RET autophosphorylation at Y1062 and the activation of signal transducer and activator of transcription 3 by blocking Y705 phosphorylation. Sunitinib caused cell cycle arrest in the G0/G1 phase and dephosphorylation of retinoblastoma protein, but did not induce apoptosis. Western blot analysis of the p38, MEK/ERK, and SAPK/JNK mitogen-activated protein kinase signal transduction pathways showed that sunitinib blocked ERK 1/2 and JNK phosphorylation in the cytoplasm. Sunitinib treatment of RET/PTC1 cell lines, in combination, with forskolin induced expression of the sodium (Na)/iodide (I) symporter (NIS) and the transcription factors that bind the NIS upstream enhancer. Mechanistically, the inhibition of both MEK/ERK and SAPK/JNK cytoplasmic pathways individually and in combination caused an increase in NIS gene expression. Conclusion: Sunitinib appears to target the cytosolic MEK/ERK and SAPK/JNK pathways in the RET/PTC1 cell lines, suggesting that blocking these pathways is at least part of the mechanism by which sunitinib inhibits cell proliferation and causes stimulation of NIS gene expression in RET/PTC1 cells. C1 Univ Calif Los Angeles, Dept Med, Endocrinol & Diabet Div, Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Hershman, JM (reprint author), VA Med Ctr W Los Angeles, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jhershmn@ucla.edu FU Department of Veterans Affairs; Pfizer, Inc. FX The authors thank Dr. Gregory Brent and Dr. Takahiko Kogai for kindly providing the hNIS and hGAPDH primers and for enlightening discussions and review of the manuscript. The authors thank Dr. Masahiro Sugawara for providing material used in this work. The authors thank Matthew Rettig for helpful discussions. This work was supported by Merit Research Funds from the Department of Veterans Affairs to J.M.H. and a grant from Pfizer, Inc. NR 27 TC 20 Z9 24 U1 0 U2 3 PU MARY ANN LIEBERT, INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1050-7256 EI 1557-9077 J9 THYROID JI Thyroid PD SEP PY 2010 VL 20 IS 9 BP 965 EP 974 DI 10.1089/thy.2010.0008 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 648BW UT WOS:000281666400006 PM 20629553 ER PT J AU Arrieta-Cruz, I Pavlides, C Pasinetti, GM AF Arrieta-Cruz, Isabel Pavlides, Constantine Pasinetti, Giulio Maria TI DEEP BRAIN STIMULATION IN MIDLINE THALAMIC REGION FACILITATES SYNAPTIC TRANSMISSION AND SHORT-TERM MEMORY IN A MOUSE MODEL OF ALZHEIMER'S DISEASE SO TRANSLATIONAL NEUROSCIENCE LA English DT Article DE Alzheimer's disease; Deep brain stimulation; Hippocampus; LTP; Neuronal transmission Synaptic plasticity; Memory; TgCRND8 mice; Thalamus AB Based on evidence suggesting that deep brain stimulation (DBS) may promote certain cognitive processes, we have been interested in developing DBS as a means of mitigating memory and learning impairments in Alzheimer's disease (AD). In this study we used an animal model of AD (TgCRND8 mice) to determine the effects of high-frequency stimulation (HFS) on non-amyloidogenic alpha-secretase activity and DBS in short-term memory. We tested our hypothesis using hippocampal slices (in vitro studies) from TgCRND8 mice to evaluate whether HFS increases a-secretase activity (non-amyloidogenic pathway) in the CA1 region. In a second set of experiments, we performed in vivo studies to evaluate whether DBS in midline thalamic region re-establishes hippocampal dependent short-term memory in TgCRND8 mice. The results showed that application of HFS to isolated hippocampal slices significantly increased synaptic plasticity in the CA1 region and promoted a 2-fold increase of non-amyloidogenic a-secretase activity, in comparison to low frequency stimulated controls from TgCRND8 mice. In the in vivo studies, DBS treatment facilitated acquisition of object recognition memory in TgCRND8 mice, in comparison to their own baseline before treatment. These results provide evidence that DBS could enhance short-term memory in the CA1 region of hippocampus in a mouse model of AD. C1 [Arrieta-Cruz, Isabel; Pasinetti, Giulio Maria] Mt Sinai Sch Med, Dept Neurol, New York, NY 10029 USA. [Pavlides, Constantine] Rockefeller Univ, New York, NY 10065 USA. [Pasinetti, Giulio Maria] James J Peters Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY 10468 USA. RP Arrieta-Cruz, I (reprint author), Mt Sinai Sch Med, Dept Neurol, New York, NY 10029 USA. EM giulio.pasinetti@mssm.edu FU NIA NIH HHS [U01 AG029310] NR 16 TC 8 Z9 8 U1 0 U2 9 PU VERSITA PI WARSAW PA SOLIPSKA 14A-1, 02-482 WARSAW, POLAND SN 2081-3856 J9 TRANSL NEUROSCI JI Transl. Neurosci. PD SEP PY 2010 VL 1 IS 3 BP 188 EP 194 DI 10.2478/v10134-010-0023-x PG 7 WC Neurosciences SC Neurosciences & Neurology GA V20PZ UT WOS:000208153200001 PM 23227306 ER PT J AU Kane, CJ Im, R Amling, CL Presti, JC Aronson, WJ Terris, MK Freedland, SJ AF Kane, Christopher J. Im, Ronald Amling, Christopher L. Presti, Joseph C., Jr. Aronson, William J. Terris, Martha K. Freedland, Stephen J. CA SEARCH Database Study Grp TI Outcomes After Radical Prostatectomy Among Men Who Are Candidates for Active Surveillance: Results From the SEARCH Database SO UROLOGY LA English DT Article ID AGENT-ORANGE; CANCER; RISK; BIOPSY; PREDICTOR; RECURRENCE; MANAGEMENT; CARCINOMA; VETERANS; EXPOSURE AB OBJECTIVE We sought to evaluate outcomes after radical prostatectomy among men with low-risk prostate cancer who would be candidates for active surveillance. METHODS Using the Shared Equal Access Regional Cancer Hospital (SEARCH) database of men treated with radical prostatectomy at multiple equal-access medical centers between 1988 and 2007, 398 of 2062 men (19%) met our criteria for potential active surveillance: clinical stage T1c or T2a, prostate-specific antigen (PSA) < 10 ng/mL, Gleason sum <= 6, and no more than 1 or 2 positive cores on at least a sextant biopsy. We examined the risk of adverse pathology, biochemical progression, and PSA doubling time (PSADT) at the time of recurrence. We used a Cox proportional hazards model to determine the significant predictors of PSA progression. RESULTS Of the men with low-risk prostate cancer, 85% had organ-confined disease, only 2% had seminal vesicle invasion, and no patient had lymph node metastasis. The 5- and 10 year PSA-free survival rates were 81% (95% CI: 76-86%) and 66% (95% CI: 54-76%). On multivariate analysis, older age (P = .005), Agent Orange exposure (P = .02), and obesity (P = .03) were all significantly associated with biochemical failure. Mean and median PSADT among men who experienced recurrence were 37 and 20 months. Only 3 patients experienced recurrence with PSADT < 9 months. CONCLUSIONS Most men with low-risk prostate cancer treated with radical prostatectomy experience long-term PSA control. Those who did experience recurrence often did so with a long PSADT. Consistent with prior SEARCH database reports, older age, Agent Orange exposure, and obesity increased the risk of recurrence. UROLOGY 76: 695-702, 2010. (C) 2010 Elsevier Inc. All rights reserved. C1 Univ Calif San Diego, Div Urol, Dept Surg, San Diego, CA 92103 USA. Moores UCSD Canc Ctr, La Jolla, CA USA. Vet Affairs San Diego Med Ctr, Urol Sect, San Diego, CA USA. Univ Alabama, Dept Urol, Birmingham, AL USA. Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA. Vet Affairs Palo Alto Hlth Care Syst, Urol Sect, Palo Alto, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Urol Sect, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA USA. Charlie Norwood Vet Affairs Med Ctr, Urol Sect, Augusta, GA USA. Med Coll Georgia, Urol Sect, Augusta, GA 30912 USA. Vet Affairs Med Ctr, Urol Sect, Durham, NC USA. Duke Univ, Sch Med, Dept Surg, Div Urol Surg, Durham, NC USA. Duke Univ, Sch Med, Dept Pathol, Durham, NC 27706 USA. Duke Univ, Sch Med, Duke Prostate Ctr, Durham, NC 27706 USA. RP Kane, CJ (reprint author), Univ Calif San Diego, Div Urol, Dept Surg, W Arbor Dr 8897, San Diego, CA 92103 USA. EM ckane@ucsd.edu OI Terris, Martha/0000-0002-3843-7270 FU Department of Veterans Affairs, National Institute of Health [R01CA100938]; National Institutes of Health Specialized Programs of Research Excellence [P50 CA92131-01A1] FX Supported by the Department of Veterans Affairs, National Institute of Health R01CA100938 (W.J.A.), National Institutes of Health Specialized Programs of Research Excellence Grant P50 CA92131-01A1 (W.J.A.), the Georgia Cancer Coalition (M. K. T.), the Department of Defense, Prostate Cancer Research Program, (S.J.F.), and the American Urological Association Foundation/Astellas Rising Star in Urology Award (S.J.F.). Views and opinions of, and endorsements by, the author(s) do not reflect those of the US Army or the Department of Defense. NR 30 TC 49 Z9 51 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0090-4295 J9 UROLOGY JI Urology PD SEP PY 2010 VL 76 IS 3 BP 695 EP 700 DI 10.1016/j.urology.2009.12.073 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 649AD UT WOS:000281736300063 PM 20394969 ER PT J AU Fein, AS Wang, YF Curtis, JP Masoudi, FA Varosy, PD Reynolds, MR AF Fein, Adam S. Wang, Yongfei Curtis, Jeptha P. Masoudi, Frederick A. Varosy, Paul D. Reynolds, Matthew R. CA Natl Cardiovasc Data Registry TI Prevalence and Predictors of Off-Label Use of Cardiac Resynchronization Therapy in Patients Enrolled in the National Cardiovascular Data Registry Implantable Cardiac-Defibrillator Registry SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE cardiac resynchronization therapy; CRT; NCDR; ICD registry; overuse; guideline adherence; cardiac pacing utilization ID ATRIOVENTRICULAR JUNCTION ABLATION; LEFT-VENTRICULAR DYSFUNCTION; CHRONIC HEART-FAILURE; NARROW QRS COMPLEXES; CARDIOVERTER-DEFIBRILLATOR; DISEASE PROGRESSION; ATRIAL-FIBRILLATION; ASSOCIATION; TRIAL; COMPLICATIONS AB Objectives The purpose of the study was to define the extent and nature of cardiac resynchronization therapy (CRT) device usage outside consensus guidelines using national data. Background Recent literature has shown that the application of CRT in clinical practice frequently does not adhere to evidence-based consensus guidelines. Factors underlying these practices have not been fully explored. Methods From the National Cardiovascular Data Registry's Implantable Cardiac-Defibrillator Registry, we defined a cohort of 45,392 cardiac resynchronization therapy-defibrillator (CRT-D) implants between January 2006 and June 2008 with a primary prevention indication. We defined "off-label" implants as those in which the ejection fraction was >35%, the New York Heart Association functional class was below III, or the QRS interval duration was <120 ms in the absence of a documented need for ventricular pacing. The relationships between patient, implanting physician, and hospital characteristics with off-label use were explored with multivariable hierarchical logistic regression models. Results Overall, 23.7% of devices were placed without meeting all 3 implant criteria, most often due to New York Heart Association functional class below III (13.1% of implants) or QRS interval duration <120 ms (12.0%). Atrial fibrillation/flutter, previous percutaneous coronary intervention, and the performance of an electrophysiology study before implant were independently associated with increased odds of off-label use, whereas diabetes mellitus, increasing age, and female sex were associated with decreased odds. Physician training and insurance payer were weakly associated with the likelihood of off-label use. Conclusions Nearly 1 in 4 patients receiving CRT devices in the study time frame did not meet guideline-based indications. Given the evolving evidence base supporting the use of CRT, these practices require careful scrutiny. (J Am Coll Cardiol 2010;56:766-73) (C) 2010 by the American College of Cardiology Foundation C1 [Fein, Adam S.; Reynolds, Matthew R.] Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Boston, MA 02217 USA. [Wang, Yongfei; Curtis, Jeptha P.] Yale Univ, Sch Med, New Haven, CT USA. [Masoudi, Frederick A.] Univ Colorado, Denver Hlth Med Ctr, Denver, CO 80202 USA. [Varosy, Paul D.] Univ Colorado, Denver Vet Affairs Med Ctr, Denver, CO 80202 USA. [Masoudi, Frederick A.] Kaiser Permanente Colorado Inst Hlth Res, Denver, CO USA. RP Reynolds, MR (reprint author), Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, 185 Pilgrim Rd, Boston, MA 02217 USA. EM mreynold@bidmc.harvard.edu FU NHLBI NIH HHS [K23 HL077171-05, K23 HL077171] NR 29 TC 21 Z9 22 U1 0 U2 5 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 31 PY 2010 VL 56 IS 10 BP 766 EP 773 DI 10.1016/j.jacc.2010.05.025 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 642JH UT WOS:000281207700004 PM 20797489 ER PT J AU Kleiner-Fisman, G Stern, MB Fisman, DN AF Kleiner-Fisman, Galit Stern, Matthew B. Fisman, David N. TI Health-Related Quality of Life in Parkinson disease: Correlation between Health Utilities Index III and Unified Parkinson's Disease Rating Scale (UPDRS) in US male veterans SO HEALTH AND QUALITY OF LIFE OUTCOMES LA English DT Article ID ECONOMIC-IMPACT; DISORDERS; DETERMINANTS; STIMULATION; POPULATION; PREDICTORS; SELECTION; SYMPTOMS; COMMON; TRIAL AB Objective: To apply a scaled, preference-based measure to the evaluation of health-related quality of life (HRQoL) in Parkinson's disease (PD); to evaluate the relationship between disease-specific rating scales and estimated HRQoL; and to identify predictors of diminished HRQoL. Background: Scaled, preference-based measures of HRQoL ("utilities") serve as indices of impact of disease, and can be used to generate quality-adjusted estimates of survival for health-economic evaluations. Evaluation of utilities for PD and their correlation with standard rating scales have been limited. Methods: Utilities were generated using the Health Utilities Index Mark III (HUI-III) on consecutive patients attending a PD Clinic between October 2003 and June 2006. Disease severity, medical, surgical (subthalamic nucleus deep brain stimulation (STN-DBS)), and demographic information were used as model covariates. Predictors of HUI-III utility scores were evaluated using the Wilxocon rank-sum test and linear regression models. Results: 68 men with a diagnosis of PD and a mean age of 74.0 (SD 7.4) were included in the data analysis. Mean HUI-III utility at first visit was 0.45 (SD 0.33). In multivariable models, UPDRS-II score (r(2) = 0.56, P < 0.001) was highly predictive of HRQoL. UPDRS-III was a weaker, but still significant, predictor of utility scores, even after adjustment for UPDRS-II (P = 0.01). Conclusions: Poor self-care in PD reflected by worsening UPDRS-II scores is strongly correlated with low generic HRQoL. HUI-III-based health utilities display convergent validity with the UPDRS-II. These findings highlight the importance of measures of independence as determinants of HRQoL in PD, and will facilitate the utilization of existing UPDRS data into economic analyses of PD therapies. C1 [Kleiner-Fisman, Galit] Baycrest Geriatr Hosp, Dept Neurol, Toronto, ON M6A 2E1, Canada. [Stern, Matthew B.] Philadelphia VA Med Ctr, Parkinson Dis Res Educ & Clin Ctr PADRECC, Philadelphia, PA 19104 USA. [Fisman, David N.] Univ Toronto, Dalla Lana Sch Publ Hlth, Div Epidemiol, Toronto, ON M5T 3M7, Canada. RP Kleiner-Fisman, G (reprint author), Baycrest Geriatr Hosp, Dept Neurol, 3560 Bathurst St, Toronto, ON M6A 2E1, Canada. EM gkleinerfisman@yahoo.com NR 50 TC 7 Z9 8 U1 1 U2 7 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1477-7525 J9 HEALTH QUAL LIFE OUT JI Health Qual. Life Outcomes PD AUG 30 PY 2010 VL 8 AR 91 DI 10.1186/1477-7525-8-91 PG 9 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 656CN UT WOS:000282303600001 PM 20799993 ER PT J AU Leak, RK Castro, SL Jaumotte, JD Smith, AD Zigmond, MJ AF Leak, Rehana K. Castro, Sandra L. Jaumotte, Juliann D. Smith, Amanda D. Zigmond, Michael J. TI Assaying multiple biochemical variables from the same tissue sample SO JOURNAL OF NEUROSCIENCE METHODS LA English DT Article DE Sodium fluoride; Sonication; Dopamine; Parkinson's disease; Tyrosine hydroxylase; Dopamine Transporter; Phosphorylation; ERK1/2; Akt ID SUBSTANTIA-NIGRA; HUMAN BRAIN AB Experiments often involve multiple analyses, such as assays of neurotransmitters and proteins, and this can require different initial sample preparations. Typically, this is accomplished by using different animals or different tissue samples from the same animal. Either approach renders comparisons between assays more variable and greatly increases the effort and/or cost. Using tissue collected from rat striatum and molecules of special relevance to studies of Parkinson's disease, we show that tissue sonication in water prior to aliquoting into the appropriate concentrated solutions (e.g. HClO4 and lysis buffers) permits several types of measurements to be made from the same initial samples. Dopamine and its metabolite homovanillic acid, serotonin and its metabolite 5-hydroxyindoleacetic acid, tyrosine hydroxylase and its phosphorylation at Ser19 and Ser31, and the dopamine transporter were unaffected. However, phospho-Akt levels fell slightly and phospho-ERK1/2 tended to drop. We also present a simple technique to preserve phosphorylation state of proteins such as ERK1/2 by perfusing animals through the heart with a phosphatase inhibitor, NaF. Dopamine metabolite dihydroxyphenyl acetic acid (DOPAC) levels were raised with both techniques, however. The general principles reported here are likely to apply to other brain regions, facilitate multiple comparisons of variables, increase efficiency, and decrease costs. (C) 2010 Elsevier B.V. All rights reserved. C1 [Leak, Rehana K.] Duquesne Univ, Dept Pharmacol, Mylan Sch Pharm, Pittsburgh, PA 15282 USA. [Leak, Rehana K.; Castro, Sandra L.; Jaumotte, Juliann D.; Smith, Amanda D.; Zigmond, Michael J.] Univ Pittsburgh, Dept Neurol, Pittsburgh Inst Neurodegenerat Dis, Pittsburgh, PA 15260 USA. [Smith, Amanda D.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Leak, RK (reprint author), Duquesne Univ, Dept Pharmacol, Mylan Sch Pharm, Mellon Hall,Room 407-600 Forbes Ave, Pittsburgh, PA 15282 USA. EM leakr@duq.edu OI Leak, Rehana/0000-0003-2817-7417 FU NIH [P50 NS019608, R01 TW008040] FX This work was supported by NIH grants P50 NS019608 and R01 TW008040 to MJZ at the University of Pittsburgh and a startup award to RKL at Duquesne University. NR 10 TC 10 Z9 10 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0270 EI 1872-678X J9 J NEUROSCI METH JI J. Neurosci. Methods PD AUG 30 PY 2010 VL 191 IS 2 BP 234 EP 238 DI 10.1016/j.jneumeth.2010.06.023 PG 5 WC Biochemical Research Methods; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 651KR UT WOS:000281927100012 PM 20600314 ER PT J AU Smith, JC Paulson, ES Cook, DB Verber, MD Tian, Q AF Smith, J. Carson Paulson, Eric S. Cook, Dane B. Verber, Matthew D. Tian, Qu TI Detecting changes in human cerebral blood flow after acute exercise using arterial spin labeling: Implications for fMRI SO JOURNAL OF NEUROSCIENCE METHODS LA English DT Article DE Acute exercise; Physical activity; Cerebral blood flow; fMRI BOLD; Physiological monitoring; End-tidal CO2 ID DYNAMIC EXERCISE; ACTIVATION AB The use of arterial spin labeling to measure cerebral blood flow (CBF) after acute exercise has not been reported. The aims of this study were to examine: (1) the optimal inversion time to detect changes in CBF after acute exercise and (2) if acute exercise alters CBF in the motor cortex at rest or during finger-tapping. Subjects (n = 5) performed 30 min of moderate intensity exercise on an electronically braked cycle ergometer (perceived exertion 'somewhat hard'). Before and after exercise, relative CBF was measured using multiple inversion time (TI) pulsed arterial spin labeling (PASL). Two multiple TI runs were obtained at rest and during 4 Hz finger-tapping. Four inversion times (675, 975, 1275, and 1575 ms) were acquired per run, with 20 interleaved pairs of tag and control images per inversion time (320 s run). The results indicated that global CBF increased approximately 20% following exercise, with significant differences observed at an inversion time of 1575 ms (p < .05). Finger-tapping induced CBF in the motor cortex significantly increased from before to after exercise at TI = 1575 ms (p < .01). These findings suggest changes in human cerebral blood flow that result from acute moderate intensity exercise can be detected afterwards using PASL at 3T with an inversion time of 1575 ms. The effect of prior acute exercise to increase motor cortex CBF during the performance of a motor task suggests future use of indices of functional activation should account for exercise-induced changes in cardio-pulmonary physiology and CBF. (C) 2010 Elsevier B.V. All rights reserved. C1 [Smith, J. Carson; Tian, Qu] Univ Wisconsin, Dept Human Movement Sci, Milwaukee, WI 53201 USA. [Paulson, Eric S.] Med Coll Wisconsin, Dept Radiat Oncol, Milwaukee, WI 53226 USA. [Cook, Dane B.] Univ Wisconsin, Dept Kinesiol, Madison, WI 53706 USA. [Cook, Dane B.] William S Middleton Mem Vet Adm Med Ctr, Res Serv, Madison, WI 53706 USA. [Verber, Matthew D.] Med Coll Wisconsin, Clin & Translat Sci Inst, Milwaukee, WI 53226 USA. RP Smith, JC (reprint author), Univ Wisconsin, Dept Human Movement Sci, POB 413, Milwaukee, WI 53201 USA. EM jcarson@uwm.edu; epaulson@mcw.edu; dcook@education.wisc.edu; mverber@mcw.edu; qutian@uwm.edu RI Smith, J. Carson/G-6404-2013 OI Smith, J. Carson/0000-0001-6142-0920; Kennedy, Kristen/0000-0001-5373-9026 FU General Clinical Research Center at the Medical College of Wisconsin FX This work was supported by the General Clinical Research Center at the Medical College of Wisconsin. NR 15 TC 24 Z9 25 U1 2 U2 14 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0270 EI 1872-678X J9 J NEUROSCI METH JI J. Neurosci. Methods PD AUG 30 PY 2010 VL 191 IS 2 BP 258 EP 262 DI 10.1016/j.jneumeth.2010.06.028 PG 5 WC Biochemical Research Methods; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 651KR UT WOS:000281927100017 PM 20603148 ER PT J AU Kogai, T Liu, YY Richter, LL Mody, K Kagechika, H Brent, GA AF Kogai, Takahiko Liu, Yan-Yun Richter, Laura L. Mody, Kaizeen Kagechika, Hiroyuki Brent, Gregory A. TI Retinoic Acid Induces Expression of the Thyroid Hormone Transporter, Monocarboxylate Transporter 8 (Mct8) SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID EMBRYONIC STEM-CELLS; PLASMINOGEN-ACTIVATOR GENE; BREAST-CANCER CELLS; SODIUM/IODIDE SYMPORTER; INDUCED TRANSCRIPTION; RETINOBENZOIC ACIDS; BINDING PROTEINS; RECEPTOR-ALPHA; START SITES; DIFFERENTIATION AB Retinoic acid (RA) and thyroid hormone are critical for differentiation and organogenesis in the embryo. Mct8 (monocarboxylate transporter 8), expressed predominantly in the brain and placenta, mediates thyroid hormone uptake from the circulation and is required for normal neural development. RA induces differentiation of F9 mouse teratocarcinoma cells toward neurons as well as extraembryonal endoderm. We hypothesized that Mct8 is functionally expressed in F9 cells and induced by RA. All-trans-RA (tRA) and other RA receptor (RAR) agonists dramatically (>300-fold) induced Mct8. tRA treatment significantly increased uptake of triiodothyronine and thyroxine (4.1- and 4.3-fold, respectively), which was abolished by a selective Mct8 inhibitor, bromosulfophthalein. Sequence inspection of the Mct8 promoter region and 5'-rapid amplification of cDNA ends PCR analysis in F9 cells identified 11 transcription start sites and a proximal Sp1 site but no TATA box. tRA significantly enhanced Mct8 promoter activity through a consensus RA-responsive element located 6.6 kilobases upstream of the coding region. A chromatin immunoprecipitation assay demonstrated binding of RAR and retinoid X receptor to the RA response element. The promotion of thyroid hormone uptake through the transcriptional up-regulation of Mct8 by RAR is likely to be important for extraembryonic endoderm development and neural differentiation. This finding demonstrates cross-talk between RA signaling and thyroid hormone signaling in early development at the level of the thyroid hormone transporter. C1 [Kogai, Takahiko; Liu, Yan-Yun; Richter, Laura L.; Mody, Kaizeen; Brent, Gregory A.] Vet Affairs Greater Los Angeles Healthcare Syst, Mol Endocrinol Lab, Los Angeles, CA 90073 USA. [Kogai, Takahiko; Liu, Yan-Yun; Richter, Laura L.; Mody, Kaizeen; Brent, Gregory A.] Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, Los Angeles, CA 90073 USA. [Kogai, Takahiko; Liu, Yan-Yun; Richter, Laura L.; Mody, Kaizeen; Brent, Gregory A.] Univ Calif Los Angeles, Dept Physiol, David Geffen Sch Med, Los Angeles, CA 90073 USA. [Kagechika, Hiroyuki] Tokyo Med & Dent Univ, Inst Biomat & Bioengn, Tokyo 1010062, Japan. RP Kogai, T (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Mol Endocrinol Lab, Bldg 114,Rm 230,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM tkogai@ucla.edu; gbrent@ucla.edu FU Veterans Affairs; National Institutes of Health [RO1 CA089364] FX This work was supported, in whole or in part, by Veterans Affairs Merit Review Funds. This work was also supported by National Institutes of Health Grant RO1 CA089364 (to G. A. B.). NR 51 TC 13 Z9 13 U1 0 U2 4 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 27 PY 2010 VL 285 IS 35 BP 27279 EP 27288 DI 10.1074/jbc.M110.123158 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 641ZQ UT WOS:000281172700058 PM 20573951 ER PT J AU Leykum, LK Parchman, M Pugh, J Lawrence, V Noel, PH McDaniel, RR AF Leykum, Luci K. Parchman, Michael Pugh, Jacqueline Lawrence, Valerie Noel, Polly H. McDaniel, Reuben R., Jr. TI The importance of organizational characteristics for improving outcomes in patients with chronic disease: a systematic review of congestive heart failure SO IMPLEMENTATION SCIENCE LA English DT Review ID RANDOMIZED CONTROLLED-TRIAL; HOME-BASED INTERVENTION; QUALITY-OF-LIFE; MANAGEMENT PROGRAM; PRIMARY-CARE; HEALTH-CARE; CHRONIC ILLNESS; OLDER PATIENTS; UNPLANNED READMISSIONS; MULTIDISCIPLINARY CARE AB Background: Despite applications of models of care and organizational or system-level interventions to improve patient outcomes for chronic disease, consistent improvements have not been achieved. This may reflect a mismatch between the interventions and the nature of the settings in which they are attempted. The application of complex adaptive systems (CAS) framework to understand clinical systems and inform efforts to improve them may lead to more successful interventions. We performed a systematic review of interventions to improve outcomes of patients with congestive heart failure (CHF) to examine whether interventions consistent with CAS are more likely to be effective. We then examine differences between interventions that are most effective for improving outcomes for patients with CHF versus previously published data for type 2 diabetes to explore the potential impact of the nature of the disease on the types of interventions that are more likely to be effective. Methods: We conducted a systematic review of the literature between 1998 and 2008 of organizational interventions to improve care of patients with CHF. Two independent reviewers independently assessed studies that met inclusion criteria to determine whether each reported intervention reflected one or more CAS characteristics. The effectiveness of interventions was rated as either 0 (no effect), 0.5 (mixed effect), or 1.0 (effective) based on the type, number, and significance of reported outcomes. Fisher's exact test was used to examine the association between CAS characteristics and intervention effectiveness. Specific CAS characteristics associated with intervention effectiveness for CHF were contrasted with previously published data for type 2 diabetes. Results and discussion: Forty-four studies describing 46 interventions met eligibility criteria. All interventions utilized at least one CAS characteristic, and 85% were either 'mixed effect' or 'effective' in terms of outcomes. The number of CAS characteristics present in each intervention was associated with effectiveness (p < 0.001), supporting the idea that interventions consistent with CAS are more likely to be effective. The individual CAS characteristics associated with CHF intervention effectiveness were learning, self-organization, and co-evolution, a finding different from our previously published analysis of interventions for diabetes. We suggest this difference may be related to the degree of uncertainty involved in caring for patients with diabetes versus CHF. Conclusion: These results suggest that for interventions to be effective, they must be consistent with the CAS nature of clinical systems. The difference in specific CAS characteristics associated with intervention effectiveness for CHF and diabetes suggests that interventions must also take into account attributes of the disease. C1 [Leykum, Luci K.; Pugh, Jacqueline; Lawrence, Valerie; Noel, Polly H.] Univ Texas Hlth Sci Ctr San Antonio, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. [Leykum, Luci K.; Parchman, Michael; Pugh, Jacqueline; Lawrence, Valerie; Noel, Polly H.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. [Parchman, Michael] Univ Texas Hlth Sci Ctr San Antonio, Dept Family & Community Med, San Antonio, TX 78229 USA. [McDaniel, Reuben R., Jr.] Univ Texas Austin, McCombs Sch Business, Austin, TX 78712 USA. RP Leykum, LK (reprint author), Univ Texas Hlth Sci Ctr San Antonio, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. EM leykum@uthscsa.edu OI Pugh, Jacqueline/0000-0003-4933-141X; Parchman, Michael/0000-0001-7129-2889 FU Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service [01-091, REA 05-129] FX The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (TRX # 01-091 & REA 05-129). Investigator salary support is provided through this funding, and through the South Texas Veterans Health Care System. Dr. McDaniel receives support from the IC2 Institute of the University of Texas at Austin. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. NR 72 TC 10 Z9 10 U1 1 U2 7 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1748-5908 J9 IMPLEMENT SCI JI Implement. Sci. PD AUG 25 PY 2010 VL 5 AR 66 DI 10.1186/1748-5908-5-66 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 656EN UT WOS:000282309100001 PM 20735859 ER PT J AU Cornia, PB Hersh, AL Lipsky, BA Newman, TB Gonzales, R AF Cornia, Paul B. Hersh, Adam L. Lipsky, Benjamin A. Newman, Thomas B. Gonzales, Ralph TI Does This Coughing Adolescent or Adult Patient Have Pertussis? SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID CLINICAL-PRACTICE GUIDELINES; IMMUNIZATION PRACTICES ACIP; UNITED-STATES; EOSINOPHILIC BRONCHITIS; ADVISORY-COMMITTEE; PREVENTING TETANUS; PERSISTENT COUGH; EPIDEMIOLOGY; RECOMMENDATIONS; AZITHROMYCIN AB Context Pertussis is often overlooked as a cause of chronic cough, especially in adolescents and adults. Several symptoms are classically thought to be suggestive of pertussis, but the diagnostic value of each of them is uncertain. Objective To systematically review the evidence regarding the diagnostic value of 3 classically described symptoms of pertussis: paroxysmal cough, posttussive emesis, and inspiratory whoop. Data Sources, Study Selection, and Data Extraction We searched MEDLINE (January 1966 April 2010), EMBASE (January 1969 to April 2010), and the bibliographies of pertinent articles to identify relevant English-language studies. Articles were selected that included children older than 5 years, adolescents, or adults and confirmed the diagnosis of pertussis among patients with cough illness (of any duration) with an a priori defined accepted reference standard. Two authors independently extracted data from articles that met selection criteria and resolved any discrepancies by consensus. Data Synthesis Five prospective studies met inclusion criteria; 3 were used in the analysis. Presence of posttussive emesis (summary likelihood ratio [LR], 1.8; 95% confidence interval [Cl], 1.4-2.2) or inspiratory whoop (summary LR, 1.9; 95% Cl, 1.4-2.6) increases the likelihood of pertussis. Absence of paroxysmal cough (summary LR, 0.52; 95% Cl, 0.27-1.0) or posttussive emesis (summary LR, 0.58; 95% Cl, 0.44-0.77) reduced the likelihood. Absence of inspiratory whoop was less useful (summary LR, 0.78; 95% Cl, 0.66-0.93). No studies evaluated combinations of findings. Conclusions In a nonoutbreak setting, data to determine the diagnostic usefulness of symptoms classically associated with pertussis are limited and of relatively weak quality. The presence or absence of posttussive emesis or inspiratory whoop modestly change the likelihood of pertussis; therefore, clinicians must use their overall clinical impression to decide about additional testing or empirical treatment. JAMA. 2010;304(8):890-896 C1 [Gonzales, Ralph] Univ Calif San Francisco, Dept Med, Div Clin Epidemiol, San Francisco, CA 94118 USA. [Gonzales, Ralph] Univ Calif San Francisco, Div Gen Internal Med, San Francisco, CA 94118 USA. [Hersh, Adam L.; Newman, Thomas B.] Univ Calif San Francisco, Div Gen Pediat, San Francisco, CA 94118 USA. [Hersh, Adam L.] Univ Calif San Francisco, Div Pediat Infect Dis, San Francisco, CA 94118 USA. [Cornia, Paul B.; Lipsky, Benjamin A.] Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. [Cornia, Paul B.; Lipsky, Benjamin A.] Vet Affairs Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA USA. RP Gonzales, R (reprint author), Univ Calif San Francisco, Dept Med, Div Clin Epidemiol, 3333 Calif St,Box 1211,Ste 430, San Francisco, CA 94118 USA. EM ralphg@medicine.ucsf.edu OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 47 TC 45 Z9 48 U1 0 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD AUG 25 PY 2010 VL 304 IS 8 BP 890 EP 896 DI 10.1001/jama.2010.1181 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 644OY UT WOS:000281389900027 PM 20736473 ER PT J AU Sinha, S Miller, L Subramanian, S McCarty, OJT Proctor, T Meza-Romero, R Huan, JY Burrows, GG Vandenbark, AA Offner, H AF Sinha, Sushmita Miller, Lisa Subramanian, Sandhya McCarty, Owen J. T. Proctor, Thomas Meza-Romero, Roberto Huan, Jianya Burrows, Gregory G. Vandenbark, Arthur A. Offner, Halina TI Binding of recombinant T cell receptor ligands (RTL) to antigen presenting cells prevents upregulation of CD11b and inhibits T cell activation and transfer of experimental autoimmune encephalomyelitis SO JOURNAL OF NEUROIMMUNOLOGY LA English DT Article DE EAE; RTLs; Tolerance; APCs ID MULTIPLE-SCLEROSIS; CYTOKINE SWITCH; TRANSGENIC MICE; MYELIN; THERAPY; PEPTIDE; SEVERITY; MAC-1 AB Recombinant T cell ligands (RTLs) ameliorate experimental autoimmune encephalomyelitis (EAE) in an antigen-specific manner. We evaluated effects of RTL401 (I-A(s) alpha 1 beta 1 + PLP-139-151) on splenocytes from SJL/J mice with EAE to study RTL-T cell tolerance-inducing mechanisms. RTLs bound to B, macrophages and DCs, through RTL-MHC-alpha 1 beta 1 moiety. RTL binding reduced CD11b expression on splenic macrophages/DC, and RTL401-conditioned macrophages/DC, not B cells, inhibited T cell activation. Reduced ability of RU- incubated splenocytes to transfer EAE was likely mediated through macrophages/DC, since B cells were unnecessary for RTL treatment of EAE. These results demonstrate a novel pathway of T cell regulation by RTL-bound APCs. (C) 2010 Elsevier B.V. All rights reserved. C1 [Sinha, Sushmita; Miller, Lisa; Subramanian, Sandhya; Proctor, Thomas; Meza-Romero, Roberto; Vandenbark, Arthur A.; Offner, Halina] Portland VA Med Ctr, Portland, OR 97239 USA. [Sinha, Sushmita; Meza-Romero, Roberto; Huan, Jianya; Burrows, Gregory G.; Vandenbark, Arthur A.; Offner, Halina] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97239 USA. [McCarty, Owen J. T.] Oregon Hlth & Sci Univ, Dept Biomed Engn, Portland, OR 97239 USA. [Burrows, Gregory G.] Oregon Hlth & Sci Univ, Dept Biochem & Mol Biol, Portland, OR 97239 USA. [Vandenbark, Arthur A.] Oregon Hlth & Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR 97239 USA. [Offner, Halina] Oregon Hlth & Sci Univ, Dept Anesthesiol & Perioperat Med, Portland, OR 97239 USA. [Proctor, Thomas; Meza-Romero, Roberto; Huan, Jianya; Burrows, Gregory G.; Vandenbark, Arthur A.; Offner, Halina] Oregon Hlth & Sci Univ, Tykeson MS Res Lab, Portland, OR 97239 USA. RP Offner, H (reprint author), Portland VA Med Ctr, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM offnerva@ohsu.edu FU National Multiple Sclerosis Society [FG1749-A-1, RG3794-A-4, RG3794-B-6]; NIH [NS47661, AI43960]; Biomedical Laboratory R&D Service, Department of Veterans Affairs; Artielle ImmunoTherapeutics, Inc. FX The authors wish to thank Ms. Eva Niehaus for assistance in preparing the manuscript. Dr. Sinha is a Postdoctoral Fellow of the National Multiple Sclerosis Society and this work was supported in part by the National Multiple Sclerosis Society Postdoctoral Fellowship FG1749-A-1, grants RG3794-A-4 and RG3794-B-6; NIH Grants NS47661 and AI43960; and the Biomedical Laboratory R&D Service, Department of Veterans Affairs.; Drs. Offner, Burrows, Vandenbark, and OHSU have a significant financial interest in Artielle ImmunoTherapeutics, Inc., a company that may have a commercial interest in the results of this research and technology. This potential conflict of interest has been reviewed and managed by the OHSU and VAMC Conflict of Interest in Research Committees. NR 23 TC 15 Z9 15 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-5728 J9 J NEUROIMMUNOL JI J. Neuroimmunol. PD AUG 25 PY 2010 VL 225 IS 1-2 BP 52 EP 61 DI 10.1016/j.jneuroim.2010.04.013 PG 10 WC Immunology; Neurosciences SC Immunology; Neurosciences & Neurology GA 651LA UT WOS:000281928000007 PM 20546940 ER PT J AU Lu, XY Roberts, E Xia, FC Sanchez-Alavez, M Liu, TY Baldwin, R Wu, S Chang, J Wasterlain, CG Bartfai, T AF Lu, Xiaoying Roberts, Edward Xia, Fengcheng Sanchez-Alavez, Manuel Liu, Tianyu Baldwin, Roger Wu, Stephanie Chang, James Wasterlain, Claude G. Bartfai, Tamas TI GalR2-positive allosteric modulator exhibits anticonvulsant effects in animal models SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article DE galanin; seizure; G protein-coupled receptor; status epilepticus ID GALANIN-LIKE IMMUNOREACTIVITY; CENTRAL-NERVOUS-SYSTEM; STATUS EPILEPTICUS; HIPPOCAMPAL GALANIN; KINDLING EPILEPTOGENESIS; ANTIEPILEPTIC DRUGS; MEDIATED EXPRESSION; ALZHEIMERS-DISEASE; RECEPTOR SUBTYPES; TYPE-2 RECEPTORS AB Galanin receptors type 1 (GalR1) and/or type 2 (GalR2) represent unique pharmacological targets for treatment of seizures and epilepsy. Previous studies have shown that the endogenous peptide ligand galanin exerts powerful anticonvulsant effect through activation of these two G protein-coupled receptors, which are highly expressed in the temporal lobe of rodent brain. Here we report the characterization of a putative GalR2-positive allosteric modulator CYM2503. CYM2503 potentiated the galanin-stimulated IP1 accumulation in HEK293 cells stably expressing GalR2 receptor, whereas it exhibited no detectable affinity for the (125)I galanin-binding site of GalR2 receptor, an effect consistent with that of a positive allosteric modulator. In the rat Li-pilocarpine status epilepticus model, CYM2503, injected intraperitoneally, increased the latency to first electrographic seizure and the latency to first stage 3 behavioral seizure, decreased the latency to the establishment of status epilepticus, and dramatically decreased the mortality. In a Li-pilocarpine seizure model in mice, CYM2503 increased the latency to first electrographic seizure and decreased the total time in seizure. CYM2503 also attenuated electroshock-induced seizures in mice. Thus, CYM2503 provides a starting point for the development of anticonvulsant therapy using the galanin R2 receptor as target. C1 [Lu, Xiaoying; Xia, Fengcheng; Sanchez-Alavez, Manuel; Wu, Stephanie; Chang, James; Bartfai, Tamas] Scripps Res Inst, Mol & Integrat Neurosci Dept, La Jolla, CA 92037 USA. [Roberts, Edward; Liu, Tianyu] Scripps Res Inst, Dept Chem, La Jolla, CA 92037 USA. [Baldwin, Roger; Wasterlain, Claude G.] Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. [Baldwin, Roger; Wasterlain, Claude G.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90073 USA. RP Lu, XY (reprint author), Scripps Res Inst, Mol & Integrat Neurosci Dept, La Jolla, CA 92037 USA. EM xiaoying@scripps.edu FU National Institute of Health [NS063560, R01MH074055] FX We thank Viktor Zhukov for technical assistance. The study was supported by National Institute of Health Grants NS063560 and R01MH074055 (to T. B.). The present study is Scripps Research Institute Manuscript 20798. NR 52 TC 22 Z9 22 U1 0 U2 7 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 USA SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD AUG 24 PY 2010 VL 107 IS 34 BP 15229 EP 15234 DI 10.1073/pnas.1008986107 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 643PT UT WOS:000281311500053 PM 20660766 ER PT J AU Cherra, SJ Kulich, SM Uechi, G Balasubramani, M Mountzouris, J Day, BW Chu, CT AF Cherra, Salvatore J., III Kulich, Scott M. Uechi, Guy Balasubramani, Manimalha Mountzouris, John Day, Billy W. Chu, Charleen T. TI Regulation of the autophagy protein LC3 by phosphorylation SO JOURNAL OF CELL BIOLOGY LA English DT Article ID SACCHAROMYCES-CEREVISIAE; SIGNALING PATHWAYS; CRYSTAL-STRUCTURE; CELL-DEATH; KINASE; CAMP; DEGENERATION; INDUCTION; NEURODEGENERATION; LIGHT-CHAIN-3 AB Macroautophagy is a major catabolic pathway that impacts cell survival, differentiation, tumorigenesis, and neurodegeneration. Although bulk degradation sustains carbon sources during starvation, autophagy contributes to shrinkage of differentiated neuronal processes. Identification of autophagy-related genes has spurred rapid advances in understanding the recruitment of microtubule-associated protein 1 light chain 3 (LC3) in autophagy induction, although braking mechanisms remain less understood. Using mass spectrometry, we identified a direct protein kinase A (PKA) phosphorylation site on LC3 that regulates its participation in autophagy. Both metabolic (rapamycin) and pathological (MPP+) inducers of autophagy caused dephosphorylation of endogenous LC3. The pseudophosphorylated LC3 mutant showed reduced recruitment to autophagosomes, whereas the nonphosphorylatable mutant exhibited enhanced puncta formation. Finally, autophagy-dependent neurite shortening induced by expression of a Parkinson disease-associated G2019S mutation in leucine-rich repeat kinase 2 was inhibited by dibutyryl-cyclic adenosine monophosphate, cytoplasmic expression of the PKA catalytic subunit, or the LC3 phosphorylation mimic. These data demonstrate a role for phosphorylation in regulating LC3 activity. C1 [Cherra, Salvatore J., III; Kulich, Scott M.; Chu, Charleen T.] Univ Pittsburgh, Sch Med, Dept Pathol, Pittsburgh, PA 15261 USA. [Day, Billy W.] Univ Pittsburgh, Sch Med, Dept Pharmaceut Sci & Chem, Pittsburgh, PA 15261 USA. [Chu, Charleen T.] Univ Pittsburgh, Sch Med, Ctr Neurosci, McGowan Inst Regenerat Med, Pittsburgh, PA 15261 USA. [Uechi, Guy; Balasubramani, Manimalha; Day, Billy W.] Univ Pittsburgh, Sch Med, Genom Lab, Pittsburgh, PA 15261 USA. [Uechi, Guy; Balasubramani, Manimalha; Day, Billy W.] Univ Pittsburgh, Sch Med, Prote Core Lab, Pittsburgh, PA 15261 USA. [Kulich, Scott M.] Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA 15213 USA. [Mountzouris, John] Abgent Inc, San Diego, CA 92121 USA. RP Chu, CT (reprint author), Univ Pittsburgh, Sch Med, Dept Pathol, Pittsburgh, PA 15261 USA. EM ctc4@pitt.edu RI Chu, Charleen/B-1601-2008 OI Chu, Charleen/0000-0002-5052-8271 FU National Institutes of Health [AG026389, DC009120, NS064728, NS065789, RR024153]; American Federation for Aging Research/Ellison Medical Foundation FX This work was supported in part by the National Institutes of Health (grants AG026389, DC009120, NS064728, NS065789, and RR024153). C.T. Chu is the recipient of an American Federation for Aging Research/Ellison Medical Foundation Julie Martin Mid-Career Award in Aging Research. J. Mountzouris is a former employee of Abgent, Inc. NR 28 TC 133 Z9 136 U1 2 U2 19 PU ROCKEFELLER UNIV PRESS PI NEW YORK PA 1114 FIRST AVE, 4TH FL, NEW YORK, NY 10021 USA SN 0021-9525 J9 J CELL BIOL JI J. Cell Biol. PD AUG 23 PY 2010 VL 190 IS 4 BP 533 EP 539 DI 10.1083/jcb.201002108 PG 7 WC Cell Biology SC Cell Biology GA 645RJ UT WOS:000281481800008 PM 20713600 ER PT J AU Bonner, LM Simons, CE Parker, LE Yano, EM Kirchner, JE AF Bonner, Laura M. Simons, Carol E. Parker, Louise E. Yano, Elizabeth M. Kirchner, Joann E. TI 'To take care of the patients': Qualitative analysis of Veterans Health Administration personnel experiences with a clinical informatics system SO IMPLEMENTATION SCIENCE LA English DT Article ID UNINTENDED CONSEQUENCES; DEPRESSION CARE; TIME ALLOCATION; ORDER ENTRY; EXAM-ROOM; COMMUNICATION; IMPROVEMENT; REMINDERS; BARRIERS; RECORDS AB Background: The Veterans Health Administration (VA) has invested significant resources in designing and implementing a comprehensive electronic health record (EHR) that supports clinical priorities. EHRs in general have been difficult to implement, with unclear cost-effectiveness. We describe VA clinical personnel interactions with and evaluations of the EHR. Methods: As part of an evaluation of a quality improvement initiative, we interviewed 72 VA clinicians and managers using a semi-structured interview format. We conducted a qualitative analysis of interview transcripts, examining themes relating to participants' interactions with and evaluations of the VA EHR. Results: Participants described their perceptions of the positive and negative effects of the EHR on their clinical workflow. Although they appreciated the speed and ease of documentation that the EHR afforded, they were concerned about the time cost of using the technology and the technology's potential for detracting from interpersonal interactions. Conclusions: VA personnel value EHRs' contributions to supporting communication, education, and documentation. However, participants are concerned about EHRs' potential interference with other important aspects of healthcare, such as time for clinical care and interpersonal communication with patients and colleagues. We propose that initial implementation of an EHR is one step in an iterative process of ongoing quality improvement. C1 [Bonner, Laura M.; Simons, Carol E.] VA Puget Sound Healthcare Syst, Hlth Serv Res & Dev NW Ctr Excellence Outcomes Re, Seattle, WA USA. [Bonner, Laura M.] Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Parker, Louise E.] Independent Consultant, Cambridge, MA USA. [Parker, Louise E.] Hlth Serv Res & Dev Ctr Mental Healthcare & Outco, N Little Rock, AR USA. [Yano, Elizabeth M.] VA Greater Los Angeles Healthcare Syst, Hlth Serv Res & Dev Ctr Excellence Study Hlth Car, Sepulveda, CA USA. [Yano, Elizabeth M.] Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. [Kirchner, Joann E.] Cent Arkansas Vet Healthcare Syst, VA S Cent Mental Illness Res Educ & Clin Ctr, N Little Rock, AR USA. [Kirchner, Joann E.] Univ Arkansas Med Sci, Little Rock, AR 72205 USA. [Kirchner, Joann E.] Cent Arkansas Vet Healthcare Syst, Hlth Serv Res & Dev Ctr Mental Healthcare & Outco, N Little Rock, AR USA. RP Bonner, LM (reprint author), VA Puget Sound Healthcare Syst, Hlth Serv Res & Dev NW Ctr Excellence Outcomes Re, Seattle, WA USA. EM Laura.bonner@va.gov FU VA; The VA Quality Enhancement Research Initiative [MNT-02-209] FX We gratefully acknowledge the contributions of Lisa V. Rubenstein, MD, MSPH, Mona J. Ritchie, MSW, Jacqueline Fickel, PhD, Penny White, BA, and the many study participants without whom this work would not have been possible. We thank Edmund Chaney, PhD, for helpful comments on an earlier version of the manuscript. This work was supported by the VA. The VA Quality Enhancement Research Initiative MNT-02-209 funded this study. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. NR 37 TC 8 Z9 8 U1 3 U2 11 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1748-5908 J9 IMPLEMENT SCI JI Implement. Sci. PD AUG 20 PY 2010 VL 5 AR 63 DI 10.1186/1748-5908-5-63 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 656EL UT WOS:000282308900001 PM 20727182 ER PT J AU Kerlikowske, K Cook, AJ Buist, DSM Cummings, SR Vachon, C Vacek, P Miglioretti, DL AF Kerlikowske, Karla Cook, Andrea J. Buist, Diana S. M. Cummings, Steve R. Vachon, Celine Vacek, Pamela Miglioretti, Diana L. TI Breast Cancer Risk by Breast Density, Menopause, and Postmenopausal Hormone Therapy Use SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID MAMMOGRAPHIC DENSITY; PARENCHYMAL PATTERNS; REPLACEMENT THERAPY; UNITED-STATES; ASSOCIATION; WOMEN; AGE; PROGESTIN; ESTROGEN; SURVIVAL AB Purpose We determined whether the association between breast density and breast cancer risk and cancer severity differs according to menopausal status and postmenopausal hormone therapy (HT) use. Methods We collected data on 587,369 women who underwent 1,349,027 screening mammography examinations; 14,090 women were diagnosed with breast cancer. We calculated 5-year breast cancer risk from a survival model for subgroups of women classified by their Breast Imaging Reporting and Data System (BIRADS) breast density, age, menopausal status, and current HT use, assuming a body mass index of 25 kg/m(2). Odds of advanced (ie, IIb, III, IV) versus early (ie, I, IIa) stage invasive cancer was calculated according to BIRADS density. Results Breast cancer risk was low among women with low density (BIRADS-1): women age 55 to 59 years, 5-year risk was 0.8% (95% CI, 0.6 to 0.9%) for non-HT users and 0.9% (95% CI, 0.7% to 1.1%) for estrogen and estrogen plus progestin users. Breast cancer risk was high among women with very high density (BIRADS-4), particularly estrogen plus progestin users: women age 55 to 59 years, 5-year risk was 2.4% (95% CI, 2.0% to 2.8%) for non-HT users, 3.0% (95% CI, 2.6% to 3.5%) for estrogen users, and 4.2% (95% CI, 3.7% to 4.6%) for estrogen plus progestin users. Advanced-stage breast cancer risk was increased 1.7-fold for postmenopausal HT users who had very high density (BIRADS-4) compared to those with average density (BIRADS-2). Conclusion Postmenopausal women with high breast density are at increased risk of breast cancer and should be aware of the added risk of taking HT, especially estrogen plus progestin. C1 [Kerlikowske, Karla] Univ Calif San Francisco, Gen Internal Med Sect, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Calif Pacific Med Ctr, San Francisco Coordinating Ctr, Res Inst, San Francisco, CA USA. Grp Hlth Cooperat Puget Sound, Biostat Unit, Grp Hlth Res Inst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. Mayo Clin, Coll Med, Rochester, MN USA. Univ Vermont, Coll Med, Burlington, VT USA. RP Kerlikowske, K (reprint author), Univ Calif San Francisco, Gen Internal Med Sect, San Francisco Vet Affairs Med Ctr, 111A1,4150 Clement St, San Francisco, CA 94121 USA. EM Karla.Kerlikowske@ucsf.edu FU National Cancer Institute [P01 CA107584, U01CA63740, U01CA86076, U01CA86082, U01CA63736, U01CA70013, U01CA69976, U01CA63731, U01CA70040] FX Supported by Grant No. P01 CA107584 (K. K.) from the National Cancer Institute and the Breast Cancer Surveillance Consortium Co-Operative Agreement (U01CA63740, U01CA86076, U01CA86082, U01CA63736, U01CA70013, U01CA69976, U01CA63731, U01CA70040) from the National Cancer Institute. The collection of cancer data used in this study was supported in part by several state public health departments and cancer registries throughout the United States. For a full description of these sources, please see: http://breastscreening.cancer.gov/work/acknowledgement. html. NR 38 TC 85 Z9 86 U1 0 U2 6 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD AUG 20 PY 2010 VL 28 IS 24 BP 3830 EP 3837 DI 10.1200/JCO.2009.26.4770 PG 8 WC Oncology SC Oncology GA 641ME UT WOS:000281129700007 PM 20644098 ER PT J AU Kanwal, F Schnitzler, MS Bacon, BR Hoang, TY Buchanan, PM Asch, SM AF Kanwal, Fasiha Schnitzler, Mark S. Bacon, Bruce R. Hoang, Tuyen Buchanan, Paula M. Asch, Steven M. TI Quality of Care in Patients With Chronic Hepatitis C Virus Infection A Cohort Study SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID UNITED-STATES; B VACCINATION; MISSED OPPORTUNITIES; ANTIVIRAL THERAPY; LIVER-DISEASE; VETERANS; PREDICTORS; RIBAVIRIN; IMPACT; MANAGEMENT AB Background: Medicare has proposed quality-of-care indicators for chronic hepatitis C virus (HCV) infection. The extent to which these standards are met in practice is largely unknown. Objective: To evaluate the quality of health care that patients with HCV receive and the factors associated with receipt of quality care. Design: Retrospective cohort study. Setting: Nationwide U. S. health insurance company research database. Participants: 10 385 patients with HCV enrolled in the database between 2003 and 2006. Patients were included if they were eligible for at least 1 quality indicator. Measurements: Quality of HCV care received by patients, as measured by 7 explicit quality indicators included in Medicare's 2009 Physician Quality Reporting Initiative. Results: Proportions of patients meeting quality indicators varied, ranging from 21.5% for vaccination to 79% for the HCV genotype testing indicator. Overall, 18.5% of patients (95% CI, 18% to 19%) received all recommended care. Older age and presence of comorbid conditions were associated with lower quality, whereas elevated liver enzyme levels, cirrhosis, and HIV infection were associated with higher quality. Patients who saw both generalists and specialists received the best care (odds ratio of receiving care for which a patient is eligible: specialists alone, 0.79 [CI, 0.66 to 0.95]; primary care physician alone, 0.44 [CI, 0.40 to 0.48]). Limitations: The study had an observational retrospective design, used a convenience sample, and had no information on patient ethnicity. It may be that the indicators or the reporting of the indicators of HCV care-and not the care itself-is suboptimum. Conclusion: Health care quality, based on Medicare criteria, is suboptimum for HCV. Care that included both specialists and generalists is associated with the best quality. Our results support the development of specialist and primary care collaboration to improve the quality of HCV care. C1 [Kanwal, Fasiha] John Cochran Vet Affairs Med Ctr, St Louis, MO 63106 USA. St Louis Univ, Sch Med, St Louis, MO 63110 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RAND Corp, Santa Monica, CA USA. RP Kanwal, F (reprint author), John Cochran Vet Affairs Med Ctr, 915 N Grand Blvd,111 JC GI, St Louis, MO 63106 USA. EM fasiha.kanwal@va.gov; schnitm@slu.edu; pbuchan1@slu.edu FU Saint Louis University Liver Center; Veterans Affairs Health Services Research and Development Service [IIR-07-111] FX Primary Funding Source: Saint Louis University Liver Center.; Grant Support: Dr. Kanwal is supported by Veterans Affairs Health Services Research and Development Service Investigator Initiated Research Award IIR-07-111. This study was supported by an intramural grant from the Saint Louis University Liver Center. NR 34 TC 43 Z9 43 U1 0 U2 1 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 EI 1539-3704 J9 ANN INTERN MED JI Ann. Intern. Med. PD AUG 17 PY 2010 VL 153 IS 4 BP 231 EP 239 DI 10.7326/0003-4819-153-4-201008170-00005 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 639KF UT WOS:000280973000003 PM 20713791 ER PT J AU Tobin, MJ Laghi, F Jubran, A AF Tobin, Martin J. Laghi, Franco Jubran, Amal TI Narrative Review: Ventilator-Induced Respiratory Muscle Weakness SO ANNALS OF INTERNAL MEDICINE LA English DT Review ID INDUCED DIAPHRAGMATIC DYSFUNCTION; CONTROLLED MECHANICAL VENTILATION; RAT DIAPHRAGM; PRESSURE; CONTRACTILITY; STIMULATION; ATROPHY AB Clinicians have long been aware that substantial lung injury results when mechanical ventilation imposes too much stress on the pulmonary parenchyma. Evidence is accruing that substantial injury may also result when the ventilator imposes too little stress on the respiratory muscles. Through adjustment of ventilator settings and administration of pharmacotherapy, the respiratory muscles may be rendered almost (or completely) inactive. Research in animals has shown that diaphragmatic inactivity produces severe injury and atrophy of muscle fibers. Human data have recently revealed that 18 to 69 hours of complete diaphragmatic inactivity associated with mechanical ventilation decreased the cross-sectional areas of diaphragmatic fibers by half or more. The atrophic injury seems to result from increased oxidative stress leading to activation of protein-degradation pathways. Scientific understanding of ventilator-induced respiratory muscle injury has not reached the stage where meaningful controlled trials can be done, and thus, it is not possible to give concrete recommendations for patient management. In the meantime, clinicians are advised to select ventilator settings that avoid both excessive patient effort and excessive respiratory muscle rest. The contour of the airway pressure waveform on a ventilator screen provides the most practical indication of patient effort, and clinicians are advised to pay close attention to the waveform as they titrate ventilator settings. Research on ventilator-induced respiratory muscle injury is in its infancy and portends to be an exciting area to follow. C1 [Tobin, Martin J.] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. Loyola Univ Chicago, Stritch Sch Med, Hines, IL USA. RP Tobin, MJ (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, 111 N 5th Ave & Roosevelt Rd, Hines, IL 60141 USA. EM mtobin2@lumc.edu FU Veterans Affairs Health Services Research and Development Service; National Institutes of Health [RO1 NR008782] FX Grant Support: By a Merit Review grant from the Veterans Affairs Health Services Research and Development Service and by a grant from the National Institutes of Health (RO1 NR008782). NR 36 TC 27 Z9 29 U1 0 U2 2 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 EI 1539-3704 J9 ANN INTERN MED JI Ann. Intern. Med. PD AUG 17 PY 2010 VL 153 IS 4 BP 240 EP 245 DI 10.7326/0003-4819-153-4-201008170-00006 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 639KF UT WOS:000280973000004 PM 20713792 ER PT J AU Sudore, RL Fried, TR AF Sudore, Rebecca L. Fried, Terri R. TI Redefining the "Planning" in Advance Care Planning: Preparing for End-of-Life Decision Making SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; SERIOUSLY ILL PATIENTS; HEALTH BEHAVIOR-CHANGE; SUSTAINING TREATMENT; PATIENT PREFERENCES; COMMUNICATION-SKILLS; PALLIATIVE CARE; FAMILY-MEMBERS; TRANSTHEORETICAL MODEL; HOSPITALIZED-PATIENTS AB The traditional objective of advance care planning has been to have patients make treatment decisions in advance so that clinicians can attempt to provide care consistent with their goals. The authors contend that the objective for advance care planning ought to be the preparation of patients and surrogates to participate with clinicians in making the best possible in-the-moment medical decisions. They provide practical steps for clinicians to help patients and surrogate decision makers achieve this objective in the outpatient setting. Preparation for in-the-moment decision making shifts the focus from having patients make premature decisions based on incomplete information to preparing them and their surrogates for the types of decisions and conflicts they may encounter when they do have to make in-the-moment decisions. Advance directives, although important, are just one piece of information to be used at the time of decision making. C1 [Sudore, Rebecca L.] Univ Calif San Francisco, Div Geriatr, Vet Affairs Med Ctr, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, San Francisco, CA 94121 USA. Vet Affairs Connecticut Healthcare Syst, New Haven, CT USA. Yale Univ, Sch Med, New Haven, CT USA. RP Sudore, RL (reprint author), Univ Calif San Francisco, Div Geriatr, Vet Affairs Med Ctr, 4150 Clement St,Box 151R, San Francisco, CA 94121 USA. EM Rebecca.Sudore@ucsf.edu FU Veterans Affairs Career Development Award; Pfizer Fellowship in Clear Health Communication; National Institutes of Health [K24 AG028443] FX Grant Support: Dr. Sudore is supported by a Veterans Affairs Career Development Award and a Pfizer Fellowship in Clear Health Communication. Dr. Fried is supported by the National Institutes of Health (grant K24 AG028443). NR 92 TC 210 Z9 211 U1 7 U2 42 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 EI 1539-3704 J9 ANN INTERN MED JI Ann. Intern. Med. PD AUG 17 PY 2010 VL 153 IS 4 BP 256 EP 261 DI 10.7326/0003-4819-153-4-201008170-00008 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 639KF UT WOS:000280973000006 PM 20713793 ER PT J AU Spiegel, BM Roberts, L Mody, R Harding, G Kothari-Talwar, S Kahrilas, PJ Camilleri, ML Dabbous, O Revicki, DA AF Spiegel, B. M. Roberts, L. Mody, R. Harding, G. Kothari-Talwar, S. Kahrilas, P. J. Camilleri, M. L. Dabbous, O. Revicki, D. A. TI The development and validation of a Nocturnal Gastro-oesophageal Reflux Disease Symptom Severity and Impact Questionnaire for adults SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID QUALITY-OF-LIFE; UPPER GASTROINTESTINAL DISORDERS; PATIENT-REPORTED OUTCOMES; CONTENT VALIDITY; NIGHTTIME GERD; HEALTH-STATUS; INDEX; RESPONSIVENESS AB Background Current questionnaires for assessing gastro-oesophageal reflux disease (GERD) symptoms are limited in their ability to capture nocturnal symptoms. Aim To develop and validate an instrument, the Nocturnal Gastro-oesophageal Reflux Disease Symptom Severity and Impact Questionnaire (N-GSSIQ), to assess severity and impact of nocturnal GERD symptoms. Methods Two focus groups and 16 cognitive debriefing interviews were conducted among GERD patients to identify key issues about nocturnal symptoms. A draft instrument was tested in 196 patients at 11 clinics in the US to evaluate psychometric properties. Exploratory factor and item response theory analyses were conducted to finalize items and subscales. Internal consistency reliability, reproducibility and construct validity were examined. Results Mean age was 45 (s.d. = 13.8) years; 76% were female and 68% were Caucasian. Patient-rated severity was mild-moderate for 69% of participants; 48% reported symptoms on two to three nights the past week. The final questionnaire includes 20 items and three subscales: Nocturnal GERD Symptoms, Morning Impact of Nocturnal GERD and Concern about Nocturnal GERD. The subscales demonstrated internal consistency reliability (Cronbach's alpha 0.84-0.94) and were significantly correlated with similar measures and disease severity (0.41-0.81; P < 0.0001). Conclusion The results support the reliability and validity of the N-GSSIQ as a measure of severity, morning impact and concern about nocturnal GERD. C1 [Spiegel, B. M.] Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Roberts, L.; Harding, G.; Revicki, D. A.] United BioSource Corp, Bethesda, MD 20814 USA. [Mody, R.; Kothari-Talwar, S.; Dabbous, O.] Takeda Pharmaceut Int Inc, Deerfield, IL 60015 USA. [Kahrilas, P. J.] Northwestern Univ, Div Gastroenterol, Chicago, IL 60611 USA. [Camilleri, M. L.] Mayo Clin, Rochester, MN 55905 USA. RP Spiegel, BM (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 115,Rm 215, Los Angeles, CA 90073 USA. EM bspiegel@mednet.ucla.edu NR 29 TC 9 Z9 9 U1 0 U2 1 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0269-2813 J9 ALIMENT PHARM THER JI Aliment. Pharmacol. Ther. PD AUG 15 PY 2010 VL 32 IS 4 BP 591 EP 602 DI 10.1111/j.1365-2036.2010.04385.x PG 12 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 625YF UT WOS:000279932100010 PM 20528826 ER PT J AU Baker, DA Barth, J Chang, R Obeid, LM Gilkeson, GS AF Baker, DeAnna A. Barth, Jeremy Chang, Raymond Obeid, Lina M. Gilkeson, Gary S. TI Genetic Sphingosine Kinase 1 Deficiency Significantly Decreases Synovial Inflammation and Joint Erosions in Murine TNF-alpha-Induced Arthritis SO JOURNAL OF IMMUNOLOGY LA English DT Article ID TUMOR-NECROSIS-FACTOR; RHEUMATOID-ARTHRITIS; BIOACTIVE SPHINGOLIPIDS; 1-PHOSPHATE RECEPTORS; EXPRESSION; SPHINGOSINE-1-PHOSPHATE; DISEASE; ROLES; MODULATION; INDUCTION AB Sphingosine kinase 1 (SphK1) is an enzyme that converts sphingosine to bioactive sphingosine-1-phosphate. Recent in vitro data suggest a potential role of SphK1 in TNF-alpha-mediated inflammation. Our aims in this study were to determine the in vivo significance of SphK1 in TNF-alpha-mediated chronic inflammation and to define which pathogenic mechanisms induced by TNF-alpha are SphK1 dependent. To pursue these aims, we studied the effect of SphK1 deficiency in an in vivo model of TNF-alpha-induced chronic inflammatory arthritis. Transgenic hTNF-alpha mice, which develop spontaneous inflammatory erosive arthritis beginning at 14-16 wk, were crossed with SphK1 null mice (SphK1(-/-)), on the C57BL6 genetic background. Beginning at 4 mo of age, hTNF/SphK1(-/-) mice had significantly less severe clinically evident paw swelling and deformity, less synovial and periarticular inflammation, and markedly decreased bone erosions as measured quantitatively through micro-CT images. Mechanistically, the mice lacking SphK1 had less articular cyclooxygenase 2 protein and fewer synovial Th17 cells than did hTNF/SphK1(+/+) littermates. Microarray analysis and real-time RT-PCR of the ankle synovial tissue demonstrated that hTNF/SphK1(-/-) mice had increased transcript levels of suppressor of cytokine signaling 3 compared with hTNF/SphK1(+/+) mice, likely also contributing to the decreased inflammation in the SphK1-deficient mice. Finally, significantly fewer mature osteoclasts were detected in the ankle joints of hTNF/SphK1(-/-) mice compared with hTNF/SphK1(+/+) mice. These data indicate that SphK1 plays a key role in hTNF-alpha-induced inflammatory arthritis via impacting synovial inflammation and osteoclast number. The Journal of Immunology, 2010, 185: 2570-2579. C1 [Gilkeson, Gary S.] Med Univ S Carolina, Div Rheumatol, Dept Med, Charleston, SC 29425 USA. [Baker, DeAnna A.] Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. [Barth, Jeremy] Med Univ S Carolina, Dept Regenerat Med & Cell Biol, Charleston, SC 29425 USA. [Chang, Raymond] Med Univ S Carolina, Small Anim Imaging Core Facil, Dept Radiol & Radiol Sci, Charleston, SC 29425 USA. [Obeid, Lina M.] Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. [Obeid, Lina M.; Gilkeson, Gary S.] Ralph H Johnson Vet Affairs Med Ctr, Dept Vet Affairs, Charleston, SC 29401 USA. RP Gilkeson, GS (reprint author), Med Univ S Carolina, Div Rheumatol, Dept Med, 114 Doughty St,STB 425, Charleston, SC 29425 USA. EM gilkeson@musc.edu FU American College of Rheumatology Research; Education Foundation's Within Our Reach: Finding a Cure for Arthritis Campaign; U.S. National Institutes of Health [R01GM062887, 1F31AR057307-01] FX This work was supported by the American College of Rheumatology Research and the Education Foundation's Within Our Reach: Finding a Cure for Arthritis Campaign and U. S. National Institutes of Health Grants R01GM062887 and 1F31AR057307-01. NR 40 TC 42 Z9 43 U1 0 U2 5 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD AUG 15 PY 2010 VL 185 IS 4 BP 2570 EP 2579 DI 10.4049/jimmunol.1000644 PG 10 WC Immunology SC Immunology GA 635NH UT WOS:000280661900065 PM 20644167 ER PT J AU Kozora, E West, SG Maier, SF Filley, CM Arciniegas, DB Brown, M Miller, D Grimm, A Zhang, LN AF Kozora, Elizabeth West, Sterling G. Maier, Steven F. Filley, Christopher M. Arciniegas, David B. Brown, Mark Miller, David Grimm, Alex Zhang, Lening TI Antibodies against N-methyl-D-aspartate receptors in patients with systemic lupus erythematosus without major neuropsychiatric syndromes SO JOURNAL OF THE NEUROLOGICAL SCIENCES LA English DT Article DE SLE; Neuropsychology; Auto-antibodies; NMDA ID COGNITIVE IMPAIRMENT; GLUTAMATE-RECEPTOR; CEREBROSPINAL-FLUID; NEUROPSYCHOLOGIC DYSFUNCTION; NMDA RECEPTORS; PREVALENCE; AUTOANTIBODIES; DISEASE; SERUM; MANIFESTATIONS AB Purpose: Approximately 14-54% of patients with systemic lupus erythematosus without a history of major neuropsychiatric syndromes (nonNPSLE) have cognitive deficits. Elevated N-methyl-D-aspartate (NMDA) receptor antibodies (anti-NR2) have been reported in 35% of patients with SLE, but few studies have utilized controls or a composite memory index. We hypothesized that serum anti-NR2 would be elevated in nonNPSLE compared to healthy controls, and that elevated anti-NR2 would be associated with memory dysfunction and depression. Methods: Subjects included 43 nonNPSLE patients with a mean age of 36.5 (SD = 9.0) and mean education level of 14.7 years (SD = 2.5). Twenty-seven healthy control subjects with similar demographic characteristics were also enrolled in this study. A global Cognitive Impairment Index (CII) and a Memory Impairment Index (MII) were calculated using impaired test scores from the ACR-SLE neuropsychological battery. Serum samples were analyzed using a standard ELISA for anti-NR2. Results: Elevations of serum anti-NR2 were found in 14.0% of the nonNPSLE and 7.4% of the controls (p = 0.47). There was no relationship between elevated anti-NR2 status and higher CII or performance on the MII. No relationship between levels of depressive symptoms and anti-NR2 was found. Conclusions: The frequency of elevated anti-NR2 was low (14.0%) in this sample of SLE patients and not significantly different from controls. A relationship was not found between the presence of anti-NR2 in serum and global cognitive or memory indices, or with depression. Results suggest that serum anti-NR2 is not likely related to mild cognitive dysfunction in SLE patients without a prior history of NPSLE. (C) 2010 Elsevier B.V. All rights reserved. C1 [Kozora, Elizabeth] Natl Jewish Hlth, ABPP CN, Denver, CO 80206 USA. [Kozora, Elizabeth; West, Sterling G.; Filley, Christopher M.; Arciniegas, David B.; Brown, Mark; Miller, David; Grimm, Alex; Zhang, Lening] Univ Colorado Hosp, Aurora, CO USA. [Maier, Steven F.] Univ Colorado, Boulder, CO 80309 USA. [Filley, Christopher M.] Denver Vet Affairs Med Ctr, Denver, CO USA. RP Kozora, E (reprint author), Natl Jewish Hlth, ABPP CN, 1400 Jackson St,B106, Denver, CO 80206 USA. EM Kozorae@njhealth.org FU National Institute of Musculoskeletal and Skin Diseases [RO1 AR049152-02]; National Center for Research Resources [UL1 RR025780] FX This study was supported by the National Institute of Musculoskeletal and Skin Diseases (grant RO1 AR049152-02) and supported in part by grants from the Clinical Translational Scientific Award from the National Center for Research Resources (UL1 RR025780). NR 48 TC 23 Z9 25 U1 1 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0022-510X J9 J NEUROL SCI JI J. Neurol. Sci. PD AUG 15 PY 2010 VL 295 IS 1-2 BP 87 EP 91 DI 10.1016/j.jns.2010.04.016 PG 5 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 628LA UT WOS:000280120000017 PM 20546792 ER PT J AU Rao, HY Mamikonyan, E Detre, JA Siderowf, AD Stern, MB Potenza, MN Weintraub, D AF Rao, Hengyi Mamikonyan, Eugenia Detre, John A. Siderowf, Andrew D. Stern, Matthew B. Potenza, Marc N. Weintraub, Daniel TI Decreased Ventral Striatal Activity with Impulse Control Disorders in Parkinson's Disease SO MOVEMENT DISORDERS LA English DT Article DE functional magnetic resonance imaging; Parkinson's disease; impulse control disorder ID RISK-TASK BART; DOPAMINE AGONIST USE; DECISION-MAKING; PATHOLOGICAL GAMBLERS; COGNITIVE IMPAIRMENT; COMPULSIVE BEHAVIORS; REWARD; BRAIN; FMRI; NEUROBIOLOGY AB A range of impulse control disorders (ICDs) are reported to occur in Parkinson's disease (PD). However, alterations in brain activity at rest and during risk taking occurring with ICDs in PD are not well understood. We used both arterial spin labeling perfusion functional magnetic resonance imaging (fMRI) to directly quantify resting cerebral blood flow (CBF) and blood oxygenation level dependent (BOLD) fMRI to measure neural responses to risk taking during performance on the Balloon Analogue Risk Task (BART). Eighteen PD patients, either with a diagnosis of one or more ICDs (N = 9) or no lifetime ICD history (N = 9), participated. BOLD fMRI data demonstrated that PD patients without an ICD activate the mesocorticolimbic pathway during risk taking. Compared with non-ICD patients. ICD patients demonstrated significantly diminished BOLD activity in the right ventral striatum during risk taking and significantly reduced resting CBF in the right ventral striatum. ICDs in PD are associated with reduced right ventral striatal activity at rest and diminished striatal activation during risk taking, suggesting that a common neural mechanism may underlie ICDs in individuals with PD and those without PD. Thus, treatments for ICDs in non-PD patients warrant consideration in PD patients with ICDs. (C) 2010 Movement Disorder Society C1 [Rao, Hengyi; Detre, John A.; Siderowf, Andrew D.; Stern, Matthew B.; Weintraub, Daniel] Univ Penn, Ctr Funct Neuroimaging, Dept Neurol & Radiol, Philadelphia, PA 19104 USA. [Rao, Hengyi; Mamikonyan, Eugenia; Weintraub, Daniel] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. [Rao, Hengyi] S China Normal Univ, Ctr Funct Brain Imaging, Guangzhou, Guangdong, Peoples R China. [Rao, Hengyi] S China Normal Univ, Ctr Studies Psychol Applicat, Guangzhou, Guangdong, Peoples R China. [Stern, Matthew B.; Weintraub, Daniel] Philadelphia VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA USA. [Stern, Matthew B.; Weintraub, Daniel] Philadelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. [Potenza, Marc N.] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA. [Potenza, Marc N.] Yale Univ, Ctr Child Study, Sch Med, New Haven, CT 06520 USA. RP Weintraub, D (reprint author), 3615 Chestnut St,330, Philadelphia, PA 19104 USA. EM daniel.weintraub@uphs.upenn.edu RI Rao, Hengyi/A-7064-2009 OI Rao, Hengyi/0000-0003-2735-2500 FU Center for Functional Neuroimaging at the University of Pennsylvania; NSF [BCS-0224007]; NTH [P30 NS045839, K23 MH067894, R01 DA019039, R01 AA017539] FX This research was supported by a Project Development (ProDev) Grant from the Center for Functional Neuroimaging at the University of Pennsylvania, the NSF grant BCS-0224007, the NTH Grants P30 NS045839, K23 MH067894, R01 DA019039, and R01 AA017539, VA VISNI MIRECC, Sun Yat-Sen University 985 Project, and a Center of Excellence in Gambling Research grant from the National Center for Responsible Gaming and its affiliated Institute for Research on Gambling Disorders. The contents of the manuscript are solely the responsibility of the authors and do not necessarily represent the official views of any of the funding agencies. NR 53 TC 60 Z9 63 U1 1 U2 8 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 AUG 15 PY 2010 VL 25 IS 11 BP 1660 EP 1669 DI 10.1002/mds.23147 PG 10 WC Clinical Neurology SC Neurosciences & Neurology GA 644BW UT WOS:000281346400019 PM 20589879 ER PT J AU Bailey, JN Goenjian, AK Noble, EP Walling, DP Ritchie, T Goenjian, HA AF Bailey, Julia N. Goenjian, Armen K. Noble, Ernest P. Walling, David P. Ritchie, Terry Goenjian, Haig A. TI PTSD and dopaminergic genes, DRD2 and DAT, in multigenerational families exposed to the Spitak earthquake SO PSYCHIATRY RESEARCH LA English DT Article DE Heritability; DRD2; DAT; PTSD; B category symptoms ID POSTTRAUMATIC-STRESS-DISORDER; TRAIT LINKAGE ANALYSIS; DEPRESSIVE REACTIONS; ALLELIC ASSOCIATION; RECEPTOR GENE; TRAUMA EXPOSURE; TWIN; ADOLESCENTS; SYMPTOMS; POLYMORPHISM AB The objective of this study was to assess the generality of the association of DRD2 and DAT genes and Post-Traumatic Stress Disorder (PTSD) diagnosis/symptom severity. Two hundred ethnic Armenians from 12 multigenerational families exposed to the catastrophic 1988 Spitak earthquake were studied. Common polymorphisms A1/A2 alleles of the DRD2 and '9' repeat allele of DAT gene were genotyped. Heritability, association and linkage were assessed using variance component genetic analyses. After adjusting for the covariates, the heritabilities of PTSD diagnosis and B and C category symptoms were: 0.37, 0.75 and 0.39 respectively. Category D symptoms were not heritable. Neither the DRD2 nor the DAT polymorphisms explained the variation seen in PTSD diagnosis, total PTSD symptom severity, and categories B and C symptom severities. These findings contradict prior reports of positive associations between both DRD2 and DAT, and PTSD. Published by Elsevier Ireland Ltd. C1 [Bailey, Julia N.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Epidemiol, Los Angeles, CA 90095 USA. [Goenjian, Armen K.; Noble, Ernest P.; Ritchie, Terry] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat, Los Angeles, CA 90095 USA. [Bailey, Julia N.] VA GLAHS Epilepsy Ctr Excellence, Epilepsy Genet Genom Labs, Comprehens Epilepsy Program, Los Angeles, CA USA. [Goenjian, Armen K.; Walling, David P.; Goenjian, Haig A.] Collaborat Neurosci Network, Garden Grove, CA USA. RP Bailey, JN (reprint author), VA GLAHSWest Los Angeles, Comprehens Epilepsy Program, Epilepsy Genet Genom Labs, W Los Angeles VA Med Ctr, Room 3405 127B,Bldg 500,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jbailey@mednet.ucla.edu NR 29 TC 21 Z9 24 U1 0 U2 3 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 AUG 15 PY 2010 VL 178 IS 3 BP 507 EP 510 DI 10.1016/j.psychres.2010.04.043 PG 4 WC Psychiatry SC Psychiatry GA 642CQ UT WOS:000281181400010 PM 20554017 ER PT J AU Clegg, LX Hankey, BF Tiwari, R Feuer, EJ Edwards, BK AF Clegg, Limin X. Hankey, Benjamin F. Tiwari, Ram Feuer, Eric J. Edwards, Brenda K. TI Comment on 'Estimating average annual per cent change in trend analysis' Reply SO STATISTICS IN MEDICINE LA English DT Letter C1 [Clegg, Limin X.] US Dept Vet Affairs, Washington, DC 20001 USA. [Tiwari, Ram] US FDA, Silver Spring, MD 20993 USA. [Feuer, Eric J.; Edwards, Brenda K.] NCI, Bethesda, MD 20892 USA. RP Clegg, LX (reprint author), US Dept Vet Affairs, 801 1 St NW,Room 1018, Washington, DC 20001 USA. EM ram.tiwari@fda.hhs.gov; edwardsb@mail.nih.gov NR 1 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 0277-6715 J9 STAT MED JI Stat. Med. PD AUG 15 PY 2010 VL 29 IS 18 BP 1961 EP 1961 DI 10.1002/sim.3983 PG 1 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 640XR UT WOS:000281088000010 ER PT J AU Kaufman, L Potla, U Coleman, S Dikiy, S Hata, Y Kurihara, H He, JC D'Agati, VD Klotman, PE AF Kaufman, Lewis Potla, Uma Coleman, Sarah Dikiy, Stanislav Hata, Yutaka Kurihara, Hidetake He, John C. D'Agati, Vivette D. Klotman, Paul E. TI Up-regulation of the Homophilic Adhesion Molecule Sidekick-1 in Podocytes Contributes to Glomerulosclerosis SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID FOCAL SEGMENTAL GLOMERULOSCLEROSIS; HIV-ASSOCIATED NEPHROPATHY; GLOMERULAR SLIT DIAPHRAGM; TIGHT JUNCTION PROTEIN; CELL-ADHESION; NEPHROTIC SYNDROME; GUANYLATE KINASE; RENAL-DISEASE; MAGI-1; MICE AB Focal segmental glomerulosclerosis (FSGS) is a leading cause of nephrotic syndrome and end-stage renal disease worldwide. Although the mechanisms underlying this important disease are poorly understood, the glomerular podocyte clearly plays a central role in disease pathogenesis. In the current work, we demonstrate that the homophilic adhesion molecule sidekick-1 (sdk-1) is up-regulated in podocytes in FSGS both in rodent models and in human kidney biopsy samples. Transgenic mice that have podocyte-specific overexpression of sdk-1 develop gradually progressive heavy proteinuria and severe FSGS. We also show that sdk-1 associates with the slit diaphragm linker protein MAGI-1, which is already known to interact with several critical podocyte proteins including synaptopodin, alpha-actinin-4, nephrin, JAM4, and beta-catenin. This interaction is mediated through a direct interaction between the carboxyl terminus of sdk-1 and specific PDZ domains of MAGI-1. In vitro expression of sdk-1 enables a dramatic recruitment of MAGI-1 to the cell membrane. Furthermore, a truncated version of sdk-1 that is unable to bind to MAGI-1 does not induce podocyte dysfunction when overexpressed. We conclude that the up-regulation of sdk-1 in podocytes is an important pathogenic factor in FSGS and that the mechanism involves disruption of the actin cytoskeleton possibly via alterations in MAGI-1 function. C1 [Kaufman, Lewis; Klotman, Paul E.] Mt Sinai Sch Med, Div Nephrol, New York, NY 10029 USA. [Kaufman, Lewis; He, John C.] James J Peters Vet Affairs Med Ctr, Div Nephrol, Bronx, NY 10468 USA. [Hata, Yutaka] Tokyo Med & Dent Univ, Grad Sch Med, Dept Med Biochem, Tokyo 1138519, Japan. [Kurihara, Hidetake] Juntendo Univ, Sch Med, Dept Anat, Tokyo 1138421, Japan. [D'Agati, Vivette D.] Columbia Univ Coll Phys & Surg, Dept Pathol, New York, NY 10032 USA. RP Kaufman, L (reprint author), Mt Sinai Sch Med, Div Nephrol, 1 Gustave L Levy Pl,Box 1243, New York, NY 10029 USA. EM lewis.kaufman@mssm.edu OI Dikiy, Stanislav/0000-0002-8287-6561 FU National Institutes of Health [K08 DK070530, R01 DK084006, P01 DK056492] FX This work was supported, in whole or in part, by National Institutes of Health Grants K08 DK070530 (to L. K.) R01 DK084006 (to L. K.) and P01 DK056492 (to P. E. K.). NR 39 TC 16 Z9 16 U1 0 U2 2 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 13 PY 2010 VL 285 IS 33 BP 25677 EP 25685 DI 10.1074/jbc.M110.133959 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 635UN UT WOS:000280682400061 PM 20562105 ER PT J AU Martinez, D Heudebert, G Seas, C Henostroza, G Rodriguez, M Zamudio, C Centor, RM Herrera, C Gotuzzo, E Estrada, C AF Martinez, Dalila Heudebert, Gustavo Seas, Carlos Henostroza, German Rodriguez, Martin Zamudio, Carlos Centor, Robert M. Herrera, Cesar Gotuzzo, Eduardo Estrada, Carlos TI Clinical Prediction Rule for Stratifying Risk of Pulmonary Multidrug-Resistant Tuberculosis SO PLOS ONE LA English DT Article ID METHODOLOGICAL STANDARDS; CONFIDENCE-INTERVALS; TREATMENT FAILURE; MDR-TB; DIAGNOSIS; VALIDATION; CALIFORNIA; INPATIENTS; COUNTRIES; RUSSIA AB Background: Multidrug-resistant tuberculosis (MDR-TB), resistance to at least isoniazid and rifampin, is a worldwide problem. Objective: To develop a clinical prediction rule to stratify risk for MDR-TB among patients with pulmonary tuberculosis. Methods: Derivation and internal validation of the rule among adult patients prospectively recruited from 37 health centers (Peru), either a) presenting with a positive acid-fast bacillus smear, or b) had failed therapy or had a relapse within the first 12 months. Results: Among 964 patients, 82 had MDR-TB (prevalence, 8.5%). Variables included were MDR-TB contact within the family, previous tuberculosis, cavitary radiologic pattern, and abnormal lung exam. The area under the receiver-operating curve (AUROC) was 0.76. Selecting a cut-off score of one or greater resulted in a sensitivity of 72.6%, specificity of 62.8%, likelihood ratio (LR) positive of 1.95, and LR negative of 0.44. Similarly, selecting a cut-off score of two or greater resulted in a sensitivity of 60.8%, specificity of 87.5%, LR positive of 4.85, and LR negative of 0.45. Finally, selecting a cut-off score of three or greater resulted in a sensitivity of 45.1%, specificity of 95.3%, LR positive of 9.56, and LR negative of 0.58. Conclusion: A simple clinical prediction rule at presentation can stratify risk for MDR-TB. If further validated, the rule could be used for management decisions in resource-limited areas. C1 [Martinez, Dalila; Seas, Carlos; Zamudio, Carlos; Gotuzzo, Eduardo] Univ Peruana Cayetano Heredia, Inst Trop Med Alexander von Humboldt, Lima, Peru. [Heudebert, Gustavo; Centor, Robert M.; Estrada, Carlos] Univ Alabama, Div Gen Internal Med, Birmingham, AL USA. [Heudebert, Gustavo; Centor, Robert M.; Estrada, Carlos] Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. [Herrera, Cesar] Minist Hlth, Peruvian TB Program, Lima, Peru. [Henostroza, German; Rodriguez, Martin] Univ Alabama, Div Infect Dis, Birmingham, AL USA. RP Martinez, D (reprint author), Univ Peruana Cayetano Heredia, Inst Trop Med Alexander von Humboldt, Lima, Peru. EM cestrada@uab.edu OI Zamudio, Carlos/0000-0001-7479-127X FU NIH [1U2RTW007368-01A1] FX Funding and Support: Peru ICOHRTA Network for AIDS/TB Research Training (NIH Grant 1U2RTW007368-01A1- Fogarty International Center, Dr Gotuzzo, Lima Peru) for funding the training of Dr. Martinez at the School of Public Health at University of Alabama at Birmingham (UAB). http://projectreporter. nih.gov/project_info_description.cfm?aid=7239089&icde=4053480. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 35 TC 8 Z9 8 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 AUG 11 PY 2010 VL 5 IS 8 AR e12082 DI 10.1371/journal.pone.0012082 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 637WJ UT WOS:000280849100020 PM 20711459 ER PT J AU Rasmussen, DD Raskind, MA Walker, BM Koob, GF Froehlich, JC Simpson, TL Saxon, AJ AF Rasmussen, D. D. Raskind, M. A. Walker, B. M. Koob, G. F. Froehlich, J. C. Simpson, T. L. Saxon, A. J. TI TRANSLATIONAL APPROACH TO DEVELOPMENT OF NORADRENERGIC AGENTS FOR TREATMENT OF ALCOHOL DEPENDENCE SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT World Congress on International-Society-for-Biomedical-Research-on-Alcoholism CY SEP 13-16, 2010 CL Paris, FRANCE SP Int Soc Biomed Res Alcoholism, Soc Francaise Alcoolog C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, VA Med Ctr, Seattle, WA 98108 USA. RI koob, george/P-8791-2016 NR 0 TC 0 Z9 0 U1 0 U2 1 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD AUG 10 PY 2010 VL 34 IS 8 SU S BP 64A EP 64A PG 1 WC Substance Abuse SC Substance Abuse GA 630DN UT WOS:000280252600201 ER PT J AU Ooteman, W Naassila, M Koeter, MWJ Verheul, R Schippers, GM Houchi, H Daoust, M van den Brink, W AF Ooteman, W. Naassila, M. Koeter, M. W. J. Verheul, R. Schippers, G. M. Houchi, H. Daoust, M. van den Brink, W. TI PREDICTING THE EFFECT OF NALTREXONE AND ACAMPROSATE ON CUE-INDUCED CRAVING IN ALCOHOL-DEPENDENT PATIENTS USING GENETIC INDICATORS SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT World Congress on International-Society-for-Biomedical-Research-on-Alcoholism CY SEP 13-16, 2010 CL Paris, FRANCE SP Int Soc Biomed Res Alcoholism, Soc Francaise Alcoolog C1 [Ooteman, W.; Naassila, M.; Koeter, M. W. J.; Verheul, R.; Schippers, G. M.; Houchi, H.; Daoust, M.; van den Brink, W.] Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Ctr Imaging Neurodegenerat Dis, San Francisco, CA 94121 USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD AUG 10 PY 2010 VL 34 IS 8 SU S BP 70A EP 70A PG 1 WC Substance Abuse SC Substance Abuse GA 630DN UT WOS:000280252600226 ER PT J AU Bradley, KA Lapham, GT Williams, EC Achtmeyer, C Thomas, R Hawkins, E Saitz, R Kivlahan, D AF Bradley, K. A. Lapham, G. T. Williams, E. C. Achtmeyer, C. Thomas, R. Hawkins, E. Saitz, R. Kivlahan, D. TI EFFECTS OF THE PROPORTION SCREENING POSITIVE ON A PERFORMANCE MEASURE FOR BRIEF ALCOHOL INTERVENTION SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT World Congress on International-Society-for-Biomedical-Research-on-Alcoholism CY SEP 13-16, 2010 CL Paris, FRANCE SP Int Soc Biomed Res Alcoholism, Soc Francaise Alcoolog C1 [Bradley, K. A.; Lapham, G. T.; Williams, E. C.; Achtmeyer, C.; Thomas, R.; Hawkins, E.; Saitz, R.; Kivlahan, D.] VA Puget Sound Hlth Care Syst, Seattle, WA 98146 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD AUG 10 PY 2010 VL 34 IS 8 SU S BP 82A EP 82A PG 1 WC Substance Abuse SC Substance Abuse GA 630DN UT WOS:000280252600272 ER PT J AU Williams, EC Bradley, KA Harris, AHS AF Williams, E. C. Bradley, K. A. Harris, A. H. S. TI ASSOCIATION BETWEEN ALCOHOL SCREENING SCORES AND MORTALITY AMONG BLACK, HISPANIC, AND WHITE MALE VETERANS SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT World Congress on International-Society-for-Biomedical-Research-on-Alcoholism CY SEP 13-16, 2010 CL Paris, FRANCE SP Int Soc Biomed Res Alcoholism, Soc Francaise Alcoolog C1 VA Puget Sound, NW Ctr Excellence Hlth Serv Res & Dev, Seattle, WA 98101 USA. VA Palo Alto Hlth Care Syst, Ctr Hlth Care Evaluat, Menlo Pk, CA 94025 USA. Stanford Univ, Sch Med, Menlo Pk, CA 94025 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 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD AUG 10 PY 2010 VL 34 IS 8 SU S BP 120A EP 120A PG 1 WC Substance Abuse SC Substance Abuse GA 630DN UT WOS:000280252600418 ER PT J AU Williams, EC Lapham, GT Johnson, ML Bradley, KA AF Williams, E. C. Lapham, G. T. Johnson, M. L. Bradley, K. A. TI STRATEGIES TO IMPLEMENT ALCOHOL SCREENING AND BRIEF INTERVENTION: A STRUCTURED LITERATURE REVIEW SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT World Congress on International-Society-for-Biomedical-Research-on-Alcoholism CY SEP 13-16, 2010 CL Paris, FRANCE SP Int Soc Biomed Res Alcoholism, Soc Francaise Alcoolog C1 [Williams, E. C.; Lapham, G. T.; Johnson, M. L.; Bradley, K. A.] VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98101 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 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD AUG 10 PY 2010 VL 34 IS 8 SU S BP 120A EP 120A PG 1 WC Substance Abuse SC Substance Abuse GA 630DN UT WOS:000280252600417 ER PT J AU Durazzo, TC Fryer, S Vertinski, M Gazdzinski, S Mon, A Meyerhoff, DJ AF Durazzo, T. C. Fryer, S. Vertinski, M. Gazdzinski, S. Mon, A. Meyerhoff, D. J. TI MEASURES OF LEARNING, MEMORY AND PROCESSING SPEED ACCURATELY PREDICT SMOKING STATUS IN TREATMENT SEEKING ALCOHOL DEPENDENT INDIVIDUALS SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT World Congress on International-Society-for-Biomedical-Research-on-Alcoholism CY SEP 13-16, 2010 CL Paris, FRANCE SP Int Soc Biomed Res Alcoholism, Soc Francaise Alcoolog C1 [Durazzo, T. C.; Fryer, S.; Vertinski, M.; Gazdzinski, S.; Mon, A.; Meyerhoff, D. J.] Univ Calif San Francisco, San Francisco VA Med Ctr, San Francisco, CA 94121 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD AUG 10 PY 2010 VL 34 IS 8 SU S BP 136A EP 136A PG 1 WC Substance Abuse SC Substance Abuse GA 630DN UT WOS:000280252600481 ER PT J AU Shi, M Zabetian, CP Hancock, AM Ginghina, C Hong, Z Yearout, D Chung, KA Quinn, JF Peskind, ER Galasko, D Jankovic, J Leverenz, JB Zhang, J AF Shi, Min Zabetian, Cyrus P. Hancock, Aneeka M. Ginghina, Carmen Hong, Zhen Yearout, Dora Chung, Kathryn A. Quinn, Joseph F. Peskind, Elaine R. Galasko, Douglas Jankovic, Joseph Leverenz, James B. Zhang, Jing TI Significance and confounders of peripheral DJ-1 and alpha-synuclein in Parkinson's disease SO NEUROSCIENCE LETTERS LA English DT Article DE Biomarker; DJ-1; alpha-Synuclein; Plasma; Parkinson's disease; Alzheimer's disease ID CEREBROSPINAL-FLUID; HUMAN PLASMA; BIOMARKERS; MARKER; ELISA AB DJ-1 and alpha-synuclein are leading biomarkers for Parkinson's disease diagnosis and/or monitoring disease progression. A few recent investigations have determined DJ-1 and alpha-synuclein levels in plasma or serum, a more convenient sample source than cerebrospinal fluid; but the results were variable or even contradictory. Besides limitations in detection technology and limited number of cases in some studies, inadequate control of several important confounders likely has contributed to these inconsistent results. In this study, the relative contribution of each blood component to blood DJ-1 and alpha-synuclein was evaluated, followed by quantification of plasma levels of both markers in a larger cohort of patients/subjects (similar to 300 cases) whose cerebrospinal fluid DJ-1 and alpha-synuclein levels have been determined recently. The results demonstrated that the DJ-1 and alpha-synuclein in blood resided predominantly in red blood cells (>95%), followed by platelets (1-4%), white blood cells and plasma (<= 1%), indicating that variations in hemolysis and/or platelet contamination could have a significant effect on plasma/serum DJ-1 and alpha-synuclein levels. Nonetheless, after adjusting for the age, although there was a trend of decrease in DJ-1 and alpha-synuclein in patients with Parkinson's or Alzheimer's disease compared with healthy controls, no statistical difference was observed in this cohort between any groups, even when the extent of hemolysis and platelet contamination were controlled for. Additionally, no correlation between DJ-1 or alpha-synuclein and Parkinson's disease severity was identified. In conclusion, unlike in cerebrospinal fluid, total DJ-1 or alpha-synuclein in plasma alone is not useful as biomarkers for Parkinson's disease diagnosis or progression/severity. (C) 2010 Elsevier Ireland Ltd. All rights reserved. C1 [Shi, Min; Hancock, Aneeka M.; Ginghina, Carmen; Hong, Zhen; Zhang, Jing] Univ Washington, Sch Med, Dept Pathol, Seattle, WA 98104 USA. [Zabetian, Cyrus P.; Yearout, Dora] Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Seattle, WA USA. [Zabetian, Cyrus P.; Yearout, Dora; Leverenz, James B.] Univ Washington, Sch Med, Dept Neurol, Seattle, WA 98104 USA. [Chung, Kathryn A.; Quinn, Joseph F.] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. [Peskind, Elaine R.; Leverenz, James B.] Vet Affairs Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. [Peskind, Elaine R.; Leverenz, James B.] Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98104 USA. [Galasko, Douglas] Univ Calif San Diego, Dept Neurosci, San Diego, CA 92103 USA. [Jankovic, Joseph] Baylor Coll Med, Parkinsons Dis Ctr, Houston, TX 77030 USA. [Zhang, Jing] Baylor Coll Med, Movement Disorders Clin, Houston, TX 77030 USA. RP Zhang, J (reprint author), Univ Washington, Sch Med, Dept Pathol, Box 359635,325 9th Ave, Seattle, WA 98104 USA. EM zhangj@uw.edu RI Shi, Min/G-6165-2012 OI Shi, Min/0000-0002-6901-2558; Zabetian, Cyrus/0000-0002-7739-4306 FU National Institutes of Health [ES004696, NS057567, AG025327, AG033398, NS060252, NS062684, AG005136, AG008017]; Michael J. Fox Foundation FX This research was supported by the National Institutes of Health grants (ES004696, NS057567, AG025327, AG033398, NS060252, NS062684, AG005136 and AG008017) as well as grants from the Michael J. Fox Foundation. We thank Mr. Joshua Bradner and Travis Cook for their assistance on sample preparation and assays, and Mr. Thomas Quinn for manuscript preparation. We also deeply appreciate those who have donated their blood for our studies. NR 20 TC 61 Z9 64 U1 2 U2 11 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 AUG 9 PY 2010 VL 480 IS 1 BP 78 EP 82 DI 10.1016/j.neulet.2010.06.009 PG 5 WC Neurosciences SC Neurosciences & Neurology GA 633AJ UT WOS:000280471400018 PM 20540987 ER PT J AU Ismail-Beigi, F Craven, T Banerji, MA Basile, J Calles, J Cohen, RM Cuddihy, R Cushman, WC Genuth, S Grimm, RH Hamilton, BP Hoogwerf, B Karl, D Katz, L Krikorian, A O'Connor, P Pop-Busui, R Schubart, U Simmons, D Taylor, H Thomas, A Weiss, D Hramiak, I AF Ismail-Beigi, Faramarz Craven, Timothy Banerji, Mary Ann Basile, Jan Calles, Jorge Cohen, Robert M. Cuddihy, Robert Cushman, William C. Genuth, Saul Grimm, Richard H., Jr. Hamilton, Bruce P. Hoogwerf, Byron Karl, Diane Katz, Lois Krikorian, Armand O'Connor, Patrick Pop-Busui, Rodica Schubart, Ulrich Simmons, Debra Taylor, Harris Thomas, Abraham Weiss, Daniel Hramiak, Irene CA ACCORD Trial Grp TI Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial SO LANCET LA English DT Article ID URINARY ALBUMIN EXCRETION; BLOOD-GLUCOSE CONTROL; CLINICAL-TRIALS; RISK-FACTORS; COMPLICATIONS; UKPDS; PROGRESSION; MELLITUS; MICROALBUMINURIA; HYPERTENSION AB Background Hyperglycaemia is associated with increased risk of cardiovascular complications in people with type 2 diabetes. We investigated whether reduction of blood glucose concentration decreases the rate of microvascular complications in people with type 2 diabetes. Methods ACCORD was a parallel-group, randomised trial done in 77 clinical sites in North America. People with diabetes, high HbA(1c). concentrations (>7.5%), and cardiovascular disease (or >= 2 cardiovascular risk factors) were randomly assigned by central randomisation to intensive (target haemoglobin A(1c) [HbA(1c)] of <6.0%) or standard (7.0-7.9%) glycaemic therapy. In this analysis, the prespecified composite outcomes were: dialysis or renal transplantation, high serum creatinine (>291.7 mu mol/L), or retinal photocoagulation or vitrectomy (first composite outcome); or peripheral neuropathy plus the first composite outcome (second composite outcome). 13 prespecified secondary measures of kidney, eye, and peripheral nerve function were also assessed. Investigators and participants were aware of treatment group assignment. Analysis was done for all patients who were assessed for microvascular outcomes, on the basis of treatment assignment, irrespective of treatments received or compliance to therapies. ACCORD is registered with ClinicalTrials.gov, number NCT00000620. Findings 10 251 patients were randomly assigned, 5128 to the intensive glycaemia control group and 5123 to standard group. Intensive therapy was stopped before study end because of higher mortality in that group, and patients were transitioned to standard therapy. At transition, the first composite outcome was recorded in 443 of 5107 patients in the intensive group versus 444 of 5108 in the standard group (HR 1.00, 95% CI 0.88-1.14; p=1.00), and the second composite outcome was noted in 1591 of 5107 versus 1659 of 5108 (0.96, 0.89-1.02; p=0.19). Results were similar at study end (first composite outcome 556 of 5119 vs 586 of 5115 [HR 0.95,95% CI 0.85-1.07, p=0.44]; and second 1956 of 5119 vs 2046 of 5115, respectively [0.95, 0.89-1.01, p=0.12]). Intensive therapy did not reduce the risk of advanced measures of microvascular outcomes, but delayed the onset of albuminuria and some measures of eye complications and neuropathy. Seven secondary measures at study end favoured intensive therapy (p<0.05). Interpretation Microvascular benefits of intensive therapy should be weighed against the increase in total and cardiovascular disease-related mortality, increased weight gain, and high risk for severe hypoglycaemia. C1 [Ismail-Beigi, Faramarz] Case Western Reserve Univ, Dept Med, Div Clin & Mol Endocrinol, Cleveland, OH 44106 USA. [Craven, Timothy] Wake Forest Univ, Sch Med, Winston Salem, NC 27109 USA. [Banerji, Mary Ann] Suny Downstate Med Ctr, New York, NY USA. [Basile, Jan] Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. [Calles, Jorge] Wake Forest Univ, Baptist Med Ctr, Winston Salem, NC 27109 USA. [Cohen, Robert M.] Univ Cincinnati, Cincinnati, OH USA. [Cohen, Robert M.] Cincinnati Vet Affairs Med Ctr, Cincinnati, OH USA. [Cuddihy, Robert] Int Diabet Ctr Pk Nicollet, Minneapolis, MN USA. [Cuddihy, Robert] Univ Minnesota, Sch Med, Minneapolis, MN 55455 USA. [Cushman, William C.] Memphis Vet Affairs Med Ctr, Memphis, TN USA. [Grimm, Richard H., Jr.] Berman Ctr Outcomes & Clin Res, Minneapolis, MN USA. [Hamilton, Bruce P.] VA Med Ctr, Baltimore, MD USA. [Hamilton, Bruce P.] Univ Maryland, Sch Med, Baltimore, MD 21201 USA. [Hoogwerf, Byron] Eli Lilly & Co, Indianapolis, IN 46285 USA. [Karl, Diane] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Katz, Lois] NYU, Sch Med, VA New York Harbor Healthcare Syst, New York, NY 10003 USA. [O'Connor, Patrick] HealthPartners Res Fdn, Minneapolis, MN USA. [Pop-Busui, Rodica] Univ Michigan, Med Ctr, Ann Arbor, MI USA. [Schubart, Ulrich] Albert Einstein Coll Med, Jacobi Med Ctr, Bronx, NY 10467 USA. [Simmons, Debra] Univ Arkansas Med Sci, Little Rock, AR 72205 USA. Henry Ford Hosp, Detroit, MI 48202 USA. [Weiss, Daniel] Your Diabet Endocrine Nutr Grp, Mentor, OH USA. [Hramiak, Irene] St Josephs Hlth Care, London, ON, Canada. RP Ismail-Beigi, F (reprint author), Case Western Reserve Univ, Dept Med, Div Clin & Mol Endocrinol, 10900 Euclid Ave, Cleveland, OH 44106 USA. EM faramarz.ismail-beigi@case.edu RI Friedewald, William/C-8034-2011; Bryan, R. Nick/P-1661-2014 OI Thomas, Abraham/0000-0002-3941-1195 FU National Heart, Lung, and Blood Institute [N01-HC-95178, N01-HC-95179, N01-HC-95180, N01-HC-95181, N01-HC-95182, N01-HC-95183, N01-HC-95184, IAA-Y1-HC-9035, IAA-Y1-HC-1010]; National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; National Institutes of Health, National Institute on Aging; National Institutes of Health, National Eye Institute; Centers for Disease Control and Prevention; General Clinical Research Centers; Novartis; Boehringer Ingelheim; Roche; Sanofi-Aventis; BMS; Takeda; Eli Lilly; Merck; US National Institutes of Health; Roche Diabetes; Novo Nordisk; Cequr; Bayer; Eli Lily; Abbott; Amylin; Dalichi-Sankyo; Edwards Lifesciences; Dexcom; Johnson and Johnson/Lifescan; Mannkind; Medtronic; Quotient Diagnostics; ResMed; King Pharmaceuticals; Lawson Research Institute; Bristol-Myers Squibb; Hofmann-La Roche; Merck Frosst; Pfizer; Eisai; Inekrin; Oresigen FX The ACCORD Trial was supported by grants (N01-HC-95178, N01-HC-95179, N01-HC-95180, N01-HC-95181, N01-HC-95182, N01-HC-95183, N01-HC-95184, IAA-Y1-HC-9035, and IAA-Y1-HC-1010) from the National Heart, Lung, and Blood Institute; by other components of the National Institutes of Health, including the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute on Aging, and the National Eye Institute; by the Centers for Disease Control and Prevention; and by General Clinical Research Centers. The following companies provided study medications, equipment, or supplies: Abbott Laboratories, Amylin Pharmaceutical, AstraZeneca Pharmaceuticals LP, Bayer HealthCare LLC, Closer Healthcare, GlaxoSmithKline Pharmaceuticals, King Pharmaceuticals, Merck, Novartis Pharmaceuticals, Novo Nordisk, Omron Healthcare, Sanofi-Aventis US, and Takeda Pharmaceuticals.; MAB has received consulting fees from Novartis, Boehringer Ingelheim, Roche, and Sanofi-Aventis; board membership fees from Novartis and BMS; grants from Roche, Boehringer Ingleheim, Takeda, Novartis, and Eli Lilly; honoraria from Merck and Sanofi-Aventis; and travel expenses from the US National Institutes of Health, Merck, Sanofi-Aventis, Roche and Boehringer Ingelheim. JC has received grants from Merck and honoraria and travel expenses from Sanofi-Aventis and Merck. RMC has received grants from the US National Institutes of Health and holds stock in Abbott Laboratories. RC has received grant and travel support from the US National Institutes of Health; board membership fees from Roche Diabetes; consultancy fees from Novo Nordisk, Cequr, Bayer, Eli Lily, Abbott; grant support from Amylin, Abbott, Bayer, Dalichi-Sankyo, Edwards Lifesciences, Elil Lily, Dexcom, Johnson and Johnson/Lifescan, Mannkind, Medtronic, Merck, NovoNordisk, Quotient Diagnostics, ResMed, Roche, Sanofi-Aventis, and Takeda; honoraria from Novo Nordisk and Roche; and payment for development of educational presentations from Eli Lilly, Johnson and Johnson/Lifescan, Merck, Novartis, Sanofi-Aventis. WCC has received consulting fees from Novartis, Sanofi-Aventis, Takeda, Bristol-Myers Squibb, King Pharmaceuticals, and Daiichi-Sankyo, and grant funding from Novartis and GlaxoSmithKline and NHLBI. RHG has received Data and Safety Monitoring Boards funding for Pfizer. BH has received travel support from NHLBI. BH has received full-time employment salary with stock benefits from Eli Lilly. IH has received consulting fees from GlaxoSmithKline; grants from Lawson Research Institute, Bristol-Myers Squibb, Eli Lilly, Hofmann-La Roche, Merck Frosst, Novo Nordisk, Pfizer, Sanofi-Aventis, and Abbott; honoraria from Boehringer Ingelheim, Eli Lilly, Bristol Myers Squibb, Merck Frosst, GlaxoSmithKline, Medtronic, Novo Nordisk, and Sanofi-Aventis; payment for development of educational programs from Bristol-Myers Squibb, AstraZeneca, and Merck Frosst; and travel support from Merck Frosst and Sanofi-Aventis. Fl-B has received travel support from NHLBI. DK has received grants from Amylin and Sanofi-Aventis, and honoraria from Amylin, Sanofi-Aventis, and Novo Nordisk, and travel support from NHLBI. LK has received grants from Novartis and Abbott; honoraria from Novartis; and travel support from Narrows Research Foundation. PO'C has received grant and travel support from NHLBI. RP-B has received consulting fees from Pfizer; grants from Amylin; and honoraria from GlaxoSmithKline and Pfizer. US has received grant and travel support from NHLBI. AT has received consulting fees from Novo Nordisk and Takeda; grants from Eli Lily, Amylin, Roche, and Abbot; and travel support from Novo Nordisk, Takeda, and NHLBI. DW reports grants from Amylin, Boehringer Ingelheim, Bristol-Myers Squibb, Eisai, Eli Lily, Inekrin, Mannkind, Novo Nordisk, Oresigen, Sanofi-Aventis, Takeda; honoraria from Amylin, AstraZeneca, Bristol-Myers Squibb, Daiichi-Sankyo, Eli Lily, GlaxoSmithKline, Merk, Novo Nordisk, Sanofi-Aventis, and Takeda; and payment for development of educational materials from Daiichi Sankyo. All other authors declare that they have no conflicts of interest. NR 32 TC 399 Z9 413 U1 4 U2 36 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0140-6736 J9 LANCET JI Lancet PD AUG 7 PY 2010 VL 376 IS 9739 BP 419 EP 430 DI 10.1016/S0140-6736(10)60576-4 PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA 639YK UT WOS:000281012900027 PM 20594588 ER PT J AU Murthy, S Ryan, A He, C Mallampalli, RK Carter, AB AF Murthy, Shubha Ryan, Alan He, Chao Mallampalli, Rama K. Carter, A. Brent TI Rac1-mediated Mitochondrial H2O2 Generation Regulates MMP-9 Gene Expression in Macrophages via Inhibition of SP-1 and AP-1 SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID ACTIVATED PROTEIN-KINASE; NF-KAPPA-B; MATRIX METALLOPROTEINASES; TNF-ALPHA; TRANSCRIPTIONAL ACTIVATION; SP1 PHOSPHORYLATION; SIGNAL-TRANSDUCTION; TISSUE INHIBITOR; BINDING-PROTEIN; IV COLLAGENASE AB Aberrant matrix deposition is a hallmark of pulmonary fibrosis and is characterized by an imbalance between matrix deposition and degradation. We have previously shown that mice harboring a conditional deletion of the GTP-binding protein, Rac1, in macrophages are protected from asbestos-induced pulmonary fibrosis. To investigate the contribution of aberrant matrix degradation, we addressed the role of Rac1 in regulating expression of macrophage-specific MMP-9 (matrix metalloproteinase-9). We found that MMP-9 gene transcription was significantly greater in Rac1 null macrophages. Deletion and mutational analysis of the MMP-9 promoter revealed that both SP-1 and AP-1 are essential for MMP-9 transcription. Overexpression of constitutive active Rac1 (V12) revealed that H2O2 was derived from the mitochondria. Rac1-induced H2O2 generation down-regulated MMP-9 gene transcription, whereas catalase overexpression in WT cells enhanced MMP-9 expression. SP-1 interacted directly with both c-Jun and c-Fos, and H2O2 decreased this binding, suggesting that SP-1 and AP-1 function cooperatively to regulate MMP-9 transcription. Rac1-mediated H2O2 inhibited the ERK MAPK, which was essential for activation of SP-1 and AP-1. ERK activation and MMP-9 expression were recovered by overexpressing catalase or transfecting siRNA for the mitochondrial iron-sulfur protein, Rieske. These observations were recapitulated in vivo. MMP-9 mRNA was higher in alveolar macrophages isolated from Rac1 null mice and wild type mice given catalase. Rac1 regulates MMP-9 transcription via mitochondrial H2O2 generation, providing a potential mechanism by which Rac1 null mice fail to develop pulmonary fibrosis. C1 [Murthy, Shubha; Ryan, Alan; Carter, A. Brent] Univ Iowa, Carver Coll Med, Dept Internal Med, Iowa City, IA 52242 USA. [He, Chao; Carter, A. Brent] Univ Iowa, Carver Coll Med, Dept Free Rad & Radiat Biol, Iowa City, IA 52242 USA. [Carter, A. Brent] Univ Iowa, Coll Publ Hlth, Dept Human Toxicol, Iowa City, IA 52242 USA. [Mallampalli, Rama K.] Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA 15213 USA. [Mallampalli, Rama K.] Univ Pittsburgh, Dept Med, Pittsburgh, PA 15213 USA. RP Carter, AB (reprint author), Univ Iowa, Carver Coll Med, Dept Internal Med, C33 GH, Iowa City, IA 52242 USA. FU National Institutes of Health [HL068135, HL081784, HL097376, ES015981, ES014871]; Department of Veterans Affairs, Office of Research and Development FX This work was supported, in whole or in part, by National Institutes of Health Grants HL068135, HL081784, and HL097376 (to R. K. M.) and ES015981 and ES014871 (to A. B. C.). This work was also supported by a grant from the Department of Veterans Affairs, Office of Research and Development (to R. K. M.). NR 57 TC 27 Z9 29 U1 1 U2 7 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 6 PY 2010 VL 285 IS 32 BP 25062 EP 25073 DI 10.1074/jbc.M109.099655 PG 12 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 633YB UT WOS:000280542100079 PM 20529870 ER PT J AU Bhargava, P Maki, JH AF Bhargava, Puneet Maki, Jeffrey H. TI "Cotton Wool" Appearance of Paget's Disease SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material C1 [Bhargava, Puneet; Maki, Jeffrey H.] Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RP Bhargava, P (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. EM bhargp@u.washington.edu OI Bhargava, Puneet/0000-0002-3849-9666 NR 0 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 AUG 5 PY 2010 VL 363 IS 6 BP E9 EP E9 DI 10.1056/NEJMicm0912945 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 634BB UT WOS:000280552700012 PM 20836245 ER PT J AU Shroyer, ALW Collins, JF Grover, FL AF Shroyer, A. Laurie W. Collins, Joseph F. Grover, Frederick L. TI Evaluating Clinical Applicability The STICH Trial's Findings SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Editorial Material ID SURGICAL VENTRICULAR RECONSTRUCTION; HEART-FAILURE; EPIDEMIOLOGY; RELIABILITY; SURGERY C1 [Shroyer, A. Laurie W.] SUNY Stony Brook, Sch Med, Stony Brook, NY 11794 USA. [Shroyer, A. Laurie W.] Northport VA Med Ctr, Northport, NY USA. [Collins, Joseph F.] Cooperat Studies Program Coordinating Ctr, Perry Point, MD USA. [Grover, Frederick L.] Eastern Colorado Hlth Care Syst, Denver VA Med Ctr, Denver, CO USA. [Grover, Frederick L.] Univ Colorado Denver, Sch Med, Aurora, CO USA. RP Shroyer, ALW (reprint author), SUNY Stony Brook, Sch Med, T19-020A,100 Nicholls Rd, Stony Brook, NY 11794 USA. EM annielaurie.shroyer@stonybrook.edu RI Shroyer, Annie Laurie/B-8836-2016 OI Shroyer, Annie Laurie/0000-0001-6461-0623 NR 11 TC 7 Z9 7 U1 0 U2 4 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 3 PY 2010 VL 56 IS 6 BP 508 EP 509 DI 10.1016/j.jacc.2010.03.052 PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 631TZ UT WOS:000280373400009 PM 20670762 ER PT J AU Weintraub, D Mavandadi, S Mamikonyan, E Siderowf, AD Duda, JE Hurtig, HI Colcher, A Horn, SS Nazem, S Ten Have, TR Stern, MB AF Weintraub, D. Mavandadi, S. Mamikonyan, E. Siderowf, A. D. Duda, J. E. Hurtig, H. I. Colcher, A. Horn, S. S. Nazem, S. Ten Have, T. R. Stern, M. B. TI Atomoxetine for depression and other neuropsychiatric symptoms in Parkinson disease SO NEUROLOGY LA English DT Article ID PROVISIONAL DIAGNOSTIC-CRITERIA; LOCUS-COERULEUS; EXECUTIVE DYSFUNCTION; DAYTIME SLEEPINESS; CONTROLLED-TRIAL; DOUBLE-BLIND; OPEN-LABEL; ANTIDEPRESSANTS; NOREPINEPHRINE; PERFORMANCE AB Objectives: Depression and antidepressant use, especially selective serotonin reuptake inhibitors (SSRIs), are common in Parkinson disease (PD). The objective of this clinical trial was to assess the efficacy of atomoxetine, a selective norepinephrine reuptake inhibitor (SNRI), for the treatment of clinically significant depressive symptoms and common comorbid neuropsychiatric symptoms in PD. Methods: A total of 55 subjects with PD and an Inventory of Depressive Symptomatology-Clinician (IDS-C) score >= 22 were randomized to 8 weeks of atomoxetine or placebo treatment (target dosage = 80 mg/day). Depression response (> 50% decrease in IDS-C score or Clinical Global Impression-Improvement [CGI-I] score of 1 or 2) was assessed using intention-to-treat modeling procedures. Secondary outcomes included global cognition, daytime sleepiness, anxiety, apathy, and motor function. Results: There were no between-groups differences in a priori-defined response rates. Using a more liberal response criterion of > 40% decrease in IDS score from baseline, there was a trend (p = 0.08) favoring atomoxetine. Patients receiving atomoxetine experienced significantly greater improvement in global cognition (p = 0.003) and daytime sleepiness (p = 0.001), and atomoxetine was well-tolerated. Conclusions: Atomoxetine treatment was not efficacious for the treatment of clinically significant depressive symptoms in PD, but was associated with improvement in global cognitive performance and daytime sleepiness. Larger studies of SNRIs in PD for disorders of mood, cognition, and wakefulness are appropriate. Classification of evidence: This interventional study provides Class II evidence that atomoxetine (target dosage = 80 mg/day) is not efficacious in improving clinically significant depression in PD. Neurology (R) 2010;75:448-455 C1 [Weintraub, D.; Mavandadi, S.; Mamikonyan, E.; Nazem, S.] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. [Weintraub, D.; Duda, J. E.; Stern, M. B.] Philadelphia VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA USA. [Weintraub, D.; Mavandadi, S.] Philadelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. [Siderowf, A. D.; Duda, J. E.; Hurtig, H. I.; Colcher, A.; Horn, S. S.; Stern, M. B.] Univ Penn, Dept Neurol, Penn Hosp, Parkinsons Dis & Movement Disorders Ctr, Philadelphia, PA 19104 USA. [Ten Have, T. R.] Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. RP Weintraub, D (reprint author), 3615 Chestnut St,330, Philadelphia, PA 19104 USA. EM daniel.weintraub@uphs.upenn.edu FU NIH NIMH [067894]; Avid Radiopharmaceuticals, Inc.; Boehringer Ingelheim; NIH [NIMH K23 MH067894, NINDS P50 NS053488-01, NIA RO1AG031348, NINDS R01NS065087]; Michael J. Fox Foundation for Parkinson's Research; Institute for Neurodegenerative Disorders; U.S. Department of Veterans Affairs; Samueli Institute; Johnson; Teva Pharmaceutical Industries Ltd.; Bayer Schering Pharma; Kyowa Hakko Kirin Pharma, Inc.; PRA International; Novartis; GlaxoSmithKline; Amarin Corporation; St Jude Medical; Prestwick Pharmaceutical, Inc.; HP Therapeutics Foundation, Inc.; Cephalon, Inc. FX Supported by the NIH NIMH 067894 (D.W.).; Dr. Weintraub has served on a scientific advisory board for Boehringer Ingelheim; serves on the editorial board of Movement Disorders; has received speaker honoraria from Boehringer Ingelheim, ACADIA Pharmaceuticals, Novartis, Osmotica Pharmaceutical Corp., BrainCells Inc., Merck Serono, sanofi-aventis, and Pfizer Inc; and has received/receives research support from Avid Radiopharmaceuticals, Inc., Boehringer Ingelheim, NIH (NIMH K23 MH067894 [PI], NINDS P50 NS053488-01 [Co-Investigator], NIA RO1AG031348 [Site PI], and NINDS R01NS065087 [Co-Investigator]), and from the Michael J. Fox Foundation for Parkinson's Research. Dr. Mavandadi and Ms. Mamikon-yan report no disclosures. Dr. Siderowf serves on a scientific advisory board for and has received speaker honoraria from Teva Pharmaceutical Industries Ltd.; serves as a consultant for Supernus Pharmaceuticals, Inc.; and receives research support from Avid Radiopharmaceuticals, Inc., the NIH (NINDS U10 NS044451-023 [Site PI], NINDS P50 NS053488-01 [Co-Core Leader and Project Leader], NINDS R43NS0636071 [Site PI], and NINDS R01NS065087 [Co-Investigator]), and from the Institute for Neurodegenerative Disorders. Dr. Duda serves on a grant review panel for the Michael J. Fox Foundation for Parkinson's Research; receives research support from the U.S. Department of Veterans Affairs (Merit Award [PI]), the Michael J. Fox Foundation, and the Samueli Institute; and holds stock in C. R. Bard, Inc., Celgene, Clarient, Inc., and Johnson& Johnson. Dr. Hurtig serves on a grant review panel for the Michael J. Fox Foundation for Parkinson's Research; serves on the editorial board of Parkinsonism and Related Disorders; receives publishing royalties from UpToDate, Inc.; has received speaker honoraria from Teva Pharmaceutical Industries Ltd.; receives research support from Teva Pharmaceutical Industries Ltd., Boehringer Ingelheim, Bayer Schering Pharma, Kyowa Hakko Kirin Pharma, Inc., PRA International, Novartis, GlaxoSmithKline, Avid Radiopharmaceuticals, Inc., St Jude Medical, Amarin Corporation, Prestwick Pharmaceutical, Inc., HP Therapeutics Foundation, Inc., Cephalon, Inc., NIH (NINDS P50 NS053488-01 [Core Leader and PI] and NINDS U10 NS044451-023 [Site PI]); and holds stock in Teva Pharmaceutical Industries Ltd. Dr. Colcher has received speaker honoraria from Lundbeck Inc. and Teva Pharmaceutical Industries Ltd. Dr. Horn has received speaker honoraria from Teva Pharmaceutical Industries Ltd. Ms. Nazem reports no disclosures. Dr. Ten Have serves on a scientific advisory board for the NIH; served as a consultant for Abbott and Avid Radiopharmaceuticals, Inc.; and receives research support from the NIH (R01-MH078016 [PI], R01-HL073932 [Co-Investigator], R01-MH067498 [PI], U01HL087072 [Co-Investigator], U49-CE001093 [Co-Investigator], R01HD053270 [Co-Investigator], R01-MH079736 [Co-Investigator], R01-HL086830 [Co-Investigator], P30-AG031043 [Co-Investigator], R01-AA016187 [Co-Investigator], R01-MH083717 [Co-Investigator], R01CA132656 [Co-Investigator], R01-AT004921 [Co-Investigator], R34MH085906 [Co-Investigator], NHBLI R01-HL096651 [Co-Investigator], R01-HD061061 [Co-Investigator], R01-MH082799 [Co-Investigator], R01-DA027204 [Co-Investigator], R01-CE001615 [Co-Investigator], RC1HL099612 [Co-Investigator], RC1-AA019092 [Co-Investigator], and R34MH085880 [Co-Investigator]). Dr. Stern has served on scientific advisory boards for Boehringer Ingelheim, Teva Pharmaceutical Industries Ltd., Ipsen, Schering-Plough Corp.; , Novartis, and Adamas Pharmaceuticals; has received funding for travel or speaker honorariafrom Novartis, Boehringer Ingelheim, and Teva Pharmaceutical Industries Ltd.; receives royalties from the publication of Surgical Management of Parkinson's Disease (Taylor and Francis Group, 2004); has served as a consultant for Teva Pharmaceutical Industries Ltd., Boehringer Ingelheim, Novartis, Ipsen, Schering-Plough Corp., and Adamas Pharmaceuticals; receives research support from the Institute for Neurodegenerative Disorders; and holds stock options in Adamas Pharmaceuticals. NR 38 TC 94 Z9 98 U1 0 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 EI 1526-632X J9 NEUROLOGY JI Neurology PD AUG 3 PY 2010 VL 75 IS 5 BP 448 EP 455 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 634FN UT WOS:000280565600013 PM 20679638 ER PT J AU Paranjape, AS Kuranov, R Baranov, S Ma, LL Villard, JW Wang, TY Sokolov, KV Feldman, MD Johnston, KP Milner, TE AF Paranjape, Amit S. Kuranov, Roman Baranov, Stepan Ma, Li Leo Villard, Joseph W. Wang, Tianyi Sokolov, Konstantin V. Feldman, Marc D. Johnston, Keith P. Milner, Thomas E. TI Depth resolved photothermal OCT detection of macrophages in tissue using nanorose SO BIOMEDICAL OPTICS EXPRESS LA English DT Article AB Application of photothermal Optical Coherence Tomography (OCT) to detect macrophages in ex vivo rabbit arteries which have engulfed nanoclusters of gold coated iron oxide (nanorose) is reported. Nanorose engulfed by macrophages associated with atherosclerotic lesions in rabbit arteries absorb incident laser (800nm) energy and cause optical pathlength (OP) variation which is measured using photothermal OCT. OP variation in polydimethyl siloxane tissue phantoms containing varying concentrations of nanorose match values predicted from nanoparticle and material properties. Measurement of OP variation in rabbit arteries in response to laser excitation provides an estimate of nanorose concentration in atherosclerotic lesions of 2.5x10(9) particles/ml. OP variation in atherosclerotic lesions containing macrophages taking up nanorose has a different magnitude and profile from that observed in control thoracic aorta without macrophages and is consistent with macrophage presence as identified with RAM-11 histology staining. Our results suggest that tissue regions with macrophages taking up nanorose can be detected using photothermal OCT. (C) 2010 Optical Society of America C1 [Paranjape, Amit S.; Baranov, Stepan; Wang, Tianyi; Sokolov, Konstantin V.; Milner, Thomas E.] Univ Texas Austin, Dept Biomed Engn, Austin, TX 78712 USA. [Ma, Li Leo; Johnston, Keith P.] Univ Texas Austin, Dept Chem Engn, Austin, TX 78712 USA. [Kuranov, Roman; Villard, Joseph W.; Feldman, Marc D.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Feldman, Marc D.] S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Paranjape, AS (reprint author), Univ Texas Austin, Dept Biomed Engn, Austin, TX 78712 USA. EM stepan@baranov.su RI Baranov, Stepan/G-5272-2010 OI Baranov, Stepan/0000-0002-1450-327X; Ma, Li/0000-0002-0959-5616; Sokolov, Konstantin/0000-0002-0198-2005 FU Veterans Administration; National Institutes of Health [R01EY016462-04] FX The authors gratefully acknowledge the Veterans Administration and the National Institutes of Health (R01EY016462-04) for financial support to this research. NR 35 TC 22 Z9 22 U1 2 U2 9 PU OPTICAL SOC AMER PI WASHINGTON PA 2010 MASSACHUSETTS AVE NW, WASHINGTON, DC 20036 USA SN 2156-7085 J9 BIOMED OPT EXPRESS JI Biomed. Opt. Express PD AUG 2 PY 2010 VL 1 IS 1 BP 2 EP 16 PG 15 WC Biochemical Research Methods; Optics; Radiology, Nuclear Medicine & Medical Imaging SC Biochemistry & Molecular Biology; Optics; Radiology, Nuclear Medicine & Medical Imaging GA V21LC UT WOS:000208208100001 PM 21258441 ER PT J AU Johansen, KL Smith, MW Unruh, ML Siroka, AM O'Connor, TZ Palevsky, PM AF Johansen, Kirsten L. Smith, Mark W. Unruh, Mark L. Siroka, Andrew M. O'Connor, Theresa Z. Palevsky, Paul M. CA VA NIH Acute Renal Failure Trial N TI Predictors of Health Utility among 60-Day Survivors of Acute Kidney Injury in the Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID QUALITY-OF-LIFE; LONG-TERM OUTCOMES; COGNITIVE IMPAIRMENT; REPLACEMENT THERAPY; INTENSIVE-CARE; DISEASE; DIALYSIS; BURDEN; INDEX; MORTALITY AB Background and objectives: Health-related quality of life (HRQOL) after acute kidney injury (AKI) is an area of great importance to patients. It was hypothesized that HRQOL after AKI would relate to intensity of dialysis during AKI and dialysis dependence at follow-up. Design, setting, participants, & measurements: The Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study was a multicenter, prospective, randomized trial of intensive versus less intensive renal replacement therapy in critically ill patients with AKI. Of 1124 participants, 415 survived at least 60 days and completed the Health Utilities Index (HUI), which measures 8 health attributes and calculates an overall HRQOL score, also called a utility score. How strongly pre-intensive care unit (ICU) health, severity of illness, hospital course, intensity of dialysis, and outcome were associated with 60-day HUI scores was assessed, after adjustment for demographics. Results: The overall HUI score was 0.40 +/- 0.37, indicating severely compromised health utility and was associated with only admission from home and hospital and ICU length of stay (LOS). Ambulation was better among those with a shorter hospital and ICU LOS. Better cognition was associated with dialysis independence and with fewer comorbid chronic illnesses. Emotion was associated with only hospital LOS. Pain was associated with ICU LOS. Conclusions: Health utility was low in this cohort of patients after AKI, and intensity of dialysis did not affect subsequent health utility. The effects of a lengthy hospitalization generally outweighed the effects of delayed recovery of kidney function on HRQOL after AKI. Clin J Am Soc Nephrol 5: 1366-1372, 2010. doi: 10.2215/CJN.02570310 C1 [Johansen, Kirsten L.] San Francisco VA Med Ctr, San Francisco, CA USA. [Johansen, Kirsten L.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Smith, Mark W.; Siroka, Andrew M.] VA Palo Alto Healthcare Syst, Palo Alto, CA USA. [Smith, Mark W.] Stanford Sch Med, Ctr Primary Care & Outcomes Res, Stanford, CA USA. [Unruh, Mark L.; Palevsky, Paul M.] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. [O'Connor, Theresa Z.] VA Connecticut Healthcare Syst, W Haven Cooperat Studies Program Coordinating Ctr, West Haven, CT USA. [Palevsky, Paul M.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Johansen, KL (reprint author), San Francisco VA Med Ctr 111J, Nephrol Sect, 4150 Clement St, San Francisco, CA 94121 USA. EM kirsten.johansen@ucsf.edu RI Smith, Mark/G-1522-2012 OI Smith, Mark/0000-0002-4582-9088; Palevsky, Paul/0000-0002-7334-5400 FU U.S. Department of Veterans Affairs Office of Research and Development; U.S. National Institutes of Diabetes and Digestive and Kidney Diseases [Y1-DK-3508-01] FX This study was supported by the Cooperative Studies Program of the U.S. Department of Veterans Affairs Office of Research and Development and by the U.S. National Institutes of Diabetes and Digestive and Kidney Diseases (interagency agreement Y1-DK-3508-01). This work was presented as a Free Communication at the 42nd Annual Meeting and Scientific Exposition of the American Society of Nephrology; October 27 through November 1, 2009; San Diego, CA. NR 35 TC 31 Z9 32 U1 1 U2 3 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 AUG PY 2010 VL 5 IS 8 BP 1366 EP 1372 DI 10.2215/CJN.02570310 PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 635WZ UT WOS:000280689600004 PM 20507953 ER PT J AU Blue, AV Mitcham, M Smith, T Raymond, J Greenberg, R AF Blue, Amy V. Mitcham, Maralynne Smith, Thomas Raymond, John Greenberg, Raymond TI Changing the Future of Health Professions: Embedding Interprofessional Education Within an Academic Health Center SO ACADEMIC MEDICINE LA English DT Article ID STUDENTS AB Institutions are increasingly considering interprofessional education (IPE) as a means to improve health care and reduce medical errors in the United States. Effective implementation of IPE within health professions education requires a strategic institutional approach to ensure longevity and sustainability. In 2007, the Medical University of South Carolina (MUSC) established Creating Collaborative Care (C(3)), an IPE initiative that takes a multifaceted approach to weaving interprofessional collaborative experiences throughout MUSC's culture to prepare students to participate in interprofessional, collaborative health care and research settings. In this article, the authors describe C(3)'s guiding conceptual foundation and student learning goals. They present its implementation framework to illustrate how C(3) is embedded within the institutional culture. It is housed in the provost's office, and an overarching implementation committee functions as a central coordinating group. Faculty members develop and implement C(3) activities across professions by contributing to four collaborating domains-curricular, extracurricular, faculty development, and health care simulation-each of which captures an IPE component. The authors provide examples of IPE activities developed by each domain to illustrate the breadth of IPE at MUSC. The authors believe that MUSC's efforts, including the conceptual foundation and implementation framework, can be generalized to other institutions intent on developing IPE within their organizational cultures. C1 [Blue, Amy V.] Med Univ S Carolina, Charleston, SC 29425 USA. [Mitcham, Maralynne] Med Univ S Carolina, Coll Hlth Profess, Div Occupat Therapy, Charleston, SC 29425 USA. [Smith, Thomas] Med Univ S Carolina, Ctr Acad Excellence, Charleston, SC 29425 USA. [Smith, Thomas] Med Univ S Carolina, Writing Ctr, Charleston, SC 29425 USA. [Raymond, John] Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Blue, AV (reprint author), 45 Courtenay Dr,Suite SS448,MSC 175, Charleston, SC 29425 USA. EM blueav@musc.edu NR 25 TC 29 Z9 29 U1 4 U2 16 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD AUG PY 2010 VL 85 IS 8 BP 1290 EP 1295 DI 10.1097/ACM.0b013e3181e53e07 PG 6 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 632UD UT WOS:000280453500010 PM 20671454 ER PT J AU Gubner, NR Wilhelm, CJ Phillips, TJ Mitchell, SH AF Gubner, Noah R. Wilhelm, Clare J. Phillips, Tamara J. Mitchell, Suzanne H. TI Strain Differences in Behavioral Inhibition in a Go/No-go Task Demonstrated Using 15 Inbred Mouse Strains SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE Impulsivity; Inhibition; Mice; Inbred Strains; Heritability; Go; No-go; Locomotion; Ethanol ID GENETIC-DETERMINANTS; ETHANOL WITHDRAWAL; IMPULSIVE BEHAVIOR; MICE; CONSUMPTION; SENSITIZATION; RESPONSES; SEVERITY; DRINKING; RATS AB Background: High levels of impulsivity have been associated with a number of substance abuse disorders including alcohol abuse. Research has not yet revealed whether these high levels predate the development of alcohol abuse. Methods: The current study examined impulsivity in 15 inbred strains of mice (A/HeJ, AKR/J, BALB/cJ, C3H/HeJ, C57BL/6J, C57L/J, C58/J, CBA/J, DBA/1J, DBA/2J, NZB/B1NJ, PL/J, SJL/J, SWR/J, and 129P3/J) using a Go/No-go task, which was designed to measure a subject's ability to inhibit a behavior. Numerous aspects of response to ethanol and other drugs of abuse have been examined in these strains. Results: There were significant strain differences in the number of responses made during the No-go signal (false alarms) and the extent to which strains responded differentially during the Go and No-go signals (d'). The rate of responding prior to the cue did not differ among strains, although there was a statistically significant correlation between false alarms and precue responding that was not related to basal activity level. Interstrain correlations suggested that false alarms and rate of responding were associated with strain differences in ethanol-related traits from the published literature. Conclusions: The results of this study do support a link between innate level of impulsivity and response to ethanol and are consistent with a genetic basis for some measures of behavioral inhibition. C1 [Gubner, Noah R.; Wilhelm, Clare J.; Phillips, Tamara J.; Mitchell, Suzanne H.] Oregon Hlth & Sci Univ, Dept Behav Neurosci, Portland, OR 97239 USA. [Phillips, Tamara J.; Mitchell, Suzanne H.] Portland Alcohol Res Ctr, Portland, OR USA. [Phillips, Tamara J.] Portland VA Med Ctr, Portland, OR USA. RP Mitchell, SH (reprint author), Oregon Hlth & Sci Univ, Dept Behav Neurosci L470, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM mitchesu@ohsu.edu OI Mitchell, Suzanne/0000-0002-0225-7200 FU The Portland Alcohol Research Center (PARC); Department of Veterans Affairs; [P60AA010760] FX We wish to thank John Crabbe, Pam Metten, and Andy Cameron for help analyzing the genetic correlation data. The authors also thank William Guethlein, Vanessa Wilson, Kirigin Elstad, and Carly Levine for technical assistance. This research was supported by The Portland Alcohol Research Center (PARC), P60AA010760 and the Department of Veterans Affairs. NR 33 TC 26 Z9 26 U1 0 U2 1 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD AUG PY 2010 VL 34 IS 8 BP 1353 EP 1362 DI 10.1111/j.1530-0277.2010.01219.x PG 10 WC Substance Abuse SC Substance Abuse GA 629KA UT WOS:000280195200006 PM 20491731 ER PT J AU Zeliadt, SB Ramsey, SD Van Den Eeden, SK Hamilton, AS Oakley-Girvan, I Penson, DF Fairweather, ME Arora, NK Potosky, AL AF Zeliadt, Steven B. Ramsey, Scott D. Van Den Eeden, Stephen K. Hamilton, Ann S. Oakley-Girvan, Ingrid Penson, David F. Fairweather, Megan E. Arora, Neeraj K. Potosky, Arnold L. TI Patient Recruitment Methods to Evaluate Treatment Decision Making for Localized Prostate Cancer SO AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS LA English DT Article DE prostate cancer; decision making; recruitment; registry ID BREAST-CANCER; STRATEGIES; MANAGEMENT; TRIAL; MEN; SURVEILLANCE; CARCINOMA AB Objective: To examine methods for identifying and recruiting prostate cancer patients prior to initiating treatment to gain insight into the treatment decision process and avoid recall bias. Study Design and Setting: One recruitment strategy involved providers and nursing staff approaching patients in community and academic urology clinics. The second recruitment strategy used electronic pathology reports to identify newly diagnosed cases in real time in an integrated health system. Our recruitment goal was to have patients complete the survey about the decision-making process prior to initiating therapy. Results: The two recruitment methods yielded different response rates. Of the 226 eligible participants approached in urology clinics, 187 (83%) returned a completed baseline survey. Of the 1177 surveys mailed to potentially eligible participants at KPNC, 617 (52%) returned a completed baseline survey. The number of surveys completed prior to treatment was 125 (67%) for the clinic recruitment approach and 437 (71%) for the electronic medical record approach. Younger participants and patients with less aggressive clinical characteristics were more likely to complete the survey before initiating treatment. Other patient demographic and clinical factors were not associated with the timing of survey return. Conclusions: Recruiting newly diagnosed patients prior to initiating treatment is feasible with both approach methods. The use of electronic medical records to identify subjects was more cost efficient, although it results in a lower response rate. C1 [Zeliadt, Steven B.; Ramsey, Scott D.; Fairweather, Megan E.] Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Seattle, WA 98109 USA. [Zeliadt, Steven B.] VA Puget Sound Hlth Care Syst, Hlth Serv Res, Seattle, WA USA. [Zeliadt, Steven B.] VA Puget Sound Hlth Care Syst, Dev Ctr Excellence, Seattle, WA USA. [Van Den Eeden, Stephen K.] Kaiser Permanente, Div Res, Oakland, CA USA. [Hamilton, Ann S.] Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA 90033 USA. [Oakley-Girvan, Ingrid] No Calif Canc Ctr, Fremont, CA USA. [Penson, David F.] Vanderbilt Univ, Med Ctr, Vanderbilt Inst Med & Publ Hlth, Nashville, TN USA. [Arora, Neeraj K.] NCI, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA. [Potosky, Arnold L.] Georgetown Univ, Med Ctr, Lombardi Comprehens Canc Ctr, Washington, DC 20007 USA. RP Ramsey, SD (reprint author), Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, 1100 Fairview Ave N,Box 19024,M3-B232, Seattle, WA 98109 USA. EM sramsey@fhcrc.org FU National Cancer Institute [N01-PC-35142, N01-PC-35139, N01-PC-35136] FX Supported by the National Cancer Institute contracts: N01-PC-35142, N01-PC-35139, and N01-PC-35136. NR 33 TC 3 Z9 3 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0277-3732 EI 1537-453X J9 AM J CLIN ONCOL-CANC JI Am. J. Clin. Oncol.-Cancer Clin. Trials PD AUG PY 2010 VL 33 IS 4 BP 381 EP 386 DI 10.1097/COC.0b013e3181b215d5 PG 6 WC Oncology SC Oncology GA 635OX UT WOS:000280666200011 PM 20010079 ER PT J AU Martin, MA Hallmark, KC Sharkey, FE AF Martin, Matthew A. Hallmark, Kelly C. Sharkey, Francis E. TI Periodic Review of Pathology Training Program Teaching Files A Quality Improvement Study SO AMERICAN JOURNAL OF CLINICAL PATHOLOGY LA English DT Article DE Pathology resident education; Quality improvement; Teaching file ID SURGICAL PATHOLOGY; ASSURANCE AB Pathology training programs typically retain teaching files of classic and unusual diagnostic cases. Since diagnostic criteria and terminology are mutable, we reviewed a surgical pathology teaching archive to determine if the materials continued to be acceptable for educational purposes. Each case (from 2001-2003) consisted of 1 to 3 slides and a 3 x 5 card with clinical information and the diagnosis. Cases were reviewed at a daily faculty consensus conference and categorized as follows: no diagnostic change; diagnosis added; or changed diagnosis. Slides were entirely missing from 79 (35.0%) of the 226 cases reviewed. Of the remaining 147 cases, 28 (19.0%) required additional clinical information and/or slides. The final disposition of the 147 cases was as follows: diagnosis unchanged, 126 (85.7%); diagnosis added, 15 (10.2%); and diagnosis changed, 6 (4.1%). Teaching files should be subject to prospective and retrospective controls to preserve the quality of the educational experience. C1 [Martin, Matthew A.; Sharkey, Francis E.] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. [Hallmark, Kelly C.] Audie L Murphy Mem Vet Adm Med Ctr, Dept Pathol & Lab Med, San Antonio, TX USA. RP Sharkey, FE (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 6 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 AUG PY 2010 VL 134 IS 2 BP 332 EP 334 DI 10.1309/AJCPKXBOAK5PMI8G PG 3 WC Pathology SC Pathology GA 627UE UT WOS:000280067600022 PM 20660339 ER PT J AU Kanwal, F Barkun, A Gralnek, IM Asch, SM Kuipers, EJ Bardou, M Sung, J Enns, R Agreus, L Armstrong, D Spiegel, BMR AF Kanwal, Fasiha Barkun, Alan Gralnek, Ian M. Asch, Steven M. Kuipers, Ernst J. Bardou, Marc Sung, Joseph Enns, Robert Agreus, Lars Armstrong, David Spiegel, Brennan M. R. TI Measuring Quality of Care in Patients With Nonvariceal Upper Gastrointestinal Hemorrhage: Development of an Explicit Quality Indicator Set SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID PROTON PUMP INHIBITORS; DOUBLE-BLIND TRIAL; CONSENSUS RECOMMENDATIONS; HOSPITALIZED-PATIENTS; RHEUMATOID-ARTHRITIS; PEPTIC-ULCER; ENDOSCOPY; MEDICATIONS; MANAGEMENT; INFUSION AB OBJECTIVES: With an increasing emphasis on quality in health care and recognition of inconsistencies in the management of patients with nonvariceal upper gastrointestinal hemorrhage (NVUGIH), it is critical to establish a set of explicit quality indicators (QIs) in NVUGIH. METHODS: We conducted a nine-member, multidisciplinary expert panel and followed modified Delphi methods to systematically identify a set of QIs for NVUGIH. The panel performed independent ratings of each candidate QI using a nine-point RAND appropriateness scale, then met in person and re-voted using an iterative process of discussion. The final set comprised QIs with a median RAND Appropriateness Score >= 7 and no disagreement among experts. RESULTS: Among 116 candidate QIs, the panel rated 26 as valid measures of quality care. The selected QIs cover pre-endoscopy, endoscopy, and post-endoscopy care, including diagnosis, early resuscitation, risk stratification, endoscopic care, Helicobacter pylori management, and proton pump inhibitor therapy. CONCLUSIONS: We have developed an explicit set of evidence-based QIs in NVUGIH, providing physicians and institutions with a tool to identify processes amenable to quality improvement. This tool is intended to be applicable in all institutions providing care for NVUGIH patients. C1 [Asch, Steven M.; Spiegel, Brennan M. R.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Kanwal, Fasiha] St Louis Vet Adm VA, St Louis, MO USA. [Kanwal, Fasiha] St Louis Univ, St Louis, MO 63103 USA. [Barkun, Alan] McGill Univ, Montreal Gen Hosp, GI Div, Montreal, PQ H3G 1A4, Canada. [Gralnek, Ian M.] Technion Israel Inst Technol, Haifa, Israel. [Gralnek, Ian M.] Rambam Med Ctr, Haifa, Israel. [Asch, Steven M.; Spiegel, Brennan M. R.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Kuipers, Ernst J.] Erasmus MC, Rotterdam, Netherlands. [Bardou, Marc] Univ Burgundy, Fac Med, Dijon, France. [Sung, Joseph] Chinese Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China. [Enns, Robert] Univ British Columbia, St Pauls Hosp, Vancouver, BC V5Z 1M9, Canada. [Agreus, Lars] Karolinska Inst, Stockholm, Sweden. [Armstrong, David] McMaster Univ, Hamilton, ON, Canada. RP Spiegel, BMR (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 115,Room 215, Los Angeles, CA 90073 USA. EM bspiegel@mednet.ucla.edu RI Hossain, Sarah /C-7332-2009 OI Hossain, Sarah /0000-0003-1355-0979 FU Canadian Association of Gastroenterology; European Association for Gastroenterology and Endoscopy; Asian Pacific Society of Digestive Endoscopy; Canadian Institutes of Health Research (Institute of Diabetes, Metabolism and Nutrition); AstraZeneca Molndal; Abbott Canada; Olympus Canada FX Canadian Association of Gastroenterology; European Association for Gastroenterology and Endoscopy; Asian Pacific Society of Digestive Endoscopy; Canadian Institutes of Health Research (Institute of Diabetes, Metabolism and Nutrition). Sponsors: AstraZeneca Molndal, Abbott Canada, Olympus Canada through individual unrestricted grants to the Canadian Association of Gastroenterology. The supporting agencies and the sponsors had no role in the conduct of the study. NR 44 TC 19 Z9 19 U1 0 U2 5 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD AUG PY 2010 VL 105 IS 8 BP 1710 EP 1718 DI 10.1038/ajg.2010.180 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 635LJ UT WOS:000280656800001 PM 20686458 ER PT J AU Williams, LH Rutter, CM Katon, WJ Reiber, GE Ciechanowski, P Heckbert, SR Lin, EHB Ludman, EJ Oliver, MM Young, BA Von Korff, M AF Williams, Lisa H. Rutter, Carolyn M. Katon, Wayne J. Reiber, Gayle E. Ciechanowski, Paul Heckbert, Susan R. Lin, Elizabeth H. B. Ludman, Evette J. Oliver, Malia M. Young, Bessie A. Von Korff, Michael TI Depression and Incident Diabetic Foot Ulcers: A Prospective Cohort Study SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE Complications; Depression; Diabetes; Foot ulcers ID PERIPHERAL ARTERIAL-DISEASE; RANDOMIZED CONTROLLED-TRIAL; SELF-CARE; AFRICAN-AMERICANS; LEG SYMPTOMS; RISK; MORTALITY; ASSOCIATION; COMPLICATIONS; PREVENTION AB OBJECTIVE: To test whether depression is associated with an increased risk of incident diabetic foot ulcers. METHODS: The Pathways Epidemiologic Study is a population-based prospective cohort study of 4839 patients with diabetes in 2000-2007. The present analysis included 3474 adults with type 2 diabetes and no prior diabetic foot ulcers or amputations. Mean follow-up was 4.1 years. Major and minor depression assessed by the Patient Health Questionnaire-9 were the exposures of interest. The outcome of interest was incident diabetic foot ulcers. We computed the hazard ratio and 95% confidence interval (CI) for incident diabetic foot ulcers, comparing patients with major and minor depression with those without depression and adjusting for sociodemographic characteristics, medical comorbidity, glycosylated hemoglobin, diabetes duration, insulin use, number of diabetes complications, body mass index, smoking status, and foot self-care. Sensitivity analyses also adjusted for peripheral neuropathy and peripheral arterial disease as defined by diagnosis codes. RESULTS: Compared with patients without depression, patients with major depression by Patient Health Questionnaire-9 had a 2-fold increase in the risk of incident diabetic foot ulcers (adjusted hazard ratio 2.00; 95% CI, 1.24-3.25). There was no statistically significant association between minor depression by Patient Health Questionnaire-9 and incident diabetic foot ulcers (adjusted hazard ratio 1.37; 95% CI, 0.77-2.44). CONCLUSION: Major depression by Patient Health Questionnaire-9 is associated with a 2-fold higher risk of incident diabetic foot ulcers. Future studies of this association should include better measures of peripheral neuropathy and peripheral arterial disease, which are possible confounders or mediators. (C) 2010 Elsevier Inc. All rights reserved. The American Journal of Medicine (2010) 123, 748-754 C1 [Williams, Lisa H.] Univ Washington, Div Dermatol, Dept Med, Seattle, WA 98195 USA. [Rutter, Carolyn M.; Heckbert, Susan R.; Lin, Elizabeth H. B.; Ludman, Evette J.; Oliver, Malia M.; Von Korff, Michael] Grp Hlth Ctr Hlth Studies, Seattle, WA USA. [Katon, Wayne J.; Ciechanowski, Paul] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Reiber, Gayle E.] Univ Washington, Hlth Serv Res & Dev Ctr Excellence, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. [Heckbert, Susan R.] Univ Washington, Dept Epidemiol, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA. [Reiber, Gayle E.] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. [Young, Bessie A.] Univ Washington, Epidemiol Res & Informat Ctr, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. [Young, Bessie A.] Univ Washington, Dept Med, Div Nephrol, Seattle, WA 98195 USA. RP Williams, LH (reprint author), 125 16th Ave E,Mail Stop CSB 5, Seattle, WA 98112 USA. EM lisahw@u.washington.edu FU National Institutes of Health [MH-073686]; National Institutes of Health/American Skin Association [F32 AR-056380]; Dermatology Foundation FX This research was supported by National Institutes of Health grant MH-073686. Dr Williams was supported by National Institutes of Health/American Skin Association grant F32 AR-056380 and a Dermatology Foundation Dermatologist Investigator Research Fellowship. NR 31 TC 30 Z9 34 U1 4 U2 13 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 AUG PY 2010 VL 123 IS 8 BP 748 EP U151 DI 10.1016/j.amjmed.2010.01.023 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 631UG UT WOS:000280374200017 PM 20670730 ER PT J AU Gingo, M Risbano, MG Russ, PD Chan, ED AF Gingo, Matthew Risbano, Michael G. Russ, Paul D. Chan, Edward D. TI Not Your Otitis Media 101 SO AMERICAN JOURNAL OF MEDICINE LA English DT Letter ID INTRACRANIAL COMPLICATIONS C1 [Chan, Edward D.] Natl Jewish Hlth, Denver, CO 80206 USA. [Gingo, Matthew; Risbano, Michael G.; Chan, Edward D.] Univ Colorado, Dept Med, Denver, CO USA. [Gingo, Matthew; Risbano, Michael G.; Chan, Edward D.] Univ Colorado, Div Pulm Sci & Crit Care, Denver, CO USA. [Russ, Paul D.] Univ Colorado, Dept Radiol, Denver, CO USA. [Russ, Paul D.; Chan, Edward D.] Denver Vet Affairs Med Ctr, Hlth Sci Ctr, Denver, CO USA. RP Chan, ED (reprint author), Natl Jewish Hlth, K720,Goodman Bldg,1400 Jackson St, Denver, CO 80206 USA. EM chane@njhealth.org RI Gingo, Matthew/K-7203-2013 OI Risbano, Michael/0000-0003-3334-7046 NR 5 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 0002-9343 J9 AM J MED JI Am. J. Med. PD AUG PY 2010 VL 123 IS 8 BP E9 EP E11 DI 10.1016/j.amjmed.2009.12.038 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 631UG UT WOS:000280374200024 PM 20670714 ER PT J AU Hollander, DA Giaconi, JA Holland, GN Yu, F Caprioli, J Aldave, AJ Coleman, AL Casey, R Law, SK Mondino, BJ AF Hollander, David A. Giaconi, Joann A. Holland, Gary N. Yu, Fei Caprioli, Joseph Aldave, Anthony J. Coleman, Anne L. Casey, Richard Law, Simon K. Mondino, Bartly J. TI Graft Failure After Penetrating Keratoplasty in Eyes With Ahmed Valves SO AMERICAN JOURNAL OF OPHTHALMOLOGY LA English DT Article ID GLAUCOMA DRAINAGE DEVICE; ENDOTHELIAL-CELL DENSITY; RISK-FACTORS; MOLTENO IMPLANT; TUBE SHUNT; FOLLOW-UP; SURVIVAL; OUTCOMES; THERAPY AB PURPOSE: To determine incidence and risk factors for graft failure following penetrating keratoplasty (PK) in eyes with Ahmed valves (AV). DESIGN: Retrospective, observational cohort study. METHODS: Patients who underwent PK after AV implantation (both performed at our institution through 2004) were studied. Intervals to graft failure (defined as either dysfunction [stromal thickening with retention of clarity] or decompensation [central microcystic edema or loss of clarity]) were analyzed using Kaplan-Meier technique. Risk factors for graft failure were analyzed using Cox proportional hazard models. RESULTS: Included were 77 eyes (77 patients; first procedure 1993). Following PK, 40 eyes (52%) required increased numbers of glaucoma medications; 10 eyes (13%) required additional glaucoma drainage device(s). Graft failure at 1, 2, and 3 years was 42.4% (95% confidence interval: 32.0%-54.6%), 57.1% (45.6%-69.1%), and 59.1% (47.5%-71.2%), respectively. Prior PK (HR 2.38, P = .006) and stromal vessels (HR 2.90, P = .0005) were associated with increased risk of graft failure. Use of glaucoma medications (HR 0.27, P = .009) and evidence of lower intraocular pressures (IOP) during follow-up (excluding hypotony; HR 0.92, P = .010) were associated with reduced risk of graft failure. Endothelial rejection episodes were observed in 13 eyes (17%); however, rejection was not a risk factor for graft failure (P = .98). CONCLUSIONS: Long-term survival of corneal grafts is poor in eyes with AV. The majority of graft failures are associated with progressive loss of endothelial function, without observed immunologic rejection. Despite the presence of an AV, escalation in glaucoma therapy often follows PK; graft failure may be related to poor IOP control. (Am J Ophthalmol 2010;150:169-178. Published by Elsevier Inc.) C1 [Hollander, David A.; Giaconi, Joann A.; Holland, Gary N.; Yu, Fei; Caprioli, Joseph; Aldave, Anthony J.; Coleman, Anne L.; Casey, Richard; Law, Simon K.; Mondino, Bartly J.] Univ Calif Los Angeles, Jules Stein Eye Inst, Los Angeles, CA 90095 USA. [Hollander, David A.; Giaconi, Joann A.; Holland, Gary N.; Yu, Fei; Caprioli, Joseph; Aldave, Anthony J.; Coleman, Anne L.; Casey, Richard; Law, Simon K.; Mondino, Bartly J.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Ophthalmol, Los Angeles, CA 90095 USA. [Hollander, David A.; Giaconi, Joann A.; Holland, Gary N.] Greater Los Angeles Vet Adm Healthcare Syst, Los Angeles, CA USA. RP Giaconi, JA (reprint author), Univ Calif Los Angeles, Jules Stein Eye Inst, 100 Stein Plaza, Los Angeles, CA 90095 USA. EM giaconi@jsei.ucla.edu OI Caprioli, Joseph/0000-0002-2383-7263 FU HEED OPHTHALMIC FOUNDATION CLEVELAND, OHIO; Research to Prevent Blindness (RPB), Inc, New York, New York; Vernon O. Underwood Family Endowed Professorship; RPB FX PUBLICATION OF THIS STUDY WAS SUPPORTED BY THE HEED OPHTHALMIC FOUNDATION CLEVELAND, OHIO (DR HOLLANDER); Research to Prevent Blindness (RPB), Inc, New York, New York (Dr Holland); and the Vernon O. Underwood Family Endowed Professorship (Dr Holland). Dr Holland was recipient of an RPB Physician-Scientist Award. Dr Hollander is currently an employee of Allergan, Inc. Funding entities had no role in the conduction or presentation of this study. Involved in study design (D.A.H., J.A.G., G.N.H., F.Y.); data collection (D.A.H., JAG., G.N.H., J.C., A.J.A., A.L.C., R.C., S.K.L., B.J.M.); data management and analysis (D.A.H., JAG., G.N.H., F.Y.); data interpretation (D.A.H., JAG., G.N.H., F.Y., J.C., A.J.A., A.L.C., B.J.M.); preparation of initial draft of manuscript (D.A.H., JAG., G.N.H., F.Y.); and review and approval of manuscript (D.A.H., JAG., G.N.H., F.Y., J.C., A.J.A., A.L.C., R.C., S.K.L., B.J.M.). D. Hollander and J. Giaconi contributed equally to the preparation of this article. This study was approved by the Institutional Review Board at UCLA. NR 26 TC 25 Z9 25 U1 0 U2 2 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 AUG PY 2010 VL 150 IS 2 BP 169 EP 178 DI 10.1016/j.ajo.2010.02.014 PG 10 WC Ophthalmology SC Ophthalmology GA 635ZT UT WOS:000280697800006 PM 20537311 ER PT J AU Morgenroth, DC Orendurff, MS Shakir, A Segal, A Shofer, J Czerniecki, JM AF Morgenroth, David C. Orendurff, Michael S. Shakir, Ali Segal, Ava Shofer, Jane Czerniecki, Joseph M. TI The Relationship Between Lumbar Spine Kinematics during Gait and Low-Back Pain in Transfemoral Amputees SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Article DE Amputation; Biomechanics; Low-Back Pain; Rehabilitation ID TRANS-FEMORAL AMPUTEES; LEVEL WALKING; RESIDUAL LIMB; MOTION; OSTEOARTHRITIS; DEGENERATION; AMPUTATIONS; RELIABILITY; DISABILITY; DISC AB Objective: Low-back pain is an important cause of secondary disability in transfemoral amputees. The primary aim of our study is to assess the differences in lumbar spine kinematics during gait between transfemoral amputees with and without low-back pain. Design: Lumbar spine kinematics in three planes were measured when the subjects walked in a motion analysis laboratory. Nine transfemoral amputees with low-back pain, eight transfemoral amputees without low-back pain, and six healthy, nonamputee subjects participated. Results: The Amputee Pain and Amputee No Pain groups were essentially the same in terms of all demographic and potentially confounding variable measures. Transfemoral amputees with low-back pain showed greater transverse plane rotational excursion in their lumbar spine during walking when compared with transfemoral amputees without low-back pain (P = 0.029; effect size = 1.03). There were no significant differences in sagittal or coronal plane lumbar spine excursions during walking between these two groups. Conclusions: Although our study design does not allow for proving causation, increased transverse plane rotation has been associated with intervertebral disc degeneration, suggesting that increased transverse plane rotation secondary to walking with a prosthetic limb may be a causative factor in the etiology of low-back pain in transfemoral amputees. Identifying differences in lumbar motion can lead to potential preventative and therapeutic intervention strategies. C1 [Morgenroth, David C.; Orendurff, Michael S.; Shakir, Ali; Shofer, Jane; Czerniecki, Joseph M.] VA Puget Sound Hlth Care Syst, Ctr Excellence Limb Loss Prevent & Prosthet Engn, Seattle, WA USA. [Morgenroth, David C.; Czerniecki, Joseph M.] Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. [Segal, Ava] Western Reserve Spine & Pain Inst, Kent, OH USA. RP Morgenroth, DC (reprint author), VAPSHCS, Rehabil Care Serv RCS 117, 1660 S Columbian Way, Seattle, WA 98108 USA. OI Morgenroth, David/0000-0002-0226-7775 NR 39 TC 21 Z9 22 U1 5 U2 14 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 2010 VL 89 IS 8 BP 635 EP 643 DI 10.1097/PHM.0b013e3181e71d90 PG 9 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 628JK UT WOS:000280115400004 PM 20647781 ER PT J AU Yu, T Wu, X Gupta, KB Kucik, DF AF Yu, Tao Wu, Xing Gupta, Kiran B. Kucik, Dennis F. TI Affinity, lateral mobility, and clustering contribute independently to beta(2)-integrin-mediated adhesion SO AMERICAN JOURNAL OF PHYSIOLOGY-CELL PHYSIOLOGY LA English DT Article DE single particle tracking; intracellular cell adhesion molecule-1; E-selectin; flow chamber; rolling ID INSIDE-OUT ACTIVATION; CELL-ADHESION; EXTENDED CONFORMATIONS; LEUKOCYTE TRAFFICKING; MECHANICAL-PROPERTIES; INTEGRIN ACTIVATION; AVIDITY MODULATION; ACTIN CYTOSKELETON; STRUCTURAL BASIS; LIGAND-BINDING AB Yu T, Wu X, Gupta KB, Kucik DF. Affinity, lateral mobility, and clustering contribute independently to beta(2)-integrin-mediated adhesion. Am J Physiol Cell Physiol 299: C399-C410, 2010. First published May 5, 2010; doi: 10.1152/ajpcell.00039.2009.-Affinity changes and avidity modulation both contribute to activation of beta(2)-integrin-mediated adhesion, an essential, early step in inflammation. Avidity modulation, defined as an increase in adhesiveness independent of integrin conformational changes, might be due to integrin clustering, motion, or both. Increased integrin diffusion upon leukocyte activation has been demonstrated, but whether it is proadhesive in itself, or just constitutes a mechanism for integrin clustering, remains unclear. To understand the proadhesive effects of integrin affinity changes, clustering, and motion, an experimental system was devised to separate them. Clustering and integrin motion together were induced by cytochalasin D (CD) without inducing high-affinity; integrin motion could then be frozen by fixation; and high affinity was induced independently by Mn2+. Adhesion was equivalent for fixed and unfixed cells except following pretreatment with CD or Mn2+, which increased adhesion for both. However, fixed cells were less adhesive than unfixed cells after CD, even though integrin clustering was similar. A simple explanation is that CD induces both clustering and integrin motion, fixation then stops motion on fixed cells, but integrins continue to diffuse on unfixed cells, increasing the kinetics of integrin/ICAM-1 interactions to enhance adhesion. Affinity changes are then independent of, and additive to, avidity effects. C1 [Yu, Tao; Wu, Xing; Gupta, Kiran B.; Kucik, Dennis F.] Univ Alabama, Dept Pathol, Birmingham, AL 35294 USA. [Kucik, Dennis F.] Univ Alabama, Dept Biomed Engn, Birmingham, AL 35294 USA. [Kucik, Dennis F.] Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Kucik, DF (reprint author), Univ Alabama, Dept Pathol, Kaul Bldg,Rm 640A,619 S 19th St, Birmingham, AL 35294 USA. EM kucik@uab.edu RI Yu, Tao/B-5352-2012 FU Department of Veterans Affairs FX This work was supported by a Department of Veterans Affairs Merit Award. NR 46 TC 11 Z9 11 U1 0 U2 6 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6143 J9 AM J PHYSIOL-CELL PH JI Am. J. Physiol.-Cell Physiol. PD AUG PY 2010 VL 299 IS 2 BP C399 EP C410 DI 10.1152/ajpcell.00039.2009 PG 12 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 632CK UT WOS:000280397600024 PM 20445173 ER PT J AU O'Tierney, PF Anderson, DF Faber, JJ Louey, S Thornburg, KL Giraud, GD AF O'Tierney, P. F. Anderson, D. F. Faber, J. J. Louey, S. Thornburg, K. L. Giraud, G. D. TI Reduced systolic pressure load decreases cell-cycle activity in the fetal sheep heart SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE blood pressure; enalaprilat; hyperplasia; cardiomyocyte ID CARDIAC MYOCYTES; VENOUS HYPERTENSION; ANGIOTENSIN-II; NEWBORN LAMBS; OVINE FETUS; RAT HEARTS; CARDIOMYOCYTES; HYPERTROPHY; MATURATION; PLASMA AB O'Tierney PF, Anderson DF, Faber JJ, Louey S, Thornburg KL, Giraud GD. Reduced systolic pressure load decreases cell-cycle activity in the fetal sheep heart. Am J Physiol Regul Integr Comp Physiol 299: R573-R578, 2010. First published May 19, 2010; doi: 10.1152/ajpregu.00754.2009.-The fetal heart is highly sensitive to changes in mechanical load. We have previously demonstrated that increased cardiac load can stimulate cell cycle activity and maturation of immature cardiomyocytes, but the effects of reduced load are not known. Sixteen fetal sheep were given either continuous intravenous infusion of lactated Ringer solution (LR) or enalaprilat, an angiotensin-converting enzyme inhibitor beginning at 127 days gestational age. After 8 days, fetal arterial pressure in the enalaprilat-infused fetuses (23.8 +/- 2.8 mmHg) was lower than that of control fetuses (47.5 +/- 4.7 mmHg) (P < 0.0001). Although the body weights of the two groups of fetuses were similar, the heart weight-to-body weight ratios of the enalaprilat-infused fetuses were less than those of the LR-infused fetuses (5.6 +/- 0.5 g/kg vs. 7.0 +/- 0.6 g/kg, P < 0.0001). Dimensions of ventricular myocytes were not different between control and enalaprilat-infused fetuses. However, there was a significant decrease in cell cycle activity in both the right ventricle (P < 0.005) and the left ventricle (P < 0.002) of the enalaprilat-infused fetuses. Thus, we conclude a sustained reduction in systolic pressure load decreases hyperplastic growth in the fetal heart. C1 [O'Tierney, P. F.; Anderson, D. F.; Faber, J. J.; Louey, S.; Thornburg, K. L.; Giraud, G. D.] Oregon Hlth & Sci Univ, Heart Res Ctr, Portland, OR 97239 USA. [Thornburg, K. L.; Giraud, G. D.] Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97239 USA. [Anderson, D. F.; Faber, J. J.; Louey, S.; Thornburg, K. L.; Giraud, G. D.] Oregon Hlth & Sci Univ, Dept Med Cardiovasc Med, Portland, OR 97239 USA. [Giraud, G. D.] Portland VA Med Ctr, Portland, OR USA. RP Giraud, GD (reprint author), Oregon Hlth & Sci Univ, Heart Res Ctr CH15H, Div Cardiovasc Med, Portland, OR 97239 USA. EM giraudg@ohsu.edu FU American Heart Association [0720139Z]; National Institutes of Health [P01HD34430] FX Perrie O'Tierney is a recipient of an American Heart Association Postdoctoral Fellowship (0720139Z). This research was funded by a National Institutes of Health Program Project Grant (P01HD34430), the Department of Veterans Affairs, and the M. Lowell Edwards Endowment. NR 24 TC 10 Z9 10 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6119 J9 AM J PHYSIOL-REG I JI Am. J. Physiol.-Regul. Integr. Comp. Physiol. PD AUG PY 2010 VL 299 IS 2 BP R573 EP R578 DI 10.1152/ajpregu.00754.2009 PG 6 WC Physiology SC Physiology GA 634GW UT WOS:000280569800019 PM 20484695 ER PT J AU Afrin, LB AF Afrin, Lawrence B. TI Fatal Copper Deficiency From Excessive Use of Zinc-Based Denture Adhesive SO AMERICAN JOURNAL OF THE MEDICAL SCIENCES LA English DT Article DE Zinc toxicity; Copper deficiency; Sensorimotor neuropathy; Myelodysplasia; Denture adhesive ID NEUROLOGIC DISEASE; HYPOCUPREMIA; NEUROPATHY AB Introduction: Human stores of zinc and copper exist in dynamic equilibrium; an increase in one causes a fall in the other, and clinical consequences of toxicity or deficiency of one or the other may result. Some of the most widely used denture adhesives are zinc based, creating a potential for zinc toxicity and corresponding copper deficiency. A case of denture adhesive-based zinc toxicity with corresponding copper deficiency leading to fatal ascending sensorimotor polyneuropathy was identified. The objectives of this study were to illustrate the evolution, and disparate response to treatment, of neurologic and hematologic abnormalities resulting from copper deficiency, and to discuss opportunities to mitigate denture adhesive-related zinc toxicity. Methods: Detailed clinical and laboratory data for the subject patient were compiled. The patient received copper supplementation. Copper and zinc levels were obtained posttreatment at varying intervals. Results: Hematologic and neurologic abnormalities progressed, as excessive use of zinc-based denture adhesive persisted. Hematologic and neurologic consultants were initially considered purely hematologic or neurologic diagnoses. Eventual consideration of unifying hypotheses led to definitive diagnosis 10 months after presentation. Hematologic abnormalities responded to copper supplementation, but neurologic abnormalities did not. The patient died of aspiration likely due to severe sensorimotor polyneuropathy. Conclusions: Early recognition of copper deficiency and improved warnings regarding excessive use of zinc-based denture adhesives may be the routes to improved outcomes. C1 [Afrin, Lawrence B.] Med Univ S Carolina, Div Hematol Oncol, Charleston, SC 29425 USA. [Afrin, Lawrence B.] Ralph H Johnson Vet Affairs Med Ctr, Hematol Oncol Sect, Med Serv, Charleston, SC USA. RP Afrin, LB (reprint author), Med Univ S Carolina, Div Hematol Oncol, CSB903,MSC635,96 Jonathan Lucas St, Charleston, SC 29425 USA. EM afrinl@musc.edu NR 26 TC 13 Z9 13 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-9629 J9 AM J MED SCI JI Am. J. Med. Sci. PD AUG PY 2010 VL 340 IS 2 BP 164 EP 168 DI 10.1097/MAJ.0b013e3181e3648c PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 635TC UT WOS:000280678200016 PM 20555248 ER PT J AU Leach, JR Rayz, VL Soares, B Wintermark, M Mofrad, MRK Saloner, D AF Leach, Joseph R. Rayz, Vitaliy L. Soares, Bruno Wintermark, Max Mofrad, Mohammad R. K. Saloner, David TI Carotid Atheroma Rupture Observed In Vivo and FSI-Predicted Stress Distribution Based on Pre-rupture Imaging SO ANNALS OF BIOMEDICAL ENGINEERING LA English DT Article DE Patient-specific; Vulnerable plaque; Atherosclerosis; Image-based ID MULTIDETECTOR COMPUTED-TOMOGRAPHY; ATHEROSCLEROTIC PLAQUE RUPTURE; FLUID-STRUCTURE INTERACTIONS; AMERICAN-HEART-ASSOCIATION; HISTOPATHOLOGICAL CORRELATION; ASYMPTOMATIC INDIVIDUALS; CIRCUMFERENTIAL STRESS; STRUCTURAL-ANALYSIS; SHEAR-STRESS; FIBROUS CAP AB Atherosclerosis at the carotid bifurcation is a major risk factor for stroke. As mechanical forces may impact lesion stability, finite element studies have been conducted on models of diseased vessels to elucidate the effects of lesion characteristics on the stresses within plaque materials. It is hoped that patient-specific biomechanical analyses may serve clinically to assess the rupture potential for any particular lesion, allowing better stratification of patients into the most appropriate treatments. Due to a sparsity of in vivo plaque rupture data, the relationship between various mechanical descriptors such as stresses or strains and rupture vulnerability is incompletely known, and the patient-specific utility of biomechanical analyses is unclear. In this article, we present a comparison between carotid atheroma rupture observed in vivo and the plaque stress distribution from fluid-structure interaction analysis based on pre-rupture medical imaging. The effects of image resolution are explored and the calculated stress fields are shown to vary by as much as 50% with sub-pixel geometric uncertainty. Within these bounds, we find a region of pronounced elevation in stress within the fibrous plaque layer of the lesion with a location and extent corresponding to that of the observed site of plaque rupture. C1 [Leach, Joseph R.] San Francisco VA Med Ctr, Dept Radiol, San Francisco, CA 94121 USA. [Leach, Joseph R.; Mofrad, Mohammad R. K.; Saloner, David] UC Berkeley UC San Francisco Joint Grad Grp Bioen, Berkeley, CA USA. [Leach, Joseph R.; Rayz, Vitaliy L.; Soares, Bruno; Wintermark, Max; Saloner, David] Univ Calif San Francisco, Med Ctr, Dept Radiol & Biomed Imaging, San Francisco, CA 94143 USA. RP Leach, JR (reprint author), San Francisco VA Med Ctr, Dept Radiol, Box 114D,4150 Clement St, San Francisco, CA 94121 USA. EM joseph.leach@ucsf.edu OI Wintermark, Max/0000-0002-6726-3951; Soares, Bruno/0000-0003-4185-6940 FU American Heart Association [0715072Y]; NIH [1K25NS059891]; VA; NINDS [NS059944] FX The authors would like to thank Tarik Tihan for review of the image-based plaque geometry. Funding support was provided by the following grants: American Heart Association Pre-doctoral Fellowship 0715072Y (JL), NIH Grant 1K25NS059891 (VR), VA MERIT Review Award (DS), and NS059944 from the NINDS. NR 54 TC 21 Z9 24 U1 3 U2 8 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0090-6964 J9 ANN BIOMED ENG JI Ann. Biomed. Eng. PD AUG PY 2010 VL 38 IS 8 BP 2748 EP 2765 DI 10.1007/s10439-010-0004-8 PG 18 WC Engineering, Biomedical SC Engineering GA 622RD UT WOS:000279682000023 PM 20232151 ER PT J AU Nyer, M Kasckow, J Fellows, I Lawrence, EC Golshan, S Solorzano, E Zisook, S AF Nyer, Maren Kasckow, John Fellows, Ian Lawrence, Edith C. Golshan, Shah Solorzano, Ellen Zisook, Sidney TI The relationship of marital status and clinical characteristics in middle-aged and older patients with schizophrenia and depressive symptoms SO ANNALS OF CLINICAL PSYCHIATRY LA English DT Article DE marriage; quality of life; suicide; subsyndromal depression; marital status; divorce ID QUALITY-OF-LIFE; INTIMATE-RELATIONSHIPS; GENDER-DIFFERENCES; UNITED-STATES; RATING-SCALE; SUICIDE; MARRIAGE; BEHAVIOR; MEN; DISORDERS AB BACKGROUND: This study examines the relationship of marital status to depression, positive and negative symptoms, quality of life, and suicidal ideation among 211 patients with schizophrenia-spectrum disorders and subsyndromal depressive symptoms. We hypothesized that single participants would have more severe symptomatology than married and cohabitating participants. METHODS: Outpatients, age 40 or older, were diagnosed with schizophrenia or schizoaffective disorders using the MINI Structured Clinical Interview for DSM-IV Axis 1 Disorders. Participants exhibited a score of >= 8 on the Hamilton Rating Scale for Depression but did not meet criteria for a major depressive episode. RESULTS: Participants who were married or cohabitating had a later age of onset of first psychotic episode or hospitalization than those who were single (age, 29.35 vs 24.21). Married participants rated their quality of life higher than those who were single (mean Quality of Life Scale scores, 72.28 vs 53.87) and had less suicidal ideation than those who were divorced, widowed, or separated (7.4% vs 29.2%). CONCLUSIONS: In middle-aged and older individuals with schizophrenia or schizoaffective disorder and depressive symptoms, marriage appeared. to enhance quality of life and protect against suicidal ideation. Efforts that focus on providing additional support for those who are experiencing divorce or separation could prove to be lifesaving for these individuals. C1 [Nyer, Maren; Lawrence, Edith C.] Univ Virginia, Dept Human Serv, Curry Sch Educ, Charlottesville, VA 22903 USA. [Kasckow, John] Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15213 USA. [Fellows, Ian; Golshan, Shah; Solorzano, Ellen; Zisook, Sidney] Univ Calif San Diego, Dept Psychiat, Div Geriatr Psychiat 116A 1, San Diego, CA 92103 USA. [Zisook, Sidney] VA San Diego Healthcare Syst, San Diego, CA USA. RP Nyer, M (reprint author), Univ Virginia, Dept Human Serv, Curry Sch Educ, 405 Emmet St, Charlottesville, VA 22903 USA. EM mbn4k@virginia.edu FU [MH 063931]; [MH6398] FX Supported by MH 063931(SZ) MH6398 (JWK), the VISN 4 and VISN 22 MIRECC, and the University of California, San Diego Center for Community-based Research in Older People with Psychoses. In addition J.W.K. was supported by a VISN 4 CPPF grant. We also wish to thank the Cincinnati VA Medical Center and the University of Cincinnati College of Medicine for all of their support. NR 49 TC 11 Z9 14 U1 1 U2 5 PU DOWDEN HEALTH MEDIA PI MONTVALE PA 110 SUMMIT AVE, MONTVALE, NJ 07645-1712 USA SN 1040-1237 J9 ANN CLIN PSYCHIATRY JI Ann. Clin. Psychiatry PD AUG PY 2010 VL 22 IS 3 BP 172 EP 179 PG 8 WC Psychiatry SC Psychiatry GA 640DM UT WOS:000281028300006 PM 20680190 ER PT J AU Gandy, S Simon, AJ Steele, JW Lublin, AL Lah, JJ Walker, LC Levey, AI Krafft, GA Levy, E Checler, F Glabe, C Bilker, WB Abel, T Schmeidler, J Ehrlich, ME AF Gandy, Sam Simon, Adam J. Steele, John W. Lublin, Alex L. Lah, James J. Walker, Lary C. Levey, Allan I. Krafft, Grant A. Levy, Efrat Checler, Frederic Glabe, Charles Bilker, Warren B. Abel, Ted Schmeidler, James Ehrlich, Michelle E. TI Days to Criterion as an Indicator of Toxicity Associated with Human Alzheimer Amyloid-beta Oligomers SO ANNALS OF NEUROLOGY LA English DT Article ID HEREDITARY CEREBRAL-HEMORRHAGE; IMPAIR SYNAPTIC PLASTICITY; MOUSE MODEL; A-BETA; NATURAL OLIGOMERS; TRANSGENIC MICE; DISEASE; MEMORY; DEFICITS; PEPTIDE AB Objective: Recent evidence suggests that high molecular weight soluble oligomeric A beta (oA beta) assemblies (also known as A beta-derived diffusible ligands, or ADDLs) may represent a primary neurotoxic basis for cognitive failure in Alzheimer disease (AD). To date, most in vivo studies of oA beta/ADDLs have involved injection of assemblies purified from the cerebrospinal fluid of human subjects with AD or from the conditioned media of A beta-secreting cells into experimental animals. We sought to study the bioactivities of endogenously formed oA beta/ADDLs generated in situ from the physiological processing of human amyloid precursor protein (APP) and presenitin1 (PS1) transgenes. Methods: We produced and histologically characterized single transgenic mice overexpressing APPE(693Q) or APP(E693Q) X PS1 Delta E9 bigenic mice. APP(E693Q) mice were studied in the Morris water maze (MWM) task at 6 and 12 months of age. Following the second MWM evaluation, mice were sacrificed, and brains were assayed for A beta total, A beta 40, A beta 42, and oA beta/ADDLs by enzyme-linked immunosorbent assay (ELISA) and were also histologically examined. Based on results from the oA beta/ADDL ELISA, we assigned individual APP(E693Q) mice to either an undetectable oA beta/ADDLs group or a readily detectable oA beta/ADDLs group. A days to criterion (DTC) analysis was used to determine delays in acquisition of the MWM task. Results: Both single transgenic and bigenic mice developed intraneuronal accumulation of APP/A beta, although only APP(E693Q) X PS1 Delta 9 bigenic mice developed amyloid plaques. The APP(E693Q) mice did not develop amyloid plaques at any age studied, up to 30 months. APP(E693Q) mice were tested for spatial learning and memory, and only 12-month-old APP(E693Q) mice with readily detectable oA beta/ADDLs displayed a significant delay in acquisition of the MWM task when compared to nontransgenic littermates. Interpretation: These data suggest that cerebral oA beta/ADDL assemblies generated in brain in situ from human APP transgenes may be associated with cognitive impairment. We propose that a DTC analysis may be a sensitive method for assessing the cognitive impact in mice of endogenously generated oligomeric human A beta assemblies. ANN NEUROL 2010;68:220-330 C1 [Gandy, Sam; Steele, John W.; Lublin, Alex L.; Ehrlich, Michelle E.] Mt Sinai Sch Med, Dept Neurol, New York, NY 10029 USA. [Gandy, Sam; Steele, John W.; Lublin, Alex L.; Schmeidler, James] Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. [Gandy, Sam; Steele, John W.; Lublin, Alex L.; Ehrlich, Michelle E.] Mt Sinai Sch Med, Alzheimers Dis Res Ctr, New York, NY 10029 USA. [Gandy, Sam] James J Peters VA Med Ctr, Bronx, NY USA. [Simon, Adam J.] AJ Simon Enterprises LLC, Yardley, PA USA. [Lah, James J.; Walker, Lary C.; Levey, Allan I.] Emory Univ, Dept Neurol, Ctr Neurodegenerat Dis, Atlanta, GA 30322 USA. [Walker, Lary C.] Emory Univ, Yerkes Natl Primate Res Ctr, Atlanta, GA 30322 USA. [Krafft, Grant A.] Acumen Pharmaceut Inc, Livermore, CA USA. [Levy, Efrat] NYU, Sch Med, Dept Psychiat, New York, NY USA. [Levy, Efrat] NYU, Sch Med, Dept Pharmacol, New York, NY USA. [Levy, Efrat] Nathan S Kline Inst Psychiat Res, Orangeburg, NY 10962 USA. [Checler, Frederic] Fdn Rech Med, Inst Mol & Cellular Pharmacol, Valbonne, France. [Glabe, Charles] Univ Calif Irvine, Sch Med, Dept Neurol, Irvine, CA 92717 USA. [Bilker, Warren B.] Univ Penn, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. [Abel, Ted] Univ Penn, Dept Biol, Philadelphia, PA 19104 USA. [Ehrlich, Michelle E.] Mt Sinai Sch Med, Dept Pediat, New York, NY 10029 USA. RP Gandy, S (reprint author), Mt Sinai Sch Med, Dept Neurol, 1 Gustave L Levy Pl,Box 1137, New York, NY 10029 USA. EM samuel.gandy@mssm.edu RI Walker, L/J-6541-2015; Checler, Frederic/C-1241-2009 OI Walker, L/0000-0001-9166-3261; Checler, Frederic/0000-0003-2098-1750 FU Cure Alzheimer's Fund; VA MERIT [1I01BX000348-01]; National Institute on Aging [P01AG10491, P50AG017623, P50AG025688, P50AG05138, P01AG02219]; National Center for Research Resources [RR-00165]; National Institute of General Medical Sciences [T32GM062754]; Fondation pour la Recherche Medicale; Conseil General des Alpes Maritimes FX S.G., A.L.L., J.W.S. and M.E.E. were supported by the Cure Alzheimer's Fund, VA MERIT review grant 1I01BX000348-01, and National Institute on Aging grant P01AG10491. T.A. was supported by National Institute on Aging grant P50AG017623. J.J.L. and A.I.L. were supported by National Institute on Aging grant P50AG025688. L.C.W. was supported by National Center for Research Resources grant RR-00165. J.S. was supported by National Institute on Aging grants P50AG05138 and P01AG02219. J.W.S. is a trainee in the Integrated Pharmacological Sciences Training Program supported by grant T32GM062754 from the National Institute of General Medical Sciences. F.C. was supported by the Fondation pour la Recherche Medicale and by the Conseil General des Alpes Maritimes. NR 36 TC 54 Z9 54 U1 0 U2 7 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 AUG PY 2010 VL 68 IS 2 BP 220 EP 230 DI 10.1002/ana.22052 PG 11 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 636HD UT WOS:000280721500016 PM 20641005 ER PT J AU Chaiswing, L Oberley, TD AF Chaiswing, Luksana Oberley, Terry D. TI Extracellular/Microenvironmental Redox State SO ANTIOXIDANTS & REDOX SIGNALING LA English DT Review ID EXTRACELLULAR-SUPEROXIDE-DISMUTASE; GAMMA-GLUTAMYL-TRANSPEPTIDASE; X(C)(-) CYSTINE/GLUTAMATE ANTIPORTER; PLASMA GLUTATHIONE-PEROXIDASE; PROTEIN DISULFIDE-ISOMERASE; NITRIC-OXIDE SYNTHASE; RENAL-CELL CARCINOMA; HYDROGEN-PEROXIDE; PROSTATE-CANCER; GROWTH-FACTOR AB Extracellular redox (reduction-oxidation) state is a factor that serves as an important regulator of cell-microenvironmental interactions and is determined by several known variables; including redox-modulating proteins that are located on the plasma membrane or outside of cells, extracellular thiol/disulfide couples, and reactive oxygen species (ROS)/reactive nitrogen species (RNS) that are capable of traveling across plasma membranes into the extracellular space. The extracellular redox state works in concert with the intracellular redox state to control both the influx and efflux of ROS/RNS that may serve to modulate redox signaling or to perturb normal cellular processes or both. Under physiologic conditions, the extracellular space is known to have a relatively more-oxidized redox state than the interior of the cell. During pathologic conditions, such as cancer, the extracellular redox state may be altered, causing specific proteins such as proteases, soluble factors, or the extracellular matrix to have altered functions or activities. Recent studies have strongly supported an important relation between the extracellular redox state and cancer cell aggressiveness. The purpose of this review is to identify redox buffer networks in extracellular spaces and to emphasize the possible roles of the extracellular redox state in cancer, knowledge that may contribute to potential therapeutic interventions. Antioxid. Redox Signal. 13, 449-465. C1 [Oberley, Terry D.] William S Middleton Mem Vet Adm Med Ctr, Pathol & Lab Med Serv, Madison, WI 53705 USA. [Chaiswing, Luksana; Oberley, Terry D.] 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, Room A-35,2500 Overlook Terrace, Madison, WI 53705 USA. EM toberley@wisc.edu FU Office of Research and Development, Biomedical Laboratory Research and Development Service; Department of Veterans Affairs (TDO) FX This material is based on work supported by the Office of Research and Development, Biomedical Laboratory Research and Development Service, and Department of Veterans Affairs (TDO). NR 123 TC 51 Z9 51 U1 1 U2 5 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 AUG PY 2010 VL 13 IS 4 BP 449 EP 465 DI 10.1089/ars.2009.3020 PG 17 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 619KI UT WOS:000279428700006 PM 20017602 ER PT J AU Buracchio, T Dodge, HH Howieson, D Wasserman, D Kaye, J AF Buracchio, Teresa Dodge, Hiroko H. Howieson, Diane Wasserman, Dara Kaye, Jeffrey TI The Trajectory of Gait Speed Preceding Mild Cognitive Impairment SO ARCHIVES OF NEUROLOGY LA English DT Article ID OLDER PERSONS; PARKINSONIAN SIGNS; ALZHEIMER-DISEASE; COMMUNITY POPULATION; DECLINE; PEOPLE; RISK; DYSFUNCTION; DEMENTIA; PROGRESSION AB Objectives: To compare the trajectory of motor decline, as measured by gait speed and finger-tapping speed, between elderly people who developed mild cognitive impairment (MCI) and those who remained cognitively intact. We also sought to determine the approximate time at which the decline in motor function accelerated in persons who developed MCI. Design: Longitudinal cohort study. Participants: Participants were 204 healthy seniors (57.8% women) from the Oregon Brain Aging Study evaluated for up to 20 years using annual neurologic, neuropsychological, and motor examinations. Main Outcome Measures: The pattern of motor decline with aging was compared using a mixed-effects model with an interaction term for age and a clinical diagnosis of MCI. The time before diagnosis of MCI, when the change in gait or finger-tapping speed accelerates, was assessed using a mixed-effects model with a change point for men and women, separately and combined, who developed MCI. Results: The rates of change, with aging, in gait speed (P < .001) and finger-tapping speed in the dominant hand (P=.003) and nondominant hand (P < .001) were significantly different between participants who developed MCI (converters) and those who did not (nonconverters). Using a change point analysis for MCI converters, the decrease in gait speed accelerated by 0.023 m/s/y (P < .001), occurring 12.1 years before the onset of MCI. An acceleration in gait speed decline occurred earlier in men than women. For tapping speed, the change point occurred after the onset of MCI for both dominant and nondominant hands when men and women were combined. Conclusions: Motor decline as indexed by gait speed accelerates up to 12 years before MCI. Longitudinal changes in motor function may be useful in the early detection of dementia during preclinical stages, when the utility of disease-modifying therapies would be greatest. C1 [Buracchio, Teresa; Kaye, Jeffrey] Portland VA Med Ctr, Portland, OR USA. [Kaye, Jeffrey] Oregon Ctr Aging & Technol, Portland, OR USA. [Buracchio, Teresa; Dodge, Hiroko H.; Howieson, Diane; Wasserman, Dara; Kaye, Jeffrey] Oregon Hlth & Sci Univ, Dept Neurol, Layton Aging & Alzheimers Dis Ctr, Portland, OR 97239 USA. RP Buracchio, T (reprint author), Oregon Hlth & Sci Univ, Dept Neurol, Layton Aging & Alzheimers Dis Ctr, 3181 SW Sam Jackson Pk Rd,Mail Code CR-131, Portland, OR 97239 USA. EM buracchi@ohsu.edu OI Kaye, Jeffrey/0000-0002-9971-3478 FU Department of Veterans Affairs [P30AG008017, R01AG024059]; National Institute on Aging [K01AG023014]; National Center for Research Resources FX This study was supported by the Department of Veterans Affairs; grants P30AG008017, R01AG024059, and K01AG023014 from the National Institute on Aging; and the National Center for Research Resources. NR 40 TC 109 Z9 110 U1 2 U2 16 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 AUG PY 2010 VL 67 IS 8 BP 980 EP 986 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 637HU UT WOS:000280809000011 PM 20697049 ER PT J AU Hayden, KM Breitner, JCS Welsh-Bohmer, KA AF Hayden, Kathleen M. Breitner, John C. S. Welsh-Bohmer, Kathleen A. TI Apolipoprotein E epsilon 4 Status and Cognitive Decline With and Without Dementia Reply SO ARCHIVES OF NEUROLOGY LA English DT Letter ID DISEASE; APOE C1 [Hayden, Kathleen M.] Duke Univ, Dept Psychiat & Behav Sci, Joseph & Kathleen Bryan Alzheimers Dis Res Ctr, Durham, NC 27705 USA. [Hayden, Kathleen M.; Welsh-Bohmer, Kathleen A.] Duke Univ, Div Neurol, Joseph & Kathleen Bryan Alzheimers Dis Res Ctr, Dept Med,Med Ctr, Durham, NC 27705 USA. [Breitner, John C. S.] Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. [Breitner, John C. S.] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Hayden, KM (reprint author), Duke Univ, Dept Psychiat & Behav Sci, Joseph & Kathleen Bryan Alzheimers Dis Res Ctr, 2200 W Main St,Ste A-200, Durham, NC 27705 USA. EM khayden@duke.edu RI Hayden, Kathleen/B-6442-2012 OI Hayden, Kathleen/0000-0002-7745-3513 NR 4 TC 0 Z9 0 U1 0 U2 1 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 AUG PY 2010 VL 67 IS 8 BP 1036 EP 1037 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 637HU UT WOS:000280809000028 ER PT J AU Ku, TK Rutar, T Han, Y Porco, TC Naseri, A AF Ku, Tina K. Rutar, Tina Han, Ying Porco, Travis C. Naseri, Ayman TI Resident-Performed Phacoemulsification Surgery in Tamsulosin-Treated Patients SO ARCHIVES OF OPHTHALMOLOGY LA English DT Article ID FLOPPY-IRIS-SYNDROME; BENIGN PROSTATIC HYPERTROPHY; CATARACT-SURGERY; CLINICAL FINDINGS; VITREOUS LOSS; IFIS; COMPLICATIONS; ASSOCIATION; PROPHYLAXIS; EPINEPHRINE AB Objectives: To compare intraoperative complication rates and visual outcomes for patients treated and not treated with tamsulosin hydrochloride who underwent resident-performed phacoemulsification, and to determine whether the recognition of intraoperative floppy iris syndrome in 2005 affected the subsequent complication rates for tamsulosin-treated patients. Methods: This comparative retrospective cohort study included 101 tamsulosin-treated eyes and 404 non tamsulosin-treated eyes from January 1, 1998, to August 31, 2008. Main outcome measures were major and minor complication rates and postoperative best-corrected visual acuity. Complication rates were compared between August 11, 1999, to December 31, 2005, and January 1, 2006, to September 3, 2008, for both tamsulosin-treated and non tamsulosin-treated eyes. Results: The major complication rates were 3.0% for tamsulosin-treated eyes and 8.9% for non-tamsulosin-treated eyes (P=.08), while the minor complication rates were 24.8% and 12.1%, respectively (P=.002). Both groups had an equal likelihood of attaining better than 20/40 postoperative visual acuities (82.2% vs 82.9%, rdspectively; P=.85). Frequency of major complications between tamsulosin-treated and non tamsulosin-treated eyes was 6.0% vs 15.8%, respectively (P=.09), from August 11, 1999, to December 31, 2005, compared with 0.0% vs 2.0%, respectively (P>.99), from January 1, 2006, to September 3, 2008. Conclusions: Differences in the major complication rates for tamsulosin-treated and non tamsulosin-treated eyes were not significant, whereas tamsulosin exposure was associated with a significant increase in minor complications. Both groups had similar, good postoperative visual outcomes. After 2005, a reduction in major complications was seen in both groups, attributed to programmatic changes in surgical education. Recognition of intraoperative floppy iris syndrome did not impart a significant additional protective effect in preventing major complications. C1 [Naseri, Ayman] San Francisco VA Med Ctr, Dept Ophthalmol, San Francisco, CA 94121 USA. [Ku, Tina K.; Rutar, Tina; Han, Ying; Porco, Travis C.; Naseri, Ayman] Univ Calif San Francisco, Dept Ophthalmol, San Francisco, CA 94143 USA. [Porco, Travis C.] Univ Calif San Francisco, Dept Epidemiol & Biostat, Div Prevent Med & Publ Hlth, San Francisco, CA 94143 USA. [Porco, Travis C.; Naseri, Ayman] Francis I Proctor Fdn Res Ophthalmol, San Francisco, CA USA. RP Naseri, A (reprint author), San Francisco VA Med Ctr, Dept Ophthalmol, 4150 Clement St, San Francisco, CA 94121 USA. EM ayman.naseri@va.gov FU Research to Prevent Blindness; University of California [NIH P30]; That Man May See FX This work was supported in part by unrestricted grants from Research to Prevent Blindness, the University of California Institutional Core Grant For Vision Research (NIH P30), and That Man May See, a non-profit organization. NR 37 TC 3 Z9 3 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-9950 J9 ARCH OPHTHALMOL-CHIC JI Arch. Ophthalmol. PD AUG PY 2010 VL 128 IS 8 BP 967 EP 972 PG 6 WC Ophthalmology SC Ophthalmology GA 638QJ UT WOS:000280909700002 PM 20696995 ER PT J AU Joehl, RJ AF Joehl, Raymond J. TI Mom Is Not Permitted to Be Ill SO ARCHIVES OF SURGERY LA English DT Editorial Material C1 [Joehl, Raymond J.] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Surg Serv, Hines, IL 60141 USA. [Joehl, Raymond J.] Loyola Univ, Med Ctr, Maywood, IL 60153 USA. RP Joehl, RJ (reprint author), Hines VA Hosp, 5000 S 5th Ave, Hines, IL 60141 USA. EM raymond.joehl@va.gov NR 1 TC 0 Z9 0 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 AUG PY 2010 VL 145 IS 8 BP 780 EP 780 PG 1 WC Surgery SC Surgery GA 640FB UT WOS:000281033000016 PM 20737736 ER PT J AU Wheeler, JM Guthrie, CR Kraemer, BC AF Wheeler, Jeanna M. Guthrie, Chris R. Kraemer, Brian C. TI The role of MSUT-2 in tau neurotoxicity: a target for neuroprotection in tauopathy? SO BIOCHEMICAL SOCIETY TRANSACTIONS LA English DT Article DE aggresome; Alzheimer's disease; neurodegeneration; neurofibrillary tangle; protein aggregation; tau ID CAENORHABDITIS-ELEGANS; PROTEIN AGGREGATION; AGGRESOME FORMATION; MISFOLDED PROTEINS; MISSENSE MUTATIONS; FTDP-17 MUTATIONS; POLYADENOSINE RNA; DEMENTIA FTDP-17; INCLUSION-BODIES; MOUSE MODEL AB We previously developed a transgenic Caenorhabditis elegons model of human tauopathy disorders by expressing human tau in nematode worm neurons to explore genetic pathways contributing to tau-induced neurodegeneration. This animal model recapitulates several hallmarks of human tauopathies, including altered behaviour, accumulation of detergent-insoluble phosphorylated tau protein and neurodegeneration. To identify genes required for tau neurotoxicity, we carried out a forward genetic screen for mutations that suppress tau neurotoxicity. We ultimately cloned the sut-2 (suppressor of tau pathology-2) gene, mutations in which alleviate tau neurotoxicity in C. elegons. SUT-2 encodes a novel subtype of CCCH zinc-finger protein conserved across animal phyla. SUT-2 shares significant identity with the mammalian SUT-2 (MSUT-2). We identified components of the aggresome as binding partners of MSUT-2. Thus we hypothesize that MSUT-2 plays a role in the formation and/or clearance of protein aggregates. We are currently exploring the role of MSUT-2 in tauopathy using mammalian systems. The identification of sut-2 as a gene required for tau neurotoxicity in C. elegons suggests new neuroprotective strategies targeting MSUT-2 that may be effective in modulating tau neurotoxicity in human tauopathy disorders. C1 [Kraemer, Brian C.] Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Seattle Div, Seattle, WA 98108 USA. Univ Washington, Dept Med, Div Gerontol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Div Geriatr Med, Seattle, WA 98195 USA. RP Kraemer, BC (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Seattle Div, 1660 S Colombian Way, Seattle, WA 98108 USA. EM kraemerb@u.washington.edu FU Department of Veterans Affairs; National Institute of Neurological Disorders and Stroke [R01NS064131] FX This work was Supported by a Department of Veterans Affairs Merit Review Grant and by the National Institute of Neurological Disorders and Stroke [grant number R01NS064131 (to B.C.K.)]. NR 39 TC 6 Z9 7 U1 1 U2 2 PU PORTLAND PRESS LTD PI LONDON PA THIRD FLOOR, EAGLE HOUSE, 16 PROCTER STREET, LONDON WC1V 6 NX, ENGLAND SN 0300-5127 J9 BIOCHEM SOC T JI Biochem. Soc. Trans. PD AUG PY 2010 VL 38 BP 973 EP 976 DI 10.1042/BST0380973 PN 4 PG 4 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 636QL UT WOS:000280753600021 PM 20658987 ER PT J AU Wang, J Fivecoat, H Ho, L Pan, Y Ling, E Pasinetti, GM AF Wang, Jun Fivecoat, Hayley Ho, Lap Pan, Yong Ling, Emi Pasinetti, Giulio Maria TI The role of Sirt1: At the crossroad between promotion of longevity and protection against Alzheimer's disease neuropathology SO BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS LA English DT Review DE Sirtuins; Caloric restriction; Neurodegeneration; Alzheimer's disease; Dementia ID CALORIC RESTRICTION; LIFE-SPAN; SACCHAROMYCES-CEREVISIAE; AMYLOID NEUROPATHOLOGY; MOUSE MODEL; MECHANISM; PROTEIN; DEACETYLATION; NICOTINAMIDE; YEAST AB Sirt1, a mammalian member of the sirtuin gene family, holds great potential for promoting longevity, preventing against disease and increasing cell survival. For example, studies suggest that the beneficial impact of caloric restriction in promoting longevity and cellular function may be mediated, in part, by Sirt1 through mechanisms involving PGC-1 alpha, which plays important role in the regulation of cellular metabolism and inflammatory and antioxidant responses. Sirt1 may also interfere with mechanisms implicated in pathological disorders. We will present recent evidence indicating that Sirt1 may protect against Alzheimer's disease by interfering with the generation of beta-amyloid peptides. We will discuss Sirt1 as a potential novel target, in addition to the development of Sirt1 activators for the prevention and treatment of Alzheimer's disease. Published by Elsevier B.V. C1 [Wang, Jun; Fivecoat, Hayley; Ho, Lap; Pan, Yong; Ling, Emi; Pasinetti, Giulio Maria] Mt Sinai Sch Med, Dept Neurol,Brain Inst, Ctr Excellence Novel Approaches Neurodiagnost & N, Ctr Excellence Res Complementary & Alternat Med A, New York, NY 10029 USA. [Pasinetti, Giulio Maria] James J Peters Vet Affairs Med Ctr, GRECC, Biomed Res & Training Program, Bronx, NY 10468 USA. RP Pasinetti, GM (reprint author), Mt Sinai Sch Med, Dept Neurol,Brain Inst, Ctr Excellence Novel Approaches Neurodiagnost & N, Ctr Excellence Res Complementary & Alternat Med A, 1 Gustave L Levy Pl,Box 1230, New York, NY 10029 USA. EM giulio.pasinetti@mssm.edu FU Atkins Foundation FX The studies reported in this review article were generously supported by the Atkins Foundation. NR 38 TC 38 Z9 42 U1 0 U2 8 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1570-9639 J9 BBA-PROTEINS PROTEOM JI BBA-Proteins Proteomics PD AUG PY 2010 VL 1804 IS 8 SI SI BP 1690 EP 1694 DI 10.1016/j.bbapap.2009.11.015 PG 5 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 621JA UT WOS:000279571200016 PM 19945548 ER PT J AU Hook, V Hook, G Kindy, M AF Hook, Vivian Hook, Gregory Kindy, Mark TI Pharmacogenetic features of cathepsin B inhibitors that improve memory deficit and reduce beta-amyloid related to Alzheimer's disease SO BIOLOGICAL CHEMISTRY LA English DT Article; Proceedings Paper CT 6th General Meeting of the International-Proteolysis-Society CY OCT 26-30, 2009 CL Gold Coast, AUSTRALIA SP Int Proteolysis Soc DE Alzheimer's disease; beta-amyloid; cathepsin B; cleavage site; inhibitor; memory; pharmacogenetics; protease; transgenic AD mice ID REGULATED SECRETORY VESICLES; PRECURSOR PROTEIN; TRANSGENIC MICE; WILD-TYPE; IN-VIVO; SELECTIVE INHIBITOR; CHROMAFFIN CELLS; THERAPEUTICS; PEPTIDES; BACE1 AB Beta-amyloid (A beta) in the brain is a major factor involved in Alzheimer's disease (AD) that results in severe memory deficit. Our recent studies demonstrate pharmacogenetic differences in the effects of inhibitors of cathepsin B to improve memory and reduce A beta in different mouse models of AD. The inhibitors improve memory and reduce brain A beta in mice expressing the wild-type (WT) beta-secretase site of human APP, expressed in most AD patients. However, these inhibitors have no effect in mice expressing the rare Swedish (Swe) mutant amyloid precursor protein (APP). Knockout of the cathepsin B decreased brain A beta in mice expressing WT APP, validating cathepsin B as the target. The specificity of cathepsin B to cleave the WT beta-secretase site, but not the Swe mutant site, of APP for A beta production explains the distinct inhibitor responses in the different AD mouse models. In contrast to cathepsin B, the BACE1 beta-secretase prefers to cleave the Swe mutant site. Discussion of BACE1 data in the field indicate that they do not preclude cathepsin B as also being a beta-secretase. Cathepsin B and BACE1 could participate jointly as beta-secretases. Significantly, the majority of AD patients express WT APP and, therefore, inhibitors of cathepsin B represent candidate drugs for AD. C1 [Hook, Vivian] Univ Calif San Diego, Skaggs Sch Pharm & Pharmaceut Sci, La Jolla, CA 92093 USA. [Hook, Vivian] Univ Calif San Diego, Dept Neurosci, Sch Med, La Jolla, CA 92093 USA. [Hook, Vivian] Univ Calif San Diego, Dept Pharmacol, Sch Med, La Jolla, CA 92093 USA. [Hook, Vivian] Univ Calif San Diego, Dept Med, Sch Med, La Jolla, CA 92093 USA. [Hook, Gregory] Amer Life Sci Pharmaceut Inc, San Diego, CA 92109 USA. [Kindy, Mark] Med Univ S Carolina, Dept Neurosci, Charleston, SC 29425 USA. [Kindy, Mark] Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. RP Hook, V (reprint author), Univ Calif San Diego, Skaggs Sch Pharm & Pharmaceut Sci, La Jolla, CA 92093 USA. EM vhook@ucsd.edu FU NIA NIH HHS [R21 AG027446, 1R44AG032784, R44 AG030865, R44 AG032784]; NIDA NIH HHS [R01 DA004271] NR 47 TC 16 Z9 18 U1 1 U2 8 PU WALTER DE GRUYTER & CO PI BERLIN PA GENTHINER STRASSE 13, D-10785 BERLIN, GERMANY SN 1431-6730 J9 BIOL CHEM JI Biol. Chem. PD AUG PY 2010 VL 391 IS 8 BP 861 EP 872 DI 10.1515/BC.2010.110 PG 12 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 642HL UT WOS:000281198700004 PM 20536395 ER PT J AU Felts, AS Lindsley, SR Lamb, JP Rodriguez, AL Menon, UN Jadhav, S Jones, CK Conn, PJ Lindsley, CW Emmitte, KA AF Felts, Andrew S. Lindsley, Stacey R. Lamb, Jeffrey P. Rodriguez, Alice L. Menon, Usha N. Jadhav, Satyawan Jones, Carrie K. Conn, P. Jeffrey Lindsley, Craig W. Emmitte, Kyle A. TI 3-Cyano-5-fluoro-N-arylbenzamides as negative allosteric modulators of mGlu(5): Identification of easily prepared tool compounds with CNS exposure in rats SO BIOORGANIC & MEDICINAL CHEMISTRY LETTERS LA English DT Article DE mGlu5; GPCR; Allosteric modulator; CNS; GERD; Fragile X syndrome; Addiction; PD-LID ID MGLUR5 ANTAGONIST MPEP; METABOTROPIC GLUTAMATE-RECEPTOR-5 ANTAGONIST; RECEPTOR SUBTYPE-5 ANTAGONISTS; CUE-INDUCED REINSTATEMENT; GLUTAMATE RECEPTORS; GASTROESOPHAGEAL-REFLUX; SQUIRREL-MONKEYS; SEEKING BEHAVIOR; COCAINE SEEKING; POTENT AB Development of SAR in a 3-cyano-5-fluoro-N-arylbenzamide series of non-competitive antagonists of mGlu(5) using a functional cell-based assay is described in this Letter. Further characterization of selected potent compounds in in vitro assays designed to measure their metabolic stability and protein binding is also presented. Subsequent evaluation of two new compounds in pharmacokinetic studies using intraperitoneal dosing in rats demonstrated good exposure in both plasma and brain samples. (C) 2010 Elsevier Ltd. All rights reserved. C1 [Felts, Andrew S.; Lindsley, Stacey R.; Lamb, Jeffrey P.; Rodriguez, Alice L.; Menon, Usha N.; Jadhav, Satyawan; Jones, Carrie K.; Conn, P. Jeffrey; Lindsley, Craig W.; Emmitte, Kyle A.] Vanderbilt Univ, Med Ctr, Dept Pharmacol, Nashville, TN 37232 USA. [Felts, Andrew S.; Lindsley, Stacey R.; Lamb, Jeffrey P.; Rodriguez, Alice L.; Menon, Usha N.; Jadhav, Satyawan; Jones, Carrie K.; Conn, P. Jeffrey; Lindsley, Craig W.; Emmitte, Kyle A.] Vanderbilt Univ, Med Ctr, Vanderbilt Program Drug Discovery, Nashville, TN 37232 USA. [Jones, Carrie K.; Lindsley, Craig W.] Vanderbilt Univ, Dept Chem, Nashville, TN 37232 USA. [Jones, Carrie K.] Tennesse Valley Healthcare Syst, US Dept Vet Affairs, Nashville, TN 37212 USA. RP Emmitte, KA (reprint author), Vanderbilt Univ, Med Ctr, Dept Pharmacol, Nashville, TN 37232 USA. EM kyle.a.emmitte@Vanderbilt.edu RI Conn, Peter/D-7848-2012 FU NIDA [RO1 DA023947-01]; Seaside Therapeutics [VUMC33842] FX We thank NIDA (RO1 DA023947-01) and Seaside Therapeutics (VUMC33842) for their support of our programs in the development of non-competitive antagonist of mGlu5. Matt Mulder, Chris Denicola, and Sichen Chang are also thanked for the purification of compounds using the mass-directed HPLC system. NR 48 TC 17 Z9 17 U1 0 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0960-894X J9 BIOORG MED CHEM LETT JI Bioorg. Med. Chem. Lett. PD AUG 1 PY 2010 VL 20 IS 15 BP 4390 EP 4394 DI 10.1016/j.bmcl.2010.06.064 PG 5 WC Chemistry, Medicinal; Chemistry, Organic SC Pharmacology & Pharmacy; Chemistry GA 625BK UT WOS:000279866300020 PM 20598884 ER PT J AU Altshuler, LL Abulseoud, OA Foland-Ross, L Bartzokis, G Chang, S Mintz, J Hellemann, G Vinters, HV AF Altshuler, Lori L. Abulseoud, Osama A. Foland-Ross, Lara Bartzokis, George Chang, Sean Mintz, Jim Hellemann, Gerhard Vinters, Harry V. TI Amygdala astrocyte reduction in subjects with major depressive disorder but not bipolar disorder SO BIPOLAR DISORDERS LA English DT Article DE amygdala; astrocyte; bipolar disorder; depression; glial cell; neuron ID MAGNETIC-RESONANCE SPECTROSCOPY; DORSOLATERAL PREFRONTAL CORTEX; ANTERIOR CINGULATE CORTEX; FIBRILLARY ACIDIC PROTEIN; TEMPORAL-LOBE STRUCTURES; GAMMA-AMINOBUTYRIC-ACID; GLIAL-CELL DENSITY; MOOD DISORDERS; NEUROPATHOLOGY CONSORTIUM; GLUTAMINE-SYNTHETASE AB Objectives: Several magnetic resonance imaging studies have found changes in amygdala volumes in adults with mood disorders. The cellular basis for these changes has not been explored in detail. Specifically, it is not known whether differences in the density and/or volume of neurons or glial cells contribute to tissue volume changes seen on magnetic resonance images. Methods: Postmortem amygdala samples were obtained from the Stanley Foundation Neuropathology Consortium from subjects diagnosed with bipolar disorder (n = 10), major depressive disorder (n = 11), and schizophrenia (n = 9), and from normal controls (n = 14). Samples were first stained with glial fibrillary acidic protein (GFAP) and counter-stained with hematoxylin to ascertain neuron and glia (astrocyte) densities. Results: No significant differences in neuronal densities were found between groups. However, a reduction in the density of GFAP immunoreactive astrocytes was observed in the amygdala of subjects with major depressive disorder compared to the bipolar disorder, schizophrenia, and normal control postmortem samples. Conclusions: A decrease in density of GFAP immunoreactive astrocytes in the amygdala of depressed subjects is consistent with prior histologic reports and might contribute to amygdala volume reductions reported in several in vivo neuroimaging studies. C1 [Altshuler, Lori L.; Bartzokis, George; Hellemann, Gerhard] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. [Altshuler, Lori L.; Bartzokis, George; Mintz, Jim] VA Greater Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, Los Angeles, CA USA. [Abulseoud, Osama A.] Univ So Calif, Dept Psychiat & Behav Sci, Los Angeles, CA USA. [Foland-Ross, Lara; Bartzokis, George] Univ Calif Los Angeles, David Geffen Sch Med, Lab Neuroimaging, Dept Neurol,Div Brain Mapping, Los Angeles, CA 90095 USA. [Chang, Sean] Albert Einstein Jacobi Med Ctr, Dept Radiol, Bronx, NY USA. [Vinters, Harry V.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. [Vinters, Harry V.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. RP Altshuler, LL (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, 300 UCLA Med Plaza,Suite 1544,Box 6, Los Angeles, CA 90095 USA. EM laltshuler@mednet.ucla.edu RI Bartzokis, George/K-2409-2013 FU Stanley Medical Research Institute (Bethesda, MD, USA); Daljit S. and Elaine Sarkaria Chair in Diagnostic Medicine; Janssen FX Postmortem brain tissue was donated by the Stanley Medical Research Institute's brain collection. Financial support for this research was provided by the Stanley Medical Research Institute (Bethesda, MD, USA). HHV is supported in part by the Daljit S. and Elaine Sarkaria Chair in Diagnostic Medicine. We are grateful to Arnold Scheibel for consultation regarding identification of amygdala nuclei, and to Teri English for editorial assistance.; LLA is on the scientific advisory board for Forest Laboratories (for matters related to s-citalopram). GB has received grant support from Janssen and is on the speakers bureaus for and receives honoraria from Pfizer and Novartis, none for matters related to bipolar disorder. HVV has stock holdings in the following pharmaceutical companies: Pfizer, GlaxoSmithKline Beecham, and Teva. All authors report that they do not have any conflict of interest relevant to this manuscript. NR 72 TC 46 Z9 47 U1 0 U2 3 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1398-5647 J9 BIPOLAR DISORD JI Bipolar Disord. PD AUG PY 2010 VL 12 IS 5 BP 541 EP 549 DI 10.1111/j.1399-5618.2010.00838.x PG 9 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 639PX UT WOS:000280987800010 PM 20712756 ER PT J AU Lorenz, KA Malin, JL AF Lorenz, Karl A. Malin, Jennifer L. TI How Might VA-Medicare Differences Inform the Delivery of End-of-Life Cancer Care? SO CANCER LA English DT Editorial Material ID UNITED-STATES; ASSOCIATIONS; ACCESS; HEALTH; COSTS C1 [Lorenz, Karl A.] Vet Adm Greater Los Angeles Healthcare Syst, Div Gen Internal Med, Los Angeles, CA USA. [Lorenz, Karl A.] Vet Adm Greater Los Angeles Healthcare Syst, Div Palliat Care, Los Angeles, CA USA. [Lorenz, Karl A.; Malin, Jennifer L.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Malin, Jennifer L.] Vet Adm Greater Los Angeles Healthcare Syst, Div Hematol Oncol, Los Angeles, CA USA. RP Lorenz, KA (reprint author), Vet Adm Greater Los Angeles, VA Palliat Care Qual Improvement Resource Ctr, Vet Integrated Palliat Program, 11301 Wilshire Blvd,Code 111-G, Los Angeles, CA 90073 USA. EM karl.lorenz@va.gov NR 16 TC 2 Z9 2 U1 0 U2 0 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0008-543X J9 CANCER-AM CANCER SOC JI Cancer PD AUG 1 PY 2010 VL 116 IS 15 BP 3533 EP 3536 DI 10.1002/cncr.25101 PG 4 WC Oncology SC Oncology GA 629TS UT WOS:000280223200004 PM 20564077 ER PT J AU Barnett, CM Nielson, CM Shannon, J Chan, JM Shikany, JM Bauer, DC Hoffman, AR Barrett-Connor, E Orwoll, E Beer, TM AF Barnett, Christine M. Nielson, Carrie M. Shannon, Jackie Chan, June M. Shikany, James M. Bauer, Douglas C. Hoffman, Andrew R. Barrett-Connor, Elizabeth Orwoll, Eric Beer, Tomasz M. TI Serum 25-OH vitamin D levels and risk of developing prostate cancer in older men SO CANCER CAUSES & CONTROL LA English DT Article DE Vitamin D; Prostate cancer ID UNITED-STATES; 1,25-DIHYDROXYVITAMIN D-3; SUBSEQUENT DEVELOPMENT; ULTRAVIOLET-RADIATION; D METABOLITES; COLON-CANCER; D DEFICIENCY; IN-VIVO; 25-HYDROXYVITAMIN-D; MORTALITY AB Multiple studies have shown clear evidence of vitamin D's anti-tumor effects on prostate cancer cells in laboratory experiments, but the evidence has not been consistent in humans. We sought to examine the association between vitamin D and prostate cancer risk in a cohort of older men. We conducted a prospective case-cohort study nested within the multicenter Osteoporotic Fractures in Men (MrOS) study. Baseline serum 25-OH vitamin D was measured in a randomly selected sub-cohort of 1,433 men a parts per thousand yen65 years old without a history of prostate cancer and from all participants with an incident diagnosis of prostate cancer (n = 297). Cox proportional hazards models were used to evaluate the associations between quartiles of total 25-OH vitamin D and incident prostate cancer, as well as Gleason score. In comparison with the lowest quartile of 25-OH vitamin D, the hazard ratio for the highest quartile of 25-OH vitamin D was 1.22 (CI 0.50-1.72, p = 0.25), no trend across quartiles (p = 0.94) or association with Gleason score was observed. Adjustment for covariates did not alter the results. In this prospective cohort of older men, we found no association between serum 25-OH vitamin D levels and subsequent risk of prostate cancer. C1 [Barnett, Christine M.; Beer, Tomasz M.] Oregon Hlth & Sci Univ, Div Hematol & Med Oncol, Portland, OR 97239 USA. [Barnett, Christine M.; Beer, Tomasz M.] Oregon Hlth & Sci Univ, Knight Canc Inst, Portland, OR 97239 USA. [Nielson, Carrie M.; Shannon, Jackie] Oregon Hlth & Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97239 USA. [Shannon, Jackie] Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97239 USA. [Shannon, Jackie] Oregon Hlth & Sci Univ, CROET, Portland, OR 97239 USA. [Chan, June M.] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. [Chan, June M.] Univ Calif San Francisco, Dept Urol, San Francisco, CA 94143 USA. [Shikany, James M.] Univ Alabama, Div Prevent Med, Birmingham, AL USA. [Hoffman, Andrew R.] Stanford Univ, Dept Med, Stanford, CA 94305 USA. [Barrett-Connor, Elizabeth] Univ Calif San Diego, Dept Family & Prevent Med, Div Epidemiol, San Diego, CA 92103 USA. [Orwoll, Eric] Oregon Hlth & Sci Univ, Div Endocrinol, Bone & Mineral Unit, Portland, OR 97239 USA. RP Beer, TM (reprint author), Oregon Hlth & Sci Univ, Div Hematol & Med Oncol, CH-14R,3303 SW Bond Ave, Portland, OR 97239 USA. EM beert@ohsu.edu OI Orwoll, Eric/0000-0002-8520-7355 FU NIA NIH HHS [U01 AG042140] NR 47 TC 25 Z9 26 U1 0 U2 6 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0957-5243 J9 CANCER CAUSE CONTROL JI Cancer Causes Control PD AUG PY 2010 VL 21 IS 8 BP 1297 EP 1303 DI 10.1007/s10552-010-9557-y PG 7 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 627TI UT WOS:000280065400015 PM 20383574 ER PT J AU Tyner, JW Fletcher, LB Wang, EQ Yang, WF Rutenberg-Schoenberg, ML Beadling, C Mori, M Heinrich, MC Deininger, MW Druker, BJ Loriaux, MM AF Tyner, Jeffrey W. Fletcher, Luke B. Wang, Ellen Q. Yang, Wayne F. Rutenberg-Schoenberg, Michael L. Beadling, Carol Mori, Motomi Heinrich, Michael C. Deininger, Michael W. Druker, Brian J. Loriaux, Marc M. TI MET Receptor Sequence Variants R970C and T992I Lack Transforming Capacity SO CANCER RESEARCH LA English DT Article ID CELL LUNG-CANCER; ACTIVATING MUTATIONS; FUNCTIONAL-ANALYSIS; MYELOID-LEUKEMIA; FOLLOW-UP; C-MET; PROTOONCOGENE; EXPRESSION; GEFITINIB; CARCINOMA AB High-throughput sequencing promises to accelerate the discovery of sequence variants, but distinguishing oncogenic mutations from irrelevant "passenger" mutations remains a major challenge. Here we present an analysis of two sequence variants of the MET receptor (hepatocyte growth factor receptor) R970C and T992I (also designated R988C and T1010I). Previous reports indicated that these sequence variants are transforming and contribute to oncogenesis. We screened patients with chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), chronic myelomonocytic leukemia (CMML), colorectal cancer, endometrial cancer, thyroid cancer, or melanoma, as well as individuals without cancer, and found these variants at low frequencies in most cohorts, including normal individuals. No evidence of increased phosphorylation or transformative capacity by either sequence variant was found. Because small-molecule inhibitors for MET are currently in development, it will be important to distinguish between oncogenic sequence variants and rare single-nucleotide polymorphisms to avoid the use of unnecessary, and potentially toxic, cancer therapy agents. Cancer Res; 70(15); 6233-7. (C) 2010 AACR. C1 [Tyner, Jeffrey W.; Fletcher, Luke B.; Wang, Ellen Q.; Yang, Wayne F.; Rutenberg-Schoenberg, Michael L.; Beadling, Carol; Mori, Motomi; Heinrich, Michael C.; Deininger, Michael W.; Druker, Brian J.; Loriaux, Marc M.] Oregon Hlth & Sci Univ, Knight Canc Inst, Portland, OR 97239 USA. [Tyner, Jeffrey W.; Fletcher, Luke B.; Wang, Ellen Q.; Yang, Wayne F.; Rutenberg-Schoenberg, Michael L.; Deininger, Michael W.; Druker, Brian J.; Loriaux, Marc M.] Oregon Hlth & Sci Univ, Div Hematol & Med Oncol, Portland, OR 97239 USA. [Beadling, Carol; Heinrich, Michael C.] Portland VA Med Ctr, Portland, OR USA. [Mori, Motomi] Oregon Hlth & Sci Univ, Div Biostat, Dept Publ Hlth & Prevent Med, Portland, OR 97239 USA. [Druker, Brian J.] Howard Hughes Med Inst, Portland, OR USA. [Loriaux, Marc M.] Oregon Hlth & Sci Univ, Dept Pathol, Portland, OR 97239 USA. RP Tyner, JW (reprint author), Oregon Hlth & Sci Univ, Knight Canc Inst, 3181 SW Sam Jackson Pk Rd,Mailcode L592, Portland, OR 97239 USA. EM tynerj@ohsu.edu OI Tyner, Jeffrey/0000-0002-2133-0960 FU Leukemia and Lymphoma Society; TJ Martell Foundation; Doris Duke Charitable Foundation; William Lawrence and Blanche Hughes Fund; National Center for Research Resources (NRCC); VA Merit Review Grant; OHSU cancer center [5 p30 CA069533]; Knight Cancer Institute [5P50CA069533]; Oregon Clinical & Translational Research Institute [UL1 RR024140] FX The Leukemia and Lymphoma Society, the TJ Martell Foundation, and the Doris Duke Charitable Foundation. J.W. Tyner is supported by grants from the William Lawrence and Blanche Hughes Fund, and the Oregon Clinical and Translational Research Institute (OCTRI) grant number UL1 RR024140 from the National Center for Research Resources (NRCC), a component of the NIH, and NIH Roadmap for Medical Research. M. C. Heinrich is supported in part by a VA Merit Review Grant. B.J. Druker is an investigator of the Howard Hughes Medical Institute and principal investigator of the OHSU cancer center support grant 5 p30 CA069533. M. M. Loriaux is supported by the Leukemia and Lymphoma Society and the TJ Martell Foundation. Biostatistics support (M. Mori) is in part provided by the Biostatistics Shared Resource of the Knight Cancer Institute (5P50CA069533) and the Biostatistics & Design Program of the Oregon Clinical & Translational Research Institute (UL1 RR024140). NR 22 TC 40 Z9 40 U1 1 U2 1 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD AUG 1 PY 2010 VL 70 IS 15 BP 6233 EP 6237 DI 10.1158/0008-5472.CAN-10-0429 PG 5 WC Oncology SC Oncology GA 634CQ UT WOS:000280557500013 PM 20670955 ER PT J AU Hawkins, AO Danielson, CK de Arellano, MA Hanson, RF Ruggiero, KJ Smith, DW Saunders, BE Kilpatrick, DG AF Hawkins, Alesia Oscea Danielson, Carla Kmett de Arellano, Michael A. Hanson, Rochelle F. Ruggiero, Kenneth J. Smith, Daniel W. Saunders, Benjamin E. Kilpatrick, Dean G. TI Ethnic/Racial Differences in the Prevalence of Injurious Spanking and Other Child Physical Abuse in a National Survey of Adolescents SO CHILD MALTREATMENT LA English DT Article DE adolescent victims; ethnic minority populations; physical abuse ID VIOLENCE; VICTIMIZATION; MALTREATMENT; PUNISHMENT; YOUTH AB Limited research has examined whether similar patterns in injurious spanking and other forms of child physical abuse (CPA) exist across specific ethnic/racial groups. The authors examined and compared differences in the lifetime prevalence of injurious spanking and CPA in two national samples of adolescents across ethnic/racial groups and over time. Participants were 4,023 youth (12-17 years) and 3,614 youth (12-17 years) who participated in the 1995 National Survey of Adolescents (NSA) and 2005 National Survey of Adolescents-Replication (NSA-R), respectively. Adolescents, who were identified through random digit dial procedures, completed a telephone interview assessment. Results indicated significant ethnic/racial variation across groups in reports of injurious spanking in the NSA and the NSA-R samples; however, significant differences were not observed within groups between the two samples over time. Ethnic/racial differences also were found between groups in reports of CPA in the NSA-R sample. Limitations and future directions of this research are discussed. C1 [Hawkins, Alesia Oscea] Univ Illinois, Coll Med Rockford, Dept Family & Community Med, Rockford, IL 61107 USA. [de Arellano, Michael A.] Med Univ S Carolina, Dept Psychiat & Behav Sci, Natl Crime Victims Res & Treatment Ctr, COPE, Charleston, SC 29425 USA. [Ruggiero, Kenneth J.] Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Hawkins, AO (reprint author), Univ Illinois, Coll Med Rockford, Dept Family & Community Med, 1601 Parkview Ave, Rockford, IL 61107 USA. EM alesiah@uic.edu FU NICHD NIH HHS [R01 HD046830]; NIDA NIH HHS [K23DA018686] NR 21 TC 18 Z9 18 U1 1 U2 11 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1077-5595 J9 CHILD MALTREATMENT JI Child Maltreatment PD AUG PY 2010 VL 15 IS 3 BP 242 EP 249 DI 10.1177/1077559510367938 PG 8 WC Family Studies; Social Work SC Family Studies; Social Work GA 628PJ UT WOS:000280132400005 PM 20498129 ER PT J AU Refaat, MM Hashash, JG Shalaby, AA AF Refaat, Marwan M. Hashash, Jana G. Shalaby, Alaa A. TI Late Perforation by Cardiac Implantable Electronic Device Leads: Clinical Presentation, Diagnostic Clues, and Management SO CLINICAL CARDIOLOGY LA English DT Review ID RIGHT-VENTRICULAR PERFORATION; PERMANENT PACEMAKER LEAD; OF-THE-LITERATURE; CARDIOVERTER-DEFIBRILLATOR; ICD LEAD; SUBCUTANEOUS TISSUES; DELAYED PERFORATION; LUNG PERFORATION; EXTRACTION; HEART AB Late intracardiac lead perforation is defined as migration and perforation of an implanted lead after 1 month of cardiac electronic device implantation. It is an under-recognized complication with significant morbidity and mortality, particularly if not recognized early. Two patients with late perforation caused by passive-fixation leads are reported and the clinical features of their presentation and management are reviewed. We conducted a thorough review of the available English language literature pertaining to this complication to draw relevant conclusions regarding presentation, diagnosis, and management. Early recognition of this complication is important as the indications for and numbers of patients who receive cardiac implantable electronic devices continue to expand. C1 [Refaat, Marwan M.; Shalaby, Alaa A.] VA Pittsburgh Healthcare Syst, Div Cardiol, Pittsburgh, PA 15240 USA. [Hashash, Jana G.] Univ Pittsburgh, Dept Internal Med, Med Ctr, Pittsburgh, PA USA. RP Shalaby, AA (reprint author), VA Pittsburgh Healthcare Syst, Univ Dr Div, 111C-U, Pittsburgh, PA 15240 USA. EM alaa.shalaby@va.gov NR 41 TC 22 Z9 23 U1 0 U2 2 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 AUG PY 2010 VL 33 IS 8 BP 466 EP 475 DI 10.1002/clc.20803 PG 10 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 645RM UT WOS:000281482200002 PM 20734443 ER PT J AU Melmed, GY Spiegel, BM Bressler, B Cheifetz, AS Devlin, SM Harrell, LE Irving, PM Jones, J Kaplan, GG Kozuch, PL Velayos, FS Baidoo, L Sparrow, MP Siegel, CA AF Melmed, Gil Y. Spiegel, Brennan M. Bressler, Brian Cheifetz, Adam S. Devlin, Shane M. Harrell, Laura E. Irving, Peter M. Jones, Jennifer Kaplan, Gilaad G. Kozuch, Patricia L. Velayos, Fernando S. Baidoo, Leonard Sparrow, Miles P. Siegel, Corey A. TI The Appropriateness of Concomitant Immunomodulators With Anti-Tumor Necrosis Factor Agents for Crohn's Disease: One Size Does Not Fit All SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article DE Crohn's Disease; Inflammatory Bowel Disease; Infliximab; Adalimumab; Certolizumab; Anti-Tumor Necrosis alpha Therapy ID INFLAMMATORY-BOWEL-DISEASE; T-CELL LYMPHOMA; MAINTENANCE INFLIXIMAB; CERTOLIZUMAB PEGOL; RANDOMIZED-TRIAL; THERAPY; ADALIMUMAB; EFFICACY AB BACKGROUND & AIMS: There is no consensus on the appropriateness of concomitant immunomodulators with antitumor necrosis factor (TNF) therapy for Crohn's disease Some patients benefit from concomitant immunomodulators, but concerns related to infections and lymphoma risk have dampened enthusiasm for this approach We applied the RAND/University of California Los Angeles Appropriateness Method toward establishing appropriateness of concomitant immunomodulators and anti-TNF therapies for Crohn's disease METHODS: A literature review was conducted regarding efficacy and safety of concomitant immunomodulators in the setting of anti-TNF therapy for Crohn's disease and presented to the Building Research in Inflammatory Bowel Disease Globally group, a globally diverse panel of 13 gastroenterologists clinically experienced in inflammatory bowel disease A total of 134 scenarios were constructed using several clinical variables Panelists used a modified Delphi method to rate the appropriateness of concomitant immunomodulators, and met to discuss and re-rate appropriateness Disagreement was assessed using a validated index RESULTS: Concomitant immunomodulators were generally rated appropriate for 63 scenarios, uncertain for 60 scenarios, and inappropriate for 11 scenarios In general, concomitant immunomodulators were appropriate for those with extensive disease, shorter duration of disease, perianal involvement, prior surgery, females, and older patients (>26 y) Concomitant immunomodulators were generally rated inappropriate for young males, and in some scenarios involving uncomplicated disease Smoking and the particular anti-TNF medication did not Influence ratings Disagreement was observed in 6 of 134 scenarios CONCLUSIONS: The appropriateness of concomitant immunomodulators with anti-TNF therapy for Crohn's disease was determined through a modified Delphi panel approach based on expert interpretation of the available literature. Clinicians should consider multiple factors when considering concomitant immunomodulators with anti-TNF treatment. C1 [Melmed, Gil Y.] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. [Spiegel, Brennan M.] Univ Calif Los Angeles, Los Angeles Vet Adm Ctr Outcomes Res & Educ, VA Greater Los Angeles Healthcare Syst, Ctr Ulcer Res & Educ,Digest Dis Res Ctr, Los Angeles, CA USA. [Melmed, Gil Y.; Spiegel, Brennan M.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Bressler, Brian] Univ British Columbia, Vancouver, BC V5Z 1M9, Canada. [Cheifetz, Adam S.] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Boston, MA 02215 USA. [Devlin, Shane M.; Kaplan, Gilaad G.] Univ Calgary, Calgary, AB T2N 1N4, Canada. [Harrell, Laura E.] Univ Chicago, Chicago, IL 60637 USA. [Irving, Peter M.] Guys Hosp, London SE1 9RT, England. [Irving, Peter M.] St Thomas Hosp, London, England. [Jones, Jennifer] Univ Saskatchewan, Saskatoon, SK, Canada. [Kozuch, Patricia L.] Thomas Jefferson Univ, Philadelphia, PA 19107 USA. [Velayos, Fernando S.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Baidoo, Leonard] Univ Pittsburgh, Pittsburgh, PA USA. [Sparrow, Miles P.] Alfred Hosp, Dept Gastroenterol, Melbourne, Vic, Australia. [Siegel, Corey A.] Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USA. RP Melmed, GY (reprint author), Cedars Sinai Med Ctr, 8635 W 3rd St,960-W, Los Angeles, CA 90048 USA. OI kozuch, patricia/0000-0002-7465-9671; Kaplan, Gilaad/0000-0003-2719-0556 FU Centocor; Setpoint; Amgen; Celgene; Elan; PG; AstraZeneca; Bristol Meyer Squibb; Salix; Takeda; Rose Pharmaceuticals; Prometheus; Schering-Plough Canada; UCB Pharma; Shire; Abbott; Ferring Pharmaceuticals; Abbott Pharmaceuticals; Proctor and Gamble Pharmaceuticals; Crohn's and Colitis Foundation of America; National Institute of Diabetes and Digestive and Kidney Diseases [K23DK078678]; National Institutes of Health/NCRR/OD [KL2 RR024130] FX These authors disclose the following: Gil Melmed was a consultant and/or received research support from Centocor, Setpoint, Amgen, and Celgene, was on the speakers bureaus of Abbott. P&G. and Shire, and was on the advisory board of UCB: Corey Siegel was on the advisory boards of Abbott. UCB, and P&G, was a consultant and received research support from Elan and P&G. and performed CME activities for Abbott and UCB; Brennan Spiegel received research funding from AstraZeneca, Amgen, Bristol Meyer Squibb, Salix, Takeda, Rose Pharmaceuticals, and Prometheus, and was on the advisory Boards of Takeda. Prometheus, and Ironwood, Brian Bressler was on the advisory boards of Abbott. Schering-Plough Canada, UCB, Shire. P&G. and Ferring, and was on the speaker's bureaus of Abbott, Schering-Plough Canada, and Shire. Adam Cheifetz was on the speaker's bureau of Centocor, UCB, and Abbott, and the advisory boards of Abbott and UCB. Jennifer Jones was a consultant, on the speaker's bureaus, and received educational funding from Schering-Plough Canada, UCB Pharma, Shire, P&G, and Abbott. Miles Sparrow received research support from Ferring Pharmaceuticals and Abbott Pharmaceuticals, and was on the advisory board of Schering-Plough Pharmaceuticals; Fernando Velayos was on the speaker's bureau of Centocor, Peter Irving was on the advisory board and speaker's bureau of Abbott; Shane Devlin was on the speaker's bureaus for Schering-Plough and Abbott, and on the advisory boards for Abbott, Centocor, and UCB; Gilaad Kaplan was on the advisory boards of Schering-Plough. Abbott, UCB, and Shire. and Laura Harrell was a consultant for Abbott The remaining authors disclose no conflicts.; Unrestricted funding for the in-person Dallas RAND Appropriateness Panel meeting generously was provided by Proctor and Gamble Pharmaceuticals Unrestricted funding for the Building Research in Inflammatory Bowel Disease Globally group is provided by Abbott, Shire, and Proctor and Gamble Pharmaceuticals,; Dr Kaplan is a Canadian Institutes of Health Research New Investigator and an Alberta Heritage Foundation for Medical Research Population Health Investigator; Dr Harrell is supported by a Crohn's and Colitis Foundation of America Career Development Award: Dr Siegel is supported by a Crohn's and Colitis Foundation of America Career Development Award and by grant number K23DK078678 from the National Institute of Diabetes and Digestive and Kidney Diseases. Dr Velayos is supported by a Crohn's and Colitis Foundation of America Career Development Award and the National Institutes of Health/NCRR/OD UCSF-CTSI award (KL2 RR024130) NR 20 TC 24 Z9 24 U1 0 U2 2 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 2010 VL 8 IS 8 BP 655 EP 659 DI 10.1016/j.cgh.2010.04.023 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 638YX UT WOS:000280938200007 PM 20451665 ER PT J AU Kanwal, F Kramer, J Asch, SM El-Serag, H Spiegel, BMR Edmundowicz, S Sanyal, AJ Dominitz, JA McQuaid, KR Martin, P Keeffe, EB Friedman, LS Ho, SB Durazo, F Bacon, BR AF Kanwal, Fasiha Kramer, Jennifer Asch, Steven M. El-Serag, Hashem Spiegel, Brennan M. R. Edmundowicz, Steven Sanyal, Arun J. Dominitz, Jason A. McQuaid, Kenneth R. Martin, Paul Keeffe, Emmet B. Friedman, Lawrence S. Ho, Samuel B. Durazo, Francisco Bacon, Bruce R. TI An Explicit Quality Indicator Set for Measurement of Quality of Care in Patients With Cirrhosis SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article DE Quality of Care; Cirrhosis; Delphi Panel; Performance Measures ID PORTAL-HYPERTENSION; LIVER-TRANSPLANTATION; RHEUMATOID-ARTHRITIS; VARICEAL HEMORRHAGE; ADULT PATIENTS; MANAGEMENT; GUIDELINES; DIAGNOSIS; WORKSHOP; ASCITES AB BACKGROUND & AIMS: Cirrhosis is a prevalent and expensive condition With an increasing emphasis on quality in health care and recognition of inconsistencies in the management of patients with cirrhosis, we established a set of explicit quality indicators (QIs) for their treatment METHODS: We organized an 11-member, multidisciplinary expert panel and followed modified Delphi methods to systematically identify a set of QIs for cirrhosis We provided the panel with a report that summarized the results of a comprehensive literature review of data linking candidate QIs to outcomes The panel performed independent ratings of each candidate QI by using a standard 9-point RAND appropriateness scale (RAS) (ranging from 1 = not appropriate to 9 = most appropriate) The panel members then met, reviewed the ratings, and voted again by using an iterative process of discussion The final set of QIs was selected, QIs had a median RAS >7, and panel members agreed on those selected RESULTS: Among 169 candidate QIs, the panel rated 41 QIs as valid measures of quality care The selected QIs cover 6 domains of care including ascites (13 QIs), variceal bleeding (18 QIs), hepatic encephalopathy (4 QIs), hepatocellular cancer (1 QI), liver transplantation (2 QIs), and general cirrhosis care (3 QIs) Content coverage included prevention, diagnosis, treatment, timeliness, and follow-up CONCLUSIONS: We developed an explicit set of evidence-based QIs for treatment of cirrhosis. These provide physicians and institutions with a tool to identify processes amenable to quality improvement. This tool is intended to be applicable in any setting where care for patients with cirrhosis is provided. C1 [Kanwal, Fasiha] St Louis Vet Adm VA, St Louis, MO USA. [Kanwal, Fasiha; Bacon, Bruce R.] St Louis Univ, Sch Med, Dept Gastroenterol & Hepatol, St Louis, MO 63141 USA. [Kramer, Jennifer; El-Serag, Hashem] Michael E DeBakey VA Med Ctr, Houston, TX USA. [Kramer, Jennifer; El-Serag, Hashem] Baylor Coll Med, Dept Med, Div Gastroenterol, Houston, TX 77030 USA. [Asch, Steven M.; Spiegel, Brennan M. R.] Greater Los Angeles VA Healthcare Syst, Dept Med & Hlth Serv Res, Los Angeles, CA USA. [Asch, Steven M.; Spiegel, Brennan M. R.; Durazo, Francisco] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. [Edmundowicz, Steven] Washington Univ, Sch Med, St Louis, MO USA. [Sanyal, Arun J.] Virginia Commonwealth Univ, Med Ctr, Dept Internal Med, Div Gastroenterol Hepatol & Nutr, Richmond, VA USA. [Dominitz, Jason A.] Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Seattle, WA USA. [McQuaid, Kenneth R.] Univ Calif San Francisco, Vet Affairs Med Ctr, San Francisco, CA 94143 USA. [McQuaid, Kenneth R.] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. [Martin, Paul] Univ Miami, Sch Med, Div Gastroenterol & Hepatol, Miami, FL USA. [Keeffe, Emmet B.] Stanford Univ, Med Ctr, Stanford, CA 94305 USA. [Friedman, Lawrence S.] Newton Wellesley Hosp, Dept Med, Newton, MA USA. [Ho, Samuel B.] VA San Diego Healthcare Syst, Dept Med, San Diego, CA USA. [Ho, Samuel B.] Univ Calif San Diego, San Diego, CA 92103 USA. [Durazo, Francisco] Univ Calif Los Angeles, David Geffen Sch Med, UCLA Dumont Liver Transplant Ctr, Los Angeles, CA 90095 USA. RP Kanwal, F (reprint author), St Louis VA Med Ctr, 915 N Grand,111 JC GI, St Louis, MO 63141 USA. EM fkanwal@yahoo.com OI Edmundowicz, Steven/0000-0002-6541-3485; Dominitz, Jason/0000-0002-8070-7086 FU American Society for Gastrointestinal Endoscopy; American College of Gastroenterology FX This material is based on work supported by the 2008 American Society for Gastrointestinal Endoscopy Quality of Care Award and by the 2009 American College of Gastroenterology Clinical Research Award. NR 31 TC 46 Z9 46 U1 0 U2 4 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 2010 VL 8 IS 8 BP 709 EP 717 DI 10.1016/j.cgh.2010.03.028 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 638YX UT WOS:000280938200016 PM 20385251 ER PT J AU Chang, KM AF Chang, Kyong-Mi TI Hepatitis B Immunology for Clinicians SO CLINICS IN LIVER DISEASE LA English DT Article DE Hepatitis B; Innate immunity; Adaptive immunity; Regulatory T cells; Costimulation; Pathogenesis; Programmed death 1 ID REGULATORY T-CELLS; PLASMACYTOID DENDRITIC CELLS; NATURAL-KILLER-CELLS; ADAPTIVE IMMUNE-RESPONSES; ACUTE VIRAL-HEPATITIS; CHRONIC HBV INFECTION; VIRUS-INFECTION; LIVER-DAMAGE; LYMPHOCYTE RESPONSE; ANTIVIRAL THERAPY AB Hepatitis B virus (HBV) is a hepatotrophic DNA virus that causes acute and chronic hepatitis. Despite an effective vaccine, more than 350 million people are chronically infected with HBV worldwide and are at risk for progressive liver disease. There are marked geographic variations in HBV prevalence (ranging from 0.1% to 2% in low prevalence areas and 10% to 20% in high prevalence areas) related to the timing and mode of HBV exposure. In many developed countries, HBV exposure typically occurs in adults via sexual transmission with a low chronicity rate (5%). In regions with high HBV prevalence (eg, Asia, sub-Saharan Africa), HBV exposure tends to occur in the perinatal period (eg, vertical transmission from mother to infant) with a high rate of persistence in the absence of timely vaccination. The course of viral infection is defined by the interplay between the virus and host immune defense. This article introduces the innate and adaptive immune defense mechanisms in general and as related to HBV. In particular, the current concepts regarding the innate and adaptive immune components contributing to the clinical, virologic and therapeutic outcome in acute and chronic hepatitis B are examined. C1 [Chang, Kyong-Mi] Philadelphia VA Med Ctr, Div Gastroenterol, Philadelphia, PA 19104 USA. [Chang, Kyong-Mi] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Chang, KM (reprint author), Philadelphia VA Med Ctr, Div Gastroenterol, A412-A424 Med Res Bldg, Philadelphia, PA 19104 USA. EM kmchang@mail.med.upenn.edu FU NIH [UO1 DK082866, RO1 AI047519] FX This work was supported in part by NIH UO1 DK082866 and NIH RO1 AI047519 NR 82 TC 7 Z9 7 U1 0 U2 5 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1089-3261 J9 CLIN LIVER DIS JI Clin. Liver Dis. PD AUG PY 2010 VL 14 IS 3 BP 409 EP + DI 10.1016/j.cld.2010.05.012 PG 18 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 639OP UT WOS:000280984400004 PM 20638022 ER PT J AU Patterson, JE Malani, PN Maragakis, LL AF Patterson, Jan E. Malani, Preeti N. Maragakis, Lisa L. TI Infection control in the intensive care unit: Progress and challenges in systems and accountability SO CRITICAL CARE MEDICINE LA English DT Article ID SAFETY NETWORK AB Attention to the improvement of safety in healthcare lately has focused on healthcare-associated infections, including many that occur in the intensive care unit, such as catheter-related bloodstream infections and ventilator-associated pneumonias. Great strides have been made in decreasing the rates of intensive care unit hospital-acquired infections in the past decade. This is attributable to a number of factors, including standardization of care, technological advances, provider payment reform, and consumer activism. Teamwork and communication remain the most important facets in patient safety. The papers in this supplement examine the roles of human factors and process engineering, survey a spectrum of infection control and safety challenges encountered by critical care practitioners, and assess the future challenges for continued improvement in our systems of care. (Crit Care Med 2010; 38[Suppl.]:S265-S268) C1 [Patterson, Jan E.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Patterson, Jan E.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Malani, Preeti N.] Univ Michigan Hlth Syst, Vet Affairs Ann Arbor Healthcare Syst, Ann Arbor, MI USA. [Malani, Preeti N.] Geriatr Res Educ & Clin Ctr, Ann Arbor, MI USA. [Maragakis, Lisa L.] Johns Hopkins Univ, Sch Med, Baltimore, MD USA. RP Patterson, JE (reprint author), Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. EM pattersonj@uthscsa.edu FU Basilea; Merck; Pfizer; Schering-Plough FX Dr. Patterson disclosed that her spouse received grant support from Basilea, Merck, Pfizer, and Schering-Plough and is a consultant for Merck, Pfizer, and Basilea. The remaining authors did not disclose any potential conflicts of interest. NR 28 TC 5 Z9 7 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD AUG PY 2010 VL 38 IS 8 SU S BP S265 EP S268 DI 10.1097/CCM.0b013e3181e69d48 PG 4 WC Critical Care Medicine SC General & Internal Medicine GA 628IP UT WOS:000280112100001 PM 20647783 ER PT J AU Jung, HJ Yang, MZ Kwon, KH Yenari, MA Choi, YJ Lee, WT Park, KA Lee, JE AF Jung, Hyun Joo Yang, Mei Zi Kwon, Ki Hyo Yenari, Midori A. Choi, Yoon Jung Lee, Won Taek Park, Kyung Ah Lee, Jong Eun TI Endogenous Agmatine Inhibits Cerebral Vascular Matrix Metalloproteinases Expression by Regulating Activating Transcription Factor 3 and Endothelial Nitric Oxide Synthesis SO CURRENT NEUROVASCULAR RESEARCH LA English DT Article DE Arginine decarboxylase; agmatine; activating transcription factor 3; endothelial cell; matrix metalloproteinases; endothelial nitric oxide synthase ID BLOOD-BRAIN-BARRIER; ALPHA-INDUCED APOPTOSIS; RETINAL GANGLION-CELLS; RAT-BRAIN; TISSUE INHIBITORS; ATF3 EXPRESSION; MULTIPLE ROLES; C-JUN; ISCHEMIA; MATRIX-METALLOPROTEINASE-9 AB Earlier investigations from our laboratory demonstrated that the expression of matrix metalloproteinases (MMPs) was down-regulated by exogenously administered agmatine against ischemia-like injuries in the murine brain capillary endothelial (bEnd.3) cells. In our present study, we intended to investigate the mechanism involved in the inhibition of MMPs in bEnd.3 cells infected with retroviral containing human arginine decarboxylase (hADC) gene which can synthesize agmatine endogenously (ADC Delta bEnd.3 cells). The ADC Delta bEnd.3 cells were subjected to oxygen glucose deprivation (OGD, 6 hrs) with reperfusion (18 hrs). High performance liquid chromatography (HPLC) analysis revealed the high levels of agmatine in the ADC Delta bEnd.3 cells compared to other experimental groups. The results demonstrated significant decrease in cell death and increase in the nitric oxide (NO) production in the ADC Delta bEnd.3 cells. The increased expression of MMP-2 and MMP-9, and decreased expression of endothelial nitric oxide synthase (eNOS) by ischemic injury was attenuated in ADC Delta bEnd.3 cells. Moreover, the expression of activating transcription factor 3 (ATF3) was increased significantly in ADC Delta bEnd.3 cells. In addition, the suppression of the MMP-2 and MMP-9 expression in ADC Delta bEnd.3 cells was prevented with ATF3 small interfering RNA (siRNA) treatment. These results suggest that the endogenous agmatine in ADC Delta bEnd.3 cells inhibits the MMPs expression mediated via the regulation of eNOS, NO and ATF3. C1 [Jung, Hyun Joo; Kwon, Ki Hyo; Choi, Yoon Jung; Lee, Won Taek; Park, Kyung Ah; Lee, Jong Eun] Yonsei Univ, Coll Med, Dept Anat, Seoul 120752, South Korea. [Jung, Hyun Joo; Yang, Mei Zi; Lee, Jong Eun] Yonsei Univ, Coll Med, BK Project Med Sci 21, Seoul 120752, South Korea. [Yang, Mei Zi] Binzhou Med Univ, Yantai 264003, Peoples R China. [Yenari, Midori A.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Yenari, Midori A.] San Francisco VA Med Ctr, San Francisco, CA USA. RP Lee, JE (reprint author), Yonsei Univ, Coll Med, Dept Anat, 134 Shinchon Dong, Seoul 120752, South Korea. EM jelee@yumc.yonsei.ac.kr OI Lee, Jong Eun/0000-0001-6203-7413 FU Korea government (MEST) [2009-0052626] FX This work was supported by the Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea government (MEST) (No. 2009-0052626). NR 60 TC 13 Z9 13 U1 0 U2 3 PU BENTHAM SCIENCE PUBL LTD PI SHARJAH PA EXECUTIVE STE Y26, PO BOX 7917, SAIF ZONE, 1200 BR SHARJAH, U ARAB EMIRATES SN 1567-2026 J9 CURR NEUROVASC RES JI Curr. Neurovasc. Res. PD AUG PY 2010 VL 7 IS 3 BP 201 EP 212 PG 12 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 633MG UT WOS:000280506500004 PM 20560878 ER PT J AU Markland, AD Greer, WJ Vogt, A Redden, DT Goode, PS Burgio, KL Richter, HE AF Markland, Alayne D. Greer, W. Jerod Vogt, Alicia Redden, David T. Goode, Patricia S. Burgio, Kathryn L. Richter, Holly E. TI Factors Impacting Quality of Life in Women With Fecal Incontinence SO DISEASES OF THE COLON & RECTUM LA English DT Article DE Bowel symptoms; Fecal incontinence; Quality of life; Urinary incontinence; Women ID URINARY-INCONTINENCE; ANAL INCONTINENCE; SEVERITY INDEX; RISK-FACTORS; PREVALENCE; COMMUNITY; ADULTS; OLDER; SYMPTOMS; RELIABILITY AB PURPOSE: The aim of this study was to characterize differences in health-related quality of life among women presenting for treatment of fecal incontinence. METHODS: Among 155 women presenting for treatment of fecal incontinence in a specialty clinic, validated questionnaires measured impact on quality of life (Modified Manchester Health Questionnaire) and severity (the Fecal Incontinence Severity Index). Bowel symptoms, including frequency, urgency, and stool consistency, were ascertained. Comorbid diseases were self-reported. Linear regression models were constructed from significant univariate variables to examine differences observed in quality of life scores. RESULTS: The average age was 58.7 +/- 11.5 years, with no differences found in quality of life scores according to race, body mass index, or number of vaginal deliveries (P > .05). Younger age, increased urinary incontinence symptoms, prior cholecystectomy, prior hysterectomy, and severity of bowel symptoms correlated with a negative impact on quality of life in univariate analysis (P < .05). Average severity scores were 30.5 +/- 13.7, with moderate correlation seen with increasing severity and quality of life scores (R(2) = 0.60). After controlling for severity, women had increased quality of life scores with more bowel urgency (15 points; 95% CI, 8.1-21.2), harder stool consistency (10 points; 95% CI, 3.8-16.3), and prior hysterectomy (9 points; 95% CI, 2.7-15.4). CONCLUSION: Bowel symptoms and having undergone a hysterectomy had the greatest negative impact on quality of life in women seeking treatment for fecal incontinence. Targeting individualized treatments to improve bowel symptoms may improve quality of life for women with fecal incontinence. C1 [Markland, Alayne D.; Redden, David T.; Goode, Patricia S.; Burgio, Kathryn L.] Birmingham Atlanta Geriatr Res Educ & Clin Ctr, Dept Vet Affairs Med Ctr, Birmingham, AL USA. [Markland, Alayne D.; Goode, Patricia S.; Burgio, Kathryn L.] Univ Alabama, Dept Med, Div Gerontol Geriatr & Palliat Care, Birmingham, AL 35294 USA. [Greer, W. Jerod; Vogt, Alicia; Richter, Holly E.] Univ Alabama, Dept Obstet & Gynecol, Div Womens Pelv Med & Reconstruct Surg, Birmingham, AL 35294 USA. [Redden, David T.] Univ Alabama, Birmingham Sch Publ Hlth, Birmingham, AL USA. RP Markland, AD (reprint author), Birmingham VA Med Ctr, GRECC 11G, 700 19th St S, Birmingham, AL 35233 USA. EM amarkland@aging.uab.edu OI Markland, Alayne/0000-0002-6567-6744 FU National Institutes of Health [K24DK068389-03]; Veterans Health Administration [CDA-2]; Hartford/Southeast Center of Excellence in Geriatric Medicine FX This work was supported by National Institutes of Health grant K24DK068389-03 to Dr Richter; Veterans Health Administration Career Development Award (CDA-2) to Dr Markland; and a Hartford/Southeast Center of Excellence in Geriatric Medicine Grant to Dr Markland. NR 27 TC 11 Z9 11 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0012-3706 J9 DIS COLON RECTUM JI Dis. Colon Rectum PD AUG PY 2010 VL 53 IS 8 BP 1148 EP 1154 DI 10.1007/DCR.0b013e3181d5da6c PG 7 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 625DF UT WOS:000279872600009 PM 20628278 ER PT J AU Green, TC Kershaw, T Lin, HQ Heimer, R Goulet, JL Kraemer, KL Gordon, AJ Maisto, SA Day, NL Bryant, K Fiellin, DA Justice, AC AF Green, Traci C. Kershaw, Trace Lin, Haiqun Heimer, Robert Goulet, Joseph L. Kraemer, Kevin L. Gordon, Adam J. Maisto, Steve A. Day, Nancy L. Bryant, Kendall Fiellin, David A. Justice, Amy C. TI Patterns of drug use and abuse among aging adults with and without HIV: A latent class analysis of a US Veteran cohort SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE Aging; Veterans; HIV; Substance-related disorders; Latent class analysis; Illicit drugs; Cohort studies ID ACTIVE ANTIRETROVIRAL THERAPY; SUBSTANCE USE DISORDERS; VIRUS-INFECTED VETERANS; HEALTH-CARE UTILIZATION; NEW-YORK-CITY; DEVELOPMENTAL TRAJECTORIES; YOUNG ADULTHOOD; UNITED-STATES; MARIJUANA USE; OLDER-ADULTS AB This study characterized the extent and patterns of self-reported drug use among aging adults with and without HIV, assessed differences in patterns by HIV status, and examined pattern correlates. Data derived from 6351 HIV-infected and uninfected adults enrolled in an eight-site matched cohort, the Veterans Aging Cohort Study (VACS). Using clinical variables from electronic medical records and socio-demographics, drug use consequences, and frequency of drug use from baseline surveys, we performed latent class analyses (LCA) stratified by HIV status and adjusted for clinical and socio-demographic covariates. Participants were, on average, age 50 (range 22-86), primarily male (95%) and African-American (64%). Five distinct patterns emerged: non-users, past primarily marijuana users, past multidrug users, current high consequence multidrug users, and current low consequence primarily marijuana users. HIV status strongly influenced class membership. Non-users were most prevalent among HIV uninfected (36.4%) and current high consequence multidrug users (25.5%) were most prevalent among HIV-infected. While problems of obesity marked those not currently using drugs, current users experienced higher prevalences of medical or mental health disorders. Multimorbidity was highest among past and current multidrug users. HIV-infected participants were more likely than HIV-uninfected participants to be current low consequence primarily marijuana users. In this sample, active drug use and abuse were common. HIV-infected and uninfected Veterans differed on extent and patterns of drug use and on important characteristics within identified classes. Findings have the potential to inform screening and intervention efforts in aging drug users with and without HIV. (C) 2010 Elsevier Ireland Ltd. All rights reserved. C1 [Green, Traci C.; Kershaw, Trace] Yale Univ, Sch Publ Hlth, Div Chron Dis Epidemiol, New Haven, CT USA. [Green, Traci C.; Kershaw, Trace; Heimer, Robert; Goulet, Joseph L.; Fiellin, David A.; Justice, Amy C.] Yale Ctr Interdisciplinary Res AIDS, New Haven, CT USA. [Lin, Haiqun] Yale Univ, Sch Publ Hlth, Div Biostat, New Haven, CT USA. [Heimer, Robert] Yale Univ, Sch Publ Hlth, Div Epidemiol Microbial Dis, New Haven, CT USA. [Goulet, Joseph L.; Justice, Amy C.] Vet Affairs Connecticut Healthcare Syst, West Haven, CT USA. [Goulet, Joseph L.; Fiellin, David A.; Justice, Amy C.] Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06510 USA. [Kraemer, Kevin L.; Gordon, Adam J.] Univ Pittsburgh, Sch Med, Div Gen Internal Med, Ctr Res Hlth Care, Pittsburgh, PA USA. [Gordon, Adam J.] VA Pittsburgh Healthcare Syst, Mental Illness Res Educ & Clin Ctr Comorbid VISN, Pittsburgh, PA USA. [Gordon, Adam J.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Maisto, Steve A.] Syracuse Univ, Dept Psychol, Ctr Hlth & Behav, Syracuse, NY USA. [Day, Nancy L.] Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA. [Bryant, Kendall] NIAAA, Bethesda, MD USA. [Fiellin, David A.] Yale Univ, Sch Med, Investigat Med Program, New Haven, CT USA. RP Green, TC (reprint author), 111 Plain St Bldg,Rm 111, Providence, RI 02903 USA. EM traci.c.green@brown.edu RI Day, Nancy/H-3171-2016 OI Goulet, Joseph/0000-0002-0842-804X; Fiellin, David/0000-0002-4006-010X FU National Institutes of Health, National Institute on Drug Abuse [1F31DA023862-01A1]; National Institute on Alcohol Abuse and Alcoholism [U10 AA 13566]; VHA Public Health Strategic Health Core Group FX Research for this manuscript was supported by the National Institutes of Health, National Institute on Drug Abuse grant 1F31DA023862-01A1 to TCG. The Veterans Aging Cohort Study funded by: National Institute on Alcohol Abuse and Alcoholism (U10 AA 13566) and VHA Public Health Strategic Health Core Group. The funding sources had no further involvement in the study design, data collection, analysis, writing, preparation or decision to submit this manuscript for publication. NR 94 TC 37 Z9 37 U1 2 U2 11 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0376-8716 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD AUG 1 PY 2010 VL 110 IS 3 BP 208 EP 220 DI 10.1016/j.drugalcdep.2010.02.020 PG 13 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 634ZU UT WOS:000280626200005 PM 20395074 ER PT J AU Marder, S Buchanan, RW AF Marder, S. Buchanan, R. W. TI NIMH/FDA guidelines for clinical trials for cognition in schizophrenia: how much have we advanced? SO EUROPEAN NEUROPSYCHOPHARMACOLOGY LA English DT Meeting Abstract CT 23rd Congress Meeting of European-College-of-Neuropsychopharmacology CY AUG 28-SEP 01, 2010 CL Amsterdam, NETHERLANDS SP European Coll Neuropsychopharmacol C1 [Marder, S.] W Los Angeles VA Hlth Care Ctr, Los Angeles, CA USA. [Buchanan, R. W.] Maryland Psychiat Res Ctr, Baltimore, MD 21228 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0924-977X J9 EUR NEUROPSYCHOPHARM JI Eur. Neuropsychopharmacol. PD AUG PY 2010 VL 20 SU 3 BP S194 EP S194 PG 1 WC Clinical Neurology; Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 673UB UT WOS:000283687800091 ER PT J AU Ho, L Pasinetti, GM AF Ho, Lap Pasinetti, Giulio Maria TI Polyphenolic compounds for treating neurodegenerative disorders involving protein misfolding SO EXPERT REVIEW OF PROTEOMICS LA English DT Review DE Alzheimer's disease; beta-amyloid; grape seed polyphenolic extract; Huntington's disease; neurodegenerative disorders; Parkinson's disease; polyphenols; tau; tauopathy ID ALZHEIMER TRANSGENIC MICE; PAIRED HELICAL FILAMENTS; ALPHA-SYNUCLEIN; IN-VITRO; GRAPE SEED; HUNTINGTONS-DISEASE; PARKINSONS-DISEASE; TAU PATHOLOGY; AGGREGATION; TAUOPATHIES AB A diverse group of neurodegenerative diseases are characterized by progressive, age-dependent intracellular formation of misfolded protein aggregates. These include Alzheimer's disease, Huntington's disease, Parkinson's disease and a number of tau-mediated disorders. There is no effective treatment for any of these disorders; currently approved interventions are designed to treat disease symptoms and generally lead to modest modulation of clinical symptoms. None are known to mitigate underlying neuropathologic mechanisms and, thus, it is not unexpected that existing treatments appear ineffective in modulating disease progression. We note that these neurodegenerative disorders all share a common mechanistic theme in that depositions of misfolded protein in the brain is a key molecular feature underlying disease onset and/or progression. While previous studies have identified a number of drugs and nutraceuticals capable of interfering with the formation and/or stability of misfolded protein aggregates, none have been demonstrated to be effective in vivo for treating any of the neurodegenerative disorders. We hereby review accumulating evidence that a select nutraceutical grape-seed polyphenolic extract (GSPE) is effective in vitro and in vivo in mitigating certain misfolded protein-mediated neuropathologic and clinical phenotypes. We will also review evidence implicating bioavailability of GSPE components in the brain and the tolerability as well as safety of GSPE in animal models and in humans. Collectively, available information supports continued development of the GSPE for treating a variety of neurodegenerative disorders involving misfolded protein-mediated neuropathologic mechanisms. C1 [Ho, Lap; Pasinetti, Giulio Maria] Mt Sinai Sch Med, Ctr Excellence Novel Approaches Neurodiagnost & N, Ctr Excellence Res Complementary & Alternat Med A, Dept Neurol,Brain Inst, New York, NY 10029 USA. [Pasinetti, Giulio Maria] James J Peters Vet Affairs Med Ctr, Geriatr Res Educ & Clin Ctr, Bronx, NY 10468 USA. RP Pasinetti, GM (reprint author), Mt Sinai Sch Med, Ctr Excellence Novel Approaches Neurodiagnost & N, Ctr Excellence Res Complementary & Alternat Med A, Dept Neurol,Brain Inst, 1 Gustave L Levy Pl,Box 1137, New York, NY 10029 USA. EM giulio.pasinetti@mssm.edu NR 45 TC 13 Z9 13 U1 3 U2 14 PU EXPERT REVIEWS PI LONDON PA UNITEC HOUSE, 3RD FL, 2 ALBERT PLACE, FINCHLEY CENTRAL, LONDON N3 1QB, ENGLAND SN 1478-9450 J9 EXPERT REV PROTEOMIC JI Expert Rev. Proteomics PD AUG PY 2010 VL 7 IS 4 BP 579 EP 589 DI 10.1586/EPR.10.69 PG 11 WC Biochemical Research Methods SC Biochemistry & Molecular Biology GA 637BH UT WOS:000280788800015 PM 20653511 ER PT J AU Anelli, V Gault, CR Snider, AJ Obeid, LM AF Anelli, Viviana Gault, Christopher R. Snider, Ashley J. Obeid, Lina M. TI Role of sphingosine kinase-1 in paracrine/transcellular angiogenesis and lymphangiogenesis in vitro SO FASEB JOURNAL LA English DT Article ID ENDOTHELIAL GROWTH-FACTOR; SIGNALING PATHWAYS; MOLECULAR-CLONING; FUNCTIONAL-CHARACTERIZATION; EXTRACELLULAR RELEASE; MASS-SPECTROMETRY; POOR SURVIVAL; G-PROTEIN; VEGF-C; 1-PHOSPHATE AB Sphingosine-1-phosphate (S1P) is an important bioactive sphingolipid involved in angiogenesis and lymphangiogenesis, 2 important processes that influence the growth, survival, and spread of tumors. S1P acts as an extracellular mediator through binding to 5 highly specific S1P receptors, S1P(1-5). Sphingosine kinase-1 (SK1), one of 2 known sphingosine kinase enzymes responsible for S1P production, appears to be overexpressed in many tumors. Although a role for S1P in angiogenesis and lymphangiogenesis has been established, it is unclear whether S1P secreted from cancer cells has a paracrine function in a tumor environment. Here we investigated whether modulation of cellular SK1 could initiate a paracrine angiogenic and lymphangiogenic switch. We found that SK1 overexpression in HEK cells or its down-regulation in glioma or breast cancer cells modulated extracellular S1P levels accordingly, which in turn increased or decreased both migration and tube formation in cocultured vascular or lymphatic endothelial cells. In contrast, down-regulation of sphingosine kinase 2 in both glioma and breast cancer cells had no appreciable effect on cellular or secreted S1P levels. In addition, vascular endothelial growth factors VEGF and VEGF-C down-regulation in cancer cells appeared insufficient to block the angiogenic and lymphangiogenic switch triggered by these cells. Moreover, S1P initiated endothelial cell sprouting in 3-dimensional collagen matrices, which is representative of a multistep angiogenic process. Our data collectively demonstrate for the first time that SK1 plays an essential role in regulating in vitro paracrine angiogenesis and lymphangiogenesis.-Anelli, V., Gault, C. R., Snider, A.J., Obeid, L. M. Role of sphingosine kinase-1 in paracrine/transcellular angiogenesis and lymphangiogenesis in vitro. FASEB J. 24, 2727-2738 (2010). www.fasebj.org C1 [Obeid, Lina M.] Med Univ S Carolina, Div Gen Internal Med Geriatr, Dept Med, Charleston, SC 29425 USA. [Anelli, Viviana; Obeid, Lina M.] Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. [Anelli, Viviana] Univ Milan, Dept Med Chem Biochem & Biotechnol, Milan, Italy. [Obeid, Lina M.] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Obeid, LM (reprint author), Med Univ S Carolina, Div Gen Internal Med Geriatr, Dept Med, MSC 779, Charleston, SC 29425 USA. EM obeidl@musc.edu OI obeid, lina/0000-0002-0734-0847 FU National Institutes of Health [NIH/NIGMS GM062887, NIH/NCI CA097132, NIH/P20 RR17677]; Hollings Cancer Center [P30-CA-56036] FX The authors thank Kathy Wiita-Fisk for administrative assistance. The authors also thank the Lipidomics Core at the Medical University of South Carolina. Grant support came from National Institutes of Health grants NIH/NIGMS GM062887 (L.M.O.), NIH/NCI CA097132 (L.M.O.), NIH/P20 RR17677 for the Centers of Biomedical Research Excellence (COBRE) Lipidomics Core, and Hollings Cancer Center core grant P30-CA-56036 for the Microscopy Core. NR 39 TC 39 Z9 39 U1 0 U2 1 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 AUG PY 2010 VL 24 IS 8 BP 2727 EP 2738 DI 10.1096/fj.09-150540 PG 12 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 690LD UT WOS:000285005400014 PM 20335228 ER PT J AU Rosenzweig, TM Hartman, S MacKenzie, E AF Rosenzweig, Tamara M. Hartman, Sarah MacKenzie, Elizabeth TI Disease-modifying therapy in adult relapsing-remitting multiple sclerosis SO FORMULARY LA English DT Article ID TECHNOLOGY-ASSESSMENT SUBCOMMITTEE; PLACEBO-CONTROLLED TRIAL; ACADEMY-OF-NEUROLOGY; WEEKLY INTERFERON BETA-1A; DOUBLE-BLIND; GLATIRAMER ACETATE; IMMUNOMODULATORY TREATMENTS; DIAGNOSTIC-CRITERIA; COST-EFFECTIVENESS; OPEN-LABEL AB Multiple sclerosis (MS) is a significant cause of disability among young adults, more commonly women, and usually strikes patients in the prime of their lives. Despite recent therapeutic advancements, MS remains an incurable, chronic illness. Clinical evidence supports the role of disease-modifying therapy (DMT) early in the disease course to reduce the number of acute attacks, delay disease progression, maintain quality of life, and prevent disability. However, an estimated 43% of patients are not receiving DMT. Current guidelines provide direction for making the diagnosis, identifying MS subtypes and choosing initial therapy for the relapsing-remitting forms of the disease. This review presents a summary of available DMT agents indicated for the treatment of patients with relapsing-remitting MS (RRMS), briefly touches upon the management of acute attacks, and highlights new therapies being investigated for RRMS, which show promise as adjuncts to or alternatives to currently accepted strategies. (Formulary. 2010;45:252-262.) C1 [Rosenzweig, Tamara M.; Hartman, Sarah] Univ Massachusetts, Sch Med, Clin Pharm Serv, Amherst, MA 01003 USA. [MacKenzie, Elizabeth] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Rosenzweig, TM (reprint author), Univ Massachusetts, Sch Med, Clin Pharm Serv, Amherst, MA 01003 USA. NR 60 TC 0 Z9 0 U1 0 U2 7 PU ADVANSTAR COMMUNICATIONS INC PI WOODLAND HILLS PA 6200 CANOGA AVE, 2ND FLR, WOODLAND HILLS, CA 91367 USA SN 1082-801X J9 FORMULARY JI Formulary PD AUG PY 2010 VL 45 IS 8 BP 252 EP 262 PG 11 GA 645TN UT WOS:000281489200002 ER PT J AU Rimbara, E Shulman, RJ Abraham, BP Sabounchi, S Attumi, TA Opekun, AR Graham, DY AF Rimbara, E. Shulman, R. J. Abraham, B. P. Sabounchi, S. Attumi, T. A. Opekun, A. R. Graham, D. Y. CA Baylor IBD Study Grp TI Detection of non-pylori Helicobacter species from IBD, IBS and healthy subjects: preliminary results SO HELICOBACTER LA English DT Meeting Abstract CT 23rd International Workshop on Helicobacter and Related Bacteria in Chronic Digestive Inflammation and Gastric Cancer CY SEP 16-18, 2010 CL Rotterdam, NETHERLANDS C1 [Rimbara, E.; Sabounchi, S.; Attumi, T. A.; Graham, D. Y.] VA Med Ctr, Houston, TX USA. [Shulman, R. J.; Abraham, B. P.; Opekun, A. R.] Baylor Coll Med, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1083-4389 J9 HELICOBACTER JI Helicobacter PD AUG PY 2010 VL 15 IS 4 BP 325 EP 325 PG 1 WC Gastroenterology & Hepatology; Microbiology SC Gastroenterology & Hepatology; Microbiology GA 626SC UT WOS:000279986200042 ER PT J AU El-Serag, HB Talwalkar, J Kim, WR AF El-Serag, Hashem B. Talwalkar, Jayant Kim, W. Ray TI Efficacy, Effectiveness, and Comparative Effectiveness in Liver Disease SO HEPATOLOGY LA English DT Editorial Material ID HEPATITIS-C; UNITED-STATES; HEALTH-CARE; PREDICTORS; DISPARITIES; POPULATION; VETERANS; MEDICINE C1 [Talwalkar, Jayant; Kim, W. Ray] Mayo Clin, Div Gastroenterol & Hepatol, Coll Med, Rochester, MN 55906 USA. [Talwalkar, Jayant; Kim, W. Ray] Mayo Clin, Div Healthcare Policy & Res, Coll Med, Rochester, MN 55906 USA. [El-Serag, Hashem B.] Michael E DeBakey Dept Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX USA. [El-Serag, Hashem B.] Michael E DeBakey Dept Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX USA. [El-Serag, Hashem B.] Baylor Coll Med, Houston, TX 77030 USA. RP Kim, WR (reprint author), Mayo Clin, Div Gastroenterol & Hepatol, Coll Med, PL 6,200 1st St SW, Rochester, MN 55906 USA. EM kim.ray@mayo.edu NR 16 TC 24 Z9 25 U1 0 U2 2 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD AUG PY 2010 VL 52 IS 2 BP 403 EP 407 DI 10.1002/hep.23819 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 633OZ UT WOS:000280513900001 PM 20683939 ER PT J AU Afzali, A Weiss, NS Boyko, EJ Ioannou, GN AF Afzali, Anita Weiss, Noel S. Boyko, Edward J. Ioannou, George N. TI Association Between Serum Uric Acid Level and Chronic Liver Disease in the United States SO HEPATOLOGY LA English DT Article ID ALANINE AMINOTRANSFERASE ACTIVITY; CIRRHOSIS-RELATED DEATH; CARDIOVASCULAR RISK; HYPERURICEMIA; POPULATION; PREVALENCE; HOSPITALIZATION; CONSUMPTION; PREDICTORS; OBESITY AB Elevated serum uric acid (UA) levels strongly reflect and may even cause oxidative stress, insulin resistance, and metabolic syndrome, which are risk factors for the progression of liver disease. We sought to determine whether serum UA levels are associated with the development of cirrhosis or the presence of elevated serum liver enzymes. We used cohort data from the first National Health and Nutrition Examination Survey (NHANES I) to determine whether the baseline serum UA level was associated with the incidence of hospitalization or death due to cirrhosis among 5518 participants during a mean follow-up of 12.9 years (range = 4-21 years) after the exclusion of the first 4 years of follow-up. We also used cross-sectional data from NHANES 1988-1994 (n = 10,993) and NHANES 19992006 (n = 6186) to determine whether the serum UA level was associated with elevated serum alanine aminotransferase (ALT) or gamma-glutamyl transferase (GGT), two markers of hepatic necroinflammation. Compared to persons in the lower third of the distribution of serum UA (<4.8 mg/dL), those in the top third (>6 mg/dL) had a higher risk of cirrhosis-related hospitalization or death [adjusted hazard ratio (AHR) = 2.8, 95% confidence interval (CI) =1.3-5.7], whereas the risk was not substantially increased in persons within the middle third (serum UA level = 2.6-4.8 mg/dL, AHR = 1.3, 95% CI = 0.6-2.7). A higher serum UA level was associated with greater mean serum ALT and GGT levels and a greater probability of elevated serum ALT and GGT. Conclusion: The serum UA level is associated with the development of cirrhosis and the presence of elevated serum liver enzymes after adjustments for important causes and risk factors of chronic liver disease. (HEPATOLOGY 2010;52:578-589) C1 [Afzali, Anita; Ioannou, George N.] Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Gastroenterol, Seattle, WA 98108 USA. [Afzali, Anita; Ioannou, George N.] Vet Affairs Puget Sound Hlth Care Syst, Res Enhancement Award Program, Seattle, WA 98108 USA. [Boyko, Edward J.] Vet Affairs Puget Sound Hlth Care Syst, Seattle Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. [Weiss, Noel S.] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. [Afzali, Anita; Ioannou, George N.] Univ Washington, Dept Med, Div Gastroenterol, Seattle, WA USA. [Boyko, Edward J.] Univ Washington, Dept Med, Div Internal Med, Seattle, WA 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 OI Boyko, Edward/0000-0002-3695-192X FU NIDDK NIH HHS [P30 DK-17047] NR 27 TC 35 Z9 38 U1 0 U2 3 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD AUG PY 2010 VL 52 IS 2 BP 578 EP 589 DI 10.1002/hep.23717 PG 12 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 633OZ UT WOS:000280513900020 PM 20683957 ER PT J AU Lipsky, BA Kollef, MH Miller, LG Sun, XW Johannes, RS Tabak, YP AF Lipsky, Benjamin A. Kollef, Marin H. Miller, Loren G. Sun, Xiaowu Johannes, Richard S. Tabak, Ying P. TI Predicting Bacteremia among Patients Hospitalized for Skin and Skin-Structure Infections: Derivation and Validation of a Risk Score SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID SOFT-TISSUE INFECTIONS; RESISTANT STAPHYLOCOCCUS-AUREUS; BLOOD-STREAM INFECTION; INADEQUATE ANTIMICROBIAL TREATMENT; INAPPROPRIATE ANTIBIOTIC-THERAPY; INTENSIVE-CARE-UNIT; LARGE US DATABASE; ADULT PATIENTS; NEEDLE ASPIRATION; CELLULITIS AB OBJECTIVE. Bacteremia is relatively common in patients with skin and skin-structure infection (SSSI) severe enough to require hospitalization. We used selected demographic and clinical characteristics easily assessable at initial evaluation to develop a model for the early identification of patients with SSSI who are at higher risk for bacteremia. PARTICIPANTS. A large database of adults hospitalized with SSSI at 97 hospitals in the United States during the period from 2003 through 2007 and from whom blood samples were obtained for culture at admission. METHODS. We compared selected candidate predictor variables for patients shown to have bacteremia and patients with no demonstrated bacteremia. Using stepwise logistic regression to identify independent risk factors for bacteremia, we derived a model by using 75% of a randomly split cohort, converted the model coefficients into a risk score system, and then we validated it by using the remaining 25% of the cohort. RESULTS. Bacteremia was documented in 1,021 (11.7%) of the 8,747 eligible patients. Independent predictors of bacteremia (P < .001) were infected device or prosthesis, respiratory rate less than 10 or more than 29 breaths per minute, pulse rate less than 49 or more than 125 beats per minute, temperature less than 35.6 degrees C or at least 38.0 degrees C, white blood cell band percentage of 7% or more, white blood cell count greater than 11 x 10(9)/L, healthcare-associated infection, male sex, and older age. The bacteremia rates ranged from 3.7% (lowest decile) to 30.6% (highest decile) (P < .001). The model C statistic was 0.71; the Hosmer-Lemeshow test P value was .36, indicating excellent model calibration. CONCLUSIONS. Using data available at hospital admission, we developed a risk score that differentiated SSSI patients at low risk for bacteremia from patients at high risk. This score may help clinicians identify patients who require more intensive monitoring or antimicrobial regimens appropriate for treating bacteremia. Infect Control Hosp Epidemiol 2010; 31(8): 828-837 C1 [Lipsky, Benjamin A.] VA Puget Sound Hlth Care Syst, Primary Care Clin S 111 PCC, Gen Med Serv, Seattle, WA 98108 USA. [Lipsky, Benjamin A.] Univ Washington, Dept Med, Seattle, WA USA. [Kollef, Marin H.] Washington Univ, Sch Med, St Louis, MO USA. [Miller, Loren G.] UCLA Sch Med, Los Angeles, CA USA. [Miller, Loren G.] Harbor UCLA Med Ctr, Los Angeles, CA USA. [Sun, Xiaowu; Johannes, Richard S.; Tabak, Ying P.] CareFusion, MedMined Serv, Clin Res, Marlborough, MA USA. [Johannes, Richard S.] Harvard Univ, Sch Med, Boston, MA USA. RP Lipsky, BA (reprint author), VA Puget Sound Hlth Care Syst, Primary Care Clin S 111 PCC, Gen Med Serv, 1660 S Columbian Way, Seattle, WA 98108 USA. EM balipsky@uw.edu OI Lipsky, Benjamin A./0000-0001-9886-5114 FU CareFusion Corporation; Cubis; Pfizer FX We thank CareFusion Clinical Research team members Karen Derby, Vikas Gupta, and Linda Hyde for their contributions in database management, analysis, and technical and administrative support. Editorial support was provided by Hamilton House, Virginia Beach, Virginia, and funded by CareFusion Corporation.; B. A. L. reports that he has served as a consultant to Cubist, Pfizer, Merck, Wyeth-Ayerst, and Ortho-McNeil. M. H. K. reports that he has been a member of the the speakers' bureau or served as a consultant for Astrazeneca, Pfizer, Merck, Elan, Bard, and Kimberly-Clark and has served as a consultant for Astellas, Cubist, and Bayer. L. G. M. reports that he has received research grants from Cubist and Pfizer and served as a consultant to Theravance. X. S., R.S.J., and Y.P.T. report that they are employees of CareFusion Corporation. NR 36 TC 10 Z9 10 U1 0 U2 1 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 2010 VL 31 IS 8 BP 828 EP 837 DI 10.1086/654007 PG 10 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 621SC UT WOS:000279601800009 PM 20586653 ER PT J AU Wynn, JK Horan, WP Kring, AM Simons, RF Green, MF AF Wynn, Jonathan K. Horan, William P. Kring, Ann M. Simons, Robert F. Green, Michael F. TI Impaired anticipatory event-related potentials in schizophrenia SO INTERNATIONAL JOURNAL OF PSYCHOPHYSIOLOGY LA English DT Article DE Schizophrenia; Event-related potentials (ERP); Anticipation ID STIMULUS-PRECEDING NEGATIVITY; STRIATAL REWARD PREDICTION; SLOW BRAIN POTENTIALS; PHYSICAL ANHEDONIA; FEEDBACK STIMULI; HEART-RATE; TASK; INFORMATION; DYSFUNCTION; PLEASURE AB Deficits in anticipation are implicated across a variety of cognitive and emotional processes in schizophrenia. Although diminished anticipatory event-related potentials (ERPs) have been detected during tasks requiring motor response preparation in schizophrenia, no prior ERP study has examined non-motor-related anticipatory processes or used motivationally engaging stimuli. Thirty-four schizophrenia outpatients and 36 healthy controls completed a cued, reaction-time contingent picture viewing task to assess two types of anticipatory ERPs, one involving motor response preparation (Contingent Negative Variation [CNV]) and one not involving motor preparation (Stimulus Preceding Negativity [SPN]). The ERP paradigm included emotional and non-emotional pictures, and participants also completed trait anhedonia questionnaires. Patients and controls demonstrated similar patterns of reaction time and self-reported emotional responses to the pictures. However, patients demonstrated generally lower CNV and SPN across pleasant, neutral, and unpleasant picture conditions. Patients also reported lower anticipatory pleasure than controls on a trait questionnaire. Schizophrenia patients demonstrate diminished motor- and non-motor-related anticipatory processing, which may have wide-ranging adverse functional consequences. Published by Elsevier B.V. C1 [Wynn, Jonathan K.; Horan, William P.; Green, Michael F.] Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Kring, Ann M.] Univ Calif Berkeley, Berkeley, CA 94720 USA. [Simons, Robert F.] Univ Delaware, Newark, DE 19716 USA. RP Wynn, JK (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, MIRECC 210A,Bldg 210,11301 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 [R01 MH043292, R01 MH043292-19, R01 MH065707, R01 MH065707-05, R03 MH077141, R03 MH077141-01] NR 59 TC 24 Z9 28 U1 3 U2 15 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-8760 J9 INT J PSYCHOPHYSIOL JI Int. J. Psychophysiol. PD AUG PY 2010 VL 77 IS 2 BP 141 EP 149 DI 10.1016/j.ijpsycho.2010.05.009 PG 9 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 633WZ UT WOS:000280539000008 PM 20573584 ER PT J AU Hatano, H Lampiris, H Fransen, S Gupta, S Huang, W Hoh, R Martin, JN Lalezari, J Bangsberg, D Petropoulos, C Deeks, SG AF Hatano, Hiroyu Lampiris, Harry Fransen, Signe Gupta, Soumi Huang, Wei Hoh, Rebecca Martin, Jeffrey N. Lalezari, Jacob Bangsberg, David Petropoulos, Christos Deeks, Steven G. TI Evolution of Integrase Resistance During Failure of Integrase Inhibitor-Based Antiretroviral Therapy SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE integrase inhibitors; drug resistance; virologic failure ID TREATMENT-EXPERIENCED PATIENTS; HIV-1 INFECTION; CONTROLLED-TRIAL; RALTEGRAVIR; EFFICACY; SAFETY; REPLICATION; SUBGROUP AB Background: Although integrase inhibitors are highly effective in the management of drug-resistant HIV, some patients fail to achieve durable viral suppression. The long-term consequences of integrase inhibitor failure have not been well defined. Methods: We identified 29 individuals who exhibited evidence of incomplete viral suppression on a regimen containing an integrase inhibitor (23 raltegravir, 6 elvitegravir). Before initiating the integrase inhibitor-based regimen, the median CD4(+) T-cell count and plasma HIV RNA levels were 62 cells/mm(3) and 4.65 log(10) copies/mL, respectively. Results: At the first failure time-point, the most common integrase resistance pattern for subjects taking raltegravir was wild-type, followed in order of frequency by Q148H/K/R+G140S, N155H, and Y143R/H/C. The most common resistance pattern for subjects taking elvitegravir was E92Q. Long-term failure was associated with continued viral evolution, emergence of high-level phenotypic resistance, and a decrease in replicative capacity. Conclusions: Although wild-type failure during early integrase inhibitor failure is common, most patients eventually develop high-level phenotypic drug resistance. This resistance evolution is gradual and associated with declines in replicative capacity. C1 [Hatano, Hiroyu; Lampiris, Harry; Hoh, Rebecca; Martin, Jeffrey N.; Deeks, Steven G.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Lampiris, Harry] San Francisco VA Med Ctr, San Francisco, CA 94143 USA. [Fransen, Signe; Gupta, Soumi; Huang, Wei; Petropoulos, Christos] Monogram Biosci, San Francisco, CA USA. [Lalezari, Jacob] Quest Clin Res, San Francisco, CA USA. [Bangsberg, David] Harvard Univ, Sch Med, Boston, MA USA. RP Hatano, H (reprint author), San Francisco Gen Hosp, Bldg 80,Ward 84,995 Potrero Ave, San Francisco, CA 94110 USA. EM hhatano@php.ucsf.edu FU NIAID [K23AI075985, K24 AI069994]; UCSF/Gladstone Center for AIDS Research [P30 AI27763, P30 MH59037]; Center for AIDS Prevention Studies [P30 MH62246]; UCSF Clinical and Translational Science Institute [UL1 RR024131-01]; NIH NIAID [SBIR- R43 AI057074-01]; Merck; Monogram Biosciences; Gilead FX This work was supported by grants from the NIAID (K23AI075985, K24 AI069994), the UCSF/Gladstone Center for AIDS Research (P30 AI27763, P30 MH59037), the Center for AIDS Prevention Studies (P30 MH62246), and the UCSF Clinical and Translational Science Institute (UL1 RR024131-01). The development of the PhenoSense (R) Integrase assay was partially supported by NIH NIAID SBIR- R43 AI057074-01.; Potential conflicts of interest. SG, SF, WH, and CP are employees of Monogram Biosciences. HH has received research support from Merck and Monogram Biosciences. SD has received research support from Merck, Gilead, and Monogram Biosciences. NR 13 TC 38 Z9 39 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD AUG 1 PY 2010 VL 54 IS 4 BP 389 EP 393 DI 10.1097/QAI.0b013e3181c42ea4 PG 5 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 627BR UT WOS:000280013600008 PM 20300008 ER PT J AU Willig, JH Nevin, CR Raper, JL Saag, MS Mugavero, MJ Willig, AL Burkhardt, JH Schumacher, JE Johnson, VA AF Willig, James H. Nevin, Christa R. Raper, James L. Saag, Michael S. Mugavero, Michael J. Willig, Amanda L. Burkhardt, Jeffrey H. Schumacher, Joseph E. Johnson, Victoria A. TI Cost Ramifications of Increased Reporting of Detectable Plasma HIV-1 RNA Levels by the Roche COBAS AmpliPrep/COBAS TaqMan HIV-1 Version 1.0 Viral Load Test SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Letter ID VIRUS TYPE-1 RNA; ANTIRETROVIRAL THERAPY; AMPLICOR; ASSAY; FAILURE; MONITOR C1 [Willig, James H.; Nevin, Christa R.; Raper, James L.; Saag, Michael S.; Mugavero, Michael J.; Johnson, Victoria A.] Birmingham Vet Affairs Med Ctr, Div Infect Dis, Dept Internal Med, Birmingham, AL USA. [Willig, Amanda L.] Birmingham Vet Affairs Med Ctr, Dept Nutr Sci, Birmingham, AL USA. [Burkhardt, Jeffrey H.] Birmingham Vet Affairs Med Ctr, Dept Hlth Serv Adm, Birmingham, AL USA. [Schumacher, Joseph E.] Birmingham Vet Affairs Med Ctr, Dept Med, Div Prevent Med, Birmingham, AL USA. RP Willig, JH (reprint author), Birmingham Vet Affairs Med Ctr, Div Infect Dis, Dept Internal Med, Birmingham, AL USA. OI Willig, Amanda/0000-0001-8802-4311 FU NCI NIH HHS [CA 47888, R25 CA047888]; NIAID NIH HHS [R24 AI067039, 1 R24 AI067039-1, P30 AI027767, P30 AI027767-21A1, P30-AI27767, R24 AI067039-04] NR 12 TC 9 Z9 9 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD AUG 1 PY 2010 VL 54 IS 4 BP 442 EP 444 DI 10.1097/QAI.0b013e3181d01d1d PG 3 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 627BR UT WOS:000280013600016 PM 20611035 ER PT J AU Crompton, JA North, DS Yoon, M Steenbergen, JN Lamp, KC Forrest, GN AF Crompton, Jason A. North, Donald S. Yoon, MinJung Steenbergen, Judith N. Lamp, Kenneth C. Forrest, Graeme N. TI Outcomes with daptomycin in the treatment of Staphylococcus aureus infections with a range of vancomycin MICs SO JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY LA English DT Article DE lipopeptides; S; aureus; CORE ID MINIMUM INHIBITORY CONCENTRATION; BACTERICIDAL ACTIVITY; PROSPECTIVE MULTICENTER; CLINICAL-OUTCOMES; RISK-FACTORS; BACTEREMIA; SUSCEPTIBILITY; ENDOCARDITIS; RESISTANCE; EFFICACY AB Recent recommendations by the Infectious Diseases Society of America for the treatment of Staphylococcus aureus suggest the use of alternative agents when vancomycin MIC values are >= 2 mg/L. This study examines the outcome of patients treated with daptomycin for S. aureus infections with documented vancomycin MICs. All patients with skin, bacteraemia and endocarditis infections due to S. aureus with vancomycin MIC values in CORE 2005-08, a retrospective, multicentre, observational registry, were studied. The outcome (cure, improved, failure or non-evaluable) was the investigator assessment at the end of daptomycin therapy. Success was defined as cure or improved. Five hundred and forty-seven clinically evaluable patients were identified with discrete vancomycin MIC values [MIC < 2 mg/L: 451 (82%); MIC >= 2 mg/L: 96 (18%)]. The vancomycin MIC groups were well matched for patient characteristics, types of infections, first-line daptomycin use (19%) and prior vancomycin use (58%). Clinical success was reported in 94% of patients. No differences were detected in the daptomycin success rate by the vancomycin MIC group overall or by the infection type. A multivariate logistic regression also failed to identify vancomycin MIC as a predictor of daptomycin failure. Adverse event (AE) rates were not different when analysed by MIC group; both groups had similar to 17% of patients with one AE. In this diverse population, daptomycin was associated with similar outcomes for patients, regardless of whether the vancomycin MIC was categorized as < 2 or >= 2 mg/L. Further studies are warranted. C1 [Crompton, Jason A.; North, Donald S.; Yoon, MinJung; Steenbergen, Judith N.; Lamp, Kenneth C.] Cubist Pharmaceut, Lexington, MA 02421 USA. [Forrest, Graeme N.] Portland VA Med Ctr, Portland, OR 97239 USA. RP Lamp, KC (reprint author), Cubist Pharmaceut, 65 Hayden Ave, Lexington, MA 02421 USA. EM kenneth.lamp@cubist.com FU Cubist Pharmaceuticals, Inc. FX This work was supported by Cubist Pharmaceuticals, Inc. The decision to submit this analysis for publication was made by Cubist Pharmaceuticals and the authors. No financial support or honorarium was given to the non-Cubist Pharmaceuticals author for the development of this manuscript. The Cubist Pharmaceuticals authors were not awarded any additional support outside of their salary for their participation in this study. NR 33 TC 16 Z9 18 U1 1 U2 3 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 2010 VL 65 IS 8 BP 1784 EP 1791 DI 10.1093/jac/dkq200 PG 8 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 627DD UT WOS:000280018400037 PM 20554570 ER PT J AU Menconi, F Huber, A Osman, R Concepcion, E Jacobson, EM Stefan, M David, CS Tomer, Y AF Menconi, Francesca Huber, Amanda Osman, Roman Concepcion, Erlinda Jacobson, Eric M. Stefan, Mihaela David, Chela S. Tomer, Yaron TI Tg.2098 is a major human thyroglobulin T-cell epitope SO JOURNAL OF AUTOIMMUNITY LA English DT Article DE Thyroglobulin; HLA; Gene; Thyroiditis ID AUTOIMMUNE THYROID-DISEASE; MHC CLASS-II; UNIQUE TETRANUCLEOTIDE SEQUENCES; MOLECULAR-DYNAMICS SIMULATIONS; GENETIC SUSCEPTIBILITY; HASHIMOTO THYROIDITIS; DNA OLIGONUCLEOTIDES; RHEUMATOID-ARTHRITIS; GRAVES-DISEASE; RAS-RAF AB An HLA-DR variant containing Arginine at position 74 of the DR beta 1 chain confers a strong genetic susceptibility to autoimmune thyroid diseases (AITD), Graves' disease (GD) and Hashimoto's thyroiditis (HT), while Glutamine at position DR beta 1-74 is protective. We hypothesized that the DR beta 1-Arg74 variant is able to present pathogenic thyroglobulin (Tg) peptides to T-cells more efficiently, thereby triggering thyroid autoimmunity. Indeed, we have previously identified 4 human Tg (hTg) peptides that bind specifically to DR beta 1-Arg74 with much weaker binding to the protective variant DR beta 1-Gln74. The aim of our study was to examine in vivo whether an hTg peptide that binds strongly and specifically to DR beta 1-Arg74 is capable of stimulating T-cells during the induction of thyroiditis in a "humanized" mouse expressing human DR3, and in patients positive for Tg antibodies. Sequencing of exon 2 of the DR transgene in the DR3 mice, null for endogenous MHC II molecules, confirmed that they expressed the disease-associated DR beta 1-Arg74 variant, thus making them an ideal in vivo model to test the presentation of hTg peptides by DR beta 1-Arg74 HLA-DR. Induction of EAT in the DR3 mice lead to T-cell stimulation and proliferation to Tg.2098, a strong and specific DR beta 1-Arg74 binder, while a non-binding control peptide. Tg.2766 did not induce this response. Moreover, Tg.2098 stimulated T-cells from 4 individuals who were positive for thyroglobulin antibodies, demonstrating that Tg.2098 is an immunogenic peptide capable of being presented in vivo and activating T-cells in EAT and AITD. Energetic analysis of the complex formed by Tg.2098 and DR beta-Arg74 has shown that the origin of the affinity was determined by residues 1, 7 and 9 in the peptide, while the selectivity of the peptide for the MHC was determined by the Asp in position 4. The disease-protective substitution R74Q leads to reduction in affinity due to changes in local interaction with D4 as well as non-local interaction with other residues. The electrostatic potential on the surface of the DR beta-Arg74 Tg.2098 complex has a unique signature which may be recognized by T-cell receptors leading to autoimmune thyroiditis. Taken together these findings suggest that Tg.2098, a strong and specific binder to the disease-associated HLA-DR beta-Arg74, is a major human T-cell epitope and participant in the pathoetiology of AITD. Published by Elsevier Ltd. C1 [Menconi, Francesca; Huber, Amanda; Concepcion, Erlinda; Stefan, Mihaela; Tomer, Yaron] Mt Sinai Med Ctr, Dept Med, Div Endocrinol, New York, NY 10029 USA. [Osman, Roman] Mt Sinai Sch Med, Dept Struct & Chem Biol, New York, NY USA. [Jacobson, Eric M.] Univ Cincinnati, Dept Canc & Cell Biol, Cincinnati, OH USA. [David, Chela S.] Mayo Clin, Coll Med, Dept Immunol, Rochester, MN USA. [Tomer, Yaron] James J Peters VA Med Ctr, Bronx, NY USA. RP Tomer, Y (reprint author), Mt Sinai Med Ctr, Dept Med, Div Endocrinol, Box 1118,1 Gustave L Levy Pl, New York, NY 10029 USA. EM Yaron.Tomer@mssm.edu FU NIDDK [DK61659, DK067555, DK073681]; American Thyroid Association FX This work was supported in part by grants DK61659, DK067555, & DK073681 from NIDDK (to YT), and by a grant from the American Thyroid Association (to EMJ). NR 37 TC 10 Z9 11 U1 0 U2 3 PU ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0896-8411 J9 J AUTOIMMUN JI J. Autoimmun. PD AUG PY 2010 VL 35 IS 1 BP 45 EP 51 DI 10.1016/j.jaut.2010.01.004 PG 7 WC Immunology SC Immunology GA 616HV UT WOS:000279200700006 PM 20303712 ER PT J AU Bensing, BA Sullam, PM AF Bensing, Barbara A. Sullam, Paul M. TI Transport of Preproteins by the Accessory Sec System Requires a Specific Domain Adjacent to the Signal Peptide SO JOURNAL OF BACTERIOLOGY LA English DT Article ID STREPTOCOCCUS-GORDONII DL1; BINDING PROTEIN-GSPB; SECONDARY STRUCTURE PREDICTION; SURFACE GLYCOPROTEINS GSPB; SERINE-RICH ADHESIN; SIALIC-ACID; ESCHERICHIA-COLI; STAPHYLOCOCCUS-AUREUS; TRANSLOCATION CHANNEL; SEQUENCE RECOGNITION AB The accessory Sec (SecA2/Y2) systems of streptococci and staphylococci are dedicated to the transport of large serine-rich repeat (SRR) glycoproteins to the bacterial cell surface. The means by which the glycosylated preproteins are selectively recognized by the accessory Sec system have not been fully characterized. In Streptococcus gordonii, the SRR glycoprotein GspB has a 90-residue amino-terminal signal sequence that is essential for transport by SecA2/Y2 but is not sufficient to mediate the transport of heterologous proteins by this specialized transporter. We now report that a preprotein must remain at least partially unfolded prior to transport by the accessory Sec system. In addition, a region of approximately 20 residues from the amino-terminal end of mature GspB (the accessory Sec transport or AST domain) is essential for SecA2/Y2-dependent transport. The replacement of several AST domain residues with glycine strongly interferes with export, which suggests that a helical conformation may be important. Analysis of GspB variants with alterations in the AST domain, in combination with the results with a SecY2 variant, indicates that the AST domain is essential both for targeting to the SecA2/Y2 translocase and for initiating translocation through the SecY2 channel. The combined results suggest a unique mechanism that ensures the transport of a single substrate by the SecA2/Y2 system. C1 San Francisco VA Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Sullam, PM (reprint author), Vet Affairs Med Ctr, Div Infect Dis, 111W,4150 Clement St, San Francisco, CA 94121 USA. EM paul.sullam@ucsf.edu FU Department of Veterans Affairs; National Institutes of Health [RO1AI41513, RO1AI057433] FX This work was supported by the Department of Veterans Affairs and the VA Merit Review program and by grants RO1AI41513 and RO1AI057433 from the National Institutes of Health. NR 54 TC 16 Z9 16 U1 0 U2 4 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0021-9193 J9 J BACTERIOL JI J. Bacteriol. PD AUG PY 2010 VL 192 IS 16 BP 4223 EP 4232 DI 10.1128/JB.00373-10 PG 10 WC Microbiology SC Microbiology GA 632FL UT WOS:000280406300016 PM 20562303 ER PT J AU Sevick, MA Stone, RA Zickmund, S Wang, YY Korytkowski, M Burke, LE AF Sevick, Mary Ann Stone, Roslyn A. Zickmund, Susan Wang, Yuanyuan Korytkowski, Mary Burke, Lora E. TI Factors associated with probability of personal digital assistant-based dietary self-monitoring in those with type 2 diabetes SO JOURNAL OF BEHAVIORAL MEDICINE LA English DT Article DE Handheld computer; Randomized clinical trial; Behavioral research; Compliance ID WEIGHT-LOSS PROGRAM; BEHAVIOR-CHANGE; PAPER DIARIES; HEALTH; INTERVENTION; DIVIDE; TECHNOLOGY; COMPUTERS; ADHERENCE; INTERNET AB Knowledge of factors associated with the use of technology could inform the design of technology-based behavioral interventions. This study examined modifiable and nonmodifiable factors associated with technology-based self-monitoring. 123 participants with type 2 diabetes self-monitored diet using a personal digital assistant in a 6-month behavioral intervention. Multinomial logistic regression was used to examine probability of nonadherent and suboptimally adherent behavior relative to adherent behavior. Sociodemographic characteristics were not associated with probability of self-monitoring. Probability of adherence generally was greater in the weeks preceding no group session, and lower in the weeks following no group session or following skipped sessions. Non-modifiable factors suggested by the literature to be associated with poorer access to technology (lower income, older age, minority race, and lower education) were not associated with probability of self-monitoring in this population. C1 [Sevick, Mary Ann; Zickmund, Susan; Korytkowski, Mary] Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. [Sevick, Mary Ann; Stone, Roslyn A.; Zickmund, Susan] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Sevick, Mary Ann] VA Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. [Sevick, Mary Ann; Stone, Roslyn A.; Wang, Yuanyuan; Burke, Lora E.] Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA. [Burke, Lora E.] Univ Pittsburgh, Sch Nursing, Pittsburgh, PA 15261 USA. RP Sevick, MA (reprint author), Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. EM sevick@pitt.edu FU NCRR NIH HHS [UL1-RR024153, M01-RR000056]; NIDDK NIH HHS [DK-046204]; NINR NIH HHS [NR-R01008792] NR 54 TC 10 Z9 11 U1 1 U2 4 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0160-7715 J9 J BEHAV MED JI J. Behav. Med. PD AUG PY 2010 VL 33 IS 4 BP 315 EP 325 DI 10.1007/s10865-010-9257-9 PG 11 WC Psychology, Clinical SC Psychology GA 628OE UT WOS:000280129000007 PM 20232131 ER PT J AU Aguilar, D Chan, WY Bozkurt, B Ramasubbu, K Deswal, A AF Aguilar, David Chan, Wenyaw Bozkurt, Biykem Ramasubbu, Kumudha Deswal, Anita TI Metformin Use and Mortality in Ambulatory Patients With Diabetes and Heart Failure SO JOURNAL OF CARDIAC FAILURE LA English DT Meeting Abstract CT 14th Annual Scientific Meeting of the Heart-Failure-Society-of-America CY SEP 12-15, 2010 CL San Diego, CA SP Heart Failure Soc Amer C1 [Aguilar, David; Bozkurt, Biykem; Ramasubbu, Kumudha; Deswal, Anita] Baylor Coll Med, Houston, TX 77030 USA. [Aguilar, David; Bozkurt, Biykem; Ramasubbu, Kumudha; Deswal, Anita] Michael E Debakey Med Ctr, Houston, TX USA. [Chan, Wenyaw] Univ Texas Hlth Sci Ctr, Sch Publ Hlth, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 1071-9164 J9 J CARD FAIL JI J. Card. Fail. PD AUG PY 2010 VL 16 IS 8 SU 1 MA 272 BP S83 EP S84 PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 645YJ UT WOS:000281501800272 ER PT J AU Aleong, R Sauer, WH Pellegnni, CN Yang, YF Keung, E Heidenreich, P Rumsfeld, JS Massie, BM Varosy, PD AF Aleong, Ryan Sauer, William H. Pellegnni, Cara N. Yang, Yanfei Keung, Edmund Heidenreich, Paul Rumsfeld, John S. Massie, Barry M. Varosy, Paul D. TI Clinical Subtype of Atrial Fibrillation at the Time of Implantation and Subsequent Mortality among Veterans With Implantable Defibrillators SO JOURNAL OF CARDIAC FAILURE LA English DT Meeting Abstract CT 14th Annual Scientific Meeting of the Heart-Failure-Society-of-America CY SEP 12-15, 2010 CL San Diego, CA SP Heart Failure Soc Amer C1 [Aleong, Ryan; Sauer, William H.; Rumsfeld, John S.; Varosy, Paul D.] Univ Colorado Denver, Aurora, CO USA. [Pellegnni, Cara N.; Yang, Yanfei; Keung, Edmund; Massie, Barry M.] San Francisco VA Med Ctr, San Francisco, CA USA. [Pellegnni, Cara N.; Yang, Yanfei; Keung, Edmund; Massie, Barry M.] UCSF, San Francisco, CA USA. [Heidenreich, Paul] Palo Alto VAMC, Palo Alto, CA USA. [Heidenreich, Paul] Stanford Univ, Palo Alto, CA 94304 USA. [Rumsfeld, John S.; Varosy, Paul D.] VA Eastern Colorado Hlth Care Syst, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 1071-9164 J9 J CARD FAIL JI J. Card. Fail. PD AUG PY 2010 VL 16 IS 8 SU 1 MA 185 BP S58 EP S58 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 645YJ UT WOS:000281501800186 ER PT J AU Deswal, A Richardson, P Bozkurt, B Mann, DL AF Deswal, Anita Richardson, Peter Bozkurt, Biykem Mann, Douglas L. TI Randomized Trial of Aldosterone AntagonisM in Diastolic Heart Failure (RAAM-DHF) SO JOURNAL OF CARDIAC FAILURE LA English DT Meeting Abstract CT 14th Annual Scientific Meeting of the Heart-Failure-Society-of-America CY SEP 12-15, 2010 CL San Diego, CA SP Heart Failure Soc Amer C1 [Deswal, Anita; Richardson, Peter; Bozkurt, Biykem] VA Med Ctr, Houston, TX USA. [Deswal, Anita; Richardson, Peter; Bozkurt, Biykem] Baylor Coll Med, Houston, TX 77030 USA. [Mann, Douglas L.] Washington Univ, Sch Med, St Louis, MO USA. NR 0 TC 1 Z9 1 U1 0 U2 1 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 1071-9164 J9 J CARD FAIL JI J. Card. Fail. PD AUG PY 2010 VL 16 IS 8 SU 1 MA 017 BP S7 EP S7 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 645YJ UT WOS:000281501800018 ER PT J AU Subramanian, D Subramanian, V Deswal, A Mann, DL AF Subramanian, Devika Subramanian, Venkataraman Deswal, Anita Mann, Douglas L. TI Improved Predictive Models of Mortality in Chronic Heart Failure Using Time-Series Measurements of Inflammatory Biomarkers SO JOURNAL OF CARDIAC FAILURE LA English DT Meeting Abstract CT 14th Annual Scientific Meeting of the Heart-Failure-Society-of-America CY SEP 12-15, 2010 CL San Diego, CA SP Heart Failure Soc Amer C1 Rice Univ, Houston, TX USA. Univ Nottingham Hosp, Nottingham NG7 2UH, England. VA Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Washington Univ, Sch Med, St Louis, MO USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 1071-9164 J9 J CARD FAIL JI J. Card. Fail. PD AUG PY 2010 VL 16 IS 8 SU 1 MA 307 BP S93 EP S93 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 645YJ UT WOS:000281501800306 ER PT J AU Roth, MY Page, ST Lin, K Anawalt, BD Matsumoto, AM Snyder, CN Marck, BT Bremner, WJ Amory, JK AF Roth, M. Y. Page, S. T. Lin, K. Anawalt, B. D. Matsumoto, A. M. Snyder, C. N. Marck, B. T. Bremner, W. J. Amory, J. K. TI Dose-Dependent Increase in Intratesticular Testosterone by Very Low-Dose Human Chorionic Gonadotropin in Normal Men with Experimental Gonadotropin Deficiency SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID HORMONE ANTAGONIST; MASS-SPECTROMETRY; HEALTHY-YOUNG; INFERTILE MEN; HUMAN TESTIS; SPERMATOGENESIS; MAINTENANCE; DIHYDROTESTOSTERONE; SUPPRESSION; FLUID AB Context and Objective: In men with infertility secondary to gonadotropin deficiency, treatment with relatively high dosages of human chorionic gonadotropin (hCG) stimulates intratesticular testosterone (IT-T) biosynthesis and spermatogenesis. Previously we found that lower dosages of hCG stimulated IT-T to normal. However, the minimal dose of hCG needed to stimulate IT-T and the dose-response relationship between very low doses of hCG and IT-T and serum testosterone in normal men is unknown. Design, Setting, Patients, and Intervention: We induced experimental gonadotropin deficiency in 37 normal men with the GnRH antagonist acyline and randomized them to receive one of four low doses of hCG: 0, 15, 60, or 125 IU sc every other day or 7.5 g daily testosterone gel for 10 d. Testicular fluid was obtained by percutaneous aspiration for steroid measurements at baseline and after 10 d of treatment and correlated with contemporaneous serum hormone measurements. Results: Median (25th, 75th percentile) baseline IT-T was 2508 nmol/liter (1753, 3502 nmol/liter). IT-T concentrations increased in a dose-dependent manner with very low-dosage hCG administration from 77 nmol/liter (40, 122 nmol/liter) to 923 nmol/liter (894, 1017 nmol/liter) in the 0- and 125-IU groups, respectively (P < 0.001). Moreover, serum hCG was significantly correlated with both IT-T and serum testosterone (P < 0.01). Conclusion: Doses of hCG far lower than those used clinically increase IT-T concentrations in a dose-dependent manner in normal men with experimental gonadotropin deficiency. Assessment of IT-T provides a valuable tool to investigate the hormonal regulation of spermatogenesis in man. (J Clin Endocrinol Metab 95: 3806-3813, 2010) C1 [Roth, M. Y.; Page, S. T.; Anawalt, B. D.; Matsumoto, A. M.; Snyder, C. N.; Bremner, W. J.; Amory, J. K.] Univ Washington, Dept Med, Seattle, WA 98195 USA. [Lin, K.] Univ Washington, Dept Obstet & Gynecol, Seattle, WA 98195 USA. [Roth, M. Y.; Page, S. T.; Anawalt, B. D.; Matsumoto, A. M.; Snyder, C. N.; Bremner, W. J.; Amory, J. K.] Univ Washington, Ctr Res Reprod & Contracept, Seattle, WA 98195 USA. [Matsumoto, A. M.; Marck, B. T.] Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. RP Roth, MY (reprint author), Univ Washington, Dept Med, 1959 NE Pacific St,Box 357138, Seattle, WA 98195 USA. EM mylang@u.washington.edu FU Eunice Kennedy Shriver National Institute of Child Health and Human Development [U54-HD-12629, U54-HD-42454]; Diabetes, Obesity, and Metabolism Grant [T32 DK007247]; Department of Veterans Affairs; National Institute of Aging, a division of the National Institutes of Health [K23 AG027238] FX This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development through cooperative agreements U54-HD-12629 and U54-HD-42454 as part of the specialized Cooperative Centers Program in Reproductive Research and the Cooperative Contraceptive Research Centers Program. M.Y.R. is supported by the Diabetes, Obesity, and Metabolism Grant T32 DK007247. A. M. M. is supported by the Department of Veterans Affairs. S. T. P. is supported by Grant K23 AG027238 from the National Institute of Aging, a division of the National Institutes of Health. NR 23 TC 20 Z9 20 U1 0 U2 3 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD AUG PY 2010 VL 95 IS 8 BP 3806 EP 3813 DI 10.1210/jc.2010-0360 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 635JW UT WOS:000280652400036 PM 20484472 ER PT J AU Lima, MMO Pareja, JC Alegre, SM Geloneze, SR Kahn, SE Astiarraga, BD Chaim, EA Geloneze, B AF Lima, Marcelo M. O. Pareja, Jose C. Alegre, Sarah M. Geloneze, Sylka R. Kahn, Steven E. Astiarraga, Brenno D. Chaim, Elinton A. Geloneze, Bruno TI Acute Effect of Roux-En-Y Gastric Bypass on Whole-Body Insulin Sensitivity: A Study with the Euglycemic-Hyperinsulinemic Clamp SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID TYPE-2 DIABETIC SUBJECTS; BETA-CELL FUNCTION; BARIATRIC SURGERY; WEIGHT-LOSS; OBESE-PATIENTS; METABOLIC SYNDROME; MORBID-OBESITY; RESISTANCE; RESTORATION; ADIPONECTIN AB Context: Insulin resistance ameliorates after bariatric surgery, yet there is still a need for data on the acute effect of Roux-en-Y gastric bypass (RYGBP) on insulin sensitivity. Objective: The objective of the study was to describe the acute effect of RYGBP on insulin sensitivity, measured by both the euglycemic-hyperinsulinemic clamp and homeostasis model assessment insulin resistance index (HOMA-IR). Design and Setting: Evaluations were conducted before and 1 month after RYGBP at State University of Campinas (Sao Paulo, Brazil). Patients: Patients included 19 premenopausal women with metabolic syndrome aged 35.3 (6.7) yr, body mass index 45.50 (3.74) kg/m(2) [mean (SD)]. Six had mild type 2 diabetes, seven impaired glucose tolerance, and six normal glucose tolerance. Interventions and Main Outcome Measures: The volunteers underwent RYGBP either alone or combined with omentectomy. Euglycemic-hyperinsulinemic clamp, HOMA-IR, nonesterified fatty acids, leptin, ultrasensitive C-reactive protein, adiponectin, and IL-6 were assessed at baseline and 4.5 (0.9) wk postoperatively. Results: Fasting glucose decreased [99.2 (13.1) to 83.6 (8.1) mg/dl, P < 0.01] along with a reduction in fasting insulin [30.4 (17.0) to 11.4 (6.3) mU/liter, P < 0.01]. M value did not improve postoperatively [25.82 (6.30) to 22.02 (6.05) mu mol/kg(FFM) . min] despite of a decrease in body weight [114.8 (14.5) to 102.3 (14.5) kg, P < 0.001]. This finding was discordant to the observation of an improvement in HOMA-IR [3.85 (2.10) to 1.42 (0.76), P < 0.01]. Nonesterified fatty acids increased. Leptin and C-reactive protein decreased. IL-6 and adiponectin remained unchanged. Conclusions: A month after RYGBP, fasting glucose metabolism improves independent of a change in peripheral insulin sensitivity. (J Clin Endocrinol Metab 95: 3871-3875, 2010) C1 [Lima, Marcelo M. O.; Pareja, Jose C.; Geloneze, Sylka R.; Astiarraga, Brenno D.; Geloneze, Bruno] State Univ Campinas UNICAMP, Lab Invest Metab & Diabet Gastroctr, BR-13081970 Campinas, SP, Brazil. [Pareja, Jose C.; Chaim, Elinton A.] State Univ Campinas UNICAMP, Dept Surg, BR-13081970 Campinas, SP, Brazil. [Alegre, Sarah M.; Astiarraga, Brenno D.] State Univ Campinas UNICAMP, Dept Internal Med, BR-13081970 Campinas, SP, Brazil. [Kahn, Steven E.] Vet Affairs Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98108 USA. RP Lima, MMO (reprint author), State Univ Campinas UNICAMP, Lab Invest Metab & Diabet Gastroctr, 420 Cidade Univ, BR-13081970 Campinas, SP, Brazil. EM endo.marcelolima@hotmail.com RI 5, INCT/H-4505-2013; Diabetes, Inct/I-2186-2013 OI Kahn, Steven/0000-0001-7307-9002 FU Fundacao de Apoio a Pesquisa do Estado de Sao Paulo, Sao Paulo, Brazil [05/58627-2]; U.S. Department of Veterans Affairs FX This work was supported by Fundacao de Apoio a Pesquisa do Estado de Sao Paulo, Sao Paulo, Brazil (Protocol 05/58627-2) and in part by the U.S. Department of Veterans Affairs. This study is registered at www.clinicaltrials.gov (NCT00545805). NR 19 TC 59 Z9 62 U1 0 U2 8 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD AUG PY 2010 VL 95 IS 8 BP 3871 EP 3875 DI 10.1210/jc.2010-0085 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 635JW UT WOS:000280652400044 PM 20484482 ER PT J AU Sox, HC Helfand, M Grimshaw, J Dickersin, K Tovey, D Knottnerus, JA Tugwell, P AF Sox, Harold C. Helfand, Mark Grimshaw, Jeremy Dickersin, Kay Tovey, David Knottnerus, J. Andre Tugwell, Peter CA PLoS Med Editors TI Comparative Effectiveness Research: Challenges for Medical Journals SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article C1 [Helfand, Mark] Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97201 USA. [Sox, Harold C.] Dartmouth Coll, Hitchcock Med Ctr, Dartmouth Med Sch, Dartmouth Inst, Hanover, NH 03756 USA. [Grimshaw, Jeremy] Ottawa Hosp Res Inst, Clin Epidemiol Program, Ottawa, ON, Canada. [Dickersin, Kay] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA. [Tovey, David] Cochrane Lib, London, England. [Knottnerus, J. Andre] Univ Maastricht, Dept Gen Practice, Maastricht, Netherlands. [Tugwell, Peter] Univ Ottawa, Dept Med, Ottawa, ON, Canada. [Tugwell, Peter] Univ Ottawa, Dept Epidemiol & Community Med, Ottawa, ON, Canada. RP Helfand, M (reprint author), Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97201 USA. EM helfand@ohsu.edu RI ; Grimshaw, Jeremy/D-8726-2013; Knottnerus, Andre/F-4866-2013; Knottnerus, Johannes/A-3829-2009 OI Grimshaw, Jeremy/0000-0001-8015-8243; Barbour, Virginia/0000-0002-2358-2440; Tugwell, Peter/0000-0001-5062-0556; Clark, Jocalyn/0000-0002-8014-3989 FU Public Library of Science FX Funding: The PLoS Medicine Editors are each paid a salary by the Public Library of Science, and they contributed to this editorial during their salaried time. The other authors received no specific funding for this article. NR 7 TC 5 Z9 5 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 AUG PY 2010 VL 63 IS 8 BP 862 EP 864 DI 10.1016/j.jclinepi.2010.03.001 PG 3 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 619OQ UT WOS:000279439900010 PM 20434882 ER PT J AU Bloch, MJ Basile, JN AF Bloch, Michael J. Basile, Jan N. TI EXISTING KIDNEY DISEASE CLASSIFICATION GUIDELINE NEEDS TO INCORPORATE DEGREE OF PROTEINURIA WITH ESTIMATED GLOMERULAR FILTRATION RATE TO MORE ACCURATELY PREDICT CARDIOVASCULAR AND RENAL RISK SO JOURNAL OF CLINICAL HYPERTENSION LA English DT Editorial Material C1 [Bloch, Michael J.] St Marys Reg Med Ctr, Risk Reduct Ctr, Reno, NV 89503 USA. [Bloch, Michael J.] Univ Nevada, Sch Med, Dept Med, Reno, NV 89557 USA. [Basile, Jan N.] Med Univ S Carolina, Seinsheimer Cardiovasc Hlth Program, Div Gen Internal Med Geriatr, Charleston, SC 29425 USA. [Basile, Jan N.] Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Bloch, MJ (reprint author), St Marys Reg Med Ctr, Risk Reduct Ctr, 645 N Arlington St,Suite 460, Reno, NV 89503 USA. EM mbloch@aol.com NR 0 TC 1 Z9 1 U1 0 U2 0 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1524-6175 J9 J CLIN HYPERTENS JI J. Clin. Hypertens. PD AUG PY 2010 VL 12 IS 8 BP 627 EP 630 DI 10.1111/j.1751-7176.2010.00325.x PG 4 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 635GX UT WOS:000280644700011 PM 20695941 ER PT J AU Sun, SH Sprenger, CCT Vessella, RL Haugk, K Soriano, K Mostaghel, EA Page, ST Coleman, IM Nguyen, HM Sun, HY Nelson, PS Plymate, SR AF Sun, Shihua Sprenger, Cynthia C. T. Vessella, Robert L. Haugk, Kathleen Soriano, Kathryn Mostaghel, Elahe A. Page, Stephanie T. Coleman, Ilsa M. Nguyen, Holly M. Sun, Huiying Nelson, Peter S. Plymate, Stephen R. TI Castration resistance in human prostate cancer is conferred by a frequently occurring androgen receptor splice variant SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID GROWTH-FACTOR-I; TUMOR-CELL LINES; MEDICAL CASTRATION; EPITHELIAL-CELLS; GENE-EXPRESSION; T-ANTIGEN; IGF-IR; PROGRESSION; ACTIVATION; MUTATIONS AB Progression of prostate cancer following castration is associated with increased androgen receptor (AR) expression and signaling despite AR blockade. Recent studies suggest that these activities are due to the generation of constitutively active AR splice variants, but the mechanisms by which these splice variants could mediate such effects are not fully understood. Here we have identified what we believe to be a novel human AR splice variant in which exons 5, 6, and 7 are deleted (AR(v567es)) and demonstrated that this variant can contribute to cancer progression in human prostate cancer xenograft models in mice following castration. We determined that, in human prostate cancer cell lines, AR(v567es) functioned as a constitutively active receptor, increased expression of full-length AR (AR(fl)), and enhanced the transcriptional activity of AR. In human xenografts, human prostate cancer cells transfected with AR(v567es) cDNA formed tumors that were resistant to castration. Furthermore, the ratio of AR(v567es) to AR(fl) expression within the xenografts positively correlated with resistance to castration. Importantly, we also detected AR(v567es) frequently in human prostate cancer metastases. In summary, these data indicate that constitutively active AR splice variants can contribute to the development of castration-resistant prostate cancers and may serve as biomarkers for patients who are likely to suffer from early recurrence and are candidates for therapies directly targeting the AR rather than ligand. C1 [Plymate, Stephen R.] Univ Washington, Sch Med, Harborview Med Ctr, Dept Med, Seattle, WA 98104 USA. [Vessella, Robert L.; Nguyen, Holly M.; Nelson, Peter S.; Plymate, Stephen R.] Univ Washington, Sch Med, Dept Urol, Seattle, WA 98104 USA. [Vessella, Robert L.; Haugk, Kathleen; Plymate, Stephen R.] Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Seattle, WA USA. [Mostaghel, Elahe A.; Coleman, Ilsa M.; Nelson, Peter S.] Fred Hutchinson Canc Res Ctr, Div Human Biol, Seattle, WA 98104 USA. [Sun, Huiying] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Sun, Huiying] Baylor Coll Med, Dept Med, Houston, TX 77030 USA. RP Plymate, SR (reprint author), Univ Washington, Sch Med, Harborview Med Ctr, Dept Med, Box 359625,325 9th Ave, Seattle, WA 98104 USA. EM splymate@u.washington.edu FU NIH-NCI [PO1 CA 85859]; Pacific Northwest Prostate Cancer SPORE [P50 CA 097186]; Veterans Affairs Research Program FX We would like to thank Jennifer Wu and Marco Marcelli for critical review of the manuscript and Martin Escandon for assistance with manuscript preparation. Grants from the NIH-NCI (PO1 CA 85859 to S.R. Plymate, R. Vessella, and P.S. Nelson), the Pacific Northwest Prostate Cancer SPORE (P50 CA 097186 to S.R. Plymate, R. Vessella, and P.S. Nelson), and the Veterans Affairs Research Program (to S.R. Plymate) supported this work. NR 52 TC 305 Z9 313 U1 1 U2 18 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 AUG PY 2010 VL 120 IS 8 BP 2715 EP 2730 DI 10.1172/JCI41824 PG 16 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 633HI UT WOS:000280492100010 PM 20644256 ER PT J AU Cao, HL Yu, SB Yao, Z Galson, DL Jiang, Y Zhang, XY Fan, J Lu, BF Guan, YF Luo, M Lai, YM Zhu, YB Kurihara, N Patrene, K Roodman, GD Xiao, GZ AF Cao, Huiling Yu, Shibing Yao, Zhi Galson, Deborah L. Jiang, Yu Zhang, Xiaoyan Fan, Jie Lu, Binfeng Guan, Youfei Luo, Min Lai, Yumei Zhu, Yibei Kurihara, Noriyoshi Patrene, Kenneth Roodman, G. David Xiao, Guozhi TI Activating transcription factor 4 regulates osteoclast differentiation in mice SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID BONE-MINERAL-DENSITY; OSTEOCALCIN GENE-EXPRESSION; MARROW STROMAL CELLS; LACKING C-FOS; PARATHYROID-HORMONE; KEY REGULATOR; T-CELLS; OSTEOBLAST DIFFERENTIATION; RECEPTOR ACTIVATOR; NUCLEAR-FACTOR AB Activating transcription factor 4 (ATF4) is a critical transcription factor for osteoblast (OBL) function and bone formation; however, a direct role in osteoclasts (OCLs) has not been established. Here, we targeted expression of ATF4 to the OCL lineage using the Trap promoter or through deletion of Aft4 in mice. OCL differentiation was drastically decreased in Atf4(-/-) bone marrow monocyte (BMM) cultures and bones. Coculture of Atf4(-/-) BMMs with WT OBLs or a high concentration of RANKL failed to restore the OCL differentiation defect. Conversely, Trap-Atf4-tg mice displayed severe osteopenia with dramatically increased osteoclastogenesis and bone resorption. We further showed that ATF4 was an upstream activator of the critical transcription factor Nfatc1 and was critical for RANKL activation of multiple MAPK pathways in OCL progenitors. Furthermore, ATF4 was crucial for M-CSF induction of RANK expression on BMMs, and lack of ATF4 caused a shift in OCL precursors to macrophages. Finally, ATF4 was largely modulated by M-CSF signaling and the PI3K/AKT pathways in BMMs. These results demonstrate that ATF4 plays a direct role in regulating OCL differentiation and suggest that it may be a therapeutic target for treating bone diseases associated with increased OCL activity. C1 [Cao, Huiling; Yu, Shibing; Galson, Deborah L.; Zhang, Xiaoyan; Luo, Min; Kurihara, Noriyoshi; Patrene, Kenneth; Roodman, G. David; Xiao, Guozhi] Univ Pittsburgh, Dept Med, Pittsburgh, PA USA. [Cao, Huiling; Yao, Zhi] Tianjin Med Univ, Educ Minist China, Key Lab, Dept Immunol, Tianjin, Peoples R China. [Jiang, Yu; Lai, Yumei] Univ Pittsburgh, Dept Pharmacol & Chem Biol, Pittsburgh, PA USA. [Zhang, Xiaoyan; Guan, Youfei] Peking Univ, Hlth Sci Ctr, Dept Physiol & Pathophysiol, Beijing, Peoples R China. [Fan, Jie] Univ Pittsburgh, Dept Surg, Pittsburgh, PA USA. [Lu, Binfeng; Zhu, Yibei] Univ Pittsburgh, Dept Immunol, Pittsburgh, PA USA. [Xiao, Guozhi] Nankai Univ, Coll Life Sci, Tianjin 300071, Peoples R China. RP Xiao, GZ (reprint author), VA Pittsburgh Healthcare Syst, Rm 2E-107,151-U, Pittsburgh, PA 15240 USA. EM xiaog@upmc.edu RI YU, SHIBING/B-7648-2012; Galson, Deborah/E-9370-2010 OI Galson, Deborah/0000-0002-2045-8807 FU NIH [DK072230, AR057310]; Department of Defense [W81XWH-07-1-0160]; Chinese Ministry of Science and Technology [2009CB918902] FX We thank Renny T. Franceschi (University of Michigan, Ann Arbor, Michigan, USA) for critical reading of this manuscript. Thanks to Harry Blair (University of Pittsburgh, Pittsburgh, Pennsylvania, USA) for expert advice on bone histomorphometry. This work was in part supported by NIH grant DK072230, Department of Defense grant W81XWH-07-1-0160, and Chinese Ministry of Science and Technology grant 2009CB918902 (to G. Xiao) as well as by NIH grant AR057310 (to D.L. Galson). NR 67 TC 32 Z9 33 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 AUG PY 2010 VL 120 IS 8 BP 2755 EP 2766 DI 10.1172/JCI42106 PG 12 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 633HI UT WOS:000280492100013 PM 20628199 ER PT J AU Baruch, L Agarwal, S Gupta, B Haynos, A Johnson, S Kelly-Johnson, K Eng, C AF Baruch, Lawrence Agarwal, Sanjay Gupta, Bhanu Haynos, Ann Johnson, Swapna Kelly-Johnson, Katelyn Eng, Calvin TI Is directly measured low-density lipoprotein clinically equivalent to calculated low-density lipoprotein? SO JOURNAL OF CLINICAL LIPIDOLOGY LA English DT Article DE Health policy; Hypercholesterolemia; LDL-C cholesterol; Lipids ID CORONARY-HEART-DISEASE; TREATMENT PANEL-III; CARDIOVASCULAR-DISEASE; POSITION STATEMENT; APOLIPOPROTEIN-B; HIGH-RISK; CHOLESTEROL; EVENTS; RATIOS AB BACKGROUND: Low-density lipoprotein cholesterol (LDL-C) can either be calculated or measured directly. Clinical guidelines recommend the use of calculated LDL-C (C-LDL-C) to guide therapy because the evidence base for cholesterol management is derived almost exclusively from trials that use C-LDL-C, with direct measurement of LDL-C (D-LDL-C) being reserved for those patients who are nonfasting or with significant hypertriglyceridemia. OBJECTIVE: Our aim was to determine the clinical equivalence of directly measured-LDL-C, using a Siemens Advia Chemistry System, and fasting C-LDL-C. METHODS: Eighty-one subjects recruited for two cholesterol treatment studies had at least one C-LDL-C and D-LDL-C performed simultaneously; 64 had a repeat lipid assessment after 4 to 6 weeks of therapy, resulting in 145 pairs of C-LDL-C and D-LDL-C. RESULTS: There was significant correlation between D-LDL-C and C-LDL-C (r(2) = 0.86). Correlation was significantly better in those with lower total cholesterol, triglycerides, and high-density lipoprotein. In 60% of subjects, the difference between D-LDL-C and C-LDL-C was more than 5 mg/dL and greater than 6%. Clinical concordance between D-LDL-C and C-LDL-C was present in 40% of patients, whereas clinical discordance was noted in 25%. One-third had greater than a 15 ing/dL difference between D-LDL-C and C-LDL-C, whereas 25% had a greater than 20 mg/dL difference. In 47% of subjects, the difference between D-LDL-C and C-LDL-C at baseline and follow-up changed by a minimum of 10% or 10 mg/dL. CONCLUSIONS: Our findings suggest that D-LDL-C is not clinically equivalent to C-LDL-C. This puts into question the current recommendation of using D-LDL-C in situations in which C-LDL-C would be inaccurate. Published by Elsevier Inc on behalf of the National Lipid Association. C1 [Baruch, Lawrence; Johnson, Swapna; Kelly-Johnson, Katelyn; Eng, Calvin] James J Peters VA Med Ctr, Med Serv, Bronx, NY 10468 USA. [Baruch, Lawrence; Eng, Calvin] Mt Sinai Sch Med, New York, NY USA. [Agarwal, Sanjay] Valley Hosp, Ridgewood, NJ USA. [Gupta, Bhanu] Mayo Clin, Rochester, MN USA. [Haynos, Ann] Univ Nevada, Reno, NV 89557 USA. RP Baruch, L (reprint author), James J Peters VA Med Ctr, Med Serv, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM lawrence.baruch@va.gov NR 14 TC 7 Z9 7 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1933-2874 J9 J CLIN LIPIDOL JI J. Clin. Lipidol. PD AUG PY 2010 VL 4 IS 4 BP 259 EP 264 DI 10.1016/j.jacl.2010.05.003 PG 6 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 647LB UT WOS:000281618900004 PM 21122658 ER PT J AU Liu, F Williams, RM Liu, HE Chien, NH AF Liu, Fen Williams, Rhonda M. Liu, Hsueh-Erh Chien, Nai-Hui TI The lived experience of persons with lower extremity amputation SO JOURNAL OF CLINICAL NURSING LA English DT Article DE lived experience; lower extremity amputation; nurses; nursing; qualitative research ID LOWER-LIMB AMPUTATION; DIABETIC-PATIENTS; REHABILITATION; ADJUSTMENT; MANAGEMENT; TRAUMA; DEFINITION; AMPUTEES; CARE AB Aim. The aim of this study was to describe and understand the lived experience of people with lower extremity amputation. Background. The loss of a body part can cause physical, psychological and social disturbances. The majority of previous studies in this area focus on the impact of amputation or the effectiveness of rehabilitation programmes. This is the first study in Taiwan exploring the holistic experiences of persons with amputation. Design. A phenomenological research design was used. Methods. Semi-structured interviews were performed with 22 people with lower extremity amputation. Interviews were tape-recorded and transcribed verbatim. Data were analysed using Colaizzi's phenomenological analysis method. Results. The lived experience of persons with lower extremity amputation could be categorised into the following four themes: 'lost in the dark woods', 'emotional collapse', 'difficulty in passing through the shadow' and 'igniting a gleam of hope'. Conclusions. Participants described suffering in physical, psychological and sociocultural realms and the ways they strived to cope with these challenges. The findings of this study provide an enhanced understanding of the experiences of people with lower extremity amputation and underscore the importance of truly listening and responding to their concerns. The need to appreciate cultural context and to develop the peer-based support programme was highlighted. Relevance to clinical practice. Health professionals need to acknowledge the real needs of people with lower extremity amputation and provide them a clear explanation regarding the short-term and long-term health issues associated with amputation during the pre- and post-amputation phase. Health professionals also need to expand the scope of services beyond a physical and prosthetic focus. Supportive psychological and social interventions such as formal support groups and peer support programmes may provide a powerful and inexpensive addition to routine care. Currently, such programmes are unavailable in Taiwan. C1 [Liu, Hsueh-Erh] Chang Gung Univ, Sch Nursing, Tao Yuan, Taiwan. [Liu, Fen] Chang Gung Univ, Coll Med, Grad Inst Clin Med Sci, Tao Yuan, Taiwan. [Liu, Fen; Chien, Nai-Hui] Chang Gung Inst Technol, Dept Nursing, Tao Yuan, Taiwan. [Williams, Rhonda M.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Williams, Rhonda M.] Univ Washington, Seattle, WA 98195 USA. RP Liu, HE (reprint author), Room 33,7F,2nd Med Bldg,259 Wen Haw 1st Rd, Tao Yuan, Taiwan. EM sarah@mail.cgu.edu.tw FU Chang Gung Institute of Technology FX We thank all persons who participated in this study and the prosthetic rehabilitation centres that provided us with access to these participants. Funding for this study was received gratefully from Chang Gung Institute of Technology. NR 45 TC 12 Z9 13 U1 2 U2 20 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0962-1067 J9 J CLIN NURS JI J. Clin. Nurs. PD AUG PY 2010 VL 19 IS 15-16 BP 2152 EP 2161 DI 10.1111/j.1365-2702.2010.03256.x PG 10 WC Nursing SC Nursing GA 626AI UT WOS:000279937600010 PM 20659195 ER PT J AU Myrick, H Li, XB Randall, PK Henderson, S Voronin, K Anton, RF AF Myrick, Hugh Li, Xingbao Randall, Patrick K. Henderson, Scott Voronin, Konstantin Anton, Raymond F. TI The Effect of Aripiprazole on Cue-Induced Brain Activation and Drinking Parameters in Alcoholics SO JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY LA English DT Article DE neuroimaging; alcoholism; craving; aripiprazole ID RAT NUCLEUS-ACCUMBENS; CLINICAL LABORATORY PARADIGM; EXTRACELLULAR DOPAMINE; VENTRAL STRIATUM; ANTIPSYCHOTIC-DRUG; DOUBLE-BLIND; RECEPTOR AVAILABILITY; RELAPSE PREVENTION; DEPENDENT SUBJECTS; PARTIAL AGONIST AB Because the effects of alcohol and its environmental cues on brain dopamine have been implicated in the maintenance of heavy drinking, drugs that modify dopamine might be useful in reducing drinking or promoting abstinence. The goal of the current study was to use an established brain imaging paradigm to explore the effect of aripiprazole (final dose 15 mg over a 14-day period), a dopamine stabilizer medication, on alcohol cue-induced brain activation and drinking in alcoholics. Non-treatment-seeking alcoholics were randomly assigned aripiprazole (n = 14) or identical placebo (n = 16) and reported their alcohol use while taking study medication for 14 days before an alcohol cue-induced brain functional magnetic resonance imaging study. In a Philips 3.0-T magnetic resonance imaging scanner, subjects were given a sip of alcohol before viewing a randomized presentation alcoholic-and nonalcoholic-beverage photographs while subjects rated their urge to drink. During photograph presentation, changes in regional brain activity were measured, and differences between viewing alcoholic beverage and nonalcoholic beverages were compared within and between groups. Brain activity analysis revealed increased activation for placebo-treated subjects in the right ventral striatum (P < 0.005; threshold 15 voxels), while there was a blunting of activation in this area in the aripiprazole-treated subjects. Aripiprazole-treated subjects, compared with placebo-treated subjects, also had significantly less heavy drinking during the 14-day medication period. The study provides both novel and valuable information regarding the effect of aripiprazole on cue-induced brain activation and voluntary drinking during treatment. C1 [Myrick, Hugh; Henderson, Scott] Med Univ S Carolina, Ralph H Johnson Dept Vet Affairs Med Ctr, Res & Dev Serv, Charleston, SC 29425 USA. [Myrick, Hugh; Li, Xingbao; Randall, Patrick K.; Henderson, Scott; Voronin, Konstantin; Anton, Raymond F.] Med Univ S Carolina, Alcohol Res Ctr, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. [Myrick, Hugh; Li, Xingbao] Med Univ S Carolina, Ctr Adv Imaging Res, Charleston, SC 29425 USA. RP Myrick, H (reprint author), Med Univ S Carolina, Ralph H Johnson Dept Vet Affairs Med Ctr, Res & Dev Serv, IOP 4N,67 President St,MSC 861, Charleston, SC 29425 USA. EM myrickh@musc.edu FU Charleston Alcohol Research Center [NIAAA P50 AA10761]; NIAAA [K23 AA00314]; VA Research and Development Service, Ralph H. Johnson Department of Veterans Affairs Medical Center; Bristol-Myers Squibb FX This work was funded by the Charleston Alcohol Research Center (NIAAA P50 AA10761). Dr Myrick is also funded through NIAAA K23 AA00314 and the VA Research and Development Service, Ralph H. Johnson Department of Veterans Affairs Medical Center.; Drs Anton and Myrick have received grant support from Bristol-Myers Squibb. Dr Myrick is a member of the Bristol-Myers Squibb speakers' bureau, and Dr Anton has been a consultant for Bristol-Myers Squibb. Drs Voronin, Li, and Randall and Mr Henderson reported no biomedical financial interests or potential conflicts of interest. NR 72 TC 28 Z9 29 U1 5 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0271-0749 J9 J CLIN PSYCHOPHARM JI J. Clin. Psychopharmacol. PD AUG PY 2010 VL 30 IS 4 BP 365 EP 372 DI 10.1097/JCP.0b013e3181e75cff PG 8 WC Pharmacology & Pharmacy; Psychiatry SC Pharmacology & Pharmacy; Psychiatry GA 625MY UT WOS:000279900700004 PM 20571434 ER PT J AU Dublin, S Glazer, NL Smith, NL Psaty, BM Lumley, T Wiggins, KL Page, RL Heckbert, SR AF Dublin, Sascha Glazer, Nicole L. Smith, Nicholas L. Psaty, Bruce M. Lumley, Thomas Wiggins, Kerri L. Page, Richard L. Heckbert, Susan R. TI Diabetes Mellitus, Glycemic Control, and Risk of Atrial Fibrillation SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE arrhythmia; atrial fibrillation; diabetes mellitus; glycemic control; diabetes complications ID C-REACTIVE PROTEIN; OBSTRUCTIVE SLEEP-APNEA; INSULIN SENSITIVITY; GLUCOSE-METABOLISM; INDEPENDENT RISK; PREVALENCE; POPULATION; OBESITY; HEART; OLDER AB Diabetes may be an independent risk factor for atrial fibrillation. However, results from prior studies are in conflict, and no study has examined diabetes duration or glycemic control. To examine the association of diabetes with risk of atrial fibrillation and to describe risk according to diabetes duration and glycemic control. A population-based case-control study. Within a large, integrated healthcare delivery system, we identified 1,410 people with newly-recognized atrial fibrillation from ICD-9 codes and validated cases by review of medical records. 2,203 controls without atrial fibrillation were selected from enrollment lists, stratified on age, sex, hypertension, and calendar year. Information on atrial fibrillation, diabetes and other characteristics came from medical records. Diabetes was defined based on physician diagnoses recorded in the medical record, and pharmacologically treated diabetes was defined as receiving antihyperglycemic medications. Information about hemoglobin A1c levels came from computerized laboratory data. Among people with atrial fibrillation, 252/1410 (17.9%) had pharmacologically treated diabetes compared to 311/2203 (14.1%) of controls. The adjusted OR for atrial fibrillation was 1.40 (95% CI 1.15-1.71) for people with treated diabetes compared to those without diabetes. Among those with treated diabetes, the risk of developing atrial fibrillation was 3% higher for each additional year of diabetes duration (95% CI 1-6%). Compared to people without diabetes, the adjusted OR for people with treated diabetes with average hemoglobin A1c a parts per thousand currency sign7 was 1.06 (95% CI 0.74-1.51); for A1c > 7 but a parts per thousand currency sign8, 1.48 (1.09-2.01); for A1c > 8 but a parts per thousand currency sign9, 1.46 (1.02-2.08); and for A1c > 9, 1.96 (1.22-3.14). Diabetes was associated with higher risk of developing atrial fibrillation, and risk was higher with longer duration of treated diabetes and worse glycemic control. Future research should identify and test approaches to reduce the risk of atrial fibrillation in people with diabetes. C1 [Dublin, Sascha; Psaty, Bruce M.; Heckbert, Susan R.] Grp Hlth Res Inst, Seattle, WA 98101 USA. [Dublin, Sascha; Smith, Nicholas L.; Psaty, Bruce M.; Heckbert, Susan R.] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. [Glazer, Nicole L.; Psaty, Bruce M.; Wiggins, Kerri L.] Univ Washington, Dept Med, Seattle, WA 98195 USA. [Psaty, Bruce M.] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. [Lumley, Thomas] Univ Washington, Dept Biostat, Seattle, WA 98195 USA. [Page, Richard L.] Univ Wisconsin, Sch Med & Publ Hlth, Dept Med, Madison, WI USA. [Smith, Nicholas L.] VA Puget Sound Hlth Care Syst, Seattle Epidemiol Res & Informat Ctr, Seattle, WA USA. RP Dublin, S (reprint author), Grp Hlth Res Inst, 1730 Minor Ave,Suite 1600, Seattle, WA 98101 USA. EM dublin.s@ghc.org FU National Heart, Lung and Blood Institute [HL 68986, HL 43201, HL 73410, HL 68639]; Veterans' Affairs Health Services Research Development; National Institute on Aging [K23AG028954]; Group Health Research Institute; American Federation for Aging Research; Hartford Foundation; Atlantic Philanthropies; Starr Foundation FX This research was funded by grants HL 68986, HL 43201, HL 73410, and HL 68639 from the National Heart, Lung and Blood Institute. Dr. Dublin was funded through a Veterans' Affairs Health Services Research & Development fellowship, a Paul Beeson Career Development Award from the National Institute on Aging (K23AG028954), and Group Health Research Institute internal funds. The Beeson Award is also supported in part by the American Federation for Aging Research, the Hartford Foundation, the Atlantic Philanthropies and the Starr Foundation. NR 40 TC 68 Z9 71 U1 1 U2 5 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 AUG PY 2010 VL 25 IS 8 BP 853 EP 858 DI 10.1007/s11606-010-1340-y PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 620MZ UT WOS:000279505300023 PM 20405332 ER PT J AU Keenan, CR Dhaliwal, G Henderson, MC Bowen, JL AF Keenan, Craig R. Dhaliwal, Gurpreet Henderson, Mark C. Bowen, Judith L. TI A 43-Year-Old Woman with Abdominal Pain and Fever SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material DE pattern recognition; analytic reasoning; problem representation; clinical diagnostic reasoning C1 [Keenan, Craig R.; Henderson, Mark C.] UC Davis Med Ctr, Dept Internal Med, Sacramento, CA 95817 USA. [Dhaliwal, Gurpreet] Univ Calif San Francisco, Dept Med, San Francisco, CA USA. [Dhaliwal, Gurpreet] San Francisco VA Med Ctr, San Francisco, CA USA. [Bowen, Judith L.] Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97201 USA. RP Keenan, CR (reprint author), UC Davis Med Ctr, Dept Internal Med, 4150 V St,Suite 2400, Sacramento, CA 95817 USA. EM craig.keenan@ucdmc.ucdavis.edu NR 7 TC 5 Z9 5 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 AUG PY 2010 VL 25 IS 8 BP 874 EP 877 DI 10.1007/s11606-010-1372-3 PG 4 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 620MZ UT WOS:000279505300027 PM 20440575 ER PT J AU Bray-Hall, S Schmidt, K Aagaard, E AF Bray-Hall, Susan Schmidt, Katrina Aagaard, Eva TI Toward Safe Hospital Discharge: A Transitions in Care Curriculum for Medical Students SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE care transitions; curriculum development/evaluation; home visit; undergraduate medical education; hospital discharge ID RANDOMIZED CONTROLLED-TRIAL; FOLLOW-UP; INTERVENTION; QUALITY; EVENTS; NEEDS AB Medical errors often occur when patients move between care settings. Physicians generally receive little formal education on improving patient care transitions. To develop a sustainable and effective Transition in Care Curriculum (TICC). Specific goals were to increase student confidence in and knowledge of skills necessary during care transitions at the time of hospital discharge, and to quantify the frequency of student-identified medication discrepancies during a post-discharge home visit. TICC was delivered to 136 3rd-year medical students during their required inpatient medicine clerkship at six urban Denver hospitals. TICC consists of small and large group interactive sessions and self-directed learning exercises to provide foundational knowledge of care transitions. Experiential learning occurs through direct patient care at the time of discharge and during a follow-up home, hospice, or skilled nursing visit. Students completed a pre-post confidence measure, short answer and multiple choice questions, a post-clerkship satisfaction survey, and a standardized medication discrepancy tool. Overall combined confidence in transitional care skills improved following the TICC from an average score of 2.7 (SD 0.9) to 4.0 (SD 0.8) (p < 0.01) on a 5-point confidence scale. They scored an average of 77% on the written discharge plan portion of the final exam. Students rated the usefulness of TICC at a mean of 3.1 (SD 0.7), above the combined mean of 2.7 for project work in all required clerkships. Students identified medication discrepancies during 43% of post-discharge visits (58 of 136). The most common reasons for discrepancies were patient lack of understanding of instructions and intentional non-adherence to medication plan. TICC represents a feasible and effective program to teach evidence-based transitional care. C1 [Bray-Hall, Susan] Denver VA Med Ctr, Denver, CO 80220 USA. [Bray-Hall, Susan] Univ Colorado, Dept Med, Div Geriatr, Aurora, CO USA. [Schmidt, Katrina] St Joseph Hosp, Dept Surg, Denver, CO USA. RP Bray-Hall, S (reprint author), Denver VA Med Ctr, 1055 Clermont St 111-D, Denver, CO 80220 USA. EM Susan.Bray-Hall@va.gov FU John A. Hartford Foundation, Center of Excellence, Division of Geriatrics, University of Colorado; John A. Hartford Center of Excellence, University of Colorado Denver FX Dr. Bray-Hall has received funding from the John A. Hartford Foundation, Center of Excellence, Division of Geriatrics, University of Colorado.; No sponsors or funders were involved in curricula design, data collection, management, analysis and interpretation, or the preparation, review and approval of the manuscript. This protocol was approved by the Colorado and VA IRB as exempt.; This study was supported by a grant from the John A. Hartford Center of Excellence, University of Colorado Denver. The authors wish to thank Dr. Adam Abraham who helped secure the grant and Drs. Daniel Matlock, Ethan Cumbler, and Jeannette Guerrasio for facilitating the small group sessions. NR 21 TC 20 Z9 20 U1 2 U2 7 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 AUG PY 2010 VL 25 IS 8 BP 878 EP 881 DI 10.1007/s11606-010-1364-3 PG 4 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 620MZ UT WOS:000279505300028 PM 20443072 ER PT J AU Rabquer, BJ Amin, MA Teegala, N Shaheen, MK Tsou, PS Ruth, JH Lesch, CA Imhof, BA Koch, AE AF Rabquer, Bradley J. Amin, Mohammad A. Teegala, Nanditha Shaheen, Matthew K. Tsou, Pei-Suen Ruth, Jeffrey H. Lesch, Charles A. Imhof, Beat A. Koch, Alisa E. TI Junctional Adhesion Molecule-C Is a Soluble Mediator of Angiogenesis SO JOURNAL OF IMMUNOLOGY LA English DT Article ID RHEUMATOID-ARTHRITIS; CELL-ADHESION; IMMUNOGLOBULIN SUPERFAMILY; ENDOTHELIAL-CELLS; E-SELECTIN; LEUKOCYTE ADHESION; GROWTH-FACTOR; IN-VIVO; JAM-C; PROTEIN AB Junctional adhesion molecule-C (JAM-C) is an adhesion molecule expressed by endothelial cells (ECs) that plays a role in tight junction formation, leukocyte adhesion, and transendothelial migration. In the current study, we investigated whether JAM-C is found in soluble form and whether soluble JAM-C (sJAM-C) mediates angiogenesis. We found that JAM-C is present in soluble form in normal serum and elevated in rheumatoid arthritis (RA) serum. The concentration of sJAM-C is also elevated locally in RA synovial fluid compared with RA serum or osteoarthritis synovial fluid. sJAM-C was also present in the culture supernatant of human microvascular ECs (HMVECs) and immortalized human dermal microvascular ECs, and its concentration was increased following cytokine stimulation. In addition, sJAM-C cleavage from the cell surface was mediated in part by a disintegrin and metalloproteinases 10 and 17. In functional assays, sJAM-C was both chemotactic and chemokinetic for HMVECs and induced HMVEC tube formation on Matrigel in vitro. Neutralizing anti-JAM-C Abs inhibited RA synovial fluid-induced HMVEC chemotaxis and sJAM-C-induced HMVEC tube formation on Matrigel. sJAM-C also induced angiogenesis in vivo in the Matrigel plug and sponge granuloma models. Moreover, sJAM-C-mediated HMVEC chemotaxis was dependent on Src, p38, and PI3K. Our results show that JAM-C exists in soluble form and suggest that modulation of sJAM-C may provide a novel route for controlling pathological angiogenesis. The Journal of Immunology, 2010, 185: 1777-1785. C1 [Rabquer, Bradley J.] Univ Michigan, Sch Med, Div Rheumatol, Dept Med, Ann Arbor, MI 48109 USA. [Koch, Alisa E.] US Dept Vet Affairs, Vet Affairs Med Serv, Ann Arbor, MI 48109 USA. [Imhof, Beat A.] Univ Geneva, Dept Pathol, CH-1211 Geneva, Switzerland. RP Rabquer, BJ (reprint author), Univ Michigan, Sch Med, Div Rheumatol, Dept Med, 4388 BSRB,109 Zina Pitcher Dr, Ann Arbor, MI 48109 USA. EM brabquer@umich.edu RI Koch, Alisa/B-6894-2011 FU National Institutes of Health [HL094017, AR052482, AR48267]; Office of Research and Development, Medical Research Service, Department of Veterans Affairs; Frederick G.L. Huetwell and William D. Robinson FX This work was supported by National Institutes of Health Grants HL094017 (to B.J.R.), AR052482 (to M.A.A.), and AR48267 (to A.E.K.), the Office of Research and Development, Medical Research Service, Department of Veterans Affairs, and the Frederick G.L. Huetwell and William D. Robinson, M.D., Professorship in Rheumatology. NR 44 TC 27 Z9 31 U1 0 U2 2 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD AUG 1 PY 2010 VL 185 IS 3 BP 1777 EP 1785 DI 10.4049/jimmunol.1000556 PG 9 WC Immunology SC Immunology GA 629EI UT WOS:000280177400055 PM 20592283 ER PT J AU Janle, EM Lila, MA Grannan, M Wood, L Higgins, A Yousef, GG Rogers, RB Kim, H Jackson, GS Ho, L Weaver, CM AF Janle, Elsa M. Lila, Mary Ann Grannan, Michael Wood, Lauren Higgins, Aine Yousef, Gad G. Rogers, Randy B. Kim, Helen Jackson, George S. Ho, Lap Weaver, Connie M. TI Pharmacokinetics and Tissue Distribution of C-14-Labeled Grape Polyphenols in the Periphery and the Central Nervous System Following Oral Administration SO JOURNAL OF MEDICINAL FOOD LA English DT Article DE blood-brain barrier; brain kinetics; grape; grape cell culture; interstitial fluid kinetics; neurodegenerative diseases; pharmacokinetics; polyphenols; tissue distribution ID ACCELERATOR MASS-SPECTROMETRY; CELL SUSPENSION-CULTURES; ALZHEIMERS-DISEASE; RED WINE; SEED EXTRACT; COGNITIVE DETERIORATION; IN-VIVO; BIOAVAILABILITY; RATS; ULTRAFILTRATION AB Grape polyphenols confer potential health benefits, including prevention of neurodegenerative diseases. To determine the absorption and tissue distribution of the complex grape polyphenol mixture, C-14-labeled polyphenols were biosynthesized by grape cell suspension cultures, during co-incubation with radioisotopically labeled sucrose, and fractionated into polyphenolic subfractions. The pharmacokinetics and distribution of grape polyphenols into blood, brain, and peripheral interstitial fluid were determined by tracking the C-14 label. The blood peak C-14 concentration of the fractions ranged from 15 minutes to 4 hours. Absorption and tissue distribution varied greatly between fractions. Concentrations in interstitial fluid were lower than in blood. The amount of residual label in the brain at 24 hours ranged from 0.1% to 1.7% of the dose, depending on the fraction. (14)Clabel found in the brain tissue and brain microdialysate indicated that grape polyphenols or their metabolites are able to cross the blood-brain barrier. Using C-14-labeled plant polyphenols it is possible to track the compounds or their metabolic products into any tissue and determine distribution patterns in spite of low concentrations. A central question regarding the potential role of dietary polyphenolics in neurodegenerative research is whether they are bioavailable in the brain. Our observations indicate that some grape-derived polyphenolics do reach the brain, which suggests their potential value for applications in neurodegenerative disorders. C1 [Janle, Elsa M.; Grannan, Michael; Wood, Lauren; Higgins, Aine; Weaver, Connie M.] Purdue Univ, Dept Foods & Nutr, W Lafayette, IN 47907 USA. [Lila, Mary Ann; Rogers, Randy B.] Univ Illinois, Dept Nat Resources & Environm Sci, Urbana, IL 61801 USA. [Jackson, George S.] Purdue Univ, Dept Phys, W Lafayette, IN 47907 USA. [Kim, Helen] Univ Alabama, Dept Pharmacol & Toxicol, Birmingham, AL USA. [Ho, Lap] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. [Ho, Lap] James J Peters Vet Affairs Med Ctr, Geriatr Res & Clin Ctr, Bronx, NY USA. RP Janle, EM (reprint author), Purdue Univ, Dept Foods & Nutr, 700 W State St, W Lafayette, IN 47907 USA. EM janle@purdue.edu FU Purdue University-University of Alabama at Birmingham Botanical Center for Age Related Diseases; NCCAM [P50 AT 00477] FX The authors thank Pamela Lachcik, Jane Einstein, and Tom Kubley for technical assistance. This project was supported by Purdue University-University of Alabama at Birmingham Botanical Center for Age Related Diseases funded by the Office of Dietary Supplements and NCCAM grant P50 AT 00477. NR 35 TC 24 Z9 25 U1 0 U2 8 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1096-620X J9 J MED FOOD JI J. Med. Food PD AUG PY 2010 VL 13 IS 4 BP 926 EP 933 DI 10.1089/jmf.2009.0157 PG 8 WC Chemistry, Medicinal; Food Science & Technology; Nutrition & Dietetics SC Pharmacology & Pharmacy; Food Science & Technology; Nutrition & Dietetics GA 633FL UT WOS:000280485000023 PM 20673061 ER PT J AU Hearst, SM Lopez, ME Shao, QM Liu, Y Vig, PJS AF Hearst, Scoty M. Lopez, Mariper E. Shao, Qingmei Liu, Yong Vig, Parminder J. S. TI Dopamine D-2 receptor signaling modulates mutant ataxin-1 S776 phosphorylation and aggregation SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE ataxin-1; cerebellum; dopamine 2 receptor; phosphorylation; S100B protein; spinocerebellar ataxia ID SCA1 TRANSGENIC MICE; SPINOCEREBELLAR ATAXIA; PROTEIN-KINASE; TRINUCLEOTIDE REPEAT; LOCOMOTOR IMPAIRMENT; NEURITE OUTGROWTH; ADENYLATE-CYCLASE; S100 PROTEINS; TYPE-1 GENE; CELL-LINE AB P>Spinocerebellar ataxia 1 (SCA1) is a dominantly inherited neurodegenerative disease associated with progressive ataxia resulting from the loss of cerebellar Purkinje cells (PCs) and neurons in the brainstem. In PCs of SCA1 transgenic mice, the disease causing ataxin-1 protein mediates the formation of S100B containing cytoplasmic vacuoles and further self-aggregates to form intranuclear inclusions. The exact function of the ataxin-1 protein is not fully understood. However, the aggregation and neurotoxicity of the mutant ataxin-1 protein is dependent on the phosphorylation at serine 776 (S776). Although protein kinase A (PKA) has been implicated as the S776 kinase, the mechanism of PKA/ataxin-1 regulation in SCA1 is still not clear. We propose that a dopamine D-2 receptor (D2R)/S100B pathway may be involved in modulating PKA activity in PCs. Using a D2R/S100B HEK stable cell line transiently transfected with GFP-ataxin-1[82Q], we demonstrate that stimulation of the D2R/S100B pathway caused a reduction in mutant ataxin-1 S776 phosphorylation and ataxin-1 aggregation. Activation of PKA by forskolin resulted in an enhanced S776 phosphorylation and increased ataxin-1 nuclear aggregation, which was suppressed by treatment with D2R agonist bromocriptine and PKA inhibitor H89. Furthermore, treating SCA1 transgenic PC slice cultures with forskolin induced neurodegenerative morphological abnormalities in PC dendrites consistent with those observed in vivo. Taken together our data support a mechanism where PKA dependent mutant ataxin-1 phosphorylation and aggregation can be regulated by D2R/S100B signaling. C1 [Hearst, Scoty M.; Lopez, Mariper E.; Shao, Qingmei; Vig, Parminder J. S.] Univ Mississippi, Med Ctr, Dept Neurol, Jackson, MS 39216 USA. [Hearst, Scoty M.; Vig, Parminder J. S.] Univ Mississippi, Med Ctr, Dept Biochem, Jackson, MS 39216 USA. [Liu, Yong] Oregon Hlth & Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. [Liu, Yong] Portland VA Med Ctr, Portland, OR USA. RP Vig, PJS (reprint author), Univ Mississippi, Med Ctr, Dept Neurol, 2500 N State St, Jackson, MS 39216 USA. EM pvig@neurology.umsmed.edu FU National Institutes of Health; National Ataxia Foundation FX This work was partly supported by grants from the National Institutes of Health and National Ataxia Foundation. We would like to thank Dr. Kim Neve, Department of Behavioral Neuroscience, Oregon Health & Science University and Portland Veterans Affairs Medical Center for providing the D2R/S100B HEK cell lines and for his advice in preparing this manuscript. In addition, we would like to thank Dr. Michael Hebert, Department of Biochemistry, the University of Mississippi Medical Center, for his help with cell culture and ataxin-1 plasmid propagation. NR 63 TC 15 Z9 15 U1 0 U2 3 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2010 VL 114 IS 3 BP 706 EP 716 DI 10.1111/j.1471-4159.2010.06791.x PG 11 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 620ZI UT WOS:000279541900008 PM 20477910 ER PT J AU Li, LN Quang, TS Brady, LW AF Li, Linna Quang, Tony S. Brady, Luther W. TI Monoclonal antibodies Response SO JOURNAL OF NEUROSURGERY LA English DT Editorial Material ID MALIGNANT GLIOMA; RADIOTHERAPY; GLIOBLASTOMA; PROGRESSION C1 [Li, Linna] Drexel Univ, Coll Med, Fox Chase Canc Ctr, Philadelphia, PA 19104 USA. [Brady, Luther W.] Drexel Univ, Coll Med, Dept Radiat Oncol, Philadelphia, PA 19104 USA. [Quang, Tony S.] Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Li, LN (reprint author), Drexel Univ, Coll Med, Fox Chase Canc Ctr, Philadelphia, PA 19104 USA. NR 7 TC 0 Z9 0 U1 1 U2 2 PU AMER ASSOC NEUROLOGICAL SURGEONS PI ROLLING MEADOWS PA 5550 MEADOWBROOK DRIVE, ROLLING MEADOWS, IL 60008 USA SN 0022-3085 J9 J NEUROSURG JI J. Neurosurg. PD AUG PY 2010 VL 113 IS 2 BP 190 EP 191 PG 2 WC Clinical Neurology; Surgery SC Neurosciences & Neurology; Surgery GA 632FH UT WOS:000280405900011 ER PT J AU Li, LN Quang, TS Gracely, EJ Kim, JH Emrich, JG Yaeger, TE Jenrette, JM Cohen, SC Black, P Brady, LW AF Li, Linna Quang, Tony S. Gracely, Ed J. Kim, Ji H. Emrich, Jacqueline G. Yaeger, Theodore E. Jenrette, Joseph M. Cohen, Steven C. Black, Perry Brady, Luther W. TI A Phase II study of anti-epidermal growth factor receptor radioimmunotherapy in the treatment of glioblastoma multiforme Clinical article SO JOURNAL OF NEUROSURGERY LA English DT Article DE radioimmunotherapy; glioblastoma multiforme; temozolomide; (125)iodine-labeled monoclonal antibody 425; anti-epidermal growth factor receptor ID NEWLY-DIAGNOSED GLIOBLASTOMA; ONCOLOGY-GROUP TRIAL; HIGH-GRADE GLIOMA; RADIATION-THERAPY; SUPRATENTORIAL GLIOBLASTOMA; MALIGNANT GLIOMAS; STEREOTACTIC RADIOSURGERY; MONOCLONAL ANTIBODY-425; ADJUVANT CHEMOTHERAPY; INTERFERON-BETA AB Object. This single-institution Phase II study tests the efficacy of adjuvant radioimmunotherapy with I-125-labeled anti epidermal growth factor receptor 425 murine monoclonal antibody (I-125-mAb 425) in patients with newly diagnosed glioblastoma multiforme (GBM). Methods. A total of 192 patients with GBM were treated with I-125-mAb 425 over a course of 3 weekly intravenous injections of 1.8 GBq following surgery and radiation therapy. The primary end point was overall survival, and the secondary end point was toxicity. Additional subgroup analyses were performed comparing treatment with I-125-mAb 425 (RIT, 132 patients), I-125-mAb 425 and temozolomide (TMZ+RIT, 60 patients), and a historical control group (CTL, 81 patients). Results. The median age was 53 years (range 19-78 years), and the median Karnofsky Performance Scale score was 80 (range 60-100). The percentage of patients who underwent debulking surgery was 77.6% and that of those receiving temozolomide was 31.3%. The overall median survival was 15.7 months (95% CI 13.6-17.8 months). The 1- and 2-year survivals were 62.5 and 25.5%, respectively. For subgroups RIT and TMZ+RIT, the median survivals were 14.5 and 20.2 months, respectively. No Grade 3 or 4 toxicity was seen with the administration of I-125-mAb 425. The CTL patients lacked Karnofsky Performance Scale scores, had poorer survival, were older, and were less likely to receive radiation therapy. On multivariate analysis, the hazard ratios for RIT versus CTL, TMZ+RIT versus CTL, and TMZ+RIT versus RIT were 0.49 (p < 0.001), 0.30 (p < 0.001), and 0.62 (p = 0.008), respectively. Conclusions. In this large Phase II study of 192 patients with GBM treated with anti epidermal growth factor receptor I-125-mAb 425 radioimmunotherapy, survival was 15.7 months, and treatment was safe and well tolerated. (DOI: 10.3171/2010.2.JNS091211) C1 [Li, Linna] Fox Chase Canc Ctr, Dept Radiat Oncol, Philadelphia, PA 19111 USA. [Gracely, Ed J.] Drexel Univ, Coll Med, Dept Epidemiol & Biostat, Philadelphia, PA 19104 USA. [Emrich, Jacqueline G.; Brady, Luther W.] Drexel Univ, Coll Med, Dept Radiat Oncol, Philadelphia, PA 19104 USA. [Black, Perry] Drexel Univ, Coll Med, Dept Surg Neurosurg, Philadelphia, PA 19104 USA. [Cohen, Steven C.] Bryn Mawr Hosp, Dept Hematol & Oncol, Philadelphia, PA USA. [Quang, Tony S.] Univ Washington, VA Puget Sound Hlth Care Syst, Dept Radiat Oncol, Seattle, WA 98195 USA. [Kim, Ji H.] City Hope Natl Med Ctr, Dept Radiat Oncol, Duarte, CA USA. [Yaeger, Theodore E.] Wake Forest Univ, Sch Med, Dept Radiat Oncol, Winston Salem, NC 27109 USA. [Jenrette, Joseph M.] Med Univ S Carolina, Dept Radiat Oncol, Charleston, SC 29425 USA. RP Li, LN (reprint author), Fox Chase Canc Ctr, Dept Radiat Oncol, 333 Cottman Ave, Philadelphia, PA 19111 USA. EM linna.li@fccc.edu NR 54 TC 39 Z9 39 U1 0 U2 2 PU AMER ASSOC NEUROLOGICAL SURGEONS PI ROLLING MEADOWS PA 5550 MEADOWBROOK DRIVE, ROLLING MEADOWS, IL 60008 USA SN 0022-3085 EI 1933-0693 J9 J NEUROSURG JI J. Neurosurg. PD AUG PY 2010 VL 113 IS 2 BP 192 EP 198 DI 10.3171/2010.2.JNS091211 PG 7 WC Clinical Neurology; Surgery SC Neurosciences & Neurology; Surgery GA 632FH UT WOS:000280405900012 PM 20345222 ER PT J AU Beckham, JD Tuttle, KD Tyler, KL AF Beckham, J. David Tuttle, Kathryn D. Tyler, Kenneth L. TI Caspase-3 activation is required for reovirus-induced encephalitis in vivo SO JOURNAL OF NEUROVIROLOGY LA English DT Article DE apoptosis; caspase; encephalitis; neuron; reovirus ID CENTRAL-NERVOUS-SYSTEM; JAPANESE ENCEPHALITIS; CELL-DEATH; PERSISTENT INFECTIONS; INDUCED APOPTOSIS; VIRUS INFECTION; PATHOGENESIS; REPLICATION; INHIBITOR; MUTATIONS AB Reovirus infection of neonatal mice provides a classic experimental system for understanding the molecular pathogenesis of central nervous system (CNS) viral infection. CNS tissue injury, caused by many human neurotropic viruses, including herpes viruses and West Nile virus, is associated with caspase-dependent apoptotic neuronal cell death. We have previously shown that reovirus-induced CNS tissue injury results from apoptosis and is associated with activation of both death-receptor and mitochondrial apoptotic pathways culminating in the activation of the downstream effector caspase, caspase-3. In order to directly investigate the role of caspase-3 in virus-induced neuronal death and CNS tissue injury during encephalitis, we have compared the pathogenesis of reovirus CNS infection in mice lacking the caspase-3 gene (caspase-3 (-/-)) to syngeneic wild-type mice. Prior studies of antiapoptotic treatments for reovirus-infected mice have indicated that protection from reovirus-induced neuronal injury can occur without altering the viral titer in the brains of infected mice. We now show that reovirus infection of caspase-3 (-/-) mice was associated with dramatic reduction in severity of CNS tissue injury, decreased viral antigen and titer in the brain, and enhanced survival of infected mice. Following intracerebral inoculation, the authors also show that virus spread from the brain to the eyes in reovirus-infected caspase-3 (-/-) mice, indicating that viral spread was intact in these mice. Examination of brains of long-term survivors of reovirus infection among caspase-3 (-/-) mice showed that these mice eventually clear their CNS viral infection, and do not manifest residual or delayed CNS tissue injury. Journal of NeuroVirology (2010) 16, 306-317. C1 [Beckham, J. David] Univ Colorado Denver, Dept Med, Div Infect Dis, Aurora, CO 80045 USA. [Tyler, Kenneth L.] Denver Vet Affairs Med Ctr, Denver, CO USA. RP Beckham, JD (reprint author), Univ Colorado Denver, Dept Med, Div Infect Dis, Bldg Res 2,12700 E 19th Ave,B168, Aurora, CO 80045 USA. EM david.beckham@ucdenver.edu OI Tyler, Kenneth/0000-0003-3294-5888 FU VA; NIH [5K08AI076518, 5R01NS050138, 1R01NS051403]; ASCI FX This work was supported in part by VA Merit funding, NIH 5K08AI076518, NIH 5R01NS050138, NIH 1R01NS051403, and ASCI Young Investigator Award. NR 37 TC 14 Z9 14 U1 0 U2 2 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 2010 VL 16 IS 4 BP 306 EP 317 DI 10.3109/13550284.2010.499890 PG 12 WC Neurosciences; Virology SC Neurosciences & Neurology; Virology GA 647JA UT WOS:000281613400006 PM 20626234 ER PT J AU Cook, DB Stegner, AJ Ellingson, LD AF Cook, Dane B. Stegner, Aaron J. Ellingson, Laura D. TI Exercise Alters Pain Sensitivity in Gulf War Veterans With Chronic Musculoskeletal Pain SO JOURNAL OF PAIN LA English DT Article DE Gulf War; pain; exercise; veterans; fibromyalgia; hyperalgesia ID FIBROMYALGIA SYNDROME; TEMPORAL SUMMATION; MAJOR DEPRESSION; CLINICAL PAIN; MUSCLE; PERCEPTION; ILLNESSES; QUESTIONNAIRE; CONSEQUENCES; STIMULATION AB Since returning from the Persian Gulf, nearly 100,000 veterans of the first Gulf War (GVs) have reported numerous symptoms with no apparent medical explanation. A primary complaint of these individuals is chronic musculoskeletal pain (CMP). CMP symptoms in GVs are similar to those reported by patients with fibromyalgia (FM), but have not received equivalent scientific attention. Exercise research in CMP patients suggests that acute exercise may exacerbate pain while chronic exercise can reduce pain and improve other symptoms. However, the influence of exercise on GVs with CMP is largely unexplored. This study examined the impact of an acute bout of exercise on pain sensitivity in GVs with CMP. Thirty-two GVs (CMP, n = 15; Control, n = 17) were recruited to complete a series of psychophysical assessments to determine pain sensitivity to heat and pressure stimuli before and after exercise. In response to heat-pain stimuli, GVs with CMP reported higher pain intensity and affect ratings than healthy GVs and exhibited a significant increase in ratings following exercise. GVs with CMP rated exercise as more painful and effortful and were generally more sensitive to heat-pain stimuli than healthy GVs. These results are similar to what has been reported for acute exercise in patients with FM. Perspective: Gulf War veterans with CMP perceive exercise as more painful and effortful than healthy GVs and experience increased pain sensitivity following exercise. These results suggest that similar abnormalities in central nervous system processing of nociceptive information documented in FM may also be occurring in GVs with CMP (C) 2010 by the American Pain Society C1 [Cook, Dane B.] Univ Wisconsin, Dept Kinesiol, Unit 2, Madison, WI 53706 USA. [Cook, Dane B.] William S Middleton Mem Vet Adm Med Ctr, Res Serv, Madison, WI USA. RP Cook, DB (reprint author), Univ Wisconsin, Dept Kinesiol, Unit 2, 2000 Observ Dr, Madison, WI 53706 USA. EM dcook@education.wisc.edu FU Office of Research and Development, VA Central Office, Department of Veterans Affairs [561-00215] FX Supported by the Office of Research and Development, VA Central Office, Department of Veterans Affairs (Grant #561-00215). NR 49 TC 25 Z9 25 U1 1 U2 5 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 1526-5900 J9 J PAIN JI J. Pain PD AUG PY 2010 VL 11 IS 8 BP 764 EP 772 DI 10.1016/j.jpain.2009.11.010 PG 9 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 639KP UT WOS:000280974000008 PM 20338824 ER PT J AU Lu, H Trancik, E Bailey, FA Ritchie, C Rosenfeld, K Shreve, S Furman, C Smith, D Wolff, C Casarett, D AF Lu, Hien Trancik, Emily Bailey, F. Amos Ritchie, Christine Rosenfeld, Kenneth Shreve, Scott Furman, Christian Smith, Dawn Wolff, Catherine Casarett, David TI Families' Perceptions of End-of-Life Care in Veterans Affairs versus Non-Veterans Affairs Facilities SO JOURNAL OF PALLIATIVE MEDICINE LA English DT Article ID PALLIATIVE CARE; QUALITY; SATISFACTION; PROJECT; ACCESS; ACOVE; OLDER AB Background: The Veterans Affairs (VA) has made significant investments in care for veterans. However, it is not known whether these investments have produced improvements in end-of-life care in the VA compared to other settings. Therefore, the goal of this study was to compare families' perceptions of end-of-life care among patients who died in VA and non-VA facilities. Design: Retrospective 32-item telephone surveys were conducted with family members of patients who died in VA and non-VA facilities. Setting: Five Veterans Affairs medical centers and their affiliated nursing homes and outpatient clinics. Participants: Patients were eligible if they received any care from a participating VA facility in the last month of life and if they died in an inpatient setting. One family member per patient completed the survey. Results: In bivariate analysis, patients who died in VA facilities (n = 520) had higher mean satisfaction scores compared to those who died in non-VA facilities (n = 89; 59 versus 51; rank sum test p = 0.002). After adjusting for medical center, the overall score was still significantly higher for those dying in the VA (beta = 0.07; confidence interval [CI] 0.02-0.11; p = 0.004), as was the domain measuring care around the time of death (beta = 0.11; CI = 0.04-0.17; p = 0.001). Conclusion: Families of patients who died in VA facilities rated care as being better than did families of those who died in non-VA facilities. These results provide preliminary evidence that the VA's investment in end-of-life care has contributed to improvements in care in VA facilities compared to non-VA facilities. C1 [Lu, Hien; Wolff, Catherine; Casarett, David] Univ Penn, Sch Med, Div Geriatr, Philadelphia, PA 19104 USA. [Trancik, Emily] Villanova Univ, Philadelphia, PA USA. [Bailey, F. Amos; Ritchie, Christine] Birmingham VA, Birmingham, AL USA. [Rosenfeld, Kenneth] Greater Los Angeles VA, Los Angeles, CA USA. [Shreve, Scott] Lebanon VA, Lebanon, PA USA. [Furman, Christian] Louisville VA, Louisville, KY USA. [Smith, Dawn; Casarett, David] Philadelphia VA Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RP Casarett, D (reprint author), 3615 Chestnut St, Philadelphia, PA 19104 USA. EM Casarett@mail.med.upenn.edu FU VA Merit Award [IIR 03-128-2]; Presidential Early Career Award for Scientists and Engineers FX This study was supported by a VA Merit Award (IIR 03-128-2), by a VA Advanced Research Career Development Award (Dr. Casarett), and by a Presidential Early Career Award for Scientists and Engineers (Dr. Casarett). NR 27 TC 16 Z9 16 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 2010 VL 13 IS 8 BP 991 EP 996 DI 10.1089/jpm.2010.0044 PG 6 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 639HY UT WOS:000280967100012 PM 20649437 ER PT J AU Stengel, A Goebel, M Wang, L Rivier, J Kobelt, P Monnikes, H Tache, Y AF Stengel, A. Goebel, M. Wang, L. Rivier, J. Kobelt, P. Monnikes, H. Tache, Y. TI SELECTIVE CENTRAL ACTIVATION OF SOMATOSTATIN RECEPTOR 2 INCREASES FOOD INTAKE, GROOMING BEHAVIOR AND RECTAL TEMPERATURE IN RATS SO JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY LA English DT Article DE somatostatin; somatostatin receptor-2; behavior; body temperature; food intake; gastric emptying; rat; feeding; grooming ID CENTRAL-NERVOUS-SYSTEM; GHRELIN SECRETION; BARREL ROTATION; GROWTH-HORMONE; CHOLINERGIC STIMULATION; IN-VITRO; HYPOTHALAMUS; SUPPRESSION; AGONISTS; SUBTYPE AB The consequences of selective activation of brain somatostatin receptor-2 (sst(2)) were assessed using the sst(2) agonist, des-AA(1,4-6,11-13)-[DPhe(2),Aph7(Cbm),DTrp(8)]-Cbm-SST-Thr-NH(2). Food intake (FI) was monitored in ad libitum fed rats chronically implanted with an intracerebroventricular (icy.) cannula. The sst(2) agonist injected i.c.v. at 0.1 and 1 mu g/rat dose-dependently increased light phase FI from 2 to 6 hours post injection (2.3 +/- 0.5 and 7.5 +/- 1.2 respectively vs. vehicle: 0.2 +/- 0.2 g/300 g bw, P<0.001). Peptide action was reversed by i.c.v, injection of the sst2 antagonist, des-AA(1,4-6,11-13)-[pNO(2)-Phe(2),DCys(3),Tyr(7),DAph(Cbm)(8)]-SST-2NaI-NH(2) and not reproduced by intraperitoneal injection (30 mu g/rat). The sst(2) antagonist alone i.c.v, significantly decreased the cumulative 14-hours dark phase FI by 29.5%. Other behaviors, namely grooming, drinking and locomotor activity were also increased by the sst2 agonist (1 mu g/rat, i.c.v.) as monitored during the 2(nd) hour post injection while gastric emptying of solid food was unaltered. Rectal temperature rose 1 hour after the sst(2) agonist (1 mu g/rat, i.c.v.) with a maximal response maintained from 1 to 4 hours post injection. These data show that selective activation of the brain sst(2) receptor induces a feeding response in the light phase not associated with changes in gastric emptying. The food intake reduction following sst(2) receptor blockade suggests a role of this receptor in the orexigenic drive during the dark phase. C1 [Tache, Y.] Vet Affairs Greater Los Angeles Healthcare Syst, Ctr Neurobiol Stress, Los Angeles, CA 90073 USA. [Stengel, A.; Goebel, M.; Wang, L.; Tache, Y.] Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Los Angeles, CA USA. [Stengel, A.; Goebel, M.; Wang, L.; Tache, Y.] Univ Calif Los Angeles, Dept Med, Ctr Neurobiol Stress, Div Digest Dis, Los Angeles, CA 90024 USA. [Rivier, J.] Salk Inst Biol Studies, Peptide Biol Labs, La Jolla, CA USA. [Kobelt, P.] Univ Med Berlin, Div Psychosomat Med & Psychotherapy, Dept Med, Charite, Berlin, Germany. [Monnikes, H.] Martin Luther Krankenhaus, Dept Med, Berlin, Germany. [Monnikes, H.] Martin Luther Krankenhaus, Inst Neurogastroenterol, Berlin, Germany. RP Tache, Y (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Ctr Neurobiol Stress, CURE Bldg 115,Room 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM ytache@mednet.ucla.edu FU German Research Foundation [STE 1765/1-1, GO 1718/1-1]; Veterans Administration Research Career Scientist Award [R01 NIH DK-33061, DK-41301] FX This work was supported by German Research Foundation Grants STE 1765/1-1 (A.S.), GO 1718/1-1 (M.G.), Veterans Administration Research Career Scientist Award, R01 NIH DK-33061 and Center Grant DK-41301 (Animal Core) (Y.T). J. R. is the Dr. Frederik Paulsen Chair in Neurosciences Professor. We are grateful to Mrs. Honghui Liang for her excellent technical support and we thank Ms. Eugenia Hu for reviewing the manuscript. NR 62 TC 22 Z9 22 U1 0 U2 2 PU POLISH PHYSIOLOGICAL SOC PI GRZEGORZECKA PA JAGIELLONIAN UNIV SCHOOL MED, INST PHYSIOLOGY, 31-531 KRAKOW, 16 GRZEGORZECKA, POLAND SN 0867-5910 J9 J PHYSIOL PHARMACOL JI J. Physiol. Pharmacol. PD AUG PY 2010 VL 61 IS 4 BP 399 EP 407 PG 9 WC Physiology SC Physiology GA 646IZ UT WOS:000281534500004 PM 20814067 ER PT J AU O'Tierney, PF Chattergoon, NN Louey, S Giraud, GD Thornburg, KL AF O'Tierney, P. F. Chattergoon, N. N. Louey, S. Giraud, G. D. Thornburg, K. L. TI Atrial natriuretic peptide inhibits angiotensin II-stimulated proliferation in fetal cardiomyocytes SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Article ID ACTIVATED PROTEIN-KINASE; SMOOTH-MUSCLE CELLS; A-DEFICIENT MICE; CARDIAC-HYPERTROPHY; MESANGIAL CELLS; CLEARANCE RECEPTOR; VENOUS HYPERTENSION; GENE-EXPRESSION; SHEEP HEART; RAT HEART AB The role of atrial natriuretic peptide (ANP) in regulating fetal cardiac growth is poorly understood. Angiotensin II (Ang II) stimulates proliferation in fetal sheep cardiomyocytes when growth is dependent on the activity of the mitogen-activated protein kinase (MAPK) and phosphoinositol-3-kinase (PI3K) pathways. We hypothesized that ANP would suppress near-term fetal cardiomyocyte proliferation in vitro and inhibit both the MAPK and PI3K pathways. Forty-eight hour 5-bromodeoxyuridine (BrdU) uptake (used as an index of proliferation) was measured in cardiomyocytes isolated from fetal sheep (135 day gestational age) in response to 100 nm Ang II with or without ANP (0.003-100 nm) or 1 mu m 8-bromo-cGMP. The effects of these compounds on the MAPK and PI3K pathways were assessed by measuring extracellular signal-regulated kinase (ERK) and AKT phosphorylation following 10 min of treatment with Ang II, ANP or 8-bromo-cGMP. In right ventricular myocytes (RV), the lowest dose of ANP (0.003 nm) inhibited Ang II-stimulated BrdU uptake by 68%. Similarly, 8-bromo-cGMP suppressed Ang II-stimulated proliferation by 62%. The same effects were observed in left ventricular (LV) cardiomyoytes but the RV was more sensitive to the inhibitory effects of ANP than the LV (P < 0.0001). Intracellular cGMP was increased by 4-fold in the presence of 100 nm ANP. Ang II-stimulated ERK and Akt phosphorylation was inhibited by 100 nm ANP. The activity of ANP may in part be cGMP dependent, as 8-bromo-cGMP had similar effects on the cardiomyocytes. C1 [O'Tierney, P. F.; Chattergoon, N. N.; Louey, S.; Giraud, G. D.; Thornburg, K. L.] Oregon Hlth & Sci Univ, Heart Res Ctr, Portland, OR 97239 USA. [Thornburg, K. L.] Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97239 USA. [Louey, S.; Giraud, G. D.; Thornburg, K. L.] Oregon Hlth & Sci Univ, Dept Cardiovasc Med, Portland, OR 97239 USA. [Giraud, G. D.] Portland VA Med Ctr, Portland, OR USA. RP Thornburg, KL (reprint author), Oregon Hlth & Sci Univ, Heart Res Ctr, 3303 SW Bond Ave,CH15H, Portland, OR 97239 USA. EM thornbur@ohsu.edu FU National Institute of Child Health and Human Development Program [P01HD34430]; American Heart Association; Tartar Trust Foundation; Department of Veterans Affairs FX This work at Oregon Health and Science University was supported by the National Institute of Child Health and Human Development Program Project Grant (P01HD34430), an American Heart Association Fellowship (O'Tierney), the Tartar Trust Foundation and the Department of Veterans Affairs. The authors have no conflicts of interest to declare. NR 56 TC 20 Z9 21 U1 0 U2 3 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD AUG 1 PY 2010 VL 588 IS 15 BP 2879 EP 2889 DI 10.1113/jphysiol.2010.191098 PG 11 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 635EL UT WOS:000280638300015 PM 20519318 ER PT J AU Ingraham, AM Cohen, ME Ko, CY Hall, BL AF Ingraham, Angela M. Cohen, Mark E. Ko, Clifford Y. Hall, Bruce Lee TI A Current Profile and Assessment of North American Cholecystectomy: Results from the American College of Surgeons National Surgical Quality Improvement Program SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Article; Proceedings Paper CT 95th Annual Clinical Congress of the American-College-of-Surgeons/64th Annual Sessions of the Owen H Wangensteen Forum on Fundamental Surgical Problems CY OCT 11-15, 2009 CL Chicago, IL SP Amer Coll Surg ID 8 COMMON OPERATIONS; BILE-DUCT INJURY; LAPAROSCOPIC CHOLECYSTECTOMY; ACUTE CHOLECYSTITIS; RISK-FACTORS; OUTCOMES; VOLUME; COMPLICATIONS; TRIAL; NSQIP AB BACKGROUND: Cholecystectomy is among the most common surgical procedures performed in the United States. The current state of cholecystectomy outcomes, including variations in hospital performance, is unclear. The objective of this study is to compare the risk factors, indications, and 30-day outcomes, as well as variations in hospital performance associated with laparoscopic (LC) versus open cholecystectomy (OC) at 221 hospitals during a 4-year period. STUDY DESIGN: Using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2005-2008), patients were identified who underwent cholecystectomy and related procedures (cholangiogram and/or common bile duct exploration). Four outcomes were studied, ie, 30-day overall morbidity, serious morbidity, surgical site infections, and mortality. Forward stepwise logistic regressions yielded patient-level predicted probabilities, and hospital-level observed-to-expected ratios were determined. RESULTS: Of 65,511 patients, 58,659(89.5%) underwent LC; 6,852 (10.5%) underwent OC. OC patients were considerably older with a higher comorbidity burden. LC patients were less likely to experience any morbidity (3.1% versus 17.8%; p < 0.0001), a serious morbidity (1.4% versus 11.1%; p < 0.0001), or a surgical site infection (1.3% versus 8.4%; p < 0.0001), and less likely to die (0.3% versus 2.8%; p < 0.0001). Observed-to-expected ratios for overall morbidity ranged from 0 to 3.55; for serious morbidity, 0 to 3.23; for surgical site infection, 0 to 7.02; for mortality, 0 to 13.05. CONCLUSIONS: Although overall incidence of adverse events is low after LC, substantial morbidity and mortality are associated with OC. Additionally, controlling for patient- and operation-related factors, considerable variations exist in hospital performance when evaluating 30-day outcomes after cholecystectomy. (J Am Coll Surg 2010;211:176-186. (C) 2010 by the American College of Surgeons) C1 [Ingraham, Angela M.; Cohen, Mark E.; Ko, Clifford Y.] Amer Coll Surg, Div Res & Optimal Patient Care, Chicago, IL 60611 USA. [Ingraham, Angela M.] Univ Cincinnati, Coll Med, Dept Surg, Cincinnati, OH 45267 USA. [Ko, Clifford Y.] Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. [Ko, Clifford Y.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Hall, Bruce Lee] Washington Univ, Sch Med, Dept Surg, John Cochran Vet Affairs Med Ctr, St Louis, MO 63110 USA. [Hall, Bruce Lee] Barnes Jewish Hosp, St Louis, MO 63110 USA. [Hall, Bruce Lee] Washington Univ, Ctr Hlth Policy, St Louis, MO USA. [Hall, Bruce Lee] Washington Univ, John M Olin Sch Business, St Louis, MO 63130 USA. RP Ingraham, AM (reprint author), Amer Coll Surg, Div Res & Optimal Patient Care, 633 N St Clair St,Floor 22NE, Chicago, IL 60611 USA. EM aingraham@facs.org NR 26 TC 52 Z9 52 U1 0 U2 3 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 AUG PY 2010 VL 211 IS 2 BP 176 EP 186 DI 10.1016/j.jamcollsurg.2010.04.003 PG 11 WC Surgery SC Surgery GA 638VY UT WOS:000280927200003 PM 20670855 ER PT J AU Aspinall, SL Zhao, XH Handler, SM Stone, RA Kosmoski, JC Libby, EA Francis, SD Goodman, DA Roman, RD Bieber, HL Voisine, JM Jeffery, SM Hepfinger, CA Hagen, DG Martin, MM Hanlon, JT AF Aspinall, Sherrie L. Zhao, Xinhua Handler, Steven M. Stone, Roslyn A. Kosmoski, Janine C. Libby, Elizabeth A. Francis, Susan Dove Goodman, David A. Roman, Rebecca D. Bieber, Heather L. Voisine, Jennifer M. Jeffery, Sean M. Hepfinger, Charley A. Hagen, Diane G. Martin, Micki M. Hanlon, Joseph T. TI The Quality of Warfarin Prescribing and Monitoring in Veterans Affairs Nursing Homes SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE warfarin; healthcare quality assurance; nursing homes ID ATRIAL-FIBRILLATION; ANTICOAGULATION CONTROL; MANAGEMENT; FREQUENCY; INTENSITY; THERAPY; EVENTS; DRUG; METAANALYSIS; RISK AB OBJECTIVES To describe the quality of warfarin prescribing and monitoring in Veterans Affairs (VA) nursing homes and to assess the factors associated with maintaining a therapeutic international normalized ratio (INR). DESIGN Retrospective cohort. SETTING Five VA nursing homes. PARTICIPANTS All veterans who received warfarin between January 1 and June 30, 2008, at the nursing homes. MEASUREMENTS Using medical records, the percentage of person-time spent in the target INR range, the proportion of patients with INRs in the therapeutic range on 50% or more of their person-days, and the frequency of INR monitoring were estimated. Multivariable logistic regression was used to identify factors associated with maintaining a therapeutic INR 50% or more of the time. RESULTS Over 6 months, 160 patients received 10,380 person-days of warfarin. INRs were in the therapeutic range for 55% of the person-days, and 99% of the INR tests were repeated within 4 weeks of the previous result. On an individual level, 49% of patients had INRs in the target range for 50% or more of their person-days. Achieving this outcome was more likely in patients with prevalent warfarin use than with new use (adjusted odds ratio (AOR)=2.86, 95% confidence interval (CI)=1.06-7.72). Conversely, patients with a history of a stroke (AOR=0.38, 95% CI =0.18-0.80) were less likely to have therapeutic INRs for 50% or more of their days. CONCLUSION Warfarin appears to be prescribed and monitored effectively in VA nursing home patients. Future studies should focus on increasing time in therapeutic range in patients with poor INR control. C1 [Aspinall, Sherrie L.; Zhao, Xinhua; Handler, Steven M.; Stone, Roslyn A.; Hanlon, Joseph T.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA 15206 USA. [Aspinall, Sherrie L.; Zhao, Xinhua] Vet Affairs Ctr Medicat Safety, Hines, IL USA. [Handler, Steven M.; Hanlon, Joseph T.] VA Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA 15206 USA. [Goodman, David A.; Roman, Rebecca D.] VA Pittsburgh Healthcare Syst, Dept Pharm, Pittsburgh, PA 15206 USA. [Aspinall, Sherrie L.; Hanlon, Joseph T.] Univ Pittsburgh, Sch Pharm, Pittsburgh, PA USA. [Handler, Steven M.; Hanlon, Joseph T.] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. [Stone, Roslyn A.] Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA. [Kosmoski, Janine C.; Francis, Susan Dove] Durham Vet Affairs Med Ctr, Geriatr Res Educ & Clin Ctr, Durham, NC USA. [Libby, Elizabeth A.; Hepfinger, Charley A.; Hagen, Diane G.; Martin, Micki M.] Phoenix Vet Affairs Hlth Care Syst, Dept Pharm, Phoenix, AZ USA. [Bieber, Heather L.] Lake City Vet Affairs Med Ctr, Dept Pharm, Lake City, FL USA. [Voisine, Jennifer M.; Jeffery, Sean M.] Vet Affairs Connecticut Healthcare Syst, Dept Pharm, West Haven, CT USA. RP Aspinall, SL (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, 7180 Highland Dr 151C-H, Pittsburgh, PA 15206 USA. EM sherrie.aspinall@va.gov OI Handler, Steven/0000-0002-3940-3224 FU VA Center for Medication Safety/VA Pharmacy Benefits Management Services, Hines, IL; VA Pittsburgh Healthcare System, Pittsburgh, PA; VA Connecticut Healthcare System, West Haven, CT; Durham VA Medical Center, Durham, NC; Lake City VA Medical Center, Lake City, FL; Phoenix VA Health Care System, Phoenix, AZ; National Institute of Aging [R01AG027017, P30AG024827, T32 AG021885, K07AG033174, R01AG034056]; National Institute of Mental Health [R34 MH082682]; National Institute of Nursing Research [R01 NR010135]; Agency for Healthcare Research and Quality [R01 HS017695]; VA Health Services [IIR-06-062] FX These findings are the result of work supported by the VA Center for Medication Safety/VA Pharmacy Benefits Management Services, Hines, IL; VA Pittsburgh Healthcare System (especially the Geriatric Research, Education and Clinical Center and the VA Center for Health Equity Research and Promotion), Pittsburgh, PA; VA Connecticut Healthcare System, West Haven, CT; Durham VA Medical Center (especially the Geriatric Research, Education and Clinical Center), Durham, NC; Lake City VA Medical Center, Lake City, FL; and Phoenix VA Health Care System, Phoenix, AZ.; Dr. Handler was supported by National Institutes of Health Roadmap Multidisciplinary Clinical Research Career Development Award Grant K12 RR023267.; Dr. Hanlon was supported by National Institute of Aging Grants R01AG027017, P30AG024827, T32 AG021885, K07AG033174, and R01AG034056; National Institute of Mental Health Grant R34 MH082682; National Institute of Nursing Research Grant R01 NR010135; Agency for Healthcare Research and Quality Grant R01 HS017695; and VA Health Services Research Grant IIR-06-062. NR 26 TC 8 Z9 9 U1 0 U2 6 PU WILEY-BLACKWELL PUBLISHING, INC 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 AUG PY 2010 VL 58 IS 8 BP 1475 EP 1480 DI 10.1111/j.1532-5415.2010.02967.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 635GN UT WOS:000280643700008 PM 20662956 ER PT J AU Sedor, JR Watnick, S Patel, UD Cheung, A Harmon, W Himmelfarb, J Hostetter, TH Inrig, JK Mehrotra, R Robinson, E Smedberg, PC Shaffer, RN AF Sedor, John R. Watnick, Suzanne Patel, Uptal D. Cheung, Alfred Harmon, William Himmelfarb, Jonathan Hostetter, Thomas H. Inrig, Jula K. Mehrotra, Rajnish Robinson, Emily Smedberg, Paul C. Shaffer, Rachel N. CA Amer Soc Nephrology ESRD Task Forc TI ASN End-Stage Renal Disease Task Force: Perspective on Prospective Payments for Renal Dialysis Facilities SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article C1 [Sedor, John R.] Dept Med, Cleveland, OH USA. [Sedor, John R.] Case Western Reserve Univ, Ctr Study Kidney Dis & Biol, Cleveland, OH 44106 USA. [Sedor, John R.; Watnick, Suzanne] Case Western Reserve Univ, Sch Med, Cleveland, OH 44106 USA. Portland VA Med Ctr, Portland, OR USA. [Patel, Uptal D.] Duke Univ, Duke Clin Res Inst, Durham, NC USA. [Patel, Uptal D.] Duke Univ, Dept Med, Durham, NC USA. [Patel, Uptal D.] Duke Univ, Dept Pediat, Durham, NC USA. [Cheung, Alfred] Univ Utah, Sch Med, Div Nephrol & Hypertens, Salt Lake City, UT USA. [Harmon, William] Childrens Hosp Boston, Dept Pediat, Boston, MA USA. [Himmelfarb, Jonathan] Univ Washington, Sch Med, Dept Med, Kidney Res Inst,Div Nephrol, Seattle, WA 98195 USA. Albert Einstein Coll Med, Dept Med, Bronx, NY 10461 USA. [Inrig, Jula K.] Univ Texas SW Med Ctr Dallas, Div Nephrol, Dept Med, Dallas, TX 75390 USA. [Mehrotra, Rajnish] Harbor UCLA Med Ctr, Dept Med, Los Angeles, CA USA. [Mehrotra, Rajnish] Harbor UCLA, Los Angeles Biomed Res Inst, Torrace, CA USA. [Mehrotra, Rajnish] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. [Robinson, Emily] Brigham & Womens Hosp, Div Renal Med, Boston, MA 02115 USA. RP Hostetter, TH (reprint author), Albert Einstein Coll Med, Div Nephrol, Room 615,Ullmann Bldg,1300 Morris Pk Ave, Bronx, NY 10461 USA. FU National Institutes of Health (NIH) [K23DK075929, K23 HL092297]; NIH/National Institute of Allergy and Infectious Diseases FX U.D.P. is supported by the National Institutes of Health (NIH) grant K23DK075929, W H receives grants from NIH/National Institute of Allergy and Infectious Diseases, and J K I is supported by NIH grant K23 HL092297. NR 6 TC 9 Z9 9 U1 1 U2 1 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 AUG PY 2010 VL 21 IS 8 BP 1235 EP 1237 DI 10.1681/ASN.2010060656 PG 3 WC Urology & Nephrology SC Urology & Nephrology GA 636OE UT WOS:000280746200002 PM 20675502 ER PT J AU Fried, LF AF Fried, Linda F. TI Higher Incidence of ESRD than Mortality in the AASK Study SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Editorial Material ID CHRONIC KIDNEY-DISEASE; STAGE RENAL-DISEASE; UNITED-STATES; RACIAL-DIFFERENCES; FOLLOW-UP; DEATH; POPULATION; OUTCOMES; RISK; CKD C1 [Fried, Linda F.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. [Fried, Linda F.] Univ Pittsburgh, Dept Med, Pittsburgh, PA USA. [Fried, Linda F.] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15261 USA. RP Fried, LF (reprint author), VA Pittsburgh Healthcare Syst, Univ Dr, Pittsburgh, PA 15240 USA. NR 18 TC 2 Z9 2 U1 0 U2 1 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 AUG PY 2010 VL 21 IS 8 BP 1244 EP 1246 DI 10.1681/ASN.2010060623 PG 3 WC Urology & Nephrology SC Urology & Nephrology GA 636OE UT WOS:000280746200007 PM 20651162 ER PT J AU Garzotto, M AF Garzotto, Mark TI The Association Between Statin Use and the Diagnosis of Prostate Cancer in a Population Based Cohort EDITORIAL COMMENT SO JOURNAL OF UROLOGY LA English DT Editorial Material C1 Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97201 USA. RP Garzotto, M (reprint author), Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97201 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 0022-5347 J9 J UROLOGY JI J. Urol. PD AUG PY 2010 VL 184 IS 2 BP 500 EP 500 PG 1 WC Urology & Nephrology SC Urology & Nephrology GA 623AA UT WOS:000279707700025 PM 20620407 ER PT J AU Burgio, KL Goode, PS Richter, HE Markland, AD Johnson, TM Redden, DT AF Burgio, Kathryn L. Goode, Patricia S. Richter, Holly E. Markland, Alayne D. Johnson, Theodore M. Redden, David T. TI Combined Behavioral and Individualized Drug Therapy Versus Individualized Drug Therapy Alone for Urge Urinary Incontinence in Women SO JOURNAL OF UROLOGY LA English DT Article DE urinary incontinence; behavioral therapy; drug therapy; clinical trial ID RANDOMIZED CONTROLLED-TRIAL; QUALITY-OF-LIFE; OLDER WOMEN; OVERACTIVE BLADDER; EFFICACY; TOLTERODINE; BIOFEEDBACK; PROGRAM; IMPACT AB Purpose: We tested whether individualized drug therapy enhanced with behavioral training would result in better outcomes than individualized drug therapy alone. Materials and Methods: Participants were community dwelling women with urge predominant incontinence. Using a randomized clinical trial design women were randomized to 8 weeks (4 visits) of drug therapy alone (32) or drug therapy plus behavioral training (32). Drug therapy was individually titrated, extended release oxybutynin with proactive management of side effects. Behavioral training included pelvic floor muscle training and urge suppression techniques. The primary outcome measure was reduction in frequency of incontinence episodes on bladder diary at 8 weeks (with followup at 6 and 12 months). Secondary outcomes included patient satisfaction, global perception of improvement, Urogenital Distress Inventory and Incontinence Impact Questionnaire. Results: In intent to treat analysis frequency of incontinence was reduced a mean of 88.5% in the drug alone group and 78.3% in the combined therapy group (p = 0.16). Outcomes were not significantly different between the groups in the analysis of completers (91.5% vs 86.2%, p = 0.34), or in either analysis at 6 or 12 months. The groups also did not differ significantly on secondary outcomes at any point. Participants in the drug alone group tended to be taking higher doses of oxybutynin at 8 weeks but the final dose did not differ significantly between the groups. Based on a conditional power calculation the trial was stopped early for futility. Conclusions: When drug therapy is implemented with frequent individualized dose titration, daily bladder diaries and careful management of side effects, initiating concurrent behavioral training does not enhance outcomes for urge incontinence in women. C1 [Burgio, Kathryn L.; Goode, Patricia S.; Markland, Alayne D.; Johnson, Theodore M.; Redden, David T.] Birmingham Atlanta Geriatr Res Educ & Clin Ctr, Dept Vet Affairs, Birmingham, AL USA. [Burgio, Kathryn L.; Goode, Patricia S.; Markland, Alayne D.; Johnson, Theodore M.; Redden, David T.] Birmingham Atlanta Geriatr Res Educ & Clin Ctr, Dept Vet Affairs, Atlanta, GA USA. [Burgio, Kathryn L.; Goode, Patricia S.; Richter, Holly E.; Markland, Alayne D.; Redden, David T.] Univ Alabama, Birmingham, AL USA. [Johnson, Theodore M.] Emory Univ, Atlanta, GA 30322 USA. RP Burgio, KL (reprint author), Birmingham VA Med Ctr, GRECC-11G,700 19th St S, Birmingham, AL 35233 USA. EM kburgio@aging.uab.edu OI Markland, Alayne/0000-0002-6567-6744 FU Department of Veterans Affairs; Veterans Health Administration; Rehabilitation Research and Development Service; Birmingham/Atlanta Geriatric Research Education and Clinical Center, Birmingham VA Medical Center; Pfizer; Astellas; Xanodyne; Yamanouchi; Ortho McNeil; Boehringer Ingelheim; Johnson Johnson FX Supported by a grant from the Department of Veterans Affairs, Veterans Health Administration, Rehabilitation Research and Development Service, and the Female Veterans Project, Birmingham/Atlanta Geriatric Research Education and Clinical Center, Birmingham VA Medical Center.; Financial interest and/or other relationship with Pfizer and Astellas.; Financial interest and/or other relationship with Xanodyne, Pfizer and Astellas.; Financial interest and/or other relationship with Aventis, Yamanouchi, Ortho McNeil, Boehringer Ingelheim, Johnson & Johnson and Pfizer. NR 24 TC 15 Z9 16 U1 3 U2 8 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 AUG PY 2010 VL 184 IS 2 BP 598 EP 603 DI 10.1016/j.juro.2010.03.141 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 623AA UT WOS:000279707700066 PM 20639023 ER PT J AU Lynch, CP McTigue, KM Bost, JE Tinker, LF Vitolins, M Adams-Campbell, L Sarto, GE Hays-Grudo, J Manson, JE Kuller, LH AF Lynch, Cheryl P. McTigue, Kathleen M. Bost, James E. Tinker, Lesley F. Vitolins, Mara Adams-Campbell, Lucile Sarto, Gloria E. Hays-Grudo, Jennifer Manson, Joann E. Kuller, Lewis H. TI Excess Weight and Physical Health-Related Quality of Life in Postmenopausal Women of Diverse Racial/Ethnic Backgrounds SO JOURNAL OF WOMENS HEALTH LA English DT Article ID BODY-MASS INDEX; OLDER-ADULTS; SOCIAL SUPPORT; US ADULTS; OBESITY; IMPACT; ASSOCIATION; OVERWEIGHT; MORTALITY; AGE AB Background: Studies of weight and health-related quality of life (HRQOL) generally focus on white populations. This analysis examines the association between clinical weight categories and physical HRQOL in five racial/ethnic groups of older women and determines the extent to which emotional/psychological (social support, caregiver burden) and physical health (diabetes, osteoarthritis) factors modify this relationship. Methods: The cross-sectional analysis, completed in 2007, used baseline data from postmenopausal women enrolled in the Women's Health Initiative (WHI) during the 5-year recruitment period (1993-1998). Results: Of 161,393 women, 83% were non-Hispanic white, 9% were African American, 4% were Hispanic/Latina, 3% were Asian/Pacific Islander, and <1% were American Indian/Alaska Native. Obesity (body mass index [BMI] >= 30 kg/m(2)) was most common in non-Asian minority groups. Regression modeling showed higher odds of poor physical HRQOL with increasing weight category in all groups. In the total sample, these odds were at least 6 times as high in women with class 3 obesity as in women of normal weight and were only mildly attenuated after the analysis adjusted for emotional/psychological factors. Further adjustment for physical health factors made odds ratio (OR) estimates drop from 2.36 to 1.59 for class 1 obesity and from 6.96 to 3.71 for class 3 obesity. This pattern generally persisted within each racial/ethnic group. Conclusions: Heavier weight negatively affects physical HRQOL in postmenopausal women across diverse racial/ethnic backgrounds. Weight-relevant physical health factors have a greater impact on this weight-HRQOL association than do emotional/psychological factors. C1 [Lynch, Cheryl P.] Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. [Lynch, Cheryl P.] Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. [McTigue, Kathleen M.; Bost, James E.] Univ Pittsburgh, Dept Med, Pittsburgh, PA USA. [McTigue, Kathleen M.; Kuller, Lewis H.] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15261 USA. [Tinker, Lesley F.] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. [Vitolins, Mara] Wake Forest Univ, Baptist Med Ctr, Winston Salem, NC 27109 USA. [Adams-Campbell, Lucile] Georgetown Univ, Med Ctr, Lombardi Comprehens Canc Ctr, Washington, DC 20007 USA. [Sarto, Gloria E.] Univ Wisconsin, Dept Obstet & Gynecol, Madison, WI 53706 USA. [Hays-Grudo, Jennifer] Univ Oklahoma, Dept Internal Med, Tulsa, OK USA. [Manson, Joann E.] Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Prevent Med, Boston, MA 02115 USA. RP Lynch, CP (reprint author), Med Univ S Carolina, Dept Med, 135 Rutledge Ave,MSC 593, Charleston, SC 29425 USA. EM lynchcp@musc.edu RI Sriwisit, Sukhumaphorn/G-1405-2011 OI Hays-Grudo, Jennifer/0000-0002-8107-1243 FU National Heart, Lung, and Blood Institute, U.S. Department of Health and Human Services; Division of General Internal Medicine, University of Pittsburgh FX The WHI program is funded by the National Heart, Lung, and Blood Institute, U.S. Department of Health and Human Services. C. P. L. received an internal developmental award from the Division of General Internal Medicine, University of Pittsburgh, for statistical support to conduct the analyses. The funding agencies had no role in the design and conduct of this study, in the collection, analysis, and interpretation of the data, or in the preparation, review, or approval of the article. NR 54 TC 10 Z9 10 U1 1 U2 9 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 AUG PY 2010 VL 19 IS 8 BP 1449 EP 1458 DI 10.1089/jwh.2009.1652 PG 10 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 634KH UT WOS:000280579300004 PM 20629574 ER PT J AU Chuang, PY He, JC AF Chuang, Peter Y. He, John C. TI JAK/STAT signaling in renal diseases SO KIDNEY INTERNATIONAL LA English DT Editorial Material ID DIABETIC-NEPHROPATHY; STAT3; PROLIFERATION; TRANSDUCER; ACTIVATOR; PATHWAY; INJURY AB The Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway is a pleiotropic cascade essential to cytokine and growth hormone receptor signaling. Signaling through the JAK/STAT pathway is important for the kidney's response to injury in disease. Pang et al. confirm that activation of STAT3 mediates renal fibrosis in the unilateral ureteral obstruction experimental model. Kidney International (2010) 78, 231-234. doi: 10.1038/ki.2010.158 C1 [Chuang, Peter Y.; He, John C.] Mt Sinai Sch Med, Div Nephrol, Dept Med, New York, NY 10029 USA. [He, John C.] Mt Sinai Sch Med, Dept Pharmacol & Syst Therapeut, New York, NY 10029 USA. [He, John C.] James J Peters VA Med Ctr, York, NY USA. RP He, JC (reprint author), 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 DK082760] NR 10 TC 21 Z9 22 U1 0 U2 5 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD AUG PY 2010 VL 78 IS 3 BP 231 EP 234 DI 10.1038/ki.2010.158 PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 626QV UT WOS:000279982800001 PM 20631733 ER PT J AU Albrecht, J Werth, VP AF Albrecht, J. Werth, V. P. TI Clinical outcome measures for cutaneous lupus erythematosus SO LUPUS LA English DT Review DE cutaneous lupus erythematosus; disease activity; patient outcome assessment; reproducibility of results; skin; validity ID QUALITY-OF-LIFE; DISEASE SEVERITY; ATOPIC-DERMATITIS; SURFACE-AREA; INDEX; RELIABILITY; PSORIASIS; ACNE; INSTRUMENTS; VALIDATION AB Cutaneous lupus erythematosus (CLE) is a clinically heterogeneous group of rare skin diseases that only rarely have been subjected to controlled clinical trials. This may have been partly due to a lack of suitable validated outcome instruments. Recently, the Food and Drug Administration (FDA) mandated that organ-specific trials for lupus erythematosus need to use a combination of different outcome measures. The patient's condition needs to be assessed in terms of quality of life, the patient's global response, and organ-specific instruments that measure activity of the disease as well as damage due to the disease. For the skin, the only formally validated and published instrument is currently the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI). This paper discusses the background of the development of the CLASI as well as issues related to its use and interpretation in the context of clinical research of CLE. Lupus (2010) 19, 1137-1143. C1 [Albrecht, J.] John H Stroger Jr Hosp Cook Cty, Div Dermatol, Dept Med, Chicago, IL 60612 USA. [Werth, V. P.] Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. [Werth, V. P.] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Werth, VP (reprint author), Univ Penn, Dept Dermatol, 2 Maloney 3600 Spruce St, Philadelphia, PA 19119 USA. EM werth@mail.med.upenn.edu FU National Institutes of Health [K24-AR 02207]; Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Biomedical Laboratory Research and Development FX This material is based upon work supported by the National Institutes of Health, including NIH K24-AR 02207 (Werth). This work was also partially supported by a Merit Review Grant from the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Biomedical Laboratory Research and Development. NR 43 TC 8 Z9 10 U1 0 U2 0 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 0961-2033 J9 LUPUS JI Lupus PD AUG PY 2010 VL 19 IS 9 SI SI BP 1137 EP 1143 DI 10.1177/0961203310370049 PG 7 WC Rheumatology SC Rheumatology GA 635UW UT WOS:000280683400016 PM 20693208 ER PT J AU Aslam, R Yeh, BM Yee, J AF Aslam, Rizwan Yeh, Benjamin M. Yee, Judy TI MR Imaging Evaluation of the Hepatic Vasculature SO MAGNETIC RESONANCE IMAGING CLINICS OF NORTH AMERICA LA English DT Article DE Hepatic vasculature; Liver injury; MR imaging; Portal veins; Hepatic veins ID PORTAL-VEIN THROMBOSIS; MAGNETIC-RESONANCE ANGIOGRAPHY; BUDD-CHIARI-SYNDROME; DONOR CANDIDATES; ECHO SEQUENCE; VENOUS SYSTEM; BLOOD-FLOW; CONTRAST; PORTOGRAPHY; VOLUNTEERS AB Assessment of the hepatic vasculature is essential for tumor staging, surgical planning, and understanding of liver disease. Technological advances have made contrast-enhanced magnetic resonance (MR) imaging comparable to multidetector-row computed tomography for diagnostic vascular imaging with respect to spatial resolution. Unenhanced MR angiographic sequences enable reasonable clinical assessment of vessels without contrast agents in patients with contraindications or renal insufficiency. Furthermore, MR angiography may be used to provide directional information through manipulation of the signal intensity of flowing blood. A major limitation to consistent contrast-enhanced MR angiography is the timing of MR image acquisition with arrival of the contrast bolus in the structures of interest. In this article, the authors discuss currently available techniques for imaging of the hepatic vasculature. C1 [Aslam, Rizwan; Yeh, Benjamin M.] Univ Calif San Francisco, Sch Med, Dept Radiol & Biomed Imaging, San Francisco, CA 94143 USA. [Aslam, Rizwan; Yeh, Benjamin M.; Yee, Judy] San Francisco VA Med Ctr, Dept Radiol, San Francisco, CA 94121 USA. RP Yeh, BM (reprint author), Univ Calif San Francisco, Sch Med, Dept Radiol & Biomed Imaging, 505 Parnassus Ave,M372,Box 0628, San Francisco, CA 94143 USA. EM ben.yeh@radiology.ucsf.edu NR 29 TC 2 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 1064-9689 J9 MAGN RESON IMAGING C JI Magn. Reson. Imaging Clin. N. Am. PD AUG PY 2010 VL 18 IS 3 BP 515 EP + DI 10.1016/j.mric.2010.08.005 PG 10 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 701VF UT WOS:000285851200011 PM 21094453 ER PT J AU Lin, GA Redberg, RF Anderson, HV Shaw, RE Milford-Beland, S Peterson, ED Rao, SV Werner, RM Dudley, RA AF Lin, Grace A. Redberg, Rita F. Anderson, H. Vernon Shaw, Richard E. Milford-Beland, Sarah Peterson, Eric D. Rao, Sunil V. Werner, Rachel M. Dudley, R. Adams TI Impact of Changes in Clinical Practice Guidelines on Assessment of Quality of Care SO MEDICAL CARE LA English DT Article DE performance measurement; clinical practice guidelines; quality of care; percutaneous coronary intervention ID PERCUTANEOUS CORONARY INTERVENTIONS; ELEVATION MYOCARDIAL-INFARCTION; ASSOCIATION TASK-FORCE; ANGIOGRAPHY-AND-INTERVENTIONS; DRUG-ELUTING STENTS; REGISTRY ACC-NCDR; AMERICAN-COLLEGE; APPROPRIATENESS CRITERIA; PERFORMANCE-MEASURES; ACC/AHA GUIDELINES AB Background: Measures for pay-for-performance and public reporting programs may be based on clinical practice guidelines. The impact of guideline changes over time-and whether evolving clinical evidence can render measures based on prior guidelines misleading-is not known. Objective: To assess the impact of using different percutaneous coronary intervention (PCI) guidelines when evaluating whether PCI was indicated. Research Design: PCIs from the National Cardiovascular Data Registry's CathPCI registry performed in 2003-2004 were categorized into indication classes (Class I, IIa, IIb, III), using 2001 American College of Cardiology/American Heart Association guidelines for PCI, the guidelines available at the time of the procedures. The same procedures were recategorized using 2005 guidelines, which reflect the best evidence available to clinicians at the time of PCI. Procedures unable to be categorized were labeled as "Not Certain." Subjects: Patients undergoing PCI for stable or unstable angina in 394 hospitals. Measures: Number of procedures changing classification categories using 2001 versus 2005 guidelines. Results: A total of 345,779 PCIs were evaluated. Applying 2001 guidelines, 47.9% had Class I indications; 33.3% Class IIa; 5.9% Class IIb; 3.7% Class III; and 9.2% Not Certain. Applying 2005 guidelines to the same procedures, 25.1% had Class I indications; 57.5% Class IIa; 5.5% Class IIb; 3.7% Class III; and 8.3% Not Certain; 41.1% of procedures changed the classification overall. Conclusions: The changes in guidelines resulted in a marked shift in whether PCIs done in 2003-2004 were considered indicated. Guideline-based performance measures should be carefully evaluated before implementation to avoid incorrect assessments of quality of care. C1 [Lin, Grace A.] Univ Calif San Francisco, Div Gen Internal Med, San Francisco, CA 94143 USA. [Lin, Grace A.; Dudley, R. Adams] Univ Calif San Francisco, Philip R Lee Inst Hlth Policy Studies, San Francisco, CA 94143 USA. [Redberg, Rita F.] Univ Calif San Francisco, Div Cardiol, San Francisco, CA 94143 USA. [Anderson, H. Vernon] Univ Texas Hlth Sci Ctr, Houston, TX USA. [Shaw, Richard E.] Calif Pacific Med Ctr, Dept Clin Res, San Francisco, CA USA. [Milford-Beland, Sarah; Peterson, Eric D.; Rao, Sunil V.] Duke Clin Res Inst, Durham, NC USA. [Werner, Rachel M.] Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. [Werner, Rachel M.] Univ Penn, Div Gen Internal Med, Sch Med, Philadelphia, PA 19104 USA. [Werner, Rachel M.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Lin, GA (reprint author), Univ Calif San Francisco, Div Gen Internal Med, 400 Parnassus Ave,A-405,Box 0320, San Francisco, CA 94143 USA. EM glin@medicine.ucsf.edu FU Blue Shield of California Foundation; American Heart Association; Robert Wood Johnson Foundation FX Supported by Blue Shield of California Foundation; a portion of Dr. Lin's work was supported by a Fellow-to-Faculty Transition Award from the American Heart Association; and a portion of Dr. Dudley's work was supported by an Investigator Award in Health Policy from the Robert Wood Johnson Foundation. NR 48 TC 6 Z9 6 U1 1 U2 4 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 2010 VL 48 IS 8 BP 733 EP 738 DI 10.1097/MLR.0b013e3181e35b3a PG 6 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 628JM UT WOS:000280115700010 PM 20613660 ER PT J AU Knapp, H Anaya, HD AF Knapp, Herschel Anaya, Henry D. TI Facilitating HIV Testing: Exploring Provider and Patient-Centered Barriers SO MILITARY MEDICINE LA English DT Editorial Material ID IMMUNODEFICIENCY-VIRUS-INFECTION; NEEDLE PHOBIA; BAD-NEWS; CARE; INDIVIDUALS; BEHAVIOR; SUICIDE; IMPACT; RISK C1 [Knapp, Herschel; Anaya, Henry D.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Knapp, H (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 27 TC 1 Z9 1 U1 0 U2 1 PU ASSOC MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 EI 1930-613X J9 MIL MED JI Milit. Med. PD AUG PY 2010 VL 175 IS 8 BP 541 EP 543 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 632VB UT WOS:000280456000002 PM 20731255 ER PT J AU Haake, DA Matsunaga, J AF Haake, David A. Matsunaga, James TI Leptospira: a spirochaete with a hybrid outer membrane SO MOLECULAR MICROBIOLOGY LA English DT Review ID SURFACE-EXPOSED LIPOPROTEIN; MODULATES FIBRONECTIN-BINDING; PATHOGENIC LEPTOSPIRA; MOLECULAR-CLONING; EXTRACELLULAR RELEASE; SEQUENCE-ANALYSIS; ESCHERICHIA-COLI; PROTEIN LIPL32; CALCIUM BINDS; C-TERMINUS AB P>Leptospira is a genus of spirochaetes that includes organisms with a variety of lifestyles ranging from aquatic saprophytes to invasive pathogens. Adaptation to a wide variety of environmental conditions has required leptospires to acquire a large genome and a complex outer membrane with features that are unique among bacteria. The most abundant surface-exposed outer membrane proteins are lipoproteins that are integrated into the lipid bilayer by amino-terminal fatty acids. In contrast to many spirochaetes, the leptospiral outer membrane also includes lipopolysaccharide and many homologues of well-known beta-barrel transmembrane outer membrane proteins. Research on leptospiral transmembrane outer membrane proteins has lagged behind studies of lipoproteins because of their aberrant behaviour by Triton X-114 detergent fractionation. For this reason, transmembrane outer membrane proteins are best characterized by assessing membrane integration and surface exposure. Not surprisingly, some outer membrane proteins that mediate host-pathogen interactions are strongly regulated by conditions found in mammalian host tissues. For example, the leptospiral immunoglobulin-like (Lig) repeat proteins are dramatically induced by osmolarity and mediate interactions with host extracellular matrix proteins. Development of molecular genetic tools are making it possible to finally understand the roles of these and other outer membrane proteins in mechanisms of leptospiral pathogenesis. C1 [Haake, David A.; Matsunaga, James] Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Haake, David A.; Matsunaga, James] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. [Haake, David A.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Urol, Los Angeles, CA 90095 USA. [Haake, David A.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Microbiol Immunol & Mol Genet, Los Angeles, CA 90095 USA. RP Haake, DA (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. EM dhaake@ucla.edu FU NIAID NIH HHS [R01 AI034431-14, R01 AI034431] NR 63 TC 26 Z9 26 U1 1 U2 5 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0950-382X J9 MOL MICROBIOL JI Mol. Microbiol. PD AUG PY 2010 VL 77 IS 4 BP 805 EP 814 DI 10.1111/j.1365-2958.2010.07262.x PG 10 WC Biochemistry & Molecular Biology; Microbiology SC Biochemistry & Molecular Biology; Microbiology GA 635QY UT WOS:000280672400002 PM 20598085 ER PT J AU Cheng, EM Crandall, CJ Bever, CT Giesser, B Haselkorn, JK Hays, RD Shekelle, P Vickrey, BG AF Cheng, Eric M. Crandall, Carolyn J. Bever, Christopher T., Jr. Giesser, Barbara Haselkorn, Jodie K. Hays, Ron D. Shekelle, Paul Vickrey, Barbara G. TI Quality indicators for multiple sclerosis SO MULTIPLE SCLEROSIS JOURNAL LA English DT Article DE health services research; multiple sclerosis; outcome research; quality indicators ID TECHNOLOGY-ASSESSMENT SUBCOMMITTEE; VULNERABLE OLDER PATIENTS; MEDICAL-CARE; HEALTH-CARE; OF-CARE; AMERICAN-ACADEMY; GUIDELINES; ELDERS; ADULTS; THERAPEUTICS AB Determining whether persons with multiple sclerosis (MS) receive appropriate, comprehensive healthcare requires tools for measuring quality. The objective of this study was to develop quality indicators for the care of persons with MS. We used a modified version of the RAND/UCLA Appropriateness Method in a two-stage process to identify relevant MS care domains and to assess the validity of indicators within high-ranking care domains. Based on a literature review, interviews with persons with MS, and discussions with MS providers, 25 MS symptom domains and 14 general health domains of MS care were identified. A multidisciplinary panel of 15 stakeholders of MS care, including 4 persons with MS, rated these 39 domains in a two-round modified Delphi process. The research team performed an expanded literature review for 26 highly ranked domains to draft 86 MS care indicators. Through another two-round modified Delphi process, a second panel of 18 stakeholders rated these indicators using a nine-point response scale. Indicators with a median rating in the highest tertile were considered valid. Among the most highly rated MS care domains were appropriateness and timeliness of the diagnostic work-up, bladder dysfunction, cognition dysfunction, depression, disease-modifying agent usage, fatigue, integration of care, and spasticity. Of the 86 preliminary indicators, 76 were rated highly enough to meet predetermined thresholds for validity. Following a widely accepted methodology, we developed a comprehensive set of quality indicators for MS care that can be used to assess quality of care and guide the design of interventions to improve care among persons with MS. C1 [Cheng, Eric M.; Giesser, Barbara; Vickrey, Barbara G.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. [Cheng, Eric M.; Vickrey, Barbara G.] VA Greater Los Angeles Hlth Care Syst, Dept Neurol, Los Angeles, CA USA. [Crandall, Carolyn J.; Hays, Ron D.; Shekelle, Paul] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. [Bever, Christopher T., Jr.] VA Maryland Hlth Care Syst, Multiple Sclerosis Ctr Excellence E, Res & Neurol Serv, Baltimore, MD USA. [Bever, Christopher T., Jr.] Univ Maryland, Sch Med, Dept Neurol, Baltimore, MD 21201 USA. [Haselkorn, Jodie K.] VA Puget Sound Hlth Care Syst, Multiple Sclerosis Ctr Excellence W, Seattle, WA USA. [Haselkorn, Jodie K.] Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98195 USA. [Haselkorn, Jodie K.] Univ Washington, Sch Med, Dept Epidemiol, Seattle, WA 98195 USA. [Shekelle, Paul] VA Greater Los Angeles Hlth Care Syst, Dept Med, Los Angeles, CA USA. RP Cheng, EM (reprint author), VA Greater Los Angeles, Dept Neurol, 11301 Wilshire Blvd,ML 127, Los Angeles, CA 90073 USA. EM eric.cheng@va.gov RI Hays, Ronald/D-5629-2013 FU National Multiple Sclerosis Society [HC0094]; NINDS [K23NS058571]; UCLA Resource Center for Minority Aging Research/Center for Health Improvement in Minority Elderly (RCMAR/CHIME); NIH/NIA [P30AG021684]; NCMHD [2P20MD000182] FX This research was initiated, funded, and supported by the National Multiple Sclerosis Society (HC0094). Dr Cheng is supported by a Career Development Award from NINDS (K23NS058571). Dr Hays was supported in part by the UCLA Resource Center for Minority Aging Research/Center for Health Improvement in Minority Elderly (RCMAR/CHIME), NIH/NIA Grant Award Number P30AG021684, and the UCLA/Drew Project EXPORT, NCMHD, 2P20MD000182. Dr Giesser has received compensation from Teva Neuroscience and Serono for speaking engagements. Dr Bever received consulting fees from Ingenix. NR 39 TC 9 Z9 10 U1 1 U2 2 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 1352-4585 J9 MULT SCLER J JI Mult. Scler. J. PD AUG PY 2010 VL 16 IS 8 BP 970 EP 980 DI 10.1177/1352458510372394 PG 11 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 634TO UT WOS:000280608600010 PM 20562162 ER PT J AU Prajapati, SI Martinez, CO Abraham, J Mccleish, AT Michalek, JE McManus, LM Rubin, BP Shireman, PK Keller, C AF Prajapati, Suresh I. Martinez, Carlo O. Abraham, Jinu Mccleish, Amanda T. Michalek, Joel E. McManus, Linda M. Rubin, Brian P. Shireman, Paula K. Keller, Charles TI CRIMSON CARRIER, A LONG-ACTING CONTRAST AGENT FOR IN VIVO NEAR-INFRARED IMAGING OF INJURED AND DISEASED MUSCLE SO MUSCLE & NERVE LA English DT Article DE crimson carrier; muscle injury; near-infrared contrast agent; optical imaging; tumor imaging ID REGENERATION; CANCER AB The near-infrared wavelengths (700-900 nm) are the most suitable optical window for light penetration and deep tissue imaging in small animals. Herein we report a near-infrared fluorescent contrast agent, crimson carrier, which acts as a blood pool contrast agent to detect and quantify injury and disease in live animals. After determining the excitation-emission spectra and pharmacokinetics, crimson carrier was injected into myoinjured mice to monitor their recovery. Crimson carrier was also used to image transgenic mice with spontaneous tumors. Crimson carrier has maximal excitation and emission wavelengths of 745 nm and 820 nm, respectively. Elimination occurs predominantly via urinary excretion. We demonstrate the utility of this contrast agent for serial imaging of traumatized muscle as well as muscle tumors. The unique long-acting pharmacokinetics and urinary excretion route characteristics make crimson carrier a contrast agent of choice for the visualization of tumors and injured muscle or other tissues in live animal studies. Muscle Nerve 42:245-251, 2010 C1 [Prajapati, Suresh I.; Abraham, Jinu; Mccleish, Amanda T.; Keller, Charles] Univ Texas Hlth Sci Ctr San Antonio, Greehey Childrens Canc Res Inst, San Antonio, TX 78229 USA. [Martinez, Carlo O.; Shireman, Paula K.] Univ Texas Hlth Sci Ctr San Antonio, Dept Surg, San Antonio, TX 78229 USA. [Michalek, Joel E.] Univ Texas Hlth Sci Ctr San Antonio, Dept Epidemiol & Biostat, San Antonio, TX 78229 USA. [McManus, Linda M.] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. [McManus, Linda M.] Univ Texas Hlth Sci Ctr San Antonio, Dept Peridont, San Antonio, TX 78229 USA. [Rubin, Brian P.] Cleveland Clin, Dept Anat Pathol, Taussig Canc Ctr, Cleveland, OH 44106 USA. [Rubin, Brian P.] Cleveland Clin, Lerner Res Inst, Cleveland, OH 44106 USA. [Martinez, Carlo O.; Shireman, Paula K.] S Texas Vet Hlth Care Syst, Dept Surg, San Antonio, TX USA. [Keller, Charles] Univ Texas Hlth Sci Ctr San Antonio, Dept Pediat, San Antonio, TX 78229 USA. RP Keller, C (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Greehey Childrens Canc Res Inst, San Antonio, TX 78229 USA. EM kellerc2@uthscsa.edu OI Keller, Charles/0000-0003-2505-7487 FU Veterans Administration [HL090196, HL074236]; Numira Biosciences, Inc. FX This study was supported in part by Grants HL090196 (to C.O.M.) and HL074236 (to P.K.S.) from the Veterans Administration and a sponsored research agreement with Numira Biosciences, Inc. (to C.K.). NR 7 TC 0 Z9 0 U1 0 U2 1 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0148-639X J9 MUSCLE NERVE JI Muscle Nerve PD AUG PY 2010 VL 42 IS 2 BP 245 EP 251 DI 10.1002/mus.21682 PG 7 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 631UE UT WOS:000280374000014 PM 20544935 ER PT J AU Joseph, AJ Compton, SP Holmes, LH Annand, A Self, SE Fitzgibbon, WR Ullian, ME AF Joseph, Anthony J. Compton, Susan P. Holmes, Lewis H. Annand, Andrew Self, Sally E. Fitzgibbon, Wayne R. Ullian, Michael E. TI Utility of percutaneous renal biopsy in chronic kidney disease SO NEPHROLOGY LA English DT Article DE chronic kidney disease; renal biopsy; renal bleeding; renal scarring; serum creatinine ID MANAGEMENT; THERAPY AB Background: We tested the hypothesis that patterns of serum creatinine concentrations (S-cr) prior to percutaneous renal biopsy (PRB) predict the utility of PRB in safely making renal diagnoses, revealing treatable disease, and altering therapy in chronic kidney disease patients. Methods: PRB specimens (170 patients) were assigned to 1 of 5 groups: S-cr never greater than 0.11 mM for at least 6 months prior to PRB (Group 1); S-cr greater than 0.11 mM but less than 0.18 mM during the 6 months prior to PRB (Groups 2); S-cr less than 0.18 mM during the 6 months prior to PRB but greater than 0.18 mM prior to these 6 months (Group 3); S-cr greater than 0.18 mM for less than 6 months prior to PRB (Group 4); S-cr greater than 0.18 mM for more than 6 months prior to PRB (Group 5). Results: Histopathology chronicity score (0-9) increased with increasing group number: 2.1 (Group 1); 4.4 (Group 2); 4.5 (Group 3); 5.4 (Group 4); 7.0 (Group 5). Post-PRB bleeding was more common with increasing group number. New therapy was instituted after PRB most frequently in Group 4 (62%) and least frequently in Group 5 (24%). Conclusion: After more prolonged elevations of S-cr, PRB may be less safe and less likely to reveal treatable disease and opportunities for therapy. C1 [Joseph, Anthony J.; Compton, Susan P.; Holmes, Lewis H.; Annand, Andrew; Self, Sally E.; Fitzgibbon, Wayne R.; Ullian, Michael E.] Med Univ S Carolina, Ralph H Johnson VA Hosp, Charleston, SC 29425 USA. RP Ullian, ME (reprint author), Med Univ S Carolina, Ralph H Johnson VA Hosp, 96 Jonathan Lucas St,MSC 629, Charleston, SC 29425 USA. EM ullianme@musc.edu NR 11 TC 4 Z9 5 U1 0 U2 0 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1320-5358 J9 NEPHROLOGY JI Nephrology PD AUG PY 2010 VL 15 IS 5 BP 544 EP 548 DI 10.1111/j.1440-1797.2010.01293.x PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 631OI UT WOS:000280356700006 PM 20649874 ER PT J AU Frisoni, GB Weiner, MW AF Frisoni, Giovanni B. Weiner, Michael W. TI Alzheimer's Disease Neuroimaging Initiative special issue SO NEUROBIOLOGY OF AGING LA English DT Editorial Material ID BIOMARKERS C1 [Frisoni, Giovanni B.] IRCCS Fatebenefratelli, Brescia, Italy. [Weiner, Michael W.] San Francisco VA Med Ctr, San Francisco, CA USA. RP Frisoni, GB (reprint author), IRCCS Fatebenefratelli, Brescia, Italy. RI Frisoni, Giovanni B/K-1360-2016 OI Frisoni, Giovanni B/0000-0002-6419-1753 NR 26 TC 7 Z9 7 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD AUG PY 2010 VL 31 IS 8 SI SI BP 1259 EP 1262 DI 10.1016/j.neurobiolaging.2010.05.006 PG 4 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 626UE UT WOS:000279991800001 PM 20570400 ER PT J AU Gourcerol, G Wu, SV Yuan, PQ Miampamba, M Larauche, M Sanders, P Amano, T Rivier, J Tache, Y Million, M AF Gourcerol, G. Wu, S. V. Yuan, P. Q. Miampamba, M. Larauche, M. Sanders, P. Amano, T. Rivier, J. Tache, Y. Million, M. TI CRF2 receptor activation blunts stress and CRF-induced colonic motor function in rodents SO NEUROGASTROENTEROLOGY AND MOTILITY LA English DT Meeting Abstract CT Joint International Meeting for Neurogastroenterology and Motility CY AUG 26-29, 2010 CL Boston, MA C1 [Gourcerol, G.; Wu, S. V.; Yuan, P. Q.; Miampamba, M.; Larauche, M.; Sanders, P.; Amano, T.; Tache, Y.; Million, M.] Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Los Angeles, CA USA. [Gourcerol, G.; Wu, S. V.; Yuan, P. Q.; Miampamba, M.; Larauche, M.; Sanders, P.; Amano, T.; Tache, Y.; Million, M.] Univ Calif Los Angeles, Dept Med, VA Greater Los Angeles Healthcare Syst, Ctr Neurobiol Stress,Div Digest Dis, Los Angeles, CA 90024 USA. [Rivier, J.] Salk Inst Biol Studies, Clayton Fdn Labs Peptide Biol, La Jolla, CA 92037 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1350-1925 EI 1365-2982 J9 NEUROGASTROENT MOTIL JI Neurogastroenterol. Motil. PD AUG PY 2010 VL 22 SU 1 SI SI MA 103 BP 31 EP 31 PG 1 WC Gastroenterology & Hepatology; Clinical Neurology; Neurosciences SC Gastroenterology & Hepatology; Neurosciences & Neurology GA V45OJ UT WOS:000209825600103 ER PT J AU Ford, JH Verfaellie, M Giovanello, KS AF Ford, Jaclyn Hennessey Verfaellie, Mieke Giovanello, Kelly S. TI Neural correlates of familiarity-based associative retrieval SO NEUROPSYCHOLOGIA LA English DT Article DE Associative memory; Recollection; Familiarity; Hippocampus; Perirhinal cortex; Medial temporal lobe; Unitization ID MEDIAL TEMPORAL-LOBE; RECALL-TO-REJECT; RECOGNITION MEMORY; CONJUNCTION ERRORS; HIPPOCAMPUS SUPPORTS; PERIRHINAL CORTEX; RELATIONAL MEMORY; ITEM RECOGNITION; RECOLLECTION; AMNESIA AB The current study compared the neural correlates of associative retrieval of compound (unitized) stimuli and unrelated (non-unitized) stimuli. Although associative recognition was nearly identical for compounds and unrelated pairs, accurate recognition of these different pair types was associated with activation in distinct regions within the medial temporal lobe (MTL). Recognition of previously presented compound words was associated with left perirhinal activity, whereas recognition of unrelated word pairs was associated with activity in left hippocampus. These results provide evidence that perirhinal cortex mediates familiarity-based associative memory of stimuli unitized at encoding, while the hippocampus is required for recollection-based associative memory. (C) 2010 Elsevier Ltd. All rights reserved. C1 [Ford, Jaclyn Hennessey; Giovanello, Kelly S.] Univ N Carolina, Dept Psychol, Chapel Hill, NC 27599 USA. [Verfaellie, Mieke] US Dept Vet Affairs, Boston, MA USA. [Verfaellie, Mieke] Boston Univ, Sch Med, Boston, MA 02118 USA. [Giovanello, Kelly S.] Univ N Carolina, Biomed Res Imaging Ctr, Chapel Hill, NC 27599 USA. RP Ford, JH (reprint author), Univ N Carolina, Dept Psychol, Davie Hall,CB 3270, Chapel Hill, NC 27599 USA. EM Jahennessey@gmail.com OI Verfaellie, Mieke/0000-0001-5535-4584 FU Medical Research Service of the Department of Veterans Affairs; [AG028774]; [MH57681] FX This work was supported by AG028774, MH57681, and the Medical Research Service of the Department of Veterans Affairs. NR 50 TC 25 Z9 27 U1 0 U2 7 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0028-3932 J9 NEUROPSYCHOLOGIA JI Neuropsychologia PD AUG PY 2010 VL 48 IS 10 BP 3019 EP 3025 DI 10.1016/j.neuropsychologia.2010.06.010 PG 7 WC Behavioral Sciences; Neurosciences; Psychology, Experimental SC Behavioral Sciences; Neurosciences & Neurology; Psychology GA 642AU UT WOS:000281175900023 PM 20547169 ER PT J AU Sherva, R Kranzler, HR Yu, Y Logue, MW Poling, J Arias, AJ Anton, RF Oslin, D Farrer, LA Gelernter, J AF Sherva, Richard Kranzler, Henry R. Yu, Yi Logue, Mark W. Poling, James Arias, Albert J. Anton, Raymond F. Oslin, David Farrer, Lindsay A. Gelernter, Joel TI Variation in Nicotinic Acetylcholine Receptor Genes is Associated with Multiple Substance Dependence Phenotypes SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE genetic association; substance dependence; nicotinic acetylcholine receptors ID GENOME-WIDE ASSOCIATION; POPULATION-BASED SAMPLE; LUNG-CANCER; SUSCEPTIBILITY LOCUS; EUROPEAN-AMERICANS; AFRICAN-AMERICANS; MALE TWINS; SMOKING; RISK; LINKAGE AB There is shared genetic risk for dependence on multiple substances, and the nicotinic receptor gene cluster on chromosome 15 harbors multiple polymorphisms that associate to this risk. Here, we report the results of an association study with 21 SNPs genotyped across the CHRNA5, CHRNA3, and CHRNB4 loci on chromosome 15q25.1. The sample consists of a discovery set (N = 1858) of European-American and African-American (AA) families, ascertained on the basis of a sibling pair with cocaine and/or opioid dependence, and a case-control replication sample (N = 3388) collected for association studies of alcohol, cocaine, and opioid dependence. We tested the SNPs for association with lifetime cocaine, opioid, nicotine, and alcohol dependence. We replicated several previous findings, including associations between rs16969968 and nicotine dependence (P = 0.002) and cocaine dependence (P = 0.02), with opposite risk alleles for each substance. We observed these associations in AAs, which is a novel finding. The strongest association signal in either sample was between rs684513 in CHRNA5 and cocaine dependence (OR = 1.43, P = 0.0004) in the AA replication set. We also observed two SNPs associated with alcohol dependence, that is, rs615470 in CHRNA5 (OR = 0.77, P = 0.0006) and rs578776 (OR = 0.78, P = 0.001). The associations between CD and rs684513, AD and rs615470, and AD and rs578776 remained significant after a permutation-based correction for multiple testing. These data reinforce the importance of variation in the chromosome 15 nicotinic receptor subunit gene cluster for risk of dependence on multiple substances, although the direction of the effects may vary across substances. Neuropsychopharmacology (2010) 35, 1921-1931; doi: 10.1038/npp.2010.64; published online 19 May 2010 C1 [Sherva, Richard; Yu, Yi; Logue, Mark W.; Farrer, Lindsay A.] Boston Univ, Sch Med, Dept Med, Genet Program, Boston, MA 02118 USA. [Kranzler, Henry R.; Arias, Albert J.] Univ Connecticut, Dept Psychiat, Sch Med, Farmington, CT 06107 USA. [Kranzler, Henry R.; Arias, Albert J.] Univ Connecticut, Sch Med, Dept Genet & Dev Biol, Farmington, CT USA. [Poling, James; Gelernter, Joel] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA. [Poling, James; Gelernter, Joel] VA CT Healthcare Syst, West Haven, CT USA. [Anton, Raymond F.] Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. [Oslin, David] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. [Oslin, David] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. [Farrer, Lindsay A.] Boston Univ, Sch Med, Dept Neurol, Boston, MA 02118 USA. [Farrer, Lindsay A.] Boston Univ, Sch Med, Dept Genet & Genom, Boston, MA 02118 USA. [Farrer, Lindsay A.] Boston Univ, Sch Med, Dept Biostat, Boston, MA 02118 USA. [Farrer, Lindsay A.] Boston Univ, Sch Med, Dept Epidemiol, Boston, MA 02118 USA. [Farrer, Lindsay A.] Boston Univ, Sch Publ Hlth, Dept Neurol, Boston, MA USA. [Farrer, Lindsay A.] Boston Univ, Sch Publ Hlth, Dept Genet & Genom, Boston, MA USA. [Farrer, Lindsay A.] Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA USA. [Farrer, Lindsay A.] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA. [Gelernter, Joel] Yale Univ, Sch Med, Dept Neurobiol, New Haven, CT USA. [Gelernter, Joel] Yale Univ, Sch Med, Dept Genet, New Haven, CT 06510 USA. RP Gelernter, J (reprint author), Yale Univ, Sch Med, VA CT Healthcare Ctr 116A2, 950 Campbell Ave, West Haven, CT 06516 USA. EM joel.gelernter@yale.edu RI Arias, Albert/H-1334-2011 OI Logue, Mark/0000-0001-9347-7892; Poling, James/0000-0002-0133-3136; Farrer, Lindsay/0000-0001-5533-4225 FU NIDA [R01 DA12690, R01 DA12849, R01 DA018432, K24 DA22288]; NIAAA [R01 AA11330, K24 AA013736, P50 AA12870, K05 AA017435]; NCRR [M01 RR06192]; VA CT MIRECC Center; Bristol-Myers Squibb Company; Merck Co.; Ortho-McNeil Pharmaceuticals; Eli Lilly; Merck; Hythiam; Johnson Johnson; Janssen; Schering Plough; Lundbeck; Alkermes; GlaxoSmithKline; Abbott; ACTIVE FX We thank John Farrell and Michael Jervis for database management support and An Marie Lacobelle for technical assistance. This work was supported by NIDA grants R01 DA12690, R01 DA12849, R01 DA018432, and K24 DA22288, NIAAA grants R01 AA11330, K24 AA013736, P50 AA12870, and K05 AA017435, and NCRR grant M01 RR06192, and the VA CT MIRECC Center.; Dr Gelernter reports that he has received compensation for professional services in the previous 3 years from the following entities: the Yale University School of Medicine, Veterans Affairs Healthcare System (VA) and the National Institutes of Health (NIAAA, NIDA, and NIMH) and related to academic lectures and editorial functions in various scientific venues (including the ACNP). Dr Kranzler has received compensation for professional services from the National Institutes of Health (NIAAA and NIDA) and for academic lectures and editorial functions in various scientific venues (including the ACNP). Dr Kranzler also reports consulting arrangements with Alkermes, Elbion Pharmaceuticals, Ortho-McNeil Pharmaceuticals, Sanofi-Aventis Pharmaceuticals, and Solvay Pharmaceuticals, and research support from Bristol-Myers Squibb Company, Merck & Co., and Ortho-McNeil Pharmaceuticals. Dr Anton reports the following: being a consultant for Sanofi-Aventis, Eli Lilly, Merck, Organon, Hythiam, Novartis, Johnson & Johnson, and GlaxoSmithKline; serving on an Advisory Board for Solvay, Hythiam, Novartis, and Johnson & Johnson, and receiving grant support from Eli Lilly, Merck, Hythiam, and Johnson & Johnson. Dr Anton and Dr Kranzler also report having associations with the following pharmaceutical companies: Eli Lilly, Janssen, Schering Plough, Lundbeck, Alkermes, GlaxoSmithKline, Abbott, and Johnson & Johnson, as these companies provide support to the Alcohol Clinical Trials Initiative (ACTIVE) and both Dr Kranzler and Dr Anton receive support from ACTIVE. These disclosures do not hold any influence on the content of this paper. NR 37 TC 53 Z9 53 U1 2 U2 2 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 2010 VL 35 IS 9 BP 1921 EP 1931 DI 10.1038/npp.2010.64 PG 11 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 625VQ UT WOS:000279924400010 PM 20485328 ER PT J AU Zouhary, KJ AF Zouhary, Kenneth J. TI Bone Graft Harvesting From Distant Sites: Concepts and Techniques SO ORAL AND MAXILLOFACIAL SURGERY CLINICS OF NORTH AMERICA LA English DT Article DE Graft; Harvest; Iliac; Tibial; Cranial; Calvarial ID ANTERIOR ILIAC CREST; FEMORAL CUTANEOUS NERVE; DONOR SITE; CANCELLOUS BONE; PROXIMAL TIBIA; ANATOMIC CONSIDERATIONS; CRANIOFACIAL SKELETON; UNUSUAL COMPLICATION; VOLUME MAINTENANCE; JAW RECONSTRUCTION AB Bony augmentation of the moderately to severely resorbed alveolus in preparation for endosseous dental implant placement can be challenging for the oral and maxillofacial surgeon. Autogenous bone remains the gold standard for alveolar grafting. Multiple extraoral bone graft sources can be used to help meet this challenge, including the iliac crest, proximal tibia, and calvarium. This article reviews the anatomy, harvest techniques, and morbidity associated with each of these donor sites. C1 [Zouhary, Kenneth J.] Birmingham VA Med Ctr, Dept Oral & Maxillofacial Surg, Birmingham, AL 35233 USA. [Zouhary, Kenneth J.] Univ Alabama, Dept Oral & Maxillofacial Surg, Birmingham, AL 35233 USA. RP Zouhary, KJ (reprint author), Birmingham VA Med Ctr, Dept Oral & Maxillofacial Surg, 700 19th St S, Birmingham, AL 35233 USA. EM kzouhary@uab.edu NR 59 TC 33 Z9 35 U1 0 U2 5 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1042-3699 J9 ORAL MAXIL SURG CLIN JI Oral Maxillofac. Surg. Clin. N. Am. PD AUG PY 2010 VL 22 IS 3 BP 301 EP + DI 10.1016/j.coms.2010.04.007 PG 17 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 864TW UT WOS:000298264000004 PM 20713264 ER PT J AU Yong, PL Orange, JS Sullivan, KE AF Yong, Pierre L. Orange, Jordan S. Sullivan, Kathleen E. TI Pediatric common variable immunodeficiency: Immunologic and phenotypic associations with switched memory B cells SO PEDIATRIC ALLERGY AND IMMUNOLOGY LA English DT Article DE common variable immunodeficiency; memory B cells; autoimmune disease; recurrent infections; IgG ID ANTIBODY-DEFICIENCY SYNDROME; IGA DEFICIENCY; DISEASE; MUTATIONS; CHILDREN; FEATURES; TACI; HYPOGAMMAGLOBULINEMIA; COMPLICATIONS; SUBGROUPS AB Recent studies suggest that patients with common variable immunodeficiency (CVID) and low numbers of switched memory B cells have lower IgG levels and higher rates of autoimmune disease, splenomegaly, and granulomatous disease; however, no prior literature has focused exclusively on pediatric cases. We examined the relationship between switched memory B cells and clinical and immunologic manifestations of CVID in a pediatric population. Forty-five patients were evaluated. Patients were categorized as Group I (< 5 switched memory B cells/ml, n = 24) or Group II (>= 5 switched memory B cells/mL, n = 21). CD3+ T-cell counts and CD19+ B-cell levels were lower among Group I patients. Only those in Group I had meningitis, sepsis, bronchiectasis, granulomatous lung disease, autoimmune cytopenias, or hematologic malignancies. Segregation of pediatric patients into high risk (Group I) and average risk (Group II) may assist in targeting surveillance appropriately. C1 [Yong, Pierre L.] Univ Penn, Sch Med, Robert Wood Johnson Clin Scholars Program, Philadelphia, PA 19104 USA. [Yong, Pierre L.] Hosp Univ Penn, Div Pulm Allergy & Crit Care, Philadelphia, PA 19104 USA. [Yong, Pierre L.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Yong, Pierre L.] Univ Penn, Ctr Publ Hlth Initiat, Philadelphia, PA 19104 USA. [Orange, Jordan S.; Sullivan, Kathleen E.] Childrens Hosp Philadelphia, Div Allergy & Immunol, Philadelphia, PA 19104 USA. [Yong, Pierre L.] Philadelphia Vet Affairs Med Ctr, Dept Med, Philadelphia, PA USA. RP Sullivan, KE (reprint author), Childrens Hosp Philadelphia, Div Allergy Immunol, 3615 Civ Ctr Blvd, Philadelphia, PA 19104 USA. EM sullivak@mail.med.upenn.edu OI orange, jordan/0000-0001-7117-7725; Sullivan, Kathleen/0000-0003-4018-1646 FU Philadelphia Veterans Affairs Medical Center; University of Pennsylvania FX Dr. Pierre Yong is supported by a training grant from the Philadelphia Veterans Affairs Medical Center and the Robert Wood Johnson Clinical Scholars Program at the University of Pennsylvania. We are grateful for the assistance of Benjamin Garcia, who helped with data management for this project and the assistance of Sarah Shaw, Joe McMann, and USIDNET. NR 49 TC 22 Z9 22 U1 0 U2 2 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0905-6157 J9 PEDIAT ALLERG IMM-UK JI Pediatr. Allergy Immunol. PD AUG PY 2010 VL 21 IS 5 BP 852 EP 858 DI 10.1111/j.1399-3038.2010.01004.x PG 7 WC Allergy; Immunology; Pediatrics SC Allergy; Immunology; Pediatrics GA 629LN UT WOS:000280200000008 PM 20337966 ER PT J AU Dicianno, BE Fairman, AD Juengst, SB Braun, PG Zabel, TA AF Dicianno, Brad E. Fairman, Andrea D. Juengst, Shannon B. Braun, Patricia G. Zabel, T. Andrew TI Using the Spina Bifida Life Course Model in Clinical Practice: An Interdisciplinary Approach SO PEDIATRIC CLINICS OF NORTH AMERICA LA English DT Article DE Spina bifida; Development; Milestones; Transition ID ADULTS AB The Life Course Model for patients, families, caregivers, teachers, and clinicians was developed with support by the National Spina Bifida Program, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, for individuals with spina bifida. The Life Course Model facilitates a developmental approach to assessment and intervention along life's trajectory. This Life Course Model provides information about key developmental milestones for particular age groups, validated assessments that can be performed by clinicians or teachers to determine if milestones have been reached, useful suggestions for intervening in creative ways at each step, and evidence-based references. In this article, the authors introduce the viewpoints of several key clinicians who are involved in the care of individuals with spina bifida and how the Life Course Model can assist them, their patients, and their families in the process of assessment, intervention, collaboration with other clinicians, and follow-up. A case study is used to demonstrate the experience of comprehensive and collaborative management in transitioning a child and his family from infancy to adulthood. C1 [Dicianno, Brad E.] VA Pittsburgh Healthcare Syst, Dept Vet Affairs, HERL, Pittsburgh, PA 15206 USA. [Dicianno, Brad E.; Fairman, Andrea D.] UPMC, Adult Spina Bifida Clin, Dept Phys Med & Rehabil, Pittsburgh, PA 15213 USA. [Fairman, Andrea D.] Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. [Juengst, Shannon B.] Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Occupat Therapy, Pittsburgh, PA 15260 USA. [Braun, Patricia G.] No Illinois Univ, Sch Nursing & Hlth Studies, De Kalb, IL 60115 USA. [Zabel, T. Andrew] Kennedy Krieger Inst, Philip A Keelty Ctr Spina Bifida & Related Condit, Dept Neuropsychol, Baltimore, MD 21231 USA. [Zabel, T. Andrew] Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA. RP Dicianno, BE (reprint author), VA Pittsburgh Healthcare Syst, Dept Vet Affairs, HERL, 7180 Highland Dr,151R-1, Pittsburgh, PA 15206 USA. EM dicianno@pitt.edu OI Juengst, Shannon/0000-0003-4709-545X; Dicianno, Brad/0000-0003-0738-0192 FU National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia FX This work was supported by the National Spina Bifida Program, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia. NR 20 TC 0 Z9 0 U1 1 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 0031-3955 J9 PEDIATR CLIN N AM JI Pediatr. Clin. N. Am. PD AUG PY 2010 VL 57 IS 4 BP 945 EP + DI 10.1016/j.pcl.2010.07.014 PG 15 WC Pediatrics SC Pediatrics GA 672YH UT WOS:000283623300008 PM 20883884 ER PT J AU Fairman, AD Thibadeau, JK Dicianno, BE Parmanto, B AF Fairman, Andrea D. Thibadeau, Judy K. Dicianno, Brad E. Parmanto, Bambang TI Implementing a Specialty Electronic Medical Record to Document a Life-Course Developmental Model and Facilitate Clinical Interventions in Spina Bifida Clinics SO PEDIATRIC CLINICS OF NORTH AMERICA LA English DT Article DE Electronic medical record; Spina bifida; Developmental model; Transition ID HEALTH; CARE; TRANSITION; ADULTHOOD AB This article describes the utility of a spina bifida-specific electronic medical record (SB EMR). Standardization and pooling of data through the SB EMR will facilitate development of increased knowledge for advancing interventions for SB treatment, rehabilitation, and support. Integration with a Web-based transition tool will enhance the efficiency and efficacy of interventions delivered by clinicians. The SB EMR may also be used by SB clinic staff to manage and monitor the developmental course SB through childhood and the adolescent years. Further, implementation of the SB EMR in conjunction with the life-course model will assist in the transition of young persons with SB to adult roles. C1 [Fairman, Andrea D.] Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. [Thibadeau, Judy K.] Ctr Dis Control & Prevent, Div Human Dev & Disabil, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30033 USA. [Dicianno, Brad E.] VA Pittsburgh Healthcare Syst, Dept Vet Affairs, HERL, Pittsburgh, PA 15206 USA. [Dicianno, Brad E.] UPMC, Dept Phys Med & Rehabil, Pittsburgh, PA 15213 USA. [Parmanto, Bambang] Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Hlth Informat Management, Pittsburgh, PA 15260 USA. RP Fairman, AD (reprint author), Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Rehabil Sci & Technol, Forbes Tower,Suite 5044,3600 Forbes Ave, Pittsburgh, PA 15260 USA. EM adf29@pitt.edu OI Dicianno, Brad/0000-0003-0738-0192 FU National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia FX This work was supported by the National Spina Bifida Program, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia. NR 24 TC 1 Z9 2 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 0031-3955 J9 PEDIATR CLIN N AM JI Pediatr. Clin. N. Am. PD AUG PY 2010 VL 57 IS 4 BP 959 EP + DI 10.1016/j.pcl.2010.07.015 PG 14 WC Pediatrics SC Pediatrics GA 672YH UT WOS:000283623300009 PM 20883885 ER PT J AU Swanson, ME Dicianno, BE AF Swanson, Mark E. Dicianno, Brad E. TI Physiatrists and Developmental Pediatricians Working Together to Improve Outcomes in Children with Spina Bifida SO PEDIATRIC CLINICS OF NORTH AMERICA LA English DT Article DE Spina bifida; Physiatry; Developmental pediatrics; Interdisciplinary care ID YOUNG-ADULTS; ADOLESCENTS; MYELOMENINGOCELE; HISTORY; OBESITY; FAMILY AB Based on the experience of 2 physicians from physiatry and developmental pediatrics, this article proposes a framework for improving care and outcomes for children with spina bifida. The combined skills of physiatrists and developmental pediatricians, along with other disciplines, can form the ideal team to manage the complex issues faced by this population. The developmental pediatrician is best suited for directing care for younger children through the elementary and middle school years, during which time behavioral and educational issues are prominent. As the child assumes more responsibility for self-management in adolescence, the physiatrist is ideally suited to provide major clinical input that improves functional outcomes. The addition of the discipline of physiatry to traditional, developmentally oriented pediatric interdisciplinary teams can add the much needed dimensions of activity and participation, and improve functional outcomes at the adult level by encouraging activities in adolescence that lead to full participation in adulthood. C1 [Swanson, Mark E.] Ctr Dis Control & Prevent, Div Human Dev & Disabil, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA. [Dicianno, Brad E.] VA Pittsburgh Healthcare Syst, Dept Vet Affairs, HERL, Pittsburgh, PA 15206 USA. [Dicianno, Brad E.] UPMC, Adult Spina Bifida Clin, Dept Phys Med & Rehabil, Pittsburgh, PA 15213 USA. RP Swanson, ME (reprint author), Ctr Dis Control & Prevent, Div Human Dev & Disabil, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA. EM cfu9@cdc.gov OI Dicianno, Brad/0000-0003-0738-0192 NR 22 TC 0 Z9 1 U1 1 U2 5 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0031-3955 J9 PEDIATR CLIN N AM JI Pediatr. Clin. N. Am. PD AUG PY 2010 VL 57 IS 4 BP 973 EP + DI 10.1016/j.pcl.2010.07.016 PG 10 WC Pediatrics SC Pediatrics GA 672YH UT WOS:000283623300010 PM 20883886 ER PT J AU Fiks, AG Localio, AR Alessandrini, EA Asch, DA Guevara, JP AF Fiks, Alexander G. Localio, A. Russell Alessandrini, Evaline A. Asch, David A. Guevara, James P. TI Shared Decision-Making in Pediatrics: A National Perspective SO PEDIATRICS LA English DT Article DE ADHD; asthma; communication; decision-making; telephone care ID ATTENTION-DEFICIT/HYPERACTIVITY-DISORDER; STIMULANT MEDICATION; MULTIMODAL-TREATMENT; RANDOMIZED TRIAL; MENTAL-HEALTH; FOLLOW-UP; E-MAIL; CHILDREN; CARE; COMMUNICATION AB OBJECTIVES: To identify patterns of shared decision-making (SDM) among a nationally representative sample of US children with attention-deficit/hyperactivity disorder (ADHD) or asthma and determine if demographics, health status, or access to care are associated with SDM. PATIENTS AND METHODS: We performed a cross-sectional study of the 2002-2006 Medical Expenditure Panel Survey, which represents 2 million children with ADHD and 4 million children with asthma. The outcome, high SDM, was defined by using latent class models based on 7 Medical Expenditure Panel Survey items addressing aspects of SDM. We entered factors potentially associated with SDM into logistic regression models with high SDM as the outcome. Marginal standardization then described the standardized proportion of children's households with high SDM for each factor. RESULTS: For both ADHD and asthma, 65% of children's households had high SDM. Those who reported poor general health for their children were 13% less likely to have high SDM for ADHD (64 vs 77%) and 8% less likely for asthma (62 vs 70%) when adjusting for other factors. Results for behavioral impairment were similar. Respondent demographic characteristics were not associated with SDM. Those with difficulty contacting their clinician by telephone were 26% (ADHD: 55 vs 81%) and 29% (asthma: 48 vs 77%) less likely to have high SDM than those without difficulty. CONCLUSIONS: These findings indicate that households of children who report greater impairment or difficulty contacting their clinician by telephone are less likely to fully participate in SDM. Future research should examine how strategies to foster ongoing communication between families and clinicians affect SDM. Pediatrics 2010;126:306-314 C1 [Fiks, Alexander G.] Childrens Hosp Philadelphia, Ctr Pediat Clin Effectiveness, Pediat Res Consortium, Philadelphia, PA 19104 USA. [Fiks, Alexander G.] Childrens Hosp Philadelphia, Ctr Biomed Informat, Philadelphia, PA 19104 USA. [Fiks, Alexander G.; Guevara, James P.] Childrens Hosp Philadelphia, Pediat Generalist Res Grp, Philadelphia, PA 19104 USA. [Fiks, Alexander G.; Guevara, James P.] Univ Penn, Sch Med, Dept Pediat, Philadelphia, PA 19104 USA. [Localio, A. Russell] Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. [Asch, David A.] Univ Penn, Sch Med, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Alessandrini, Evaline A.] Cincinnati Childrens Hosp Med Ctr, Div Hlth Policy, Cincinnati, OH USA. [Alessandrini, Evaline A.] Cincinnati Childrens Hosp Med Ctr, Div Clin Effectiveness & Emergency Med, Cincinnati, OH USA. [Asch, David A.] Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RP Fiks, AG (reprint author), Childrens Hosp Philadelphia, Ctr Pediat Clin Effectiveness, Pediat Res Consortium, 3535 Market St,Room 1546, Philadelphia, PA 19104 USA. EM fiks@email.chop.edu OI Asch, David/0000-0002-7970-286X; Guevara, James/0000-0003-1665-4503 FU National Institutes of Health (NIH); Academic Pediatric Association; Children's Hospital of Philadelphia; Eunice Kennedy Shriver National Institute of Child Health and Human Development [K23HD059919] FX Funded by the National Institutes of Health (NIH).; This research was supported by an Academic Pediatric Association Young Investigator Award and institutional development funds from the Children's Hospital of Philadelphia. In addition, the project described was supported by award K23HD059919 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. NR 45 TC 36 Z9 36 U1 2 U2 12 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD AUG PY 2010 VL 126 IS 2 BP 306 EP 314 DI 10.1542/peds.2010-0526 PG 9 WC Pediatrics SC Pediatrics GA 634FO UT WOS:000280565700020 PM 20624804 ER PT J AU Look, AE Flory, JD Harvey, PD Siever, LJ AF Look, Amy E. Flory, Janine D. Harvey, Philip D. Siever, Larry J. TI Psychometric properties of a short form of the Affective Lability Scale (ALS-18) SO PERSONALITY AND INDIVIDUAL DIFFERENCES LA English DT Article DE Affective Lability Scale; Affect dysregulation; Cluster B personality ID BORDERLINE PERSONALITY-DISORDER; AFFECTIVE INSTABILITY; BIPOLAR-II AB Psychometric properties of a short form of the Affective Lability Scale (ALS) that was developed in a non-clinical sample (i.e., undergraduate students) were examined in a sample of people diagnosed with Cluster B DSM-IV Axis II personality disorders (n = 236), other personality disorders (n = 180), and healthy comparison participants (n = 164). The total score of the ALS-18 score correlated strongly with the original 54-item scale (r = .97) and aspects of convergent and discriminant validity of the ALS-18 subscales (Anxiety/Depression, Depression/Elation, and Anger) were evaluated using self-report measures of affective and psychosocial functioning in the domains of affect intensity, anxiety, anger, and minimization/denial. Clinical utility of the scale was also demonstrated; participants diagnosed with Cluster B personality disorders reported higher affective lability scores, and healthy control participants reported lower scores, relative to individuals with Cluster A or Cluster C personality disorders (p's < .001). Confirmatory factor analyses were conducted and demonstrated reasonably good fit to the data but future research is needed to test the three factor substructure of the ALS-18 against alternative factor models in samples that include clinical and non-clinical participants. Published by Elsevier Ltd. C1 [Flory, Janine D.] CUNY Queens Coll, Dept Psychol, Flushing, NY 11367 USA. [Look, Amy E.; Siever, Larry J.] James J Peters VA Med Ctr, MIRECC, Bronx, NY USA. [Flory, Janine D.; Siever, Larry J.] James J Peters VA Med Ctr, Psychiat Serv, Bronx, NY USA. [Harvey, Philip D.] Emory Univ, Sch Med, Dept Psychiat & Behav Sci, Atlanta, GA USA. [Siever, Larry J.] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. RP Flory, JD (reprint author), CUNY Queens Coll, Dept Psychol, 65-30 Kissena Blvd, Flushing, NY 11367 USA. EM janine.flory@qc.cuny.edu FU NCRR NIH HHS [M01 RR000071-340193, M01 RR000071]; NIMH NIH HHS [R01 MH063875, K01 MH069979, R01 MH065554, K01 MH069979-01A1] NR 20 TC 9 Z9 9 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0191-8869 J9 PERS INDIV DIFFER JI Pers. Individ. Differ. PD AUG PY 2010 VL 49 IS 3 BP 187 EP 191 DI 10.1016/j.paid.2010.03.030 PG 5 WC Psychology, Social SC Psychology GA 611NU UT WOS:000278824100006 PM 20606710 ER PT J AU Reitmair, A Lambrecht, NWG Yakubov, I Nieves, A Old, D Donde, Y Dinh, D Burk, R Sachs, G Bin Im, W Wheeler, L AF Reitmair, Armin Lambrecht, Nils W. G. Yakubov, Iskandar Nieves, Amelia Old, David Donde, Yariv Dinh, Danny Burk, Robert Sachs, George Bin Im, Wha Wheeler, Larry TI Prostaglandin E-2 receptor subtype EP2-and EP4-regulated gene expression profiling in human ciliary smooth muscle cells SO PHYSIOLOGICAL GENOMICS LA English DT Article DE gene regulation; glaucoma; intraocular pressure ID TYPE-1 MATRIX-METALLOPROTEINASE; KERATINOCYTE GROWTH-FACTOR; AQUEOUS-HUMOR DYNAMICS; NECROSIS-FACTOR-ALPHA; MORPHOGENETIC PROTEIN-2 BMP-2; EP4 PROSTANOID RECEPTORS; ELEMENT-BINDING PROTEIN; EXTRACELLULAR-MATRIX; CYNOMOLGUS MONKEY; TISSUE INHIBITOR AB Reitmair A, Lambrecht NW, Yakubov I, Nieves A, Old D, Donde Y, Dinh D, Burk R, Sachs G, Im WB, Wheeler L. Prostaglandin E-2 receptor subtype EP2-and EP4-regulated gene expression profiling in human ciliary smooth muscle cells. Physiol Genomics 42: 348-360, 2010. First published June 15, 2010; doi: 10.1152/physiolgenomics.00012.2010.-Prostanoids are an important class of intraocular pressure (IOP)-lowering antiglaucoma agents that act primarily via increased uveo-scleral aqueous humor outflow through the ciliary body. We have developed two novel PGE(2) analogs that are specific agonists for the PGE(2) receptor subtypes EP2 and EP4, respectively. To identify gene regulatory networks and key players that mediate the physiological effects observed in vivo, we performed genomewide expression studies using human ciliary smooth muscle cells. Quantitative real-time RT-PCR confirmed a largely overlapping gene expression profile subsequent to EP2 and EP4 agonist treatment, with 65 significantly regulated genes identified overall, 5 being specific for the EP2 agonist and 6 specific for the EP4 agonist. We found predicted functional cAMP-response elements in promoter regions of a large fraction of the predominantly upregulated genes, which suggests that the cAMP signaling pathway is the most important intracellular signaling pathway for these agonists in these cells. Several target genes were identified that, as part of complex regulatory networks, are implicated in tissue remodeling processes and osmoregulation (e. g., AREG, LOXL3, BMP2, AQP3) and thus may help elucidate the mechanism of action of these IOP-lowering drugs involving the uveo-scleral outflow path. C1 [Reitmair, Armin; Nieves, Amelia; Bin Im, Wha; Wheeler, Larry] Allergan Pharmaceut Inc, Dept Biol Sci, Irvine, CA 92612 USA. [Old, David; Donde, Yariv; Dinh, Danny; Burk, Robert] Allergan Pharmaceut Inc, Dept Med Chem, Irvine, CA 92612 USA. [Lambrecht, Nils W. G.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. [Sachs, George] Univ Calif Los Angeles, David Geffen Sch Med, Dept Physiol, Los Angeles, CA 90095 USA. [Yakubov, Iskandar; Sachs, George] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. [Lambrecht, Nils W. G.; Yakubov, Iskandar; Sachs, George] W Los Angeles Vet Affairs Med Ctr, Membrane Biol Lab, Los Angeles, CA 90073 USA. RP Reitmair, A (reprint author), Allergan Pharmaceut Inc, Dept Biol Sci, RD3,2525 Dupont Dr, Irvine, CA 92612 USA. EM reitmair_armin@allergan.com OI Lambrecht, Nils/0000-0002-1275-1384 NR 122 TC 3 Z9 4 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1094-8341 J9 PHYSIOL GENOMICS JI Physiol. Genomics PD AUG PY 2010 VL 42 IS 3 BP 348 EP 360 DI 10.1152/physiolgenomics.00012.2010 PG 13 WC Cell Biology; Genetics & Heredity; Physiology SC Cell Biology; Genetics & Heredity; Physiology GA 655UU UT WOS:000282278700004 PM 20551148 ER PT J AU Sanchez, CJ Shivshankar, P Stol, K Trakhtenbroit, S Sullam, PM Sauer, K Hermans, PWM Orihuela, CJ AF Sanchez, Carlos J. Shivshankar, Pooja Stol, Kim Trakhtenbroit, Samuel Sullam, Paul M. Sauer, Karin Hermans, Peter W. M. Orihuela, Carlos J. TI The Pneumococcal Serine-Rich Repeat Protein Is an Intra-Species Bacterial Adhesin That Promotes Bacterial Aggregation In Vivo and in Biofilms SO PLOS PATHOGENS LA English DT Article ID STREPTOCOCCUS-PNEUMONIAE VIRULENCE; SURFACE GLYCOPROTEINS GSPB; FIMBRIA-ASSOCIATED ADHESIN; STAPHYLOCOCCUS-AUREUS; EXTRACELLULAR DNA; INVASIVE DISEASE; MIDDLE-EAR; BINDING; GORDONII; CELLS AB The Pneumococcal serine-rich repeat protein (PsrP) is a pathogenicity island encoded adhesin that has been positively correlated with the ability of Streptococcus pneumoniae to cause invasive disease. Previous studies have shown that PsrP mediates bacterial attachment to Keratin 10 (K10) on the surface of lung cells through amino acids 273-341 located in the Basic Region (BR) domain. In this study we determined that the BR domain of PsrP also mediates an intra-species interaction that promotes the formation of large bacterial aggregates in the nasopharynx and lungs of infected mice as well as in continuous flow-through models of mature biofilms. Using numerous methods, including complementation of mutants with BR domain deficient constructs, fluorescent microscopy with Cy3-labeled recombinant (r) BR, Far Western blotting of bacterial lysates, co-immunoprecipitation with rBR, and growth of biofilms in the presence of antibodies and competitive peptides, we determined that the BR domain, in particular amino acids 122-166 of PsrP, promoted bacterial aggregation and that antibodies against the BR domain were neutralizing. Using similar methodologies, we also determined that SraP and GspB, the Serine-rich repeat proteins (SRRPs) of Staphylococcus aureus and Streptococcus gordonii, respectively, also promoted bacterial aggregation and that their Non-repeat domains bound to their respective SRRPs. This is the first report to show the presence of biofilm-like structures in the lungs of animals infected with S. pneumoniae and show that SRRPs have dual roles as host and bacterial adhesins. These studies suggest that recombinant Non-repeat domains of SRRPs (i.e. BR for S. pneumoniae) may be useful as vaccine antigens to protect against Gram-positive bacteria that cause infection. C1 [Sanchez, Carlos J.; Shivshankar, Pooja; Trakhtenbroit, Samuel; Orihuela, Carlos J.] Univ Texas Hlth Sci Ctr San Antonio, Dept Microbiol & Immunol, San Antonio, TX 78229 USA. [Stol, Kim; Hermans, Peter W. M.] Radboud Univ Nijmegen, Med Ctr, Lab Pediat Infect Dis, NL-6525 ED Nijmegen, Netherlands. [Sullam, Paul M.] San Francisco VA Med Ctr, Div Infect Dis, San Francisco, CA USA. [Sullam, Paul M.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Sauer, Karin] SUNY Binghamton, Dept Biol Sci, Binghamton, NY USA. RP Sanchez, CJ (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Microbiol & Immunol, San Antonio, TX 78229 USA. EM orihuela@uthscsa.edu RI Hermans, Peter/F-4655-2010; Hermans, Peter/H-8042-2014 FU NIDCR [DE14318]; EC; NIH [AI41513, AI057433, AI078972]; VA FX CJS is supported through the NIDCR DE14318 for the COSTAR program. KS is funded by the EC Sixth Framework Program (OMVac project). PS is supported by the VA Merit Review Program and by NIH grants AI41513 and AI057433. For CJO this work was supported by the NIH grant AI078972. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 55 TC 70 Z9 71 U1 3 U2 28 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 AUG PY 2010 VL 6 IS 8 AR e1001044 DI 10.1371/journal.ppat.1001044 PG 15 WC Microbiology; Parasitology; Virology SC Microbiology; Parasitology; Virology GA 644SM UT WOS:000281399900017 PM 20714350 ER PT J AU Hicken, BL Plowhead, A AF Hicken, Bret L. Plowhead, Angela TI A Model for Home-Based Psychology From the Veterans Health Administration SO PROFESSIONAL PSYCHOLOGY-RESEARCH AND PRACTICE LA English DT Article DE home care; psychology and home based primary care; therapy; assessment; homebound ID CORONARY-ARTERY-BYPASS; FAMILY-THERAPY; IN-HOME; ANTIRETROVIRAL THERAPY; CARE; SERVICES; DEPRESSION; PROGRAM; REHABILITATION; INTERVENTION AB The changing healthcare environment is creating opportunities for psychologists to practice in non-traditional settings. This paper describes a Veterans Health Administration (VA) initiative to integrate psychologists into its Home Based Primary Care (HBPC) program. As psychologists new to HBPC are learning, the home offers opportunities and challenges not routinely encountered in the traditional office setting. Home-based psychology offers improved access to mental health services, more effective treatment planning, and more accurate assessments in an underserved patient population. Psychologists practicing in this setting also encounter challenges in dealing with patient confidentiality, distractions, role confusion and boundaries, time management, safety, and professional competency. The VA experience is an instructive case example for psychologists considering this growing field of practice. This paper offers lessons learned from this VA initiative and discusses strategies for dealing with potential challenges. C1 [Hicken, Bret L.] George E Wahlen VA Med Ctr, Salt Lake City, UT USA. [Plowhead, Angela] Portland VA Med Ctr, Portland, OR USA. RP Hicken, BL (reprint author), VA Salt Lake City Hlth Care Syst, VA Rural Hlth Resource Ctr Western Reg, 500 Foothill Dr 182,SLC, Salt Lake City, UT 84148 USA. EM bret.hicken@va.gov NR 37 TC 8 Z9 8 U1 2 U2 3 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0735-7028 J9 PROF PSYCHOL-RES PR JI Prof. Psychol.-Res. Pract. PD AUG PY 2010 VL 41 IS 4 BP 340 EP 346 DI 10.1037/a0020431 PG 7 WC Psychology, Multidisciplinary SC Psychology GA 642LF UT WOS:000281214300010 ER PT J AU Danz, MS Rubenstein, LV Hempel, S Foy, R Suttorp, M Farmer, MM Shekelle, PG AF Danz, M. S. Rubenstein, L. V. Hempel, S. Foy, R. Suttorp, M. Farmer, M. M. Shekelle, P. G. TI Identifying quality improvement intervention evaluations: is consensus achievable? SO QUALITY & SAFETY IN HEALTH CARE LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; HEALTH-CARE; FRAMEWORK AB Background The diversity of quality improvement interventions (QIIs) has impeded the use of evidence review to advance quality improvement activities. An agreed-upon framework for identifying QII articles would facilitate evidence review and consensus around best practices. Aim To adapt and test evidence review methods for identifying empirical QII evaluations that would be suitable for assessing QII effectiveness, impact or success. Design Literature search with measurement of multilevel inter-rater agreement and review of disagreement. Methods Ten journals (2005-2007) were searched electronically and the output was screened based on title and abstract. Three pairs of reviewers then independently rated 22 articles, randomly selected from the screened list. Kappa statistics and percentage agreement were assessed. 12 stakeholders in quality improvement, including QII experts and journal editors, rated and discussed publications about which reviewers disagreed. Results The level of agreement among reviewers for identifying empirical evaluations of QII development, implementation or results was 73% (with a paradoxically low kappa of 0.041). Discussion by raters and stakeholders regarding how to improve agreement focused on three controversial article selection issues: no data on patient health, provider behaviour or process of care outcomes; no evidence for adaptation of an intervention to a local context; and a design using only observational methods, as correlational analyses, with no comparison group. Conclusion The level of reviewer agreement was only moderate. Reliable identification of relevant articles is an initial step in assessing published evidence. Advancement in quality improvement will depend on the theory-and consensus-based development and testing of a generalizable framework for identifying QII evaluations. C1 [Danz, M. S.; Rubenstein, L. V.; Hempel, S.; Suttorp, M.; Shekelle, P. G.] RAND Corp, Santa Monica, CA 90407 USA. [Danz, M. S.; Rubenstein, L. V.; Farmer, M. M.; Shekelle, P. G.] Vet Affairs Greater Los Angeles Healthcare Syst, North Hills, CA USA. [Foy, R.] Univ Leeds, Leeds Inst Hlth Sci, Leeds, W Yorkshire, England. RP Danz, MS (reprint author), RAND Corp, Santa Monica, CA 90407 USA. EM mjsdanz@gmail.com FU Robert Wood Johnson (RWJ) Foundation [65113] FX Robert Wood Johnson (RWJ) Foundation under a grant to LVR (grant ID 65113: Advancing the science of continuous quality improvement: A framework for identifying, classifying and evaluating continuous quality improvement studies). NR 18 TC 13 Z9 13 U1 1 U2 4 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1475-3898 J9 QUAL SAF HEALTH CARE JI Qual. Saf. Health Care PD AUG PY 2010 VL 19 IS 4 BP 279 EP 283 DI 10.1136/qshc.2009.036475 PG 5 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 688TB UT WOS:000284875300007 PM 20630931 ER PT J AU Gaffo, AL AF Gaffo, Angelo L. TI Diagnostic Approach to ANCA-associated Vasculitides SO RHEUMATIC DISEASE CLINICS OF NORTH AMERICA LA English DT Article DE ANCA; Anti-neutrophil cytoplasmic antibody; Vasculitis; Diagnosis; Differential diagnosis ID CHURG-STRAUSS-SYNDROME; ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES; MIDLINE DESTRUCTIVE LESIONS; RHEUMATOLOGY 1990 CRITERIA; AUTOANTIBODY-ASSOCIATED GLOMERULONEPHRITIS; INTERNATIONAL CONSENSUS STATEMENT; LIMITED WEGENERS-GRANULOMATOSIS; NERVOUS-SYSTEM INVOLVEMENT; HUMAN NEUTROPHIL ELASTASE; OPEN LUNG BIOPSIES AB Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) include Wegener's granulomatosis, microscopic polyangiitis, and Churg-Strauss syndrome. Given their rarity, protean clinical manifestations, imperfect diagnostic tests, and wide differential diagnosis, they pose a diagnostic challenge even to experienced clinicians. This article describes diagnostic approaches for patients suspected of having one of the ANCA-associated vasculitides. The clinical findings at presentation, the role of laboratory and imaging tests, and the importance of tissue diagnosis are presented. In each section, issues relevant to the differential diagnosis of AAV are discussed C1 [Gaffo, Angelo L.] Univ Alabama, Div Clin Immunol & Rheumatol, Birmingham, AL 35233 USA. [Gaffo, Angelo L.] Birmingham VA Med Ctr, Birmingham, AL 35233 USA. RP Gaffo, AL (reprint author), Univ Alabama, Div Clin Immunol & Rheumatol, 700 S 19th St, Birmingham, AL 35233 USA. NR 101 TC 9 Z9 11 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 0889-857X J9 RHEUM DIS CLIN N AM JI Rheum. Dis. Clin. North Am. PD AUG PY 2010 VL 36 IS 3 BP 491 EP + DI 10.1016/j.rdc.2010.05.009 PG 17 WC Rheumatology SC Rheumatology GA 649AL UT WOS:000281737300006 PM 20688246 ER PT J AU Rajasekhar, A Clancy, CJ AF Rajasekhar, Anita Clancy, Cornelius J. TI Meningitis due to group C Streptococcus: A case report and review of the literature SO SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID LANCEFIELD GROUP-C; EQUI SUBSPECIES EQUI; BACTERIAL-MENINGITIS; ZOOEPIDEMICUS MENINGITIS; SERIOUS INFECTION; BACTEREMIA; ADULTS; SECONDARY; OUTBREAK; HORSE AB Group C streptococci (GCS) are common causes of veterinary diseases and may colonize humans. Human diseases due to GCS are uncommon and generally occur in the elderly and persons exposed to animals or animal products. We report a case of Streptococcus equi subsp. zooepidemicus meningitis in a horse trainer and review 36 cases of GCS meningitis reported in the literature. The median age was 48 y and the majority of patients were previously healthy. Thirty-one percent (11/36) of the reported cases followed equine exposure and 19% (7/36) ingestion of dairy products. Sixty-seven percent (24/36) were found to have concomitant bacteraemia. The case fatality rate was 31% (11/36), and 28% (7/25) of survivors were reported to have residual neurological impairments. At least 4 days of antibiotics were typically required before symptoms improved. Isolates were generally susceptible to beta-lactams. In conclusion, it is important to consider GCS in the differential of bacterial meningitis, in particular in elderly patients exposed to horses or dairy products. Beta-lactams are first-line therapy, but outcomes are poor. C1 [Clancy, Cornelius J.] Univ Pittsburgh, Dept Med, Pittsburgh, PA 15260 USA. [Clancy, Cornelius J.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15260 USA. [Rajasekhar, Anita] Univ Florida, Dept Med, Gainesville, FL USA. RP Clancy, CJ (reprint author), Univ Pittsburgh, Dept Med, 930 Scaife Hall, Pittsburgh, PA 15260 USA. EM cjc76@pitt.edu NR 37 TC 6 Z9 7 U1 0 U2 2 PU TAYLOR & FRANCIS AS PI OSLO PA KARL JOHANS GATE 5, NO-0154 OSLO, NORWAY SN 0036-5548 J9 SCAND J INFECT DIS JI Scand. J. Infect. Dis. PD AUG PY 2010 VL 42 IS 8 BP 571 EP 578 DI 10.3109/00365541003754428 PG 8 WC Infectious Diseases SC Infectious Diseases GA 640HR UT WOS:000281041300002 PM 20632899 ER PT J AU Ventura, J Reise, SP Keefe, RSE Baade, LE Gold, JM Green, MF Kern, RS Mesholam-Gately, R Nuechterlein, KH Seidman, LJ Bilder, RM AF Ventura, Joseph Reise, Steven P. Keefe, Richard S. E. Baade, Lyle E. Gold, James M. Green, Michael F. Kern, Robert S. Mesholam-Gately, Raquelle Nuechterlein, Keith H. Seidman, Larry J. Bilder, Robert M. TI The Cognitive Assessment Interview (CAI): Development and validation of an empirically derived, brief interview-based measure of cognition SO SCHIZOPHRENIA RESEARCH LA English DT Article DE Cognitive assessment; Schizophrenia Item response theory; Unidimensionality; Intermediate outcomes; Functional outcome ID CLINICAL-TRIALS; RATING-SCALE; SCHIZOPHRENIA; PERFORMANCE; RELIABILITY; DYSFUNCTION; VALIDITY; BATTERY AB Background: Practical, reliable "real world" measures of cognition are needed to supplement neurocognitive performance data to evaluate possible efficacy of new drugs targeting cognitive deficits associated with schizophrenia. Because interview-based measures of cognition offer one possible approach, data from the MATRICS initiative (n = 176) were used to examine the psychometric properties of the Schizophrenia Cognition Rating Scale (SCoRS) and the Clinical Global Impression of Cognition in Schizophrenia (CGI-CogS). Method: We used classical test theory methods and item response theory to derive the 10-item Cognitive Assessment Interview (CAI) from the SCoRS and CGI-CogS ("parent instruments"). Sources of information for CAI ratings included the patient and an informant. Validity analyses examined the relationship between the CAI and objective measures of cognitive functioning, intermediate measures of cognition, and functional outcome. Results: The rater's score from the newly derived CAI (10 items) correlate highly (r=.87) with those from the combined set of the SCoRS and CGI-CogS (41 items). Both the patient (r=.82) and the informant (r=.95) data were highly correlated with the rater's score. The CAI was modestly correlated with objectively measured neurocognition (r=-.32), functional capacity (r=-.44), and functional outcome (r=-.32), which was comparable to the parent instruments. Conclusions: The CAI allows for expert judgment in evaluating a patient's cognitive functioning and was modestly correlated with neurocognitive functioning, functional capacity, and functional outcome. The CAI is a brief, repeatable, and potentially valuable tool for rating cognition in schizophrenia patients who are participating in clinical trials. (C) 2010 Elsevier B.V. All rights reserved. C1 [Ventura, Joseph] Univ Calif Los Angeles, Dept Psychiat, Semel Inst Neurosci & Human Behav, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Reise, Steven P.; Nuechterlein, Keith H.; Bilder, Robert M.] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA. [Keefe, Richard S. E.] Duke Univ, Dept Psychiat & Behav Sci, Durham, NC USA. [Baade, Lyle E.] Univ Kansas, Sch Med, Wichita, KS 67214 USA. [Gold, James M.] Univ Maryland, Sch Med, Maryland Psychiat Res Ctr, Baltimore, MD 21201 USA. [Green, Michael F.; Kern, Robert S.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Mesholam-Gately, Raquelle; Seidman, Larry J.] Harvard Univ, Beth Israel Deaconess Med Ctr, Massachusetts Mental Hlth Ctr, Publ Psychiat Div,Med Sch, Boston, MA 02215 USA. RP Ventura, J (reprint author), Univ Calif Los Angeles, Dept Psychiat, Semel Inst Neurosci & Human Behav, David Geffen Sch Med, 300 Med Plaza,Room 2243, Los Angeles, CA 90095 USA. EM jventura@ucla.edu RI Bilder, Robert/A-8894-2008 OI Bilder, Robert/0000-0001-5085-7852 FU Pfizer, Inc.; NIMH [1R21MH073971, N01MH22006]; National Institute of Mental Health [MH37705, P50 MH066286] FX This research was supported by an investigator initiated grant from Pfizer, Inc., and from an NIMH grant 1R21MH073971 that were awarded to Joseph Ventura, Ph.D. Funding for the MATRICS Initiative was provided through contract N01MH22006 from NIMH to the University of California, Los Angeles, Dr. Marder, Principal Investigator; Dr. Green, Co-principal investigator; Dr. Fenton, Project Officer. Funding for MATRICS PASS came from an option (Dr. Green, principal investigator; Dr. Nuechterlein, co-principal investigator) to the NIMH MATRICS Initiative. This research was also supported in part by National Institute of Mental Health Grants MH37705 (P.I: Keith H. Nuechterlein, Ph.D.), and P50 MH066286 (PI: Keith H. Nuechterlein, Ph.D.). NR 21 TC 27 Z9 27 U1 1 U2 2 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 2010 VL 121 IS 1-3 BP 24 EP 31 DI 10.1016/j.schres.2010.04.016 PG 8 WC Psychiatry SC Psychiatry GA 640SW UT WOS:000281073700003 PM 20542412 ER PT J AU Fujimura, R AF Fujimura, Robert TI Shock and Age SO SCIENTIST LA English DT Letter C1 VA Puget Sound Hlth Care Syst, GRECC, Seattle, WA USA. RP Fujimura, R (reprint author), VA Puget Sound Hlth Care Syst, GRECC, Seattle, WA USA. EM fujimr@u.washington.edu NR 1 TC 0 Z9 0 U1 0 U2 0 PU SCIENTIST INC PI PHILADELPHIA PA 400 MARKET ST, STE 1250, PHILADELPHIA, PA 19106 USA SN 0890-3670 J9 SCIENTIST JI Scientist PD AUG PY 2010 VL 24 IS 8 BP 15 EP 15 PG 1 WC Information Science & Library Science; Multidisciplinary Sciences SC Information Science & Library Science; Science & Technology - Other Topics GA 629SE UT WOS:000280219200007 ER PT J AU Randhawa, K Smethurst, P Hoo, GWS AF Randhawa, Kanwal Smethurst, Peter Hoo, Guy W. Soo TI Nine-Year Progression of Untreated Pulmonary Mycobacterium szulgai Infection SO SOUTHERN MEDICAL JOURNAL LA English DT Article DE clarithromycin; Mycobacterium szulgai; nontuberculous mycobacterium ID UNUSUAL PATHOGEN; LUNG AB A 58-year-old man was seen with complaints of fevers, night sweats, weight loss, and multiple bilateral cavitary lung lesions. Mycobacterium szulgai with nearly identical antibiograms grew from separate sputum specimens 9 years apart. He was treated with a combination of clarithromycin and ethambutol with clinical, microbiologic, and radiographic resolution of disease. This is the longest untreated case of documented Mycobacterium szulgai infection reported, and offers a glimpse of its natural history when left untreated. Despite an infrequent isolation (<0.5% of cases), it is a pathogenic organism which warrants treatment. C1 VA Greater Angeles Healthcare Syst, W Los Angeles Vet Affairs Med Ctr, Pulm & Crit Care Sect, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Hoo, GWS (reprint author), W Los Angeles Vet Affairs Med Ctr, Pulm & Crit Care Sect 111Q, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Guy.soohoo@va.gov NR 12 TC 2 Z9 2 U1 0 U2 1 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 AUG PY 2010 VL 103 IS 8 BP 828 EP 830 DI 10.1097/SMJ.0b013e3181e6cc26 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 703FU UT WOS:000285964600022 PM 20622732 ER PT J AU Ingraham, AM Cohen, ME Bilimoria, KY Raval, MV Ko, CY Nathens, AB Hall, BL AF Ingraham, Angela M. Cohen, Mark E. Bilimoria, Karl Y. Raval, Mehul V. Ko, Clifford Y. Nathens, Avery B. Hall, Bruce L. TI Comparison of 30-day outcomes after emergency general surgery procedures: Potential for targeted improvement SO SURGERY LA English DT Article ID LAPAROSCOPIC CHOLECYSTECTOMY; SURGICAL CARE; RISK-FACTORS; COLECTOMY; QUALITY; PATIENT; PROGRAM; APPENDICITIS; MANAGEMENT; NATIONWIDE AB Background. Patients who undergo emergency operations represent a high-risk population and have been shown to have a high risk of poor outcomes Little Is known, however; about the variability in the quality of emergency general surgical care across hospitals or within hospitals across different procedures. The objectives of this study were to identify risk factors associated with. adverse events, to compare 30-day outcomes after 3 common emergency general surgery procedures within and across hospitals, and thus, to determine whether the quality of emergency surgical cam is procedure-dependent or intrinsic to oilier aspects of the hospital environment. Methods. Patients who underwent emergency appendectomy, cholecystectomy, or colorectal resection at 95 hospitals that submitted at least 20 of each procedure were identified in the 2005-2008 American College of Surgeons National Surgical Quality Improvement Project database. Outcomes of interest included 30-day overall moridity and serious morbidity/mortality Step-wise logistic regression generated patient-level piedicted probabilities of an outcome. Based on the expected probabilities, observed to expected (O/E) ratios for each outcome, after each of the 3 procedures, were calculated for each hospital. Hospitals were divided into terciles based on O/E ratios. The agreement on hospital outcomes performance for overall morbidity and serious morbidity/mortality after appendectomy, cholecystectomy, and colorectal resection was assessed using weighted kappa statistics. Results. Of the 30,788 appendectomies, 1,984 (6.44%) patients had any morbidity, and 1,140 (3 70%) patients had a serious morbidity or died Of the 5,824 cholecystectomies, 503 (8.64%) patients had any morbidity, and 371 (6.37%) patients had a serious morbidity or died Of the 8,990 colorectal resections, 4,202 (46 74%) patients had any morbidity, and 3,736 (41.56%) patients had a serious morbidity or died For overall morbidity, O/E ratios for appendectomy ranged from 0 26 to 2 36, O/E ratios for cholecystectomy ranged from 0 to 3.04, O/E ratios for colorectal resection ranged from. 0.45 to 1.51. For serious morbidity/mortality, O/E ratios for appendectomy ranged from 0.23 to 2.54; O/E ratios for choloystectomy ranged from 0 to 4 28, O/E ratios for colorectal resection ranged from 0.59 to 1.75 Associations of risk-adjusted hospital outcomes based on tercile rank between procedures demonstrated slight but significant agreement for both overall morbidity (weighted kappa between 0 20 and 0 22) and serious.morbidity/mortality (weighted kappa. bet won 0 18 and 0 22) Despite this, 7 (7.4%) hospitals for overall morbidity and 9 (9.5 %) hospitals for serious morbidity/modality were rated in the highest (best) tercile for all procedures. Eight (8.4%) hospitals for overall morbidity and 8 (8 4%) hospitals for serious.morbidity/mortality were rated in the lowest tercile for all procedures Conclusion. Emergency general surgery procedures, particularly colorectal resections, were associated with substantial 30-day overall morbidity and serious morbidity/mortality. Most hospitals did not have consistent risk-adjusted outcomes across all 3 procedures, but for a substantive minority of institutions (7-10%), good or had performance was generalizable across procedures. Individual hospitals should examine then pocedure-specific outcomes after emergency general surge?), operations to focus quality improvement initiatives appropriately. (Singer), 2010;148.217-38.) C1 [Ingraham, Angela M.; Cohen, Mark E.; Raval, Mehul V.; Ko, Clifford Y.] Amer Coll Surg, Div Res & Optimal Patient Care, Chicago, IL 60611 USA. [Ingraham, Angela M.] Univ Cincinnati, Coll Med, Dept Surg, Cincinnati, OH 45267 USA. [Bilimoria, Karl Y.; Raval, Mehul V.] Northwestern Univ, Feinberg Sch Med, Dept Surg, Chicago, IL 60611 USA. [Ko, Clifford Y.] Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. [Ko, Clifford Y.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Nathens, Avery B.] St Michaels Hosp, Li Ka Shing Knowledge Inst, Keenan Res Ctr, Div Surg & Trauma, Toronto, ON M5B 1W8, Canada. [Hall, Bruce L.] John Cochran Vet Affairs Med Ctr, Dept Surg, St Louis, MO USA. [Hall, Bruce L.] Washington Univ, Sch Med, Dept Surg, St Louis, MO 63110 USA. [Hall, Bruce L.] Barnes Jewish Hosp, St Louis, MO 63110 USA. [Hall, Bruce L.] Washington Univ, Ctr Hlth Policy, St Louis, MO USA. [Hall, Bruce L.] Washington Univ, John M Olin Sch Business, St Louis, MO 63130 USA. RP Ingraham, AM (reprint author), Amer Coll Surg, Div Res & Optimal Patient Care, 633 N St Clau St,Floor 22NE, Chicago, IL 60611 USA. OI Raval, Mehul/0000-0002-1527-2661 NR 31 TC 40 Z9 40 U1 0 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0039-6060 J9 SURGERY JI Surgery PD AUG PY 2010 VL 148 IS 2 BP 217 EP 238 DI 10.1016/j.surg.2010.05.009 PG 22 WC Surgery SC Surgery GA 632OE UT WOS:000280433200009 PM 20633727 ER PT J AU Galofre, JC Haber, RS Mitchell, AA Pessah, R Davies, TF AF Galofre, Juan C. Haber, Richard S. Mitchell, Adele A. Pessah, Rachel Davies, Terry F. TI Increased Postpartum Thyroxine Replacement in Hashimoto's Thyroiditis SO THYROID LA English DT Article ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; SUBCLINICAL HYPOTHYROIDISM; LEVOTHYROXINE REQUIREMENTS; PEROXIDASE ANTIBODIES; FOLLOW-UP; PREGNANCY; WOMEN; DYSFUNCTION; DISEASE; IMMUNOLOGY AB Background: The thyroidal response of pregnant patients with established Hashimoto's thyroiditis remains poorly described. The aim of this study was to determine the impact of pregnancy on Hashimoto's thyroiditis as revealed by changes in postpregnancy levothyroxine requirements. Methods: We performed a retrospective study of 799 hypothyroid patients in a university hospital. We reviewed the clinical records and selected a group of well-documented pregnant (n = 34) and nonpregnant (n 32) hypothyroid women for study. We reviewed levothyroxine intake and serum thyrotropin (TSH) levels during three consecutive 9-month time intervals that were immediately before, during, and after pregnancy. We compared the percent change in levothyroxine dose between the prepregnancy level and each trimester during and after pregnancy. Results: There were two patterns of levothyroxine supplementation during gestation. In pattern 1 (n 11) there was either no change or a single levothyroxine dose increase with no subsequent changes in each trimester (T1 = T2 = T3). In pattern 2 (n 18), multistep levothyroxine dose increases were required throughout pregnancy (T1< T2< T3) to maintain desired TSH levels (< 2.0 mU/L). Women with pattern 2 had mean TSH levels during gestation that differed significantly from pattern 1 (2.8 +/- 0.5 vs. 1.3 +/- 0.1 mU/L respectively; p<0.03). Further, in multivariate logistic regression, women with pattern 2 were 62 times more likely than women with pattern 1 to have a levothyroxine dose at least 20% above baseline at 3 months postpartum (p - 0.04). Conclusions: We showed that >50% of hypothyroid women with Hashimoto's thyroiditis experienced an increase in levothyroxine requirements in the postpartum compared to pregestational doses. This pattern of enhanced levothyroxine need was most likely dependent on the preexisting thyroid functional reserve and postpartum progression of autoimmune destruction. C1 [Galofre, Juan C.; Davies, Terry F.] Mt Sinai Hosp, Mt Sinai Sch Med, Thyroid Res Unit, James J Peters VA Med Ctr, New York, NY 10029 USA. [Galofre, Juan C.] Univ Navarra, Clin Univ, Dept Endocrinol, E-31080 Pamplona, Spain. [Haber, Richard S.; Pessah, Rachel; Davies, Terry F.] Mt Sinai Hosp, Mt Sinai Sch Med, Dept Med, James J Peters VA Med Ctr, New York, NY 10029 USA. [Mitchell, Adele A.] Mt Sinai Hosp, Mt Sinai Sch Med, Dept Genet & Genom Sci, James J Peters VA Med Ctr, New York, NY 10029 USA. RP Davies, TF (reprint author), Mt Sinai Med Ctr, Dept Med, Box 1055,1 Gustave L Levy Pl, New York, NY 10029 USA. EM terry.davies@mssm.edu FU NIDDKD [DK069713]; VA; David Owen Segal Fund; Clinica Universitaria, University of Navarra FX This study was supported in part by grants from NIDDKD (DK069713), the VA Merit Award Program, and the David Owen Segal Fund (Dr. Davies) and the Clinica Universitaria, University of Navarra (Dr. Galofre). NR 33 TC 5 Z9 6 U1 0 U2 3 PU MARY ANN LIEBERT, INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1050-7256 EI 1557-9077 J9 THYROID JI Thyroid PD AUG PY 2010 VL 20 IS 8 BP 901 EP 908 DI 10.1089/thy.2009.0391 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 634KF UT WOS:000280579000011 PM 20615129 ER PT J AU Sun, HY Singh, N AF Sun, H. -Y. Singh, N. TI Should intravesical Bacillus Calmette-Guerin be employed in transplant recipients with bladder carcinoma? SO TRANSPLANT INFECTIOUS DISEASE LA English DT Article DE transplant; bladder carcinoma; pro-inflammatory; responses; Bacillus Calmette-Guerin; BCG ID PHASE-III TRIAL; KIDNEY-TRANSPLANTATION; BCG IMMUNOTHERAPY; MYCOBACTERIUM-BOVIS; IN-SITU; IMMUNOSUPPRESSIVE DRUGS; EUROPEAN ORGANIZATION; IMMUNE-RESPONSES; CANCER INCIDENCE; MESSENGER-RNA AB Bacillus Calmette-Guerin (BCG) exerts its antitumor activity through induction of pro-inflammatory cytokines, while immunosuppressive agents prevent organ rejection by suppressing pro-inflammatory and promoting anti-inflammatory responses. Thus, in the setting of transplant populations, the use of intravesical BCG for bladder cancer has the possibility of either promoting allograft rejection or being rendered ineffective by the action of immunosuppressive agents that block pro-inflammatory responses. We discuss the potential immunologic interactions between BCG and immunosuppression, and review relevant outcomes in renal transplant recipients with bladder cancer receiving intravesical BCG. C1 [Sun, H. -Y.; Singh, N.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Sun, H. -Y.] Natl Taiwan Univ, Coll Med, Dept Internal Med, Natl Taiwan Univ Hosp, Taipei, Taiwan. [Singh, N.] Univ Pittsburgh, Div Infect Dis, Pittsburgh, PA USA. RP Singh, N (reprint author), VA Med Ctr, Infect Dis Sect, Univ Dr C, Pittsburgh, PA 15240 USA. EM nis5@pitt.edu OI SUN, HSIN-YUN/0000-0003-0074-7721 NR 51 TC 7 Z9 7 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1398-2273 J9 TRANSPL INFECT DIS JI Transpl. Infect. Dis. PD AUG PY 2010 VL 12 IS 4 BP 358 EP 362 DI 10.1111/j.1399-3062.2010.00506.x PG 5 WC Immunology; Infectious Diseases; Transplantation SC Immunology; Infectious Diseases; Transplantation GA 640ON UT WOS:000281061000012 PM 20412534 ER PT J AU Poorkaj, P Raskind, WH Leverenz, JB Matsushita, M Zabetian, CP Samii, A Kim, S Gazi, N Nutt, JG John, W Yearout, D Greenup, JL Steinbart, EJ Bird, TD AF Poorkaj, Parvoneh Raskind, Wendy H. Leverenz, James B. Matsushita, Mark Zabetian, Cyrus P. Samii, Ali Kim, Sophia Gazi, Nayiry Nutt, John G. John, Wolff Yearout, Dora Greenup, J. Lynne Steinbart, Ellen J. Bird, Thomas D. TI A Novel X-Linked Four-Repeat Tauopathy with Parkinsonism and Spasticity SO MOVEMENT DISORDERS LA English DT Article DE genetic linkage; Parkinson's disease/Parkinsonism; X-linked Parkinsonism; X-linked spastic paraparesis; tauopathy ID WIDE LINKAGE ANALYSIS; DYSTONIA-PARKINSONISM; CORTICOBASAL DEGENERATION; PYRAMIDAL SYNDROME; FRAGILE-X; DISEASE; GENE; SUSCEPTIBILITY; ASSOCIATION; MUTATIONS AB The parkinsonian syndromes comprise a highly heterogeneous group of disorders. Although 15 loci are linked to predominantly familial Parkinson's disease (PD), additional PD loci are likely to exist. We recently identified a multigenerational family of Danish and German descent in which five males in three generations presented with a unique syndrome characterized by parkinsonian features and variably penetrant spasticity for which X-linked disease transmission was strongly suggested (XPDS). Autopsy in one individual failed to reveal synucleinopathy; however, there was a significant four-repeat tauopathy in the striatum. Our objective was to identify the locus responsible for this unique parkinsonian disorder. Members of the XPDS family were genotyped for markers spanning the X chromosome. Two-point and multipoint linkage analyses were performed and the candidate region refined by analyzing additional markers. A multipoint LOD(max) score of 2.068 was obtained between markers DXS991 and DXS993. Haplotype examination revealed an similar to 20 cM region bounded by markers DXS8042 and DXS1216 that segregated with disease in all affected males and obligate carrier females and was not carried by unaffected at-risk males. To reduce the possibility of a false-positive linkage result, multiple loci and genes associated with other parkinsonian or spasticity syndromes were excluded. In conclusion, we have identified a unique X-linked parkinsonian syndrome with variable spasticity and four-repeat tau pathology, and defined a novel candidate gene locus spanning similar to 28 Mb from Xp11.2-Xq13.3. (C) 2010 Movement Disorder Society C1 [Poorkaj, Parvoneh; Raskind, Wendy H.; Leverenz, James B.; Kim, Sophia; Gazi, Nayiry; Greenup, J. Lynne] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Poorkaj, Parvoneh; Raskind, Wendy H.; Matsushita, Mark; John, Wolff; Bird, Thomas D.] Univ Washington, Dept Med, Seattle, WA USA. [Raskind, Wendy H.; Leverenz, James B.] Vet Affairs Puget Sound Hlth Care Syst, VISN Mental Illness Res Educ & Clin Ctr 20, Seattle, WA USA. [Leverenz, James B.; Zabetian, Cyrus P.; Samii, Ali; Yearout, Dora; Steinbart, Ellen J.; Bird, Thomas D.] Univ Washington, Dept Neurol, Seattle, WA 98195 USA. [Leverenz, James B.; Zabetian, Cyrus P.; Samii, Ali] Vet Affairs Puget Sound Hlth Care Syst, Parkinsons Dis Res Educ & Clin Ctr, Seattle, WA USA. [Nutt, John G.] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR USA. [Zabetian, Cyrus P.; Yearout, Dora; Bird, Thomas D.] Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Seattle, WA USA. RP Poorkaj, P (reprint author), Univ Washington, Dept Psychiat & Behav Sci, Box 356560,1959 NE Pacific St, Seattle, WA 98195 USA. EM pips@uw.edu OI Zabetian, Cyrus/0000-0002-7739-4306 FU Department of Veterans Affairs; University of Washington; Mary Gates Research Scholarship; UW Royalty Research; NICHD; MA; NHGRI; Morris Udall and Alzheimer's Centers; NIH; P Disease Foundation; American Parkinson Disease Association; Northwest Collaborative Care; VA Parkinson Disease Research, Education, and Clinical Center (PADRECC); NIH-NINDS; Schering-Plough Research; VA Merit FX This work was supported, in part, by funds from the Department of Veterans Affairs (T.D.B., P.P., W.R., J.W., A.S., J.N.), a University of Washington Royalty Research Fund grant (P.P.), and a Mary Gates Research Scholarship (S.K.). We are grateful to the members of the family who participated in this research. We wish to thank Lisa M. Tisch, BS, for contributing to this study.; P. Poorkaj: Grants: UW Royalty Research grant; Employment: University of Washington. W. H. Raskind: Grants: NICHD, MA, NHGRI; Employment: University of Washington; Royalties: Athena Diagnostics, Inc. J. B. Leverenz: Consultancies: Novartis, Noven, Forest; Grants: Morris Udall and Alzheimer's Centers, NIH; Employment: Department of Veteran's Affairs. M. Matsushita: Employment: University of Washington. C. P. Zabetian: Honoraria: Oregon Health and Science University, American Parkinson Disease Association; Grants: Department of Veteran's Affairs, NIH, P Disease Foundation, American Parkinson Disease Association, Northwest Collaborative Care; Employment: Department of Veteran's Affairs. A. Samii: Honoraria: Boerhinger-Ingelheim, Teva, Ipsen Pharmaceuticals; Grants: Partial salary support from VA Parkinson Disease Research, Education, and Clinical Center (PADRECC) grant; Employment: University of Washington. S. Kim: Employment: Medical student. N. Gazi: Employment: Dental Student. J. G. Nutt: Advisory Boards: Xenoport, Impax, Neurogen, Synosia; Honoraria: Novartis; Grants: NIH-NINDS: Employment: OHSU and Portland VAH; Contracts: Schering-Plough Research. J. Wolff: Employment: University of Washington. D. Yearout: Employment: University of Washington. J. L. Greenup: Employment: University of Washington. E. J. Steinbart: Employment: University of Washington. T. D. Bird: Honoraria: American Academy of Neurology; Grants: VA Merit; Employment: Department of Veteran's Affairs; Royalties: Athena Diagnostics, Inc. NR 35 TC 5 Z9 5 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 JUL 30 PY 2010 VL 25 IS 10 BP 1409 EP 1417 DI 10.1002/mds.23085 PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 636QI UT WOS:000280753200011 PM 20629132 ER PT J AU Singh, H Graber, M AF Singh, Hardeep Graber, Mark TI Reducing Diagnostic Error Through Medical Home-Based Primary Care Reform SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID SAFETY C1 [Singh, Hardeep] Baylor Coll Med, Houston VA Hlth Serv Res & Dev Serv Ctr Excellenc, Houston, TX 77030 USA. [Singh, Hardeep] Baylor Coll Med, Ctr Inquiry Improve Outpatient Safety Effect Elec, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Singh, Hardeep] Baylor Coll Med, Dept Med, Sect Hlth Serv Res, Houston, TX 77030 USA. [Graber, Mark] Northport VA Med Ctr, Northport, NY USA. [Graber, Mark] SUNY Stony Brook, Dept Med, Stony Brook, NY 11794 USA. RP Singh, H (reprint author), VA Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM hardeeps@bcm.tmc.edu FU AHRQ HHS [1R1 3HS018321-01, R18 HS 17820]; NCI NIH HHS [K23 CA125585, K23 CA125585-05, K23CA125585] NR 9 TC 24 Z9 24 U1 0 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 28 PY 2010 VL 304 IS 4 BP 463 EP 464 DI 10.1001/jama.2010.1035 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 631MA UT WOS:000280350100031 PM 20664048 ER PT J AU Peacock, WF Braunwald, E Abraham, W Albert, N Burnett, J Christenson, R Collins, S Diercks, D Fonarow, G Hollander, J Kellerman, A Gheorghiade, M Kirk, D Levy, P Maisel, A Massie, BM O'Connor, C Pang, P Shah, M Sopko, G Stevenson, L Storrow, A Teerlink, J AF Peacock, W. Frank Braunwald, Eugene Abraham, William Albert, Nancy Burnett, John Christenson, Rob Collins, Sean Diercks, Deborah Fonarow, Greg Hollander, Judd Kellerman, Art Gheorghiade, Mihai Kirk, Doug Levy, Phil Maisel, Alan Massie, Barry M. O'Connor, Christopher Pang, Peter Shah, Monica Sopko, George Stevenson, Lynne Storrow, Alan Teerlink, John TI National Heart, Lung, and Blood Institute Working Group on Emergency Department Management of Acute Heart Failure Research Challenges and Opportunities SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE emergency medicine; heart failure; research ID IN-HOSPITAL MORTALITY; NATRIURETIC PEPTIDE; PRACTICE GUIDELINES; CARDIAC TROPONIN; RATE-VARIABILITY; ACUTE DYSPNEA; DIAGNOSIS; TRIAL; READMISSION; ASSOCIATION AB This paper details the substance and recommendations arising from a meeting convened by the National Heart, Lung, and Blood Institute in August 2009, to assess the challenges and opportunities of emergency department management of acute heart failure syndrome (AHFS). The assembled faculty represented a large cross section of medical professionals spanning the medical management continuum of patients presenting with acute heart failure and included heart failure cardiologists, emergency physicians, laboratory medicine specialists, nurses, and bench scientists. Their recommendations include proposals regarding the design and conduct of emergency department-based clinical trials, suggestions regarding the development of improved methods for early detection and monitoring of AHFS, and potential needs for expanding translational and applied AHFS focused research and biotechnology. We anticipate that this review will serve as a starting point for future investigations across the spectrum of funding sources. (J Am Coll Cardiol 2010;56:343-51) (c) 2010 by the American College of Cardiology Foundation C1 [Peacock, W. Frank; Albert, Nancy] Cleveland Clin, Emergency Med Inst, Cleveland, OH 44195 USA. [Braunwald, Eugene] Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA. [Burnett, John] Mayo Fdn, Rochester, MN USA. [Abraham, William] Ohio State Univ, Columbus, OH 43210 USA. [Christenson, Rob] Univ Maryland, Sch Med, Baltimore, MD 21201 USA. [Collins, Sean] Univ Cincinnati, Cincinnati, OH USA. [Diercks, Deborah; Kirk, Doug] Univ Calif, Davis Med Ctr, Sacramento, CA USA. [Fonarow, Greg] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Hollander, Judd] Univ Penn, Philadelphia, PA 19104 USA. [Kellerman, Art] Emory Sch Med, Atlanta, GA USA. [Gheorghiade, Mihai; Pang, Peter] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA. [Levy, Phil] Wayne State Univ, Sch Med, Detroit, MI USA. [Maisel, Alan] Univ Calif San Diego, San Diego, CA 92103 USA. [Massie, Barry M.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Massie, Barry M.; Teerlink, John] San Francisco VA Med Ctr, San Francisco, CA USA. [Shah, Monica; Sopko, George] NHLBI, Bethesda, MD 20892 USA. [O'Connor, Christopher] Duke Univ, Durham, NC USA. [Stevenson, Lynne] Harvard Univ, Sch Med, Boston, MA USA. [Storrow, Alan] Vanderbilt Univ, Nashville, TN USA. RP Peacock, WF (reprint author), Cleveland Clin, Emergency Med Inst, Desk E-19,9500 Euclid Ave, Cleveland, OH 44195 USA. EM Peacocw@ccf.org RI Max, Mad/E-5238-2010; Teerlink, John/D-2986-2012 OI Max, Mad/0000-0001-6966-6829; Hollander, Judd/0000-0002-1318-2785 FU National Heart, Lung, and Blood Institute FX Vanderbilt University, Nash ville, Tennessee. The meeting that this manuscript was derived from was completely and solely supported by the National Heart, Lung, and Blood Institute. For full author disclosures, please see the end of this paper. Jay Cohn, MD, served as Guest Editor for this paper. NR 56 TC 36 Z9 36 U1 2 U2 7 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 27 PY 2010 VL 56 IS 5 BP 343 EP 351 DI 10.1016/j.jacc.2010.03.051 PG 9 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 628IH UT WOS:000280109400001 PM 20650354 ER PT J AU Heidenreich, PA Sahay, A Kapoor, JR Pham, MX Massie, B AF Heidenreich, Paul A. Sahay, Anju Kapoor, John R. Pham, Michael X. Massie, Barry TI Divergent Trends in Survival and Readmission Following a Hospitalization for Heart Failure in the Veterans Affairs Health Care System 2002 to 2006 SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE heart failure; quality of care; outcomes assessment ID LONG-TERM TRENDS; EJECTION FRACTION; BETA-BLOCKERS; POPULATION; MORTALITY; OUTCOMES; ADMISSIONS; PROGNOSIS; INDEX AB Objectives This study sought to determine recent trends over time in heart failure hospitalization, patient characteristics, treatment, rehospitalization, and mortality within the Veterans Affairs health care system. Background Use of recommended therapies for heart failure has increased in the U.S. However, it is unclear to what extent hospitalization rates and the associated mortality have improved. Methods We compared rates of hospitalization for heart failure, 30-day rehospitalization for heart failure, and 30-day mortality following discharge from 2002 to 2006 in the Veterans Affairs Health Care System. Odds ratios for outcome were adjusted for patient diagnoses within the past year, laboratory data, and for clustering of patients within hospitals. Results We identified 50,125 patients with a first hospitalization for heart failure from 2002 to 2006. Mean age did not change (70 years), but increases were noted for most comorbidities (mean Charlson score increased from 1.72 to 1.89, p < 0.0001). Heart failure admission rates remained constant at about 5 per 1,000 veterans. Mortality at 30 days decreased (7.1% to 5.0%, p < 0.0001), whereas rehospitalization for heart failure at 30 days increased (5.6% to 6.1%, p = 0.11). After adjustment for patient characteristics, the odds ratio for rehospitalization in 2006 (vs. 2002) was 0.54 (95% confidence interval [CI]: 0.47 to 0.61) for mortality, but 1.21 (95% CI: 1.04 to 1.41) for heart failure rehospitalization at 30 days. Conclusions Recent mortality and rehospitalization rates in the Veterans Affairs Health Care System have trended in opposite directions. These results have implications for using rehospitalization as a measure of quality of care. (J Am Coll Cardiol 2010;56:362-8) (c) 2010 by the American College of Cardiology Foundation C1 [Heidenreich, Paul A.; Sahay, Anju; Pham, Michael X.] Palo Alto VA Hlth Care Syst, Palo Alto, CA 94304 USA. [Heidenreich, Paul A.; Kapoor, John R.; Pham, Michael X.] Stanford Univ, Dept Med, Stanford, CA 94305 USA. [Massie, Barry] Univ Calif San Francisco, San Francisco VA Med Ctr, San Francisco, CA 94143 USA. [Massie, Barry] Univ Calif San Francisco, Dept Med, San Francisco, CA USA. RP Heidenreich, PA (reprint author), Palo Alto VA Hlth Care Syst, 111C Cardiol,3801 Miranda Ave, Palo Alto, CA 94304 USA. EM heiden@stanford.edu RI Max, Mad/E-5238-2010 OI Max, Mad/0000-0001-6966-6829; Heidenreich, Paul/0000-0001-7730-8490 FU Veterans Affairs Health Services Research Development Office [CHF QUERI-04-326] FX Department of Medicine, University of California at San Francisco, San Francisco, California. Supported by grants from the Veterans Affairs Health Services Research Development Office (CHF QUERI-04-326). Views expressed are those of the authors and not necessarily those of the Department of Veterans Affairs or other affiliated organizations. NR 24 TC 74 Z9 74 U1 1 U2 6 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 27 PY 2010 VL 56 IS 5 BP 362 EP 368 DI 10.1016/j.jacc.2010.02.053 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 628IH UT WOS:000280109400003 PM 20650356 ER PT J AU Hoffman, RM Zeliadt, SB AF Hoffman, Richard M. Zeliadt, Steven B. TI The Cautionary Tale of PSA Testing SO ARCHIVES OF INTERNAL MEDICINE LA English DT Editorial Material ID PROSTATE-SPECIFIC ANTIGEN; TREATMENT DECISIONS; CANCER; MORTALITY; OUTCOMES; TRIAL; MEN C1 [Hoffman, Richard M.] New Mexico VA Hlth Care Syst, Med Serv, Albuquerque, NM USA. [Hoffman, Richard M.] Univ New Mexico, Sch Med, Albuquerque, NM 87131 USA. [Zeliadt, Steven B.] Univ Washington, Hlth Serv Res & Dev Ctr Excellence, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. [Zeliadt, Steven B.] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. RP Hoffman, RM (reprint author), 1501 San Pedro Dr SE,Mail Stop 111, Albuquerque, NM 87108 USA. EM rhoffman@unm.edu NR 18 TC 5 Z9 5 U1 0 U2 0 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 26 PY 2010 VL 170 IS 14 BP 1262 EP 1263 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 631LD UT WOS:000280347400012 PM 20660847 ER PT J AU Pekary, AE Sattin, A Blood, J AF Pekary, A. E. Sattin, Albert Blood, James TI Rapid modulation of TRH and TRH-like peptide release in rat brain and peripheral tissues by leptin SO BRAIN RESEARCH LA English DT Article DE Leptin; TRH-like peptide; Rat; Limbic system ID HORMONE TRH; MOOD DISORDERS; RECEPTOR; DEPRESSION; SEIZURES; TESTIS; ANTIDEPRESSANT; CEREBELLUM; EXPRESSION; EPIDIDYMIS AB Leptin is not only a feedback modulator of feeding and energy expenditure but also regulates reproductive functions, CNS development and mood. Obesity and major depression are growing public health concerns which may derive, in part, from disregulation of leptin feedback at the level of the hypothalamic feeding centers and mood regulators within the limbic system. Identifying downstream mediators of leptin action may provide therapeutic opportunities. We and others have previously reported that thyrotropin-releasing hormone (TRH, pGlu-His-Pro-NH(2)) and TRH-like peptides (pGlu-X-Pro-NH(2), where "X" can be any amino acid residue) have neuroprotective, antidepressant, anti-epileptic, analeptic, anti-ataxic, and anorectic properties. For this reason, young, adult male Sprague-Dawley rats were injected ip with 1 mg/kg rat leptin and peptide and protein levels were measured in brain and peripheral tissues at 0, 0.5, 1 and 2 h later. Eleven brain regions: pyriform cortex (PYR), entorhinal cortex (ENT), cerebellum (CBL), nucleus accumbens (NA), frontal cortex (FCX), amygdala (AY), posterior cingulate (PCNG), striatum (STR), hippocampus (HC), medulla oblongata (MED) and anterior cingulate (ACNG) and five peripheral tissues (adrenals, testes, epididymis, pancreas and prostate) were analyzed. TRH and six TRH-like peptide levels in STR fell by 0.5 h consistent with leptin-induced release of these peptides: STR (7 down arrow). Significant changes in TRH and TRH-like peptide levels for other brain regions were: CBL (5 down arrow), ENT (5 down arrow), HC (4 down arrow), AY (4 down arrow), FCX (3 down arrow), and ACNG (1 down arrow). The rapid modulation of TRH and TRH-like peptide release combined with their similarity in behavioral, neuroendocrine, immunomodulatory, metabolic and steroidogenic effects to that of leptin is consistent with these peptides participating in downstream signaling. Published by Elsevier B.V. C1 [Pekary, A. E.; Sattin, Albert; Blood, James] VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. [Sattin, Albert] VA Greater Los Angeles Healthcare Syst, Psychiat Serv, Los Angeles, CA 90073 USA. [Pekary, A. E.] VA Greater Los Angeles Healthcare Syst, Ctr Ulcer Res & Educ, Los Angeles, CA 90073 USA. [Sattin, Albert] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90073 USA. [Sattin, Albert] Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. [Pekary, A. E.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90073 USA. RP Pekary, AE (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv, Bldg 114,Rm 229,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Eugene.Pekary@va.gov FU Department of Veterans Affairs; Pekary Family Trust FX This work was supported by the Department of Veterans Affairs Medical Research funds (AEP and AS) and the Pekary Family Trust. NR 51 TC 10 Z9 10 U1 0 U2 2 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 23 PY 2010 VL 1345 BP 9 EP 18 DI 10.1016/j.brainres.2010.05.039 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 635KZ UT WOS:000280655400002 PM 20546704 ER PT J AU Thompson, MA Aberg, JA Cahn, P Montaner, JSG Rizzardini, G Telenti, A Gatell, JM Gunthard, HF Hammer, SM Hirsch, MS Jacobsen, DM Reiss, P Richman, DD Volberding, PA Yeni, P Schooley, RT AF Thompson, Melanie A. Aberg, Judith A. Cahn, Pedro Montaner, Julio S. G. Rizzardini, Giuliano Telenti, Amalio Gatell, Jose M. Guenthard, Huldrych F. Hammer, Scott M. Hirsch, Martin S. Jacobsen, Donna M. Reiss, Peter Richman, Douglas D. Volberding, Paul A. Yeni, Patrick Schooley, Robert T. TI Antiretroviral Treatment of Adult HIV Infection 2010 Recommendations of the International AIDS Society-USA Panel SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Review ID NAIVE HIV-1-INFECTED PATIENTS; HEPATITIS-B-VIRUS; TWICE-DAILY LOPINAVIR/RITONAVIR; ONCE-DAILY ATAZANAVIR/RITONAVIR; OPTIMIZED BACKGROUND THERAPY; EARLY VIROLOGICAL FAILURE; DRUG-RESISTANCE; MYOCARDIAL-INFARCTION; COLLABORATIVE ANALYSIS; DAILY DARUNAVIR/RITONAVIR AB Context Recent data regarding the consequences of untreated human immunodeficiency virus (HIV) infection and the expansion of treatment choices for antiretroviral-naive and antiretroviral-experienced patients warrant an update of the International AIDS Society-USA guidelines for the use of antiretroviral therapy in adults with HIV infection. Objectives To provide updated recommendations for management of HIV-infected adults, using antiretroviral drugs and laboratory monitoring tools available in the international, developed-world setting. This report provides guidelines for when to initiate antiretroviral therapy, selection of appropriate initial regimens, patient monitoring, when to change therapy, and what regimens to use when changing. Data Sources and Study Selection A panel with expertise in HIV research and clinical care reviewed relevant data published or presented at selected scientific conferences since the last panel report through April 2010. Data were identified through a PubMed search, review of scientific conference abstracts, and requests to antiretroviral drug manufacturers for updated clinical trials and adverse event data. Data Extraction and Synthesis New evidence was reviewed by the panel. Recommendations were drafted by section writing committees and reviewed and edited by the entire panel. The quality and strength of the evidence were rated and recommendations were made by full panel consensus. Conclusions Patient readiness for treatment should be confirmed before initiation of antiretroviral treatment. Therapy is recommended for asymptomatic patients with a CD4 cell count <= 500/mu L, for all symptomatic patients, and those with specific conditions and comorbidities. Therapy should be considered for asymptomatic patients with CD4 cell count >500/mu L. Components of the initial and subsequent regimens must be individualized, particularly in the context of concurrent conditions. Patients receiving antiretroviral treatment should be monitored regularly; treatment failure should be detected and managed early, with the goal of therapy, even in heavily pretreated patients, being HIV-1 RNA suppression below commercially available assay quantification limits. JAMA. 2010;304(3):321-333 www.jama.com C1 [Thompson, Melanie A.] AIDS Res Consortium Atlanta, Atlanta, GA USA. [Richman, Douglas D.; Schooley, Robert T.] Univ Calif San Diego, La Jolla, CA 92093 USA. [Aberg, Judith A.] NYU, Sch Med, New York, NY USA. [Cahn, Pedro] Univ Buenos Aires, Sch Med, Hosp Juan Fernandez, RA-1053 Buenos Aires, DF, Argentina. [Cahn, Pedro] Univ Buenos Aires, Fdn Huesped, RA-1053 Buenos Aires, DF, Argentina. [Gatell, Jose M.] Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain. [Guenthard, Huldrych F.] Univ Zurich, Univ Zurich Hosp, Div Infect Dis & Hosp Epidemiol, Zurich, Switzerland. [Hammer, Scott M.] Columbia Univ, Coll Phys & Surg, New York, NY USA. [Hirsch, Martin S.] Harvard Univ, Sch Med, Boston, MA USA. [Jacobsen, Donna M.] Int AIDS Soc USA, San Francisco, CA USA. [Montaner, Julio S. G.] BC Ctr Excellence HIV AIDS, Vancouver, BC, Canada. [Montaner, Julio S. G.] Univ British Columbia, Vancouver, BC V5Z 1M9, Canada. [Reiss, Peter] Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands. [Richman, Douglas D.] Vet Affairs San Diego Healthcare Syst, San Diego, CA USA. [Rizzardini, Giuliano] Luigi Sacco Hosp, Milan, Italy. [Telenti, Amalio] Univ Lausanne Hosp, Lausanne, Switzerland. [Volberding, Paul A.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Volberding, Paul A.] San Francisco VA Med Ctr, San Francisco, CA USA. [Yeni, Patrick] Hop Bichat Claude Bernard, F-75877 Paris 18, France. [Yeni, Patrick] Xavier Bichat Med Sch, Paris, France. RP Thompson, MA (reprint author), 131 Ponce de Leon Ave NE,Ste 130, Atlanta, GA 30308 USA. EM drmt@mindspring.com RI gunthard, huldrych/F-1724-2011; Infektiologie, USZ/A-6921-2011; Rizzardini, Giuliano/K-9458-2016 OI gunthard, huldrych/0000-0002-1142-6723; Rizzardini, Giuliano/0000-0002-5183-7818 FU Abbott Laboratories; Avexa; Boehringer Ingelheim Pharmaceuticals; Bristol-Myers Squibb; GlaxoSmithKline; Gilead Sciences; GeoVax; Katketsuken; Koronis Pharmaceuticals; Merck Research Laboratories; Myriad; Ora-Sure; Pfizer; Progenics Pharmaceuticals; Roche Laboratories; Roche Molecular Systems; Serono; Theratechnologies Tibotec Therapeutics; Tobira Therapeutics; Trimeris; VaxGen; GlaxoSmithKline Italy; International AIDS Society-USA; ViiV Healthcare FX Dr Thompson reported receiving research grants awarded to AIDS Research Consortium of Atlanta from Abbott Laboratories, Avexa, Boehringer Ingelheim Pharmaceuticals, Bristol-Myers Squibb, GlaxoSmithKline, Gilead Sciences, GeoVax, Katketsuken, Koronis Pharmaceuticals, Merck Research Laboratories, Myriad, Ora-Sure, Panacos Pharmaceuticals (now Myriad), Pfizer, Progenics Pharmaceuticals, Roche Laboratories, Roche Molecular Systems, Serono, Theratechnologies Tibotec Therapeutics, Tobira Therapeutics, Trimeris, and VaxGen; has served on the scientific advisory boards or as a clinical trial design consultant for Chimerix, GeoVax, GlaxoSmithKline, Panacos Pharmaceuticals, Progenics Pharmaceuticals, and Tibotec Therapeutics; has received honoraria for scientific lectures from GlaxoSmithKline and Serono; and has served on data and safety monitoring boards for Tibotec Therapeutics. Dr Aberg reported serving as a scientific advisor to Abbott Laboratories, Boehringer Ingelheim Pharmaceutical, Gilead Sciences, GlaxoSmithKline, Merck, Pfizer, Theratechnologies, Tibotec Therapeutics, and ViiV Healthcare; has received grants and research support from Gilead Sciences, GlaxoSmithKline, Merck, Pfizer, Schering-Plough, Theratechnologies, Tibotec Therapeutics, Virco Lab, and Wyeth; and has received honoraria from Abbott Laboratories, Bristol-Myers Squibb, and Gilead Sciences. Dr Cahn reported serving on the advisory boards for Avexa, Gilead Sciences, GlaxoSmithKline, Myriad Genetics, Merck, Pfizer, Pharmasset, ScheringPlough, and Tibotec Therapeutics; has served as an investigator for Avexa, Boehringer Ingelheim Pharmaceuticals, Gilead Sciences, GlaxoSmithKline, Merck, Pfizer, Pharmasset, Roche Laboratories, ScheringPlough, and Tibotec Therapeutics; and has received honoraria for speaking engagements from Abbott Laboratories, Bristol-Myers Squibb, Boehringer Ingelheim, GlaxoSmithKline, Merck, Pfizer, and Tibotec Therapeutics. Dr Montaner reported receiving research grants from, and served as an ad hoc advisor or consultant to, Abbott Laboratories, Argos Therapeutics, Boehringer Ingelheim Pharmaceuticals, Bristol-Myers Squibb, Cato Research Canada, ConjuChem Biotech, Gilead Sciences, GlaxoSmithKline, Hoffmann-La Roche, Johnson& Johnson, Merck Canada, Merck Frosst Laboratories, Pfizer Canada, Serono, Theratechnologies, and Tibotec Pharmaceuticals and has served on an endpoint adjudication committee for Schering-Plough. Dr Rizzardini reported receiving research grants from Gilead Sciences and Merck Sharp& Dohme. Dr Telenti reported receiving research grants or honoraria for lectures from Abbott Laboratories, Boehringer Ingelheim Pharmaceuticals, Bristol-Myers Squibb, and GlaxoSmithKline. Dr Gatell reported receiving research grants or honoraria for serving on advisory boards or for lectures from Abbott Laboratories, Boehringer Ingelheim Pharmaceuticals, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck Sharpe & Dohme, Pfizer, GlaxoSmithKline, Roche Laboratories, Theratechnologies, Tibotec Therapeutics, Tobira Therapeutics, and Virco Lab. Dr Gunthard reported serving as a consultant and medical advisor for Abbott Laboratories, Bristol-Myers Squibb, Boehringer Ingelheim Pharmaceuticals, Gilead Sciences, GlaxoSmithKline, Pfizer, Tibotec Therapeutics, and ViiV Healthcare and has received unrestricted research and educational grants from Abbott Laboratories, Bristol-Myers Squibb, Gilead Sciences, Merck Sharp& Dohme, and Pfizer.; Dr Hammer reported serving on a scientific or clinical advisory boards for Merck, Progenics Pharmaceuticals, TaiMed Biologics, TibotecTherapeutics, and Wyeth; has received clinical research contracts from Merck; and has served on data and safety monitoring boards and committees for Bristol-Myers Squibb and on the board of directors of SIGA Pharmaceuticals. Dr Hirsch reported serving on data and safety monitoring boards for Merck and TaiMed Biologics. Dr Reiss reported serving as a scientific advisor to Boehringer Ingelheim Pharmaceuticals, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Merck, Theratechnologies, Tibotec Therapeutics, and Tobira Therapeutics; has served on data and safety monitoring boards and endpoint adjudication committees for Tibotec Therapeutics; has received honoraria for speaking engagements at scientific conferences from Boehringer Ingelheim Pharmaceuticals, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, and Theratechnologies; and has received research support from Gilead Sciences, ViiV Healthcare, and Boehringer Ingelheim Pharmaceuticals. Dr Richman reported being a consultant to Anadys Pharmaceuticals, Biota, Boehringer Ingelheim Pharmaceuticals, Bristol-Myers Squibb, Chimerix, GenProbe, Gilead Sciences, Idenix Pharmaceuticals, Koronis Pharmaceuticals, Merck, Monogram Biosciences, Myriad Genetics, Pfizer, Roche, Theraclone Sciences, and Tobira Therapeutics; has served on an endpoint adjudication committee for Schering-Plough; has been the recipient of a research grant from Merck; and has been a stock options holder of Chimerix and Idenix Pharmaceuticals. Dr Volberding reported serving on data and safety monitoring boards for Merck and TaiMed Biologics and on an endpoint adjudication committee for Schering-Plough; has provided paid expert testimony for commercial firms; has served on scientific or clinical advisory boards for Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Pfizer, and Tobira Therapeutics; and has been the recipient of service grants for, or held contracts from, GlaxoSmithKline Italy. Dr Yeni reported receiving scientific grants from Abbott Laboratories, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Pfizer, Merck, and Roche Laboratories. Dr Schooley reported serving as a consultant to Achillion Pharmaceuticals, Anadys Pharmaceuticals, Ardea Biosciences, Gilead Sciences, GlaxoSmithKline, Inhibitex, iTherX, Johnson & Johnson, LabCorp, Merck, Myriad Biosciences, Pfizer, TaiMed Biologics, Tanox, Tobira Therapeutics, Vertex Pharmaceuticals, and Vical; has received grants from Gilead Sciences and Pfizer; and has stock options for Achillion Pharmaceuticals.; This work was funded by the International AIDS Society-USA. Panel members serve in volunteer capacities (ie, are not compensated). No private sector or government funding was used to support the effort. The International AIDS Society-USA has received grants for selected CME activities (unrelated to guidelines development) from Abbott Laboratories, Boehringer Ingelheim Pharmaceuticals, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Merck, Pfizer, Roche Laboratories, Tibotec Therapeutics, and ViiV Healthcare. Grants are pooled such that no single company supports any single effort. NR 146 TC 586 Z9 604 U1 5 U2 56 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 21 PY 2010 VL 304 IS 3 BP 321 EP 333 DI 10.1001/jama.2010.1004 PG 13 WC Medicine, General & Internal SC General & Internal Medicine GA 628HV UT WOS:000280107500022 PM 20639566 ER PT J AU Chiao, EY Dezube, BJ Krown, SE Wachsman, W Brock, MV Giordano, TP Mitsuyasu, R Pantanowitz, L AF Chiao, Elizabeth Y. Dezube, Bruce J. Krown, Susan E. Wachsman, William Brock, Malcolm V. Giordano, Thomas P. Mitsuyasu, Ronald Pantanowitz, Liron TI Time for Oncologists to Opt In for Routine Opt-Out HIV Testing? SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ACTIVE ANTIRETROVIRAL THERAPY; HUMAN-IMMUNODEFICIENCY-VIRUS; AIDS-RELATED MALIGNANCIES; SQUAMOUS-CELL CARCINOMA; HEALTH-CARE SETTINGS; LUNG-CANCER; INFECTED PATIENTS; UNITED-STATES; ANAL CANCER; DEFINING CANCERS AB Human immunodeficiency virus (HIV)-infected individuals are at high risk of malignancies. However, it is not currently the standard of care to routinely test cancer patients for HIV. In 2006, the Centers for Disease Control and Prevention recommended HIV testing in all health care settings, calling for standard nontargeted "opt-out" HIV screening. For a variety of reasons, routine opt-out HIV testing is still not widely used in the United States. Although many barriers to routine opt-out HIV testing have been addressed, such opt-out HIV testing continues to be conducted primarily in venues that target specific patient populations such as pregnant women. Although opt-out testing has been piloted in emergency departments, less emphasis has been placed on opt-out HIV testing in other clinical settings. In this article, the background, rationale, and evidence for supporting opt-out HIV testing as routine care for cancer patients are presented. In addition, evidence is discussed for the potential of opt-out HIV testing to improve clinical outcomes by facilitating appropriate HIV management during cancer treatment for individuals who are found to be HIV positive. JAMA. 2010;304(3):334-339 www.jama.com C1 [Chiao, Elizabeth Y.; Giordano, Thomas P.] Baylor Coll Med, Dept Med, Houston, TX 77030 USA. [Chiao, Elizabeth Y.; Giordano, Thomas P.] Dept Vet Affairs Med Ctr, Houston, TX USA. [Dezube, Bruce J.] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Div Hematol Oncol, Boston, MA 02215 USA. [Krown, Susan E.] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA. [Wachsman, William] Univ Calif San Diego, Med Ctr, San Diego, CA 92103 USA. [Brock, Malcolm V.] Johns Hopkins Med Ctr, Baltimore, MD USA. [Mitsuyasu, Ronald] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles Ctr Clin AIDS Res & Educ, Los Angeles, CA 90095 USA. [Pantanowitz, Liron] Tufts Univ, Sch Med, Baystate Med Ctr, Dept Pathol, Springfield, MA 01199 USA. RP Chiao, EY (reprint author), Michael E DeBakey VA Med Ctr 152, Houston VA Hlth Serv Res & Dev, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM echiao@bcm.edu FU National Cancer Institute [UO1 CA 121947]; Houston VA Health Services Research and Development Center of Excellence [HFP90-020]; National Cancer Institute, National Institutes of Health [K23CA124318] FX This material is based on work supported by National Cancer Institute grant UO1 CA 121947 to the AIDS Malignancy Consortium. This work was also supported in part by the Houston VA Health Services Research and Development Center of Excellence (grant HFP90-020). Dr Chiao received support from the National Cancer Institute, National Institutes of Health, grant K23CA124318. NR 50 TC 20 Z9 20 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 21 PY 2010 VL 304 IS 3 BP 334 EP 339 DI 10.1001/jama.2010.752 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 628HV UT WOS:000280107500023 PM 20639567 ER PT J AU Buscher, AL Giordano, TP AF Buscher, April L. Giordano, Thomas P. TI Gaps in Knowledge in Caring for HIV Survivors Long-term SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID UNITED-STATES; POPULATION C1 Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Michael E DeBakey VA Med Ctr, Hlth Serv Res & Dev Ctr Excellence, Houston, TX USA. RP Giordano, TP (reprint author), Michael E DeBakey VA Med Ctr 152, Hlth Serv Res & Dev Ctr Excellence, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM tpg@bcm.tmc.edu NR 9 TC 7 Z9 7 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 21 PY 2010 VL 304 IS 3 BP 340 EP 341 DI 10.1001/jama.2010.870 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 628HV UT WOS:000280107500024 PM 20639568 ER PT J AU Bayomy, AF Aubin, PM Sangeorzan, BJ Ledoux, WR AF Bayomy, Ahmad F. Aubin, Patrick M. Sangeorzan, Bruce J. Ledoux, William R. TI Arthrodesis of the First Metatarsophalangeal Joint: A Robotic Cadaver Study of the Dorsiflexion Angle SO JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME LA English DT Article ID HALLUX-RIGIDUS; PLANTAR PRESSURE; PLATE FIXATION; GAIT ANALYSIS; OSTEOARTHRITIS; VALGUS; ARTHRITIS AB Background: Arthrodesis of the first metatarsophalangeal joint is indicated for severe osteoarthritis or as a revision of failed treatment for hallux valgus. The literature suggests that an optimum fused dorsiflexion angle is between 20 degrees and 25 degrees from the axis of the first metatarsal. The purpose of this study was to investigate the relationship between dorsiflexion angle and plantar pressure in the postoperative gait. We assumed that there is a fused dorsiflexion angle at which pressures are minimized under the hallux and the first metatarsal head. Methods: Six cadaver foot specimens underwent incremental changes in simulated fused metatarsophalangeal joint dorsiflexion angle followed by dynamic gait simulation. A robotic gait simulator performed at 50% of body weight and one-fifteenth of physiologic velocity. In vitro tibial kinematics and tendon forces were based on normative in vivo gait and electromyographic data and were manually tuned to match the in vitro ground reaction force and tendon force behavior. Regression lines were calculated for peak pressure and pressure-time integral under the hallux and the metatarsal head by dorsiflexion angle. Results: Peak pressure and pressure-time integral under the hallux were negatively correlated with dorsiflexion angle (p < 0.004), while peak pressure and pressure-time integral under the metatarsal head were positively correlated with dorsiflexion angle (p < 0.004). The intersection of the regression lines that represented the angle at which peak pressure and pressure-time integral were minimized was 24.7 degrees for peak pressure and 21.3 degrees for pressure-time integral. Conclusions: Our findings support the hypothesis that an angle-pressure relationship exists following arthrodesis of the first metatarsophalangeal joint and that it is inversely related for the hallux and the metatarsal head. Our results encompass the suggested range of 20 degrees to 25 degrees. Clinical Relevance: This investigation provides a basis for assessing clinical decisions surrounding operative technique and hardware utilization that may improve gait, quality of life, and functional performance in patients undergoing operative treatment of osteoarthritis of the first metatarsophalangeal joint. C1 [Bayomy, Ahmad F.; Aubin, Patrick M.; Sangeorzan, Bruce J.; Ledoux, William R.] VA Puget Sound Hlth Care Syst, Ctr Excellence Limb Loss Prevent & Prosthet Engn, Rehabil Res & Dev Serv, Dept Vet Affairs, Seattle, WA 98108 USA. Univ Washington, Dept Orthopaed & Sports Med, Seattle, WA 98195 USA. RP Bayomy, AF (reprint author), VA Puget Sound Hlth Care Syst, Ctr Excellence Limb Loss Prevent & Prosthet Engn, Rehabil Res & Dev Serv, Dept Vet Affairs, MS 151,1660 S Columbian Way, Seattle, WA 98108 USA. EM wrledoux@u.washington.edu RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 FU Department of Veterans Affairs Rehabilitation Research and Development Service [A2661C, A4843C]; University of Washington FX In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants of less than $10,000 from the Department of Veterans Affairs Rehabilitation Research and Development Service (#A2661C and #A4843C) and the University of Washington Medical Student Research Training Program. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. NR 30 TC 13 Z9 14 U1 2 U2 3 PU JOURNAL BONE JOINT SURGERY INC PI NEEDHAM PA 20 PICKERING ST, NEEDHAM, MA 02192 USA SN 0021-9355 J9 J BONE JOINT SURG AM JI J. Bone Joint Surg.-Am. Vol. PD JUL 21 PY 2010 VL 92A IS 8 BP 1754 EP 1764 DI 10.2106/JBJS.I.00984 PG 11 WC Orthopedics; Surgery SC Orthopedics; Surgery GA 629RE UT WOS:000280216600009 PM 20660239 ER PT J AU Malin, JL Diamant, AL Leake, B Liu, YH Thind, A Kahn, KL Schneider, EC Epstein, AM Maly, RC AF Malin, Jennifer L. Diamant, Allison L. Leake, Barbara Liu, Yihang Thind, Amardeep Kahn, Katherine L. Schneider, Eric C. Epstein, Arnold M. Maly, Rose C. TI Quality of Care for Breast Cancer for Uninsured Women in California Under the Breast and Cervical Cancer Prevention Treatment Act SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID INSURANCE STATUS; UNITED-STATES; LOW-INCOME; STAGE; IMPLEMENTATION; DISPARITIES; SURVIVAL; OUTCOMES; SOCIETY; IMPACT AB Purpose The objective of this study was to evaluate the quality of care provided to uninsured women with breast cancer who received treatment through the Breast and Cervical Cancer Prevention Treatment Program (BCCTP). Methods Participants included women with stage I to III breast cancer (n = 658) from a consecutive sample of women 18 years or older who received coverage through the California BCCTP between February 2003 and September 2005 who consented to a survey and medical record review (61% response rate). Quality of breast cancer care was evaluated using 29 evidence-based quality measures developed for the National Initiative for Cancer Care Quality (NICCQ). NICCQ, a largely insured cohort of women diagnosed with stage I to III breast cancer in 1998, was used to benchmark the results. Results Twenty-three percent of women presented with stage III disease compared with fewer than 10% nationally. Patients received 93% of recommended care (95% CI, 92% to 93%). Adherence to recommended care within domains ranged from 87% for post-treatment surveillance (95% CI, 84% to 90%) to 97% for diagnostic evaluation (95% CI, 96% to 97%). Compared to the NICCQ cohort, adherence to quality measures was as good or better for the BCCPT cohort in all domains except post-treatment surveillance. Conclusion The BCCTP has made important inroads in providing poor, uninsured women with access to high quality care when faced with the diagnosis of breast cancer; however, many present at an advanced stage, which is associated with worse outcomes. C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA USA. Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. Brigham & Womens Hosp, Div Gen Med & Primary Care, Boston, MA 02115 USA. Univ Western Ontario, Schulich Sch Med, London, ON, Canada. RP Malin, JL (reprint author), VA Greater Los Angeles Healthcare Syst, Div Hematol Oncol 111 H, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jennifer.malin@va.gov OI Schneider, Eric/0000-0002-1132-5084 FU American Cancer Society [TURSG-02-081]; California Breast Cancer Research Program [7PB-0070]; National Cancer Institute [R01CA119197-0181] FX Supported by Grant No. TURSG-02-081 from the American Cancer Society, Grant No. 7PB-0070 from the California Breast Cancer Research Program, and Grant No. R01CA119197-0181 from the National Cancer Institute. NR 27 TC 8 Z9 8 U1 0 U2 2 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD JUL 20 PY 2010 VL 28 IS 21 BP 3479 EP 3484 DI 10.1200/JCO.2009.27.7491 PG 6 WC Oncology SC Oncology GA 626YE UT WOS:000280003700013 PM 20530279 ER PT J AU Lee, BY Popovich, MJ Ye, TA Bailey, RR Ufberg, PJ Wiringa, AE Muder, RR AF Lee, Bruce Y. Popovich, Michael J. Ye Tian Bailey, Rachel R. Ufberg, Paul J. Wiringa, Ann E. Muder, Robert R. TI The potential value of Clostridium difficile vaccine: An economic computer simulation model SO VACCINE LA English DT Article DE Clostridium difficile; Vaccine; Economics; Computer simulation ID IMMUNE-RESPONSE; TOXIN-A; COLITIS; DIARRHEA; DISEASE; VANCOMYCIN; METRONIDAZOLE; IMMUNIZATION; INFECTION; TRIAL AB Efforts are currently underway to develop a vaccine against Clostridium difficile infection (CDI). We developed two decision analytic Monte Carlo computer simulation models: (1) an Initial Prevention Model depicting the decision whether to administer C. difficile vaccine to patients at-risk for CDI and (2) a Recurrence Prevention Model depicting the decision whether to administer C. difficile vaccine to prevent CDI recurrence. Our results suggest that a C. difficile vaccine could be cost-effective over a wide range of C. difficile risk, vaccine costs, and vaccine efficacies especially, when being used post-CDI treatment to prevent recurrent disease. (C) 2010 Elsevier Ltd. All rights reserved. C1 [Lee, Bruce Y.; Popovich, Michael J.; Ye Tian; Bailey, Rachel R.; Ufberg, Paul J.; Wiringa, Ann E.] Univ Pittsburgh, Publ Hlth Computat & Operat Res Grp PHICOR, Pittsburgh, PA 15213 USA. [Lee, Bruce Y.; Popovich, Michael J.; Ye Tian; Bailey, Rachel R.; Ufberg, Paul J.; Wiringa, Ann E.] Univ Pittsburgh, Dept Biomed Informat, Pittsburgh, PA 15213 USA. [Lee, Bruce Y.; Popovich, Michael J.; Ye Tian; Bailey, Rachel R.; Ufberg, Paul J.; Wiringa, Ann E.] Univ Pittsburgh, Dept Epidemiol, Grad Sch Publ Hlth, Pittsburgh, PA 15213 USA. [Muder, Robert R.] Univ Pittsburgh, Div Infect Dis, VA Pittsburgh Hlth Syst, Pittsburgh, PA 15213 USA. RP Lee, BY (reprint author), Univ Pittsburgh, Publ Hlth Computat & Operat Res Grp PHICOR, 200 Meyran Ave,Suite 200, Pittsburgh, PA 15213 USA. EM BYL1@pitt.edu OI Slayton, Rachel/0000-0003-4699-8040 FU National Institute of General Medical Sciences Models of Infectious Disease Agent Study (MIDAS) [1U54GM088491-0109]; Pennsylvania Department of Health; Bill and Melinda Gates Foundation FX This study was supported by the National Institute of General Medical Sciences Models of Infectious Disease Agent Study (MIDAS) grant 1U54GM088491-0109, the Pennsylvania Department of Health, and the Vaccine Modeling Initiative (VMI), funded by the Bill and Melinda Gates Foundation. The funders had no role in the design and conduct of the study: collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. NR 55 TC 29 Z9 29 U1 1 U2 4 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 JUL 19 PY 2010 VL 28 IS 32 BP 5245 EP 5253 DI 10.1016/j.vaccine.2010.05.062 PG 9 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 639QF UT WOS:000280988600015 PM 20541582 ER PT J AU Kao, KK Fink, MP AF Kao, Kenneth K. Fink, Mitchell P. TI The biochemical basis for the anti-inflammatory and cytoprotective actions of ethyl pyruvate and related compounds SO BIOCHEMICAL PHARMACOLOGY LA English DT Article DE ROS; Inflammation; NF-kappaB; Glyoxalase; Janus-associated kinase ID NF-KAPPA-B; SEVERE ACUTE-PANCREATITIS; ISCHEMIA-REPERFUSION INJURY; WIDE THERAPEUTIC WINDOW; HUMAN ENDOTHELIAL-CELLS; DIRECTLY TARGETING P65; DISTANT ORGAN INJURY; HEMORRHAGIC-SHOCK; IMPROVES SURVIVAL; OXIDATIVE STRESS AB Pyruvate is an important metabolic intermediate, and also is an effective scavenger of hydrogen peroxide and other reactive oxygen species (ROS). Pharmacological administration of pyruvate has been shown to improve organ function in animal models of oxidant-mediated cellular injury. However, pyruvate is relatively unstable in aqueous solutions, which could limit the therapeutic potential of this compound. Ethyl pyruvate (EP), a simple derivative of pyruvic acid, is also an ROS scavenger, but seems to exert pharmacological effects, such as suppression of inflammation, which are at least quantitatively different and in some instances are qualitatively distinct from those exerted by pyruvate anion. Treatment with EP has been shown to improve survival and/or ameliorate organ dysfunction in a wide variety of pre-clinical models of acute illnesses, such as severe sepsis, acute pancreatitis and stroke. Using other animal models, some studies have demonstrated that more prolonged treatment with EP can ameliorate inflammatory bowel disease or slow the rate of growth of malignant tumors. In a clinical trial of patients undergoing cardiac surgery, treatment with EP was shown to be safe, but it failed to improve outcome. The true therapeutic potential of EP and related compounds remains to be elucidated. In this review, some of the biochemical mechanisms, which might be responsible for the pharmacological effects of EP, are discussed. Published by Elsevier Inc. C1 [Kao, Kenneth K.; Fink, Mitchell P.] VA Greater Angeles Hlth Care Syst, Dept Surg, Los Angeles, CA USA. [Kao, Kenneth K.; Fink, Mitchell P.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. [Fink, Mitchell P.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Anesthesiol, Los Angeles, CA 90095 USA. RP Fink, MP (reprint author), VA Greater Los Angeles UCLA, Dept Surg, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Mitchell.Fink@va.gov RI Ji, Haofeng/G-6206-2012 NR 104 TC 87 Z9 90 U1 2 U2 14 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0006-2952 J9 BIOCHEM PHARMACOL JI Biochem. Pharmacol. PD JUL 15 PY 2010 VL 80 IS 2 BP 151 EP 159 DI 10.1016/j.bcp.2010.03.007 PG 9 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 599UN UT WOS:000277939300001 PM 20230800 ER PT J AU Wasif, N Bentrem, DJ Farrell, JJ Ko, CY Hines, OJ Reber, HA Tomlinson, JS AF Wasif, Nabil Bentrem, David J. Farrell, James J. Ko, Clifford Y. Hines, Oscar J. Reber, Howard A. Tomlinson, James S. TI Invasive Intraductal Papillary Mucinous Neoplasm Versus Sporadic Pancreatic Adenocarcinoma A Stage-Matched Comparison of Outcomes SO CANCER LA English DT Article DE intraductal papillary mucinous neoplasm; pancreatic cancer; stage-matched; survival; outcomes ID ADDITIONAL PRIMARY CANCERS; INSTITUTIONAL EXPERIENCE; DUCTAL ADENOCARCINOMA; UPDATED EXPERIENCE; SURGICAL RESECTION; SURVIVAL; PROGNOSIS; PREDICTORS; CARCINOMA; MUCUS AB BACKGROUND: Although invasive intraductal papillary mucinous neoplasm (IPMN) of the pancreas is thought to be more indolent than sporadic pancreatic adenocarcinoma (PAC), the natural history remains poorly defined. The authors compared survival and identify prognostic factors after resection for invasive IPMN versus stage-matched PAC. METHODS: The Surveillance, Epidemiology, and End Results database (1991-2005) was used to identify 729 patients with invasive IPMN and 8082 patients with PAC who underwent surgical resection. RESULTS: Patients with resected invasive IPMN experienced improved overall survival when compared with resected PAC (median survival, 21 vs 14 months; P < .001). Stratification by nodal status demonstrated no difference in survival among lymph node-positive patients; however, median survival of resected, lymph node-negative, invasive IPMN was significantly improved compared with lymph node-negative PAC (34 vs 18 months; P < .001). On multivariate analysis, PAC histology was an adverse predictor of overall survival (hazard ratio [HR], 1.31; 95% confidence interval [CI], 1.15-1.50) compared with invasive IPMN. For patients with invasive IPMN, positive lymph nodes (HR, 1.98; 95% CI, 1.50-2.60), high tumor grade (HR, 1.74; 95% CI, 1.31-2.31), tumor size >2 cm (HR, 1.50; 95% CI, 1.04-2.19), and age >66 years (HR, 1.33; 95% CI, 1.03-1.73) were adverse predictors of survival. CONCLUSIONS: Although lymph node-negative invasive IPMN showed improved survival after resection compared with lymph node-negative PAC, the natural history of lymph node-positive invasive IPMN mimicked that of lymph node-positive PAC. The authors also identified adverse predictors of survival in invasive IPMN to guide discussions regarding use of adjuvant therapies and prognosis after resection of invasive IPMN. Cancer 2010;116:3369-77. (C) 2010 American Cancer Society. C1 [Tomlinson, James S.] Univ Calif Los Angeles, Div Surg Oncol, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. [Wasif, Nabil] St Johns Hlth Ctr, John Wayne Canc Inst, Santa Monica, CA USA. [Bentrem, David J.] Northwestern Univ, Dept Surg, Jesse Brown VA Med Ctr, Chicago, IL 60611 USA. [Farrell, James J.] Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Ko, Clifford Y.; Tomlinson, James S.] Greater Los Angeles VA Med Ctr, Dept Surg, Los Angeles, CA USA. RP Tomlinson, JS (reprint author), Univ Calif Los Angeles, Div Surg Oncol, David Geffen Sch Med, Dept Surg, Box 951782,54-139A CHS,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM jtomlinson@mednet.ucla.edu FU National Cancer Institute [CA090848]; Rod Fasone Memorial Cancer Fund (Indianapolis, Ind); Henry L. Guenther Foundation (Los Angeles, Calif); William Randolph Hearst Foundation (San Francisco, Calif); Davidow Charitable Fund (Los Angeles, Calif) FX Supported by grant CA090848 from the National Cancer Institute and by funding from the Rod Fasone Memorial Cancer Fund (Indianapolis, Ind), the Henry L. Guenther Foundation (Los Angeles, Calif), the William Randolph Hearst Foundation (San Francisco, Calif), the Davidow Charitable Fund (Los Angeles, Calif), and Mrs. Ruth Well (Los Angeles, Calif). NR 36 TC 45 Z9 47 U1 0 U2 3 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER-AM CANCER SOC JI Cancer PD JUL 15 PY 2010 VL 116 IS 14 BP 3369 EP 3377 DI 10.1002/cncr.25070 PG 9 WC Oncology SC Oncology GA 623PM UT WOS:000279754300011 PM 20564064 ER PT J AU Crowe, SR Ash, LL Engler, RJM Ballard, JD Harley, JB Farris, AD James, JA AF Crowe, Sherry R. Ash, Linda L. Engler, Renata J. M. Ballard, Jimmy D. Harley, John B. Farris, A. Darise James, Judith A. TI Select Human Anthrax Protective Antigen Epitope-Specific Antibodies Provide Protection from Lethal Toxin Challenge SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID LINKED-IMMUNOSORBENT-ASSAY; BACILLUS-ANTHRACIS; MONOCLONAL-ANTIBODIES; NEUTRALIZING ANTIBODIES; INHALATIONAL ANTHRAX; PASSIVE PROTECTION; IMMUNE-RESPONSES; GUINEA-PIGS; IN-VITRO; VACCINE AB Bacillus anthracis remains a serious bioterrorism concern, and the currently licensed vaccine remains an incomplete solution for population protection from inhalation anthrax and has been associated with concerns regarding efficacy and safety. Thus, understanding how to generate long-lasting protective immunity with reduced immunizations or provide protection through postexposure immunotherapeutics are long-sought goals. Through evaluation of a large military cohort, we characterized the levels of antibodies against protective antigen and found that over half of anthrax vaccinees had low serum levels of in vitro toxin neutralization capacity. Using solid-phase epitope mapping and confirmatory assays, we identified several neutralization-associated humoral epitopes and demonstrated that select antipeptide responses mediated protection in vitro. Finally, passively transferred antibodies specific for select epitopes provided protection in an in vivo lethal toxin mouse model. Identification of these antigenic regions has important implications for vaccine design and the development of directed immunotherapeutics. C1 [Crowe, Sherry R.; Ash, Linda L.; Harley, John B.; Farris, A. Darise; James, Judith A.] Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. [Ballard, Jimmy D.; Harley, John B.; Farris, A. Darise; James, Judith A.] Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA. [Harley, John B.] US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. [Engler, Renata J. M.] Walter Reed Army Med Ctr, Vaccine Healthcare Ctr Network, Washington, DC 20307 USA. RP James, JA (reprint author), Clin Immunol Program, 825 NE 13th St, Oklahoma City, OK 73104 USA. EM jamesj@omrf.org FU National Institute of Allergy and Infectious Diseases [U19AI062629]; National Center for Research Resources [P20RR15577]; Walter Reed Army Medical Center Vaccine Healthcare Centers Network and Allergy-Immunology Department FX National Institute of Allergy and Infectious Diseases (grant U19AI062629); National Center for Research Resources (grant P20RR15577); Walter Reed Army Medical Center Vaccine Healthcare Centers Network and Allergy-Immunology Department (local protocol development and management). NR 47 TC 20 Z9 20 U1 0 U2 8 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1537-6613 J9 J INFECT DIS JI J. Infect. Dis. PD JUL 15 PY 2010 VL 202 IS 2 BP 251 EP 260 DI 10.1086/653495 PG 10 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 612VL UT WOS:000278932900010 PM 20533877 ER PT J AU Rosenthal, E Brennan, L Xie, S Hurtig, H Milber, J Weintraub, D Karlawish, J Siderowf, A AF Rosenthal, Emily Brennan, Laura Xie, Sharon Hurtig, Howard Milber, Joshua Weintraub, Daniel Karlawish, Jason Siderowf, Andrew TI Association Between Cognition and Function in Patients With Parkinson Disease With and Without Dementia SO MOVEMENT DISORDERS LA English DT Article DE Parkinson's disease; cognitive impairment; ADL ID MENTAL-STATE-EXAMINATION; SCREENING TOOL; RATING-SCALE; IMPAIRMENT; DISABILITY; SCORE AB Patients with Parkinson's disease (PD) often have cognitive deficits from the time of diagnosis. Except in patients with dementia, the impact of cognitive symptoms on daily function is not well documented. This study had two objectives: (I) to determine the functional significance of cognitive deficits in nondemented patients with PD and (2) to assess the sensitivity of two measures of global cognitive abilities to identify individuals with impaired ADL function. One hundred eleven subjects with PD and a range of cognitive abilities were included. Of these, 20 were diagnosed with PDD. All subjects were assessed with the Mattis Dementia Rating Scale to two (DRS-2) and the Mini-Mental State Examination (MMSE). ADL function was reported by an informant using the Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL). The ability of the DRS-2 and MMSE to capture the impact of cognitive impairment on ADL function was assessed in the entire cohort and in subsets of nondemented individuals. After adjustment for covariates, cognition as measured by the DRS-2 was strongly related to ADL function in the entire cohort (partial correlation coefficient = 0.55, P < 0.001). The association remained strong when only nondemented subjects were included (r = 0.42, P < 0.001). The DRS-2 was significantly more accurate than the MMSE, particularly for detecting milder degrees of ADL impairment (ROC area = 0.87 vs. 0.75, P = 0.0008). Cognition is associated with impairment in ADL function, even in nondemented patients with PD. However, sensitive cognitive assessment measures may be needed to identify these functionally relevant impairments. (C) 2010 Movement Disorder Society C1 [Rosenthal, Emily; Brennan, Laura; Hurtig, Howard; Milber, Joshua; Siderowf, Andrew] Univ Penn, Dept Neurol, Sch Med, Div Geriatr, Philadelphia, PA 19107 USA. [Xie, Sharon] Univ Penn, Dept Biostat, Sch Med, Div Geriatr, Philadelphia, PA 19107 USA. [Weintraub, Daniel] Univ Penn, Dept Psychiat, Sch Med, Div Geriatr, Philadelphia, PA 19107 USA. [Weintraub, Daniel] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. [Karlawish, Jason] Univ Penn, Dept Med & Med Eth, Sch Med, Div Geriatr, Philadelphia, PA 19107 USA. RP Siderowf, A (reprint author), Univ Penn, Dept Neurol, Sch Med, Div Geriatr, 330 S 9th St,2nd Floor, Philadelphia, PA 19107 USA. EM andrew.siderowf@uphs.upenn.edu FU NINDS NIH HHS [P50 NS053488-01A20001, P50 NS053488-020001, P50 NS053488-030001] NR 28 TC 57 Z9 57 U1 1 U2 8 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 2010 VL 25 IS 9 BP 1170 EP 1176 DI 10.1002/mds.23073 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 636YN UT WOS:000280781500009 PM 20310053 ER PT J AU Ku, S Glass, GA AF Ku, Stephen Glass, Graham A. TI Age of Parkinson's Disease Onset as a Predictor for the Development of Dyskinesia SO MOVEMENT DISORDERS LA English DT Article DE Parkinson's disease; dyskinesia; age of onset ID MOTOR FLUCTUATIONS; DOPAMINE AGONISTS; INITIAL TREATMENT; LEVODOPA; PRAMIPEXOLE; ROPINIROLE; THERAPY; TRIAL; RISK AB The risk of developing levodopa-associated dyskinesia is known to vary inversely with the age of Parkinson's disease onset. This study quantifies dyskinesia risks for different Parkinson's onset ages in a patient population treated at the Parkinson's Disease Research, Education, and Clinical Center at the San Francisco Veterans Affairs Medical Center. Medical records were reviewed to determine age of Parkinson's onset, medication history, and dyskinesia onset. Dyskinesia risks were determined by using Kaplan-Meier analysis. Cox proportional hazard models were used to compare age groups and to perform multivariate modeling. This study included 109 patients with Parkinson's, 105 of whom had onset of symptoms after 1989. At 5 years of levodopa treatment, the dyskinesia risk for patients with onset age 40-49 was 70%, decreasing to 42% for onset ages 50-59, 33% for onset ages 60-69, and 24% for onset ages 70-79. Pairwise comparisons between the 40-49 age group and the other age groups were statistically significant in time-to-event models. After 5 years of levodopa treatment, dyskinesia risks became uniformly high regardless of age of onset. These results suggest it is appropriate to use different baseline dyskinesia risks in clinical decision-making for patients on the basis of their ages of onset. However, the most significant difference occurs between ages 40-49 and ages 50-79, and if more than 5 years of levodopa therapy are anticipated, dyskinesia risk may have less utility when deciding upon Parkinson's therapy. Drug studies for Parkinson's disease should also take age of Parkinson's onset into account when analyzing dyskinesia outcomes. (C) 2010 Movement Disorder Society C1 [Glass, Graham A.] Univ Calif San Francisco, UCSF Med Ctr, Dept Neurol, San Francisco, CA 94143 USA. [Ku, Stephen] Univ Calif San Francisco, Sch Med, San Francisco, CA 94143 USA. [Ku, Stephen; Glass, Graham A.] San Francisco VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, San Francisco, CA USA. RP Glass, GA (reprint author), Univ Calif San Francisco, UCSF Med Ctr, Dept Neurol, San Francisco, CA 94143 USA. EM graham.glass@ucsf.edu FU NIH/NCRR UCSF-CTSI [UL1 RR024131]; University of California, San Francisco School of Medicine; Allergan, Inc; Movement Disorders Society FX This project was supported by NIH/NCRR UCSF-CTSI Grant Number UL1 RR024131. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Additional support was provided by the University of California, San Francisco School of Medicine Quarterly Research Fellowship. Honoraria: Dr. Glass has received $8,000 in compensation from Allergan Inc. for speakers bureau participation. Grants: Stephen Ku has received two University of California, San Francisco (UCSF) School of Medicine Quarterly Research Fellowships and a UCSF Pathways to Careers in Clinical and Translational Research Program Quarterly Fellowship. UCSF has received unrestricted educational grants from Allergan, Inc in the last 12 months. Expert Testimony: Dr. Glass has provided legal guidance and received compensation in sum amounting to less than $10,000. He has not testified. Employment: Stephen Ku has been employed by the Asian & Pacific Islander Health Parity Coalition, leading a hepatitis B community education program. Other: Stephen Ku has received a Movement Disorders Society travel grant and a UCSF School of Medicine travel grant. NR 17 TC 18 Z9 22 U1 0 U2 2 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 2010 VL 25 IS 9 BP 1177 EP 1182 DI 10.1002/mds.23068 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 636YN UT WOS:000280781500010 PM 20310028 ER PT J AU Sun, HY Forrest, G Gupta, KL Aguado, JM Lortholary, O Julia, MB Safdar, N Patel, R Kusne, S Singh, N AF Sun, Hsin-Yun Forrest, Graeme Gupta, Krishan L. Aguado, Jose M. Lortholary, Olivier Blanes Julia, Marino Safdar, Nasia Patel, Robin Kusne, Shimon Singh, Nina TI Rhino-Orbital-Cerebral Zygomycosis in Solid Organ Transplant Recipients SO TRANSPLANTATION LA English DT Article DE Zygomycosis; Solid organ transplant; Rhino-orbital-cerebral ID LIPOSOMAL AMPHOTERICIN-B; RENAL-ALLOGRAFT RECIPIENT; CENTRAL-NERVOUS-SYSTEM; INVASIVE FUNGAL-INFECTIONS; RHINOCEREBRAL MUCORMYCOSIS; KIDNEY-TRANSPLANTATION; LIPID COMPLEX; CUNNINGHAMELLA-BERTHOLLETIAE; CRYPTOCOCCAL MENINGITIS; CARDIAC TRANSPLANTATION AB Background. Rhino-orbital-cerebral disease is a significant manifestation of zygomycosis in solid organ transplant (SOT) recipients. However, its characteristics and outcome are not well addressed. Methods. SOT recipients with zygomycosis as per the European Organization for Research and Treatment in Cancer and the Mycoses Study Group criteria in a cohort study at our centers published previously and those identified with a PubMed search from the 1950s to November 2009 were studied. Patients with mycosis involving the sinuses, orbits, or central nervous system (CNS) were included. Results. Patients comprised a total of 90 SOT recipients with rhino-orbital-cerebral zygomycosis, including 13 in our cohort and 77 in the literature. CNS disease occurred in 57% (51 of 90). Overall mortality was 52.3% (46 of 88), and the mortality in patients with CNS disease was 73.5% (36 of 49). In logistic regression analysis, older age (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.04-1.21, P=0.002) was associated with a higher mortality rate, whereas lipid formulations of amphotericin B compared with amphotericin B deoxycholate (OR 0.09, 95% CI 0.02-0.50, P=0.006) and surgery (OR 0.12, 95% CI 0.01-0.94, P=0.043) were independently associated with an improved survival even when controlled for CNS involvement and the era of diagnosis of disease. Conclusions. Rhino-orbital-cerebral zygomycosis, particularly CNS disease, is associated with substantial mortality rate in SOT recipients. Older age is a significant risk factor for mortality, whereas lipid formulations of amphotericin B and surgery improved outcomes. C1 [Sun, Hsin-Yun; Singh, Nina] VA Pittsburgh Healthcare Syst, Dept Med, Div Infect Dis, Pittsburgh, PA USA. [Sun, Hsin-Yun] Natl Taiwan Univ, Coll Med, Taipei 10764, Taiwan. [Sun, Hsin-Yun] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei 100, Taiwan. [Forrest, Graeme] Univ Maryland, Dept Med, Div Infect Dis, Baltimore, MD 21201 USA. [Gupta, Krishan L.] Postgrad Inst Med Educ & Res, Dept Nephrol, Chandigarh 160012, India. [Gupta, Krishan L.] Postgrad Inst Med Educ & Res, Dept Pathol, Chandigarh 160012, India. [Aguado, Jose M.] Hosp Octubre, Unidad Enfermedades Infecciosas, Infect Dis Unit, Madrid, Spain. [Lortholary, Olivier] Univ Paris 05, Hop Necker Enfants Malad, Dept Immunol Infect Dis & Hematol, Ctr Infectiol Necker Pasteur, Paris, France. [Lortholary, Olivier] Inst Pasteur, Ctr Natl Reference Mycol & Antifong, Paris, France. [Blanes Julia, Marino] Hosp Univ La Fe, Infect Dis Unit, Valencia, Spain. [Safdar, Nasia] Univ Wisconsin, Dept Med, Infect Dis Sect, Madison, WI USA. [Patel, Robin] Mayo Clin, Div Clin Microbiol, Rochester, MN USA. [Patel, Robin] Mayo Clin, Div Infect Dis, Rochester, MN USA. [Kusne, Shimon] Mayo Clin, Div Infect Dis & Transplantat Med, Scottsdale, AZ USA. [Singh, Nina] Univ Pittsburgh, Pittsburgh, PA USA. RP Singh, N (reprint author), VA Med Ctr, Infect Dis Sect, Univ Dr C, Pittsburgh, PA 15240 USA. EM nis5@pitt.edu OI SUN, HSIN-YUN/0000-0003-0074-7721 FU Pfizer; Schering Plough; Astellas FX N.S. has received grant support from Pfizer and Schering Plough. G.F. has received grant support from Astellas. Other authors declare no conflicts of interest.; This work was in part supported by Schering Plough (N.S.). NR 83 TC 34 Z9 34 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0041-1337 J9 TRANSPLANTATION JI Transplantation PD JUL 15 PY 2010 VL 90 IS 1 BP 85 EP 92 DI 10.1097/TP.0b013e3181dde8fc PG 8 WC Immunology; Surgery; Transplantation SC Immunology; Surgery; Transplantation GA 622ES UT WOS:000279644400012 PM 20626095 ER PT J AU O'Hare, AM Rodriguez, RA Hailpern, SM Larson, EB Tamura, MK AF O'Hare, Ann M. Rodriguez, Rudolph A. Hailpern, Susan M. Larson, Eric B. Tamura, Manjula Kurella TI Regional Variation in Health Care Intensity and Treatment Practices for End-stage Renal Disease in Older Adults SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID OF-LIFE CARE; DECISION-MAKING; NATIONAL-SURVEY; UNITED-STATES; DIALYSIS; POPULATION AB Context An increasing number of older adults are being treated for end-stage renal disease (ESRD) with long-term dialysis. Objectives To determine how ESRD treatment practices for older adults vary across regions with differing end-of-life intensity of care. Design, Setting, and Participants Retrospective observational study using a national ESRD registry to identify a cohort of 41 420 adults (of white or black race), aged 65 years or older, who started long-term dialysis or received a kidney transplant between June 1, 2005, and May 31, 2006. Regional end-of-life intensity of care was defined using an index from the Dartmouth Atlas of Healthcare. Main Outcome Measures Incidence of treated ESRD (dialysis or transplant), preparedness for ESRD (under the care of a nephrologist, having a fistula [vs graft or catheter] at time of hemodialysis initiation), and end-of-life care practices. Results Among whites, the incidence of ESRD was progressively higher in regions with greater intensity of care and this trend was most pronounced at older ages. Among blacks, a similar relationship was present only at advanced ages (men aged >= 80 years and women aged >= 85 years). Patients living in regions in the highest compared with lowest quintile of end-of-life intensity of care were less likely to be under the care of a nephrologist before the onset of ESRD (62.3% [95% confidence interval {CI}, 61.3%-63.3%] vs 71.1% [95% CI, 69.9%-72.2%], respectively) and less likely to have a fistula (vs graft or catheter) at the time of hemodialysis initiation (11.2% [95% CI, 10.6%-11.8%] vs 16.9% [95% CI, 15.9%-17.8%]). Among patients who died within 2 years of ESRD onset (n=21 190), those living in regions in the highest compared with lowest quintile of end-of-life intensity of care were less likely to have discontinued dialysis before death (22.2% [95% CI, 21.1%-23.4%] vs 44.3% [95% CI, 42.5%-46.1%], respectively), less likely to have received hospice care (20.7% [95% CI, 19.5%-21.9%] vs 33.5% [95% CI, 31.7%-35.4%]), and more likely to have died in the hospital (67.8% [95% CI, 66.5%-69.1%] vs 50.3% [95% CI, 48.5%-52.1%]). These differences persisted in adjusted analyses. Conclusion There are pronounced regional differences in treatment practices for ESRD in older adults that are not explained by differences in patient characteristics. JAMA. 2010; 304(2): 180-186 www.jama.com C1 [O'Hare, Ann M.; Rodriguez, Rudolph A.] VA Puget Sound Healthcare Syst, Dept Med, Seattle, WA 98108 USA. [O'Hare, Ann M.] VA Puget Sound Healthcare Syst, HSR&D Ctr Excellence, Seattle, WA 98108 USA. [O'Hare, Ann M.; Rodriguez, Rudolph A.; Larson, Eric B.] Univ Washington, Dept Med, Seattle, WA USA. [Larson, Eric B.] Grp Hlth Cooperat Puget Sound, Grp Hlth Res Inst, Seattle, WA USA. [Tamura, Manjula Kurella] Stanford Univ, Dept Med, Palo Alto, CA 94304 USA. [Tamura, Manjula Kurella] VA Palo Alto Healthcare Syst, Dept Med, Palo Alto, CA USA. RP O'Hare, AM (reprint author), VA Puget Sound Healthcare Syst, Dept Med, 111J Nephrol,1660 S Columbian Way, Seattle, WA 98108 USA. EM Ann.OHare@va.gov RI Kurella Tamura, Manjula/C-8284-2014 OI Kurella Tamura, Manjula/0000-0001-5227-2479 FU Beeson Career Development Award [K23AG28980, K23AG028952]; National Institutes of Health; Satellite Research; Amgen; American Society of Nephrology; Association of Subspecialty Professors; University of California, San Francisco FX Dr O'Hare reported receiving royalties from UpToDate, an honorarium from the Japanese Society for Foot Care, and a Career Development Award from the Department of Veterans Affairs' Health Services Research and Development Service and serving as the principal investigator on an interagency agreement between the Centers for Disease Control and Prevention and the VA Puget Sound Healthcare System. Dr Hailpern reported being employed by LipoScience (Raleigh, North Carolina) during the time frame that she was working on this study but her work on the project was completed during her free time and was not part of her work for the company. Dr Larson reported receiving research support from the National Institutes of Health, royalties from UpToDate, Springer, and Elsevier, and speaker honoraria from universities and other nonprofit organizations. Dr Kurella Tamura reported receiving research funding from Satellite Research, Amgen, a Junior Development Award in Geriatric Nephrology from the American Society of Nephrology and Association of Subspecialty Professors, and an intramural grant from the University of California, San Francisco. The financial disclosures listed herein for Drs O'Hare and Kurella Tamura are for the last 5 years.; Dr O'Hare is supported by Beeson Career Development Award K23AG28980. Dr Kurella Tamura is supported by Beeson Career Development Award K23AG028952. NR 13 TC 75 Z9 75 U1 2 U2 9 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 14 PY 2010 VL 304 IS 2 BP 180 EP 186 DI 10.1001/jama.2010.924 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 624IN UT WOS:000279811000024 PM 20628131 ER PT J AU Seetharaman, SV Winkler, DD Taylor, AB Cao, XH Whitson, LJ Doucette, PA Valentine, JS Schirf, V Demeler, B Carroll, MC Culotta, VC Hart, PJ AF Seetharaman, Sai V. Winkler, Duane D. Taylor, Alexander B. Cao, Xiaohang Whitson, Lisa J. Doucette, Peter A. Valentine, Joan S. Schirf, Virgil Demeler, Borries Carroll, Mark C. Culotta, Valeria C. Hart, P. John TI Disrupted Zinc-Binding Sites in Structures of Pathogenic SOD1 Variants D124V and H80R SO BIOCHEMISTRY LA English DT Article ID AMYOTROPHIC-LATERAL-SCLEROSIS; HUMAN SUPEROXIDE-DISMUTASE; MOTOR-NEURON DEGENERATION; COPPER CHAPERONE CCS; CU,ZN-SUPEROXIDE DISMUTASE; BIOPHYSICAL PROPERTIES; ALS; DISULFIDE; ACTIVATION; CYSTEINE-111 AB Mutations in human copper-zinc superoxide dismutase (SOD1) cause an inherited form of the fatal neurodegenerative disease amyotrophic lateral sclerosis (ALS). Here, we present structures of the pathogenic SOD1 variants D124V and H80R, both of which demonstrate compromised zinc-binding sites. The disruption of the zinc-binding sites in H80R SOD1 leads to conformational changes in loop elements, permitting non-native SOD1-SOD1 interactions that mediate the assembly of these proteins into higher-order filamentous arrays. Analytical ultracentrifugation sedimentation velocity experiments indicate that these SOD1 variants are more prone to monomerization than the wild-type enzyme. Although D124V and H80R SOD1 proteins appear to have fully functional copper-binding sites, inductively coupled plasma mass spectrometery (ICP-MS) and anomalous scattering X-ray diffraction analyses reveal that zinc (not copper) occupies the copper-binding sites in these variants. The absence of copper in these proteins, together with the results of covalent thiol modification experiments in yeast strains with and without the gene encoding the copper chaperone for SOD1 (CCS), suggests that CCS may not fully act on newly translated forms of these polypeptides. Overall, these findings lend support to the hypothesis that immature mutant SOD1 species contribute to toxicity in SOD1-linked ALS. C1 [Seetharaman, Sai V.; Winkler, Duane D.; Taylor, Alexander B.; Cao, Xiaohang; Whitson, Lisa J.; Schirf, Virgil; Demeler, Borries; Hart, P. John] Univ Texas Hlth Sci Ctr San Antonio, Dept Biochem, San Antonio, TX 78229 USA. [Seetharaman, Sai V.; Winkler, Duane D.; Taylor, Alexander B.; Cao, Xiaohang; Whitson, Lisa J.; Hart, P. John] Univ Texas Hlth Sci Ctr San Antonio, Xray Crystallog Core Lab, San Antonio, TX 78229 USA. [Doucette, Peter A.; Valentine, Joan S.] Univ Calif Los Angeles, Dept Chem & Biochem, Los Angeles, CA 90095 USA. [Carroll, Mark C.; Culotta, Valeria C.] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Environm Hlth Sci, Baltimore, MD 21205 USA. [Hart, P. John] S Texas Vet Hlth Care Syst, Dept Vet Affairs, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Hart, PJ (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Biochem, San Antonio, TX 78229 USA. EM pjhart@biochem.uthscsa.edu FU National Institutes of Health [NS39112, RR022200, NS049134, GM50016]; National Science Foundation [TG-MCB070038]; Johns Hopkins University NIEHS center; American Foundation for Aging Research; Judith and Jean Pape Adams Charitable Foundation; William and Ella Owens Medical Research Foundation; Texas Advanced Computing Center at The University of Texas; Bioinformatics Core Facility at The University of Texas Health Science Center FX This work was supported by National Institutes of Health Grants NS39112 (P.J.H.), RR022200 (B.D.), NS049134 (J.S.V.), and GM50016 (V.C.C.), National Science Foundation Grant TG-MCB070038 (B.D.), and the Johns Hopkins University NIEHS center (V.C.C.). D.D.W. and L.J.W. were supported in part by an American Foundation for Aging Research predoctoral fellowship. X.C. and S.V.S. were supported in part by the Judith and Jean Pape Adams Charitable Foundation and the William and Ella Owens Medical Research Foundation.; We acknowledge the support provided by the staff at the Texas Advanced Computing Center at The University of Texas and by Jeremy Mann at the Bioinformatics Core Facility at The University of Texas Health Science Center. Support for the X-ray Crystallography Core Laboratory and the Center for Analytical Ultracentrifugation of Macromolecular Assemblies by The University of Texas Health Science Center Executive Research Committee and the San Antonio Cancer Institute is also gratefully acknowledged NR 57 TC 22 Z9 22 U1 1 U2 11 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0006-2960 J9 BIOCHEMISTRY-US JI Biochemistry PD JUL 13 PY 2010 VL 49 IS 27 BP 5714 EP 5725 DI 10.1021/bi100314n PG 12 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 618XL UT WOS:000279389300010 PM 20515040 ER PT J AU Zaman, MS Chen, Y Deng, G Shahryari, V Suh, SO Saini, S Majid, S Liu, J Khatri, G Tanaka, Y Dahiya, R AF Zaman, M. S. Chen, Y. Deng, G. Shahryari, V. Suh, S. O. Saini, S. Majid, S. Liu, J. Khatri, G. Tanaka, Y. Dahiya, R. TI The functional significance of microRNA-145 in prostate cancer SO BRITISH JOURNAL OF CANCER LA English DT Article DE miR145; prostate; cell growth; apoptosis; TNFSF10 ID HISTONE DEACETYLASE INHIBITORS; CARCINOMA-CELL-LINES; HUMAN BREAST-CANCER; CYCLE ARREST; EXPRESSION; APOPTOSIS; PROTEIN; LIGAND; CHEMOPREVENTION; ADENOCARCINOMA AB BACKGROUND: MicroRNAs (miRNAs) are small noncoding RNAs that have important roles in numerous cellular processes. Recent studies have shown aberrant expression of miRNAs in prostate cancer tissues and cell lines. On the basis of miRNA microarray data, we found that miR-145 is significantly downregulated in prostate cancer. METHODS AND RESULTS: We investigated the expression and functional significance of miR-145 in prostate cancer. The expression of miR-145 was low in all the prostate cell lines tested (PC3, LNCaP and DU145) compared with the normal cell line, PWR-1E, and in cancerous regions of human prostate tissue when compared with the matched adjacent normal. Overexpression of miR-145 in PC3-transfected cells resulted in increased apoptosis and an increase in cells in the G2/M phase, as detected by flow cytometry. Investigation of the mechanisms of inactivation of miR-145 through epigenetic pathways revealed significant DNA methylation of the miR-145 promoter region in prostate cancer cell lines. Microarray analyses of miR-145-overexpressing PC3 cells showed upregulation of the pro-apoptotic gene TNFSF10, which was confirmed by real-time PCR and western analysis. CONCLUSION: One of the genes significantly upregulated by miR-145 overexpression is the proapoptotic gene TNFSF10. Therefore, modulation of miR-145 may be an important therapeutic approach for the management of prostate cancer. British Journal of Cancer (2010) 103, 256-264. doi: 10.1038/sj.bjc.6605742 www.bjcancer.com Published online 29 June 2010 (C) 2010 Cancer Research UK C1 [Zaman, M. S.; Chen, Y.; Deng, G.; Shahryari, V.; Suh, S. O.; Saini, S.; Majid, S.; Liu, J.; Khatri, G.; Tanaka, Y.; Dahiya, R.] San Francisco VA Med Ctr, Dept Urol, San Francisco, CA USA. [Zaman, M. S.; Chen, Y.; Deng, G.; Shahryari, V.; Suh, S. O.; Saini, S.; Majid, S.; Liu, J.; Khatri, G.; Tanaka, Y.; Dahiya, R.] Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Dahiya, R (reprint author), San Francisco VA Med Ctr, Dept Urol, San Francisco, CA USA. EM rdahiya@urology.ucsf.edu RI Jackson, Benjamin/C-4297-2012; Chen, Yi /J-4807-2012 FU NIH [RO1CA111470] FX We thank Dr Roger Erickson for support and assistance with the preparation of the article. This study was supported by the NIH Grant RO1CA111470 (to the principal investigator, Dr R Dahiya). NR 50 TC 84 Z9 90 U1 1 U2 11 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0007-0920 J9 BRIT J CANCER JI Br. J. Cancer PD JUL 13 PY 2010 VL 103 IS 2 BP 256 EP 264 DI 10.1038/sj.bjc.6605742 PG 9 WC Oncology SC Oncology GA 625JV UT WOS:000279892300015 PM 20588276 ER PT J AU Wright, J Fiocchi, F Kehoe, K Mitchell, K Thrutchley, D Breeding, T Gupte, S Buchanan, D Spertus, J Rumsfeld, J AF Wright, Janet Fiocchi, Fran Kehoe, Katie Mitchell, Kristi Thrutchley, Duane Breeding, Tracie Gupte, Sunil Buchanan, Donna Spertus, John Rumsfeld, John TI Building Quality Improvement from the Ground Up: Lessons from the Design and Implementation of the IC3 Program National Practice-Based Quality Improvement Program SO CIRCULATION LA English DT Meeting Abstract CT World Congress of Cardiology Scientific Sessions CY JUN 16-19, 2010 CL Beijing, PEOPLES R CHINA C1 [Wright, Janet; Fiocchi, Fran; Kehoe, Katie; Mitchell, Kristi; Gupte, Sunil] Amer Coll Cardiol, Washington, DC USA. [Thrutchley, Duane; Breeding, Tracie; Buchanan, Donna; Spertus, John] St Lukes Mid Amer Heart Inst, Kansas City, MO USA. [Rumsfeld, John] Denver VA Med Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD JUL 13 PY 2010 VL 122 IS 2 MA 0347 BP E84 EP E84 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 624FI UT WOS:000279801701315 ER PT J AU Chang, AN Walter, LC AF Chang, Anna Walter, Louise C. TI Recognizing Dementia as a Terminal Illness in Nursing Home Residents SO ARCHIVES OF INTERNAL MEDICINE LA English DT Editorial Material ID CARE C1 [Chang, Anna] Univ Calif San Francisco, Dept Med, Div Geriatr, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, San Francisco, CA 94121 USA. RP Chang, AN (reprint author), Univ Calif San Francisco, Dept Med, Div Geriatr, 4150 Clement St,Box 181G, San Francisco, CA 94121 USA. EM Anna.Chang2@va.gov FU NCI NIH HHS [1R01CA134425-01] NR 11 TC 5 Z9 5 U1 0 U2 5 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 12 PY 2010 VL 170 IS 13 BP 1107 EP 1109 DI 10.1001/archinternmed.2010.166 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 624DY UT WOS:000279797700004 PM 20625014 ER PT J AU Balasubramanian, S Mani, SK Kasiganesan, H Baicu, CC Kuppuswamy, D AF Balasubramanian, Sundaravadivel Mani, Santhosh K. Kasiganesan, Harinath Baicu, Catalin C. Kuppuswamy, Dhandapani TI Hypertrophic Stimulation Increases beta-actin Dynamics in Adult Feline Cardiomyocytes SO PLOS ONE LA English DT Article ID OVERLOAD CARDIAC-HYPERTROPHY; CYTOPLASMIC GAMMA-ACTIN; FOCAL COMPLEX-FORMATION; PRESSURE-OVERLOAD; SKELETAL-MUSCLE; C-SRC; INTEGRIN; EXPRESSION; HEART; MYOCARDIUM AB The myocardium responds to hemodynamic stress through cellular growth and organ hypertrophy. The impact of cytoskeletal elements on this process, however, is not fully understood. While alpha-actin in cardiomyocytes governs muscle contraction in combination with the myosin motor, the exact role of beta-actin has not been established. We hypothesized that in adult cardiomyocytes, as in non-myocytes, beta-actin can facilitate cytoskeletal rearrangement within cytoskeletal structures such as Z-discs. Using a feline right ventricular pressure overload (RVPO) model, we measured the level and distribution of beta-actin in normal and pressure overloaded myocardium. Resulting data demonstrated enriched levels of beta-actin and enhanced translocation to the Triton-insoluble cytoskeletal and membrane skeletal complexes. In addition, RVPO in vivo and in vitro hypertrophic stimulation with endothelin (ET) or insulin in isolated adult cardiomyocytes enhanced the content of polymerized fraction (F-actin) of beta-actin. To determine the localization and dynamics of beta-actin, we adenovirally expressed GFP-tagged beta-actin in isolated adult cardiomyocytes. The ectopically expressed beta-actin-GFP localized to the Z-discs, costameres, and cell termini. Fluorescence recovery after photobleaching (FRAP) measurements of beta-actin dynamics revealed that beta-actin at the Z-discs is constantly being exchanged with beta-actin from cytoplasmic pools and that this exchange is faster upon hypertrophic stimulation with ET or insulin. In addition, in electrically stimulated isolated adult cardiomyocytes, while beta-actin overexpression improved cardiomyocyte contractility, immunoneutralization of beta-actin resulted in a reduced contractility suggesting that beta-actin could be important for the contractile function of adult cardiomyocytes. These studies demonstrate the presence and dynamics of beta-actin in the adult cardiomyocyte and reinforce its usefulness in measuring cardiac cytoskeletal rearrangement during hypertrophic stimulation. C1 [Balasubramanian, Sundaravadivel; Mani, Santhosh K.; Kasiganesan, Harinath; Baicu, Catalin C.; Kuppuswamy, Dhandapani] Med Univ S Carolina, Gazes Cardiac Res Inst, Dept Med, Div Cardiol, Charleston, SC 29425 USA. [Kuppuswamy, Dhandapani] Vet Affairs Med Ctr, Ralph H Johnson Dept, Charleston, SC 29403 USA. RP Balasubramanian, S (reprint author), Med Univ S Carolina, Gazes Cardiac Res Inst, Dept Med, Div Cardiol, Charleston, SC 29425 USA. EM balasubr@musc.edu FU National Institutes of Health (NIH) [RHL092124A] FX This study was supported by National Institutes of Health (NIH) grant RHL092124A (to D.K). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 50 TC 11 Z9 11 U1 0 U2 0 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 JUL 12 PY 2010 VL 5 IS 7 AR e11470 DI 10.1371/journal.pone.0011470 PG 10 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 623XV UT WOS:000279781600003 PM 20635003 ER PT J AU Molander, RC Yonker, JA Krahn, DD AF Molander, Rachel C. Yonker, James A. Krahn, Dean D. TI Age-Related Changes in Drinking Patterns From Mid- to Older Age: Results From the Wisconsin Longitudinal Study SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE Alcohol; Aging; Longitudinal; Drinking Behavior ID NATIONAL EPIDEMIOLOGIC SURVEY; LIFE-COURSE VARIATION; ALCOHOL-CONSUMPTION; UNITED-STATES; SWEDISH WOMEN; HEALTH; RETIREMENT; BEHAVIORS; MEN; MORTALITY AB Background: Drinking has generally been shown to decline with age in older adults. However, results vary depending on the measure of alcohol consumption used and the study population. The goals of this study were to (i) describe changes in drinking in a current cohort of older adults using a variety of measures of drinking and (ii) examine a number of different possible predictors of change. Methods: This is a longitudinal study of a community-based sample surveyed at 2 time points, ages 53 and 64 years. We estimated a series of logistic regressions to predict change and stability in drinking categories of nondrinking, moderate drinking, and heavy drinking. Linear regressions were used to predict change in past-month drinking days, past-month average drinks per drinking day, and past-month total drinks. Results: From age 53 to 64, average drinks per drinking day and heavy drinking decreased. Frequency of drinking increased for men and women, and total drinks per month increased for men. The most consistent predictors of drinking changes were gender, health, and education. Other factors predicted drinking change but were not consistent across drinking measures including: adolescent IQ, income, lifetime history of alcohol-related problems, religious service attendance, depression, debt, and changes in employment. Conclusions: Heavy drinking decreases with age, but we may see more frequent moderate drinking with current and upcoming cohorts of older adults. Components of quantity and frequency of drinking change differently. Composite measures of total alcohol consumption may not be adequate for describing relevant changes in drinking over time. A number of factors predicted patterns of change in drinking and warrant further exploration. C1 [Molander, Rachel C.; Krahn, Dean D.] Univ Wisconsin, Sch Med, Dept Psychiat, Madison, WI 53719 USA. [Yonker, James A.] Univ Wisconsin, Dept Sociol, Ctr Demog & Ecol, Madison, WI 53719 USA. [Yonker, James A.; Krahn, Dean D.] Univ Wisconsin, Ctr Demog Hlth & Aging, Madison, WI 53719 USA. [Krahn, Dean D.] William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. RP Molander, RC (reprint author), Univ Wisconsin, Sch Med, Dept Psychiat, 3001 Res Pk Rd, Madison, WI 53719 USA. EM r.molander@hosp.wisc.edu RI Yonker, James/J-6561-2014 OI Yonker, James/0000-0002-9483-8511 FU National Institute on Aging [R01 AG-9775, P01 AG-21079]; William Vilas Estate Trust; Graduate School of the University of Wisconsin-Madison; National Institute of Child Health and Human Development FX The research reported herein was supported by the National Institute on Aging (R01 AG-9775 and P01 AG-21079), by the William Vilas Estate Trust, and by the Graduate School of the University of Wisconsin-Madison. Computation was carried out using facilities of the Center for Demography and Ecology at the University of Wisconsin-Madison, which are supported by Center and Training Grants from the National Institute of Child Health and Human Development and the National Institute on Aging. NR 46 TC 30 Z9 30 U1 5 U2 13 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0145-6008 EI 1530-0277 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUL 10 PY 2010 VL 34 IS 7 BP 1182 EP 1192 DI 10.1111/j.1530-0277.2010.01195.x PG 11 WC Substance Abuse SC Substance Abuse GA 615GM UT WOS:000279122600007 PM 20477774 ER PT J AU Williams, EC Palfai, T Cheng, DM Samet, JH Bradley, KA Koepsell, TD Wickizer, TM Heagerty, PJ Saitz, R AF Williams, Emily C. Palfai, Tibor Cheng, Debbie M. Samet, Jeffrey H. Bradley, Katharine A. Koepsell, Thomas D. Wickizer, Thomas M. Heagerty, Patrick J. Saitz, Richard TI Physical Health and Drinking Among Medical Inpatients With Unhealthy Alcohol Use: A Prospective Study1 SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE Hospital-Based Brief Intervention; Physical Health; Readiness to Change; Unhealthy Alcohol Use; Alcohol Dependence ID PRIMARY-CARE PATIENTS; RANDOMIZED CONTROLLED-TRIAL; BRIEF INTERVENTION; UNITED-STATES; SUBSTANCE-ABUSE; HEAVY DRINKERS; USE DISORDERS; LIVER-TRANSPLANTATION; FOLLOW-UP; CONSUMPTION AB Objective: Unhealthy alcohol use is common in medical inpatients, and hospitalization has been hypothesized to serve as a "teachable moment" that could motivate patients to decrease drinking, but studies of hospital-based brief interventions have often not found decreases. Evaluating associations between physical health and subsequent drinking among medical inpatients with unhealthy alcohol use could inform refinement of hospital-based brief interventions by identifying an important foundation on which to build them. We tested associations between poor physical health and drinking after hospitalization and whether associations varied by alcohol dependence status and readiness to change. Methods: Participants were medical inpatients who screened positive for unhealthy alcohol use and consented to participate in a randomized trial of brief intervention (n = 341). Five measures of physical health were independent variables. Outcomes were abstinence and the number of heavy drinking days (HDDs) reported in the 30 days prior to interviews 3 months after hospitalization. Separate regression models were fit to evaluate each independent variable controlling for age, gender, randomization group, and baseline alcohol use. Interactions between each independent variable and alcohol dependence and readiness to change were tested. Stratified models were fit when significant interactions were identified. Results: Among all participants, measures of physical health were not significantly associated with either abstinence or number of HDDs at 3 months. Having an alcohol-attributable principal admitting diagnosis was significantly associated with fewer HDDs in patients who were nondependent [adjusted incidence rate ratio (aIRR) 0.10, 95% CI 0.03-0.32] or who had low alcohol problem perception (aIRR 0.36, 95% CI 0.13-0.99) at hospital admission. No significant association between alcohol-attributable principal admitting diagnosis and number of HDDs was identified for participants with alcohol dependence or high problem perception. Conclusions: Among medical inpatients with nondependent unhealthy alcohol use and those who do not view their drinking as problematic, alcohol-attributable illness may catalyze decreased drinking. Brief interventions that highlight alcohol-related illness might be more successful. C1 [Williams, Emily C.; Bradley, Katharine A.] VA Hlth Serv Res & Dev, Seattle, WA USA. [Bradley, Katharine A.] Univ Washington, Dept Med, Seattle, WA USA. [Williams, Emily C.; Bradley, Katharine A.; Koepsell, Thomas D.; Wickizer, Thomas M.] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. [Koepsell, Thomas D.] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. [Heagerty, Patrick J.] Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Boston Med Ctr, Gen Internal Med Sect, Clin Addict Res & Educ CARE Unit, Boston, MA USA. [Palfai, Tibor; Cheng, Debbie M.; Samet, Jeffrey H.; Saitz, Richard] Boston Univ, Sch Med, Boston, MA 02118 USA. [Palfai, Tibor] Boston Univ, Dept Psychol, Boston, MA 02215 USA. [Cheng, Debbie M.] Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA USA. [Saitz, Richard] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA. [Samet, Jeffrey H.] Boston Univ, Sch Publ Hlth, Dept Social & Behav Sci, Boston, MA USA. RP Williams, EC (reprint author), VA Puget Sound Hlth Care Syst, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM emily.williams3@va.gov FU NIAAA [R01-AA 12617]; VA Puget Sound Health Care System, Seattle, Washington FX Views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs, the University of Washington, or Boston University. Preliminary versions of this work were presented at the 2007 meeting of the International Network on Brief Interventions for Alcohol Problems and the 2008 Research Society on Alcoholism annual meeting, as well as included in the dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy from the University of Washington (ECW). This study was supported by NIAAA grant R01-AA 12617 (Saitz, PI), and the material presented here is the result of work supported by resources from the VA Puget Sound Health Care System, Seattle, Washington. NR 65 TC 13 Z9 13 U1 3 U2 8 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUL 10 PY 2010 VL 34 IS 7 BP 1257 EP 1265 DI 10.1111/j.1530-0277.2010.01203.x PG 9 WC Substance Abuse SC Substance Abuse GA 615GM UT WOS:000279122600015 PM 20477765 ER PT J AU Ogale, S Lee, TA Sullivan, SD AF Ogale, Sarika Lee, Todd A. Sullivan, Sean D. TI Safety of Ipratropium Bromide Response SO CHEST LA English DT Letter ID BETA-AGONISTS; COPD C1 [Ogale, Sarika; Sullivan, Sean D.] Univ Washington, Dept Pharm, Seattle, WA 98195 USA. [Lee, Todd A.] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Ctr Management Complex Chron Care, Hines, IL 60141 USA. Univ Illinois, Ctr Pharmacoecon Res, Dept Pharm Practice, Chicago, IL USA. RP Lee, TA (reprint author), Edward Hines Jr VA Hosp 151 H, 5000 S 5th Ave, Hines, IL 60141 USA. EM todd.lee@va.gov NR 4 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 JUL 10 PY 2010 VL 138 IS 1 BP 235 EP 236 DI 10.1378/chest.10-0403 PG 2 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 625MX UT WOS:000279900500043 ER PT J AU Singh, H Hirani, K Kadiyala, H Rudomiotov, O Davis, T Khan, MM Wahls, TL AF Singh, Hardeep Hirani, Kamal Kadiyala, Himabindu Rudomiotov, Olga Davis, Traber Khan, Myrna M. Wahls, Terry L. TI Characteristics and Predictors of Missed Opportunities in Lung Cancer Diagnosis: An Electronic Health Record-Based Study SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID DELAYED DIAGNOSIS; BREAST-CANCER; INFORMATION-TECHNOLOGY; MALPRACTICE CLAIMS; COLORECTAL-CANCER; UNITED-STATES; PRIMARY-CARE; FOLLOW-UP; TIME; PATIENT AB Purpose Understanding delays in cancer diagnosis requires detailed information about timely recognition and follow-up of signs and symptoms. This information has been difficult to ascertain from paper-based records. We used an integrated electronic health record (EHR) to identify characteristics and predictors of missed opportunities for earlier diagnosis of lung cancer. Methods Using a retrospective cohort design, we evaluated 587 patients of primary lung cancer at two tertiary care facilities. Two physicians independently reviewed each case, and disagreements were resolved by consensus. Type I missed opportunities were defined as failure to recognize predefined clinical clues (ie, no documented follow-up) within 7 days. Type II missed opportunities were defined as failure to complete a requested follow-up action within 30 days. Results Reviewers identified missed opportunities in 222 (37.8%) of 587 patients. Median time to diagnosis in cases with and without missed opportunities was 132 days and 19 days, respectively (P < .001). Abnormal chest x-ray was the clue most frequently associated with type I missed opportunities (62%). Follow-up on abnormal chest x-ray (odds ratio [OR], 2.07; 95% CI, 1.04 to 4.13) and completion of first needle biopsy (OR, 3.02; 95% CI, 1.76 to 5.18) were associated with type II missed opportunities. Patient adherence contributed to 44% of patients with missed opportunities. Conclusion Preventable delays in lung cancer diagnosis arose mostly from failure to recognize documented abnormal imaging results and failure to complete key diagnostic procedures in a timely manner. Potential solutions include EHR-based strategies to improve recognition of abnormal imaging and track patients with suspected cancers. C1 Michael E DeBakey VA Med Ctr, Houston Vet Affairs Hlth Serv Res & Dev Ctr Excel, Houston, TX USA. Baylor Coll Med, Dept Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Iowa City Vet Adm Med Ctr, Iowa City, IA USA. Univ Iowa, Carver Coll Med, Iowa City, IA USA. RP Singh, H (reprint author), VA Med Ctr, 152,2002 Holcombe Blvd, Houston, TX 77030 USA. EM hardeeps@bcm.edu OI Davis Giardina, Traber/0000-0002-9184-6524 FU National Institutes of Health [K23CA125585]; Houston Veterans Administration Health Services Research and Development Center of Excellence [HFP90-020] FX Supported by K23 Career Development Award No. K23CA125585 from the National Institutes of Health (H.S.) and in part by the Houston Veterans Administration Health Services Research and Development Center of Excellence (HFP90-020). NR 58 TC 41 Z9 41 U1 2 U2 5 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD JUL 10 PY 2010 VL 28 IS 20 BP 3307 EP 3315 DI 10.1200/JCO.2009.25.6636 PG 9 WC Oncology SC Oncology GA 622CW UT WOS:000279637600017 PM 20530272 ER PT J AU Mamtani, M Matsubara, T Shimizu, C Furukawa, S Akagi, T Onouchi, Y Hata, A Fujino, A He, WJ Ahuja, SK Burns, JC AF Mamtani, Manju Matsubara, Tomoyo Shimizu, Chisato Furukawa, Susumu Akagi, Teiji Onouchi, Yoshihiro Hata, Akira Fujino, Akihiro He, Weijing Ahuja, Sunil K. Burns, Jane C. TI Association of CCR2-CCR5 Haplotypes and CCL3L1 Copy Number with Kawasaki Disease, Coronary Artery Lesions, and IVIG Responses in Japanese Children SO PLOS ONE LA English DT Article ID MONOCYTE CHEMOATTRACTANT PROTEIN-1; GAMMA-GLOBULIN THERAPY; INTRAVENOUS IMMUNOGLOBULIN TREATMENT; MACROPHAGE INFLAMMATORY PROTEIN-1; CONTAINING SEGMENTAL DUPLICATIONS; RECEPTOR GENE POLYMORPHISMS; RISK-FACTORS; AUTOIMMUNE-DISEASES; HUMAN GENOME; SUSCEPTIBILITY AB Background: The etiology of Kawasaki Disease (KD) is enigmatic, although an infectious cause is suspected. Polymorphisms in CC chemokine receptor 5 (CCR5) and/or its potent ligand CCL3L1 influence KD susceptibility in US, European and Korean populations. However, the influence of these variations on KD susceptibility, coronary artery lesions (CAL) and response to intravenous immunoglobulin (IVIG) in Japanese children, who have the highest incidence of KD, is unknown. Methodology/Principal Findings: We used unconditional logistic regression analyses to determine the associations of the copy number of the CCL3L1 gene-containing duplication and CCR2-CCR5 haplotypes in 133 Japanese KD cases [33 with CAL and 25 with resistance to IVIG] and 312 Japanese controls without a history of KD. We observed that the deviation from the population average of four CCL3L1 copies (i.e., or. four copies) was associated with an increased risk of KD and IVIG resistance (adjusted odds ratio (OR) = 2.25, p = 0.004 and OR = 6.26, p = 0.089, respectively). Heterozygosity for the CCR5 HHF*2 haplotype was associated with a reduced risk of both IVIG resistance (OR = 0.21, p = 0.026) and CAL development (OR = 0.44, p = 0.071). Conclusions/Significance: The CCL3L1-CCR5 axis may play an important role in KD pathogenesis. In addition to clinical and laboratory parameters, genetic markers may also predict risk of CAL and resistance to IVIG. C1 [Mamtani, Manju; He, Weijing; Ahuja, Sunil K.] Univ Texas Hlth Sci Ctr San Antonio, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. [Mamtani, Manju; He, Weijing; Ahuja, Sunil K.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Vet Adm Ctr AIDS & HIV Infect 1, San Antonio, TX 78229 USA. [Matsubara, Tomoyo] Juntendo Univ, Grad Sch Med, Dept Pediat, Chiba, Japan. [Shimizu, Chisato; Burns, Jane C.] Univ Calif San Diego, Sch Med, Rady Childrens Hosp, Dept Pediat, La Jolla, CA 92093 USA. [Furukawa, Susumu] Yamaguchi Univ, Grad Sch Med, Dept Pediat, Yamaguchi, Japan. [Akagi, Teiji] Okayama Univ Hosp, Pediat Cardiac Care Unit, Okayama, Japan. [Onouchi, Yoshihiro] RIKEN, Ctr Genom Med, Lab Cardiovasc Dis, Kanagawa, Japan. [Hata, Akira] Chiba Univ, Dept Publ Hlth, Grad Sch Med, Chiba, Japan. [Fujino, Akihiro] Natl Ctr Child Hlth & Dev, Dept Surg, Tokyo, Japan. [Ahuja, Sunil K.] Univ Texas Hlth Sci Ctr San Antonio, Dept Microbiol & Immunol, San Antonio, TX 78229 USA. [Ahuja, Sunil K.] Univ Texas Hlth Sci Ctr San Antonio, Dept Biochem, San Antonio, TX 78229 USA. RP Mamtani, M (reprint author), Univ Texas Hlth Sci Ctr San Antonio, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. EM ahujas@uthscsa.edu RI Burns, Jane/J-6167-2015; Shimizu, Chisato/J-6516-2015 FU National Institutes of Health, National Heart, Lung, Blood Institute [HL074864, HL69413]; Max and Minnie Tomerlin Voelcker Fund; Burroughs Wellcome Clinical Scientist Award in Translational Research; Doris Duke Distinguished Clinical Scientist Award FX This work was supported in part by grants from the National Institutes of Health, National Heart, Lung, Blood Institute, HL074864 and HL69413 awarded to JCB. This work was also supported by the Voelcker Senior Scholar Award from The Max and Minnie Tomerlin Voelcker Fund awarded to SKA. SKA is also supported by a Burroughs Wellcome Clinical Scientist Award in Translational Research, and the Doris Duke Distinguished Clinical Scientist Award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 59 TC 9 Z9 12 U1 1 U2 3 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 JUL 7 PY 2010 VL 5 IS 7 AR e11458 DI 10.1371/journal.pone.0011458 PG 7 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 621OQ UT WOS:000279589300006 PM 20628649 ER PT J AU Mukherjee, R Rivers, WT Ruddy, JM Matthews, RG Koval, CN Plyler, RA Chang, EI Patel, RK Kern, CB Stroud, RE Spinale, FG AF Mukherjee, Rupak Rivers, William T. Ruddy, Jean Marie Matthews, Robert G. Koval, Christine N. Plyler, Rebecca A. Chang, Eileen I. Patel, Risha K. Kern, Christine B. Stroud, Robert E. Spinale, Francis G. TI Long-Term Localized High-Frequency Electric Stimulation Within the Myocardial Infarct Effects on Matrix Metalloproteinases and Regional Remodeling SO CIRCULATION LA English DT Article DE extracellular matrix; myocardial infarction; remodeling; matrix metalloproteinases ID INHIBITION; FIBROBLASTS; FAILURE; IDENTIFICATION; REPERFUSION; INDUCTION; ISCHEMIA; ABLATION; CULTURE; TISSUE AB Background-Disruption of the balance between matrix metalloproteinases (MMP) and MMP inhibitors (TIMPs) within a myocardial infarct (MI) contributes to left ventricular wall thinning and changes in regional stiffness at the MI region. This study tested the hypothesis that a targeted regional approach through localized high-frequency stimulation (LHFS) using low-amplitude electric pulses instituted within a formed MI scar would alter MMP/TIMP levels and prevent MI thinning. Methods and Results-At 3 weeks after MI, pigs were randomized for LHFS (n=7; 240 bpm, 0.8 V, 0.05-ms pulses) or were left unstimulated (UNSTIM; n=10). At 4 weeks after MI, left ventricular wall thickness (echocardiography; 0.89 +/- 0.07 versus 0.67 +/- 0.08 cm; P<0.05) and regional stiffness (piezoelectric crystals; 14.70 +/- 2.08 versus 9.11 +/- 1.24; P<0.05) were higher with LHFS than in UNSTIM. In vivo interstitial MMP activity (fluorescent substrate cleavage; 943 +/- 59 versus 1210 +/- 72 U; P<0.05) in the MI region was lower with LHFS than in UNSTIM. In the MI region, MMP-2 levels were lower and TIMP-1 and collagen levels were higher with LHFS than in UNSTIM (all P<0.05). Transforming growth factor-beta receptor 1 and phosphorylated SMAD-2/3 levels within the MI region were higher with LHFS than in UNSTIM. Electric stimulation (4 Hz) of isolated fibroblasts resulted in reduced MMP-2 and MT1-MMP levels but increased TIMP-1 levels compared with unstimulated fibroblasts. Conclusions-These unique findings demonstrate that LHFS of the MI region altered left ventricular wall thickness and material properties, likely as a result of reduced regional MMP activity. Thus, LHFS may provide a novel means to favorably modify left ventricular remodeling after MI. (Circulation. 2010;122:20-32.) C1 [Mukherjee, Rupak; Rivers, William T.; Ruddy, Jean Marie; Matthews, Robert G.; Koval, Christine N.; Plyler, Rebecca A.; Chang, Eileen I.; Patel, Risha K.; Stroud, Robert E.; Spinale, Francis G.] Med Univ S Carolina, Div Cardiothorac Surg, Charleston, SC 29425 USA. [Kern, Christine B.] Med Univ S Carolina, Dept Regenerat Med & Cell Biol, Charleston, SC 29425 USA. [Spinale, Francis G.] Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Mukherjee, R (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, Strom Thurmond Res Bldg,770 MUSC Complex,Suite 62, Charleston, SC 29425 USA. EM mukherr@musc.edu OI Chang, Eileen/0000-0002-3444-7260 FU National Heart, Lung, and Blood Institute [HL-45024, HL-97012, PO1-48788]; Veterans Administration Merit Award FX This study was supported in part by National Heart, Lung, and Blood Institute grants HL-45024, HL-97012, and PO1-48788 and a Veterans Administration Merit Award (Dr Spinale). NR 36 TC 7 Z9 7 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD JUL 6 PY 2010 VL 122 IS 1 BP 20 EP U64 DI 10.1161/CIRCULATIONAHA.110.936872 PG 18 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 621FL UT WOS:000279560800005 PM 20566951 ER PT J AU Volberding, PA Deeks, SG AF Volberding, Paul A. Deeks, Steven G. TI Antiretroviral therapy and management of HIV infection SO LANCET LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; CD4(+) T-CELLS; RANDOMIZED CONTROLLED-TRIAL; AIDS-DEFINING MALIGNANCIES; SOCIETY-USA PANEL; TERM-FOLLOW-UP; DRUG-RESISTANCE; VIRAL LOAD; IMMUNE ACTIVATION; HIV-1-INFECTED PATIENTS AB Antiretroviral therapy of HIV infection has changed a uniformly fatal into a potentially chronic disease. There are now 17 drugs in common use for HIV treatment. Patients who can access and adhere to combination therapy should be able to achieve durable, potentially lifelong suppression of HIV replication. Despite the unquestioned success of antiretroviral therapy, limitations persist. Treatment success needs strict lifelong drug adherence. Although the widely used drugs are generally well tolerated, most have some short-term toxic effects and all have the potential for both known and unknown long-term toxic effects. Drug and administration costs limit treatment in resource-poor regions, and are a growing concern even in resource rich settings. Finally, complete or near complete control of viral replication does not fully restore health. Long-term treated patients who are on an otherwise effective regimen often show persistent immune dysfunction and have higher than expected risk for various non-AIDS-related complications, including heart, bone, liver, kidney, and neurocognitive diseases. C1 [Volberding, Paul A.] Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Dept Med, San Francisco, CA 94121 USA. RP Volberding, PA (reprint author), Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Dept Med, 4150 Clement St, San Francisco, CA 94121 USA. EM paul.volberding@va.gov FU UCSF-Gladstone Institute of Virology and Immunology Centers for AIDS Research [PO AI027763]; NIH [AI087145, AI069994] FX This work was supported in part by the UCSF-Gladstone Institute of Virology and Immunology Centers for AIDS Research (PO AI027763) (PAV, SGD). Additional support was provided by the NIH (AI087145, AI069994) (SGD). We thank Warner Greene for permission to use figure 1, John C W Carroll for assistance with graphic design, and Pam Derish for copy editing assistance. NR 146 TC 173 Z9 174 U1 0 U2 11 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0140-6736 J9 LANCET JI Lancet PD JUL 3 PY 2010 VL 376 IS 9734 BP 49 EP 62 DI 10.1016/S0140-6736(10)60676-9 PG 14 WC Medicine, General & Internal SC General & Internal Medicine GA 624SR UT WOS:000279841600024 PM 20609987 ER PT J AU Vest, RS O'Leary, H Coultrap, SJ Kindy, MS Bayer, KU AF Vest, Rebekah S. O'Leary, Heather Coultrap, Steven J. Kindy, Mark S. Bayer, K. Ulrich TI Effective Post-insult Neuroprotection by a Novel Ca2+/Calmodulin-dependent Protein Kinase II (CaMKII) Inhibitor SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID D-ASPARTATE RECEPTOR; INDUCED CELL-DEATH; TISSUE-PLASMINOGEN ACTIVATOR; ISCHEMIC BRAIN-DAMAGE; NMDA RECEPTOR; GLUTAMATE NEUROTOXICITY; HIPPOCAMPAL-NEURONS; CEREBRAL-ISCHEMIA; SELF-ASSOCIATION; GLUCOSE DEPRIVATION AB Ca2+/calmodulin (CaM)-dependent protein kinase II (CaMKII) is a major mediator of physiological glutamate signaling involved in higher brain functions. Here, we show CaMKII involvement in pathological glutamate signaling relevant in stroke. The novel inhibitor tatCN21 was neuroprotective even when added hours after glutamate insults. By contrast, the "traditional" inhibitor KN93 attenuated excitotoxicity only when present during the insult. Both inhibitors efficiently blocked Ca2+/CaM-stimulated CaMKII activity, CaMKII interaction with NR2B and aggregation of CaMKII holoenzymes. However, only tatCN21 but not KN93 blocked the Ca2+-independent "autonomous" activity generated by Thr-286 autophosphorylation, the hallmark feature of CaMKII regulation. Mutational analysis further validated autonomous CaMKII activity as the drug target crucial for post-insult neuroprotection. Overexpression of CaMKII wild type but not the autonomy-deficient T286A mutant significantly increased glutamate-induced neuronal death. Maybe most importantly, tatCN21 also significantly reduced infarct size in a mouse stroke model (middle cerebral arterial occlusion) when injected (1 mg/kg intravenously) 1 h after onset of arterial occlusion. Together, these data demonstrate that inhibition of autonomous CaMKII activity provides a promising therapeutic avenue for post-insult neuro-protection after stroke. C1 Univ Colorado, Denver Sch Med, Dept Pharmacol, Aurora, CO 80045 USA. [Kindy, Mark S.] Med Univ S Carolina, Dept Neurosci, Charleston, SC 29425 USA. [Kindy, Mark S.] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. EM ulli.bayer@ucdenver.edu FU National Institutes of Health [P30NS048154, F31NS061584, T32GM007635]; Veterans Affairs Merit Review; State of Colorado TTO BDEGP; University of Colorado, Denver [P20RR017677-08, R01NS052644] FX This work was supported, in whole or in part, by National Institutes of Health Grants P30NS048154 (University of Colorado, Denver, center grant), P20RR017677-08, and R01NS052644 (to K. U. B.). This work was also supported by Veterans Affairs Merit Review (to M. S. K.) and State of Colorado TTO BDEGP. The University of Colorado is currently seeking patent protection for tatCN21 and its uses.; Supported by National Institutes of Health Training Grant F31NS061584.; Supported by National Institutes of Health Training Grant T32GM007635. NR 72 TC 45 Z9 45 U1 0 U2 4 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 JUL 2 PY 2010 VL 285 IS 27 BP 20675 EP 20682 DI 10.1074/jbc.M109.088617 PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 616SH UT WOS:000279228600031 PM 20424167 ER PT J AU Pastor, R Kamens, HM McKinnon, CS Ford, MM Phillips, TJ AF Pastor, Raul Kamens, Helen M. McKinnon, Carrie S. Ford, Matthew M. Phillips, Tamara J. TI Repeated ethanol administration modifies the temporal structure of sucrose intake patterns in mice: effects associated with behavioral sensitization SO ADDICTION BIOLOGY LA English DT Article DE Addiction; alcohol; behavioral sensitization; GABA(B) receptor; motivation; sucrose ID CROSS-SENSITIZATION; NUCLEUS-ACCUMBENS; INCENTIVE-SENSITIZATION; DOPAMINE TRANSMISSION; EATING-DISORDERS; SACCHARIN INTAKE; D-AMPHETAMINE; ANIMAL-MODEL; COCAINE; ADDICTION AB Neuroadaptations supporting behavioral sensitization to abused drugs are suggested to underlie pathological, excessive motivation toward drugs and drug-associated stimuli. Drug-induced sensitization has also been linked to increased appetitive responses for non-drug, natural reinforcers. The present research investigated whether ethanol (EtOH)-induced neural changes, inferred from psychomotor sensitization, can modify consumption and intake dynamics for the natural reinforcer, sucrose. The effects of EtOH-induced sensitization in mice on the temporal structure of sucrose intake patterns were measured using a lickometer system. After sensitization, sucrose intake dynamics were measured for 1 hour daily for 7 days and indicated more rapid initial approach and consumption of sucrose in EtOH-sensitized groups; animals showed a shorter latency to the first intake bout and an increased number of sucrose bottle licks during the initial 15 minutes of the 1-hour sessions. This effect was associated with increased frequency and size of bouts. For the total 1-hour session, sucrose intake and bout dynamics were not different between groups, indicating a change in patterns of sucrose intake but not total consumption. When sensitization was prevented by the gamma-aminobutyric acid B receptor agonist, baclofen, the increased rate of approach and consumption of sucrose were also prevented. Thus, EtOH-induced sensitization, and not the mere exposure to EtOH, was associated with changes in sucrose intake patterns. These data are consistent with current literature suggesting an enhancing effect of drug-induced sensitization on motivational processes involved in reinforcement. C1 [Pastor, Raul] Univ Jaume 1, Area Psicobiol, Castellon de La Plana 12071, Spain. [Pastor, Raul; Kamens, Helen M.; McKinnon, Carrie S.; Ford, Matthew M.; Phillips, Tamara J.] Oregon Hlth & Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. [Pastor, Raul; Kamens, Helen M.; McKinnon, Carrie S.; Ford, Matthew M.; Phillips, Tamara J.] Portland Alcohol Res Ctr, Portland, OR USA. [Phillips, Tamara J.] Portland VA Med Ctr, Res Serv, Portland, OR USA. RP Pastor, R (reprint author), Univ Jaume 1, Area Psicobiol, Ave Sos Baynat S-N, Castellon de La Plana 12071, Spain. EM raul.pastor@uji.es OI Kamens, Helen/0000-0001-5085-8847; Ford, Matthew/0000-0002-1204-1980 FU Department of Veterans Affairs; NIH/NIAAA [P60 AA010760] FX This study is supported by a grant from the Department of Veterans Affairs and by NIH/NIAAA grant P60 AA010760. We thank Dr. Sarah E. Holstein, Na Li and Sue Burkhart-Kasch for their technical assistance, and Dr. Amanda L. Sharpe for assistance with the lickometer apparatus. NR 64 TC 10 Z9 10 U1 0 U2 2 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1355-6215 J9 ADDICT BIOL JI Addict. Biol. PD JUL PY 2010 VL 15 IS 3 BP 324 EP 335 DI 10.1111/j.1369-1600.2010.00229.x PG 12 WC Biochemistry & Molecular Biology; Substance Abuse SC Biochemistry & Molecular Biology; Substance Abuse GA 606AX UT WOS:000278393800009 PM 20624153 ER PT J AU Weinstein, JR Anderson, S AF Weinstein, Jessica R. Anderson, Sharon TI The Aging Kidney: Physiological Changes SO ADVANCES IN CHRONIC KIDNEY DISEASE LA English DT Article DE Aging; Glomerular filtration rate; Renin-angiotensin system; Nitric oxide; Gender ID RENIN-ANGIOTENSIN SYSTEM; NITRIC-OXIDE SYNTHASE; RENAL-DISEASE; GLOMERULAR HYPERTENSION; VASCULAR-DISEASE; AGE; RAT; INJURY; HUMANS; RISK AB Age-associated loss of kidney function has been recognized for decades. With aging, many subjects exhibit progressive decreases in glomerular filtration rate and renal blood flow, with wide variability among individuals. The fall in glomerular filtration rate is because of reductions in the glomerular capillary plasma flow rate and the glomerular capillary ultrafiltration coefficient. In addition, a primary reduction in afferent arteriolar resistance is associated with an increase in glomerular capillary hydraulic pressure. These hemodynamic changes occur in concert with structural changes, including loss of renal mass; hyalinization of afferent arterioles and in some cases, development of aglomerular arterioles; an increase in the percentage of sclerotic glomeruli; and tubulointerstitial fibrosis. Aging is associated with altered activity and responsiveness to vasoactive stimuli, such that responses to vasoconstrictor stimuli are enhanced, whereas vasodilatory responses are impaired. Changes in the activity of the renin-angiotensin and nitric oxide systems appear to be particularly important, as is the modulating effect of gender. These changes may predispose the older kidney to acute kidney injury, including normotensive ischemic nephropathy, as well as progressive chronic kidney disease. (C) 2010 by the National Kidney Foundation, Inc. All rights reserved. C1 [Anderson, Sharon] Oregon Hlth & Sci Univ, Div Nephrol & Hypertens, Portland, OR 97239 USA. Portland VA Med Ctr, Med Serv, Portland, OR USA. RP Anderson, S (reprint author), Oregon Hlth & Sci Univ, Div Nephrol & Hypertens, OHSU Nephrol PP 262,3314 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM anderssh@ohsu.edu FU NTH [AG 14699]; AHRQ [HS 017582] FX This work was supported, in part, by a grant from the NTH (AG 14699), and by a training grant from the AHRQ (to J.W., HS 017582). NR 61 TC 84 Z9 89 U1 3 U2 13 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1548-5595 J9 ADV CHRONIC KIDNEY D JI Adv. Chronic Kidney Dis. PD JUL PY 2010 VL 17 IS 4 BP 302 EP 307 DI 10.1053/j.ackd.2010.05.002 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 624GD UT WOS:000279804000004 PM 20610357 ER PT J AU Fischer, MJ O'Hare, AM AF Fischer, Michael J. O'Hare, Ann M. TI Epidemiology of Hypertension in the Elderly With Chronic Kidney Disease SO ADVANCES IN CHRONIC KIDNEY DISEASE LA English DT Article DE Geriatrics; Blood pressure; Aged; Chronic kidney failure ID BLOOD-PRESSURE CONTROL; NUTRITION EXAMINATION SURVEY; EVALUATION PROGRAM KEEP; 3RD NATIONAL-HEALTH; STAGE RENAL-DISEASE; UNITED-STATES; SYSTOLIC HYPERTENSION; PREVALENCE; MANAGEMENT; RISK AB As the population of the United States ages, the prevalence of age-related chronic conditions such as hypertension and chronic kidney disease (CKD) will also increase. Available studies in nationally representative samples and select outpatient populations indicate that hypertension is very common in older adults with CKD, and despite the use of medication it is often poorly controlled. Generally, less than one-third of the elderly patients with CKD achieve a level of blood pressure control consistent with that of the current guideline recommendations. However, limited evidence is available from observational studies and clinical trials to inform management of hypertension in the elderly population with CKD. The available published data suggest that the relationship between clinical outcomes and the treatment of hypertension among older adults with CKD is complex and distinct from that of their younger counterparts. Larger and more robust analyses are needed for a better understanding of the association between hypertension, its treatment, and clinical events in elderly patients with CKD. Published by Elsevier Inc. on behalf of the National Kidney Foundation. C1 Univ Illinois, Med Ctr, Jesse Brown VA Med Ctr, Chicago, IL USA. Edward Hines Jr VA Hosp, Ctr Management Complex Chron Care, Hines, IL 60141 USA. Univ Washington, VA Puget Sound Healthcare Syst, Seattle, WA 98195 USA. RP Fischer, MJ (reprint author), Hines VA Hosp, Ctr Management Complex Chron Care, 5000 S 5th Ave 151H, Hines, IL 60141 USA. EM fischerm@uic.edu FU Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service; National Institutes of Health [K23AG28980] FX Support and Financial Disclosure Declaration: The authors received funding support for this research project from: Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (VA HSR&D Career Development Award-M. Fischer) and the National Institutes of Health (K23AG28980-A. O'Hare). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or Health Services Research and Development Service. NR 55 TC 8 Z9 8 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 1548-5595 J9 ADV CHRONIC KIDNEY D JI Adv. Chronic Kidney Dis. PD JUL PY 2010 VL 17 IS 4 BP 329 EP 340 DI 10.1053/j.ackd.2010.05.003 PG 12 WC Urology & Nephrology SC Urology & Nephrology GA 624GD UT WOS:000279804000007 PM 20610360 ER PT J AU Pinkerton, SD Bogart, LM Howerton, D Snyder, S Becker, K Asch, SM AF Pinkerton, Steven D. Bogart, Laura M. Howerton, Devery Snyder, Susan Becker, Kirsten Asch, Steven M. TI Cost of Rapid HIV Testing at 45 US Hospitals SO AIDS PATIENT CARE AND STDS LA English DT Article ID UNITED-STATES; EMERGENCY; SETTINGS AB In 2006, the United States Centers for Disease Control and Prevention (CDC) recommended expanded and routine use of single-session rapid HIV tests in all health care settings to increase the proportion of persons who learn their HIV status. Limited empiric information is available regarding the costs of rapid testing and pre- and posttest counseling in health care settings. We surveyed 45 U. S. hospitals during 2005 through 2006 to assess the costs associated with rapid testing and counseling. Cost analyses were conducted from the provider (hospital) perspective, and results were expressed in year 2006 U. S. dollars. The mean per-test cost of rapid HIV testing and counseling was $48.07 for an HIV-negative test and $64.17 for a preliminary-positive test. Pre- and posttest counseling costs accounted for 38.4% of the total cost of rapid testing for HIV-negative patients. Counseling costs were significantly correlated with overall test costs. Many hospitals contained overall test costs by limiting time spent in pre- and posttest counseling or by using lower-paid personnel for counseling activities or both. Counseling costs constituted a significant proportion of the overall costs of rapid testing and counseling activities at study hospitals. Our data provide useful baseline data before implementation of the CDC's 2006 recommendations. Costs can be reduced by limiting time spent in pre- and posttest counseling or by using lower-paid personnel for counseling activities or both. C1 [Pinkerton, Steven D.] Med Coll Wisconsin, Dept Psychiat & Behav Med, Ctr AIDS Intervent Res, Milwaukee, WI 53202 USA. [Bogart, Laura M.; Becker, Kirsten; Asch, Steven M.] RAND Corp, Hlth Program, Santa Monica, CA USA. [Bogart, Laura M.] Harvard Univ, Sch Med, Childrens Hosp Boston, Boston, MA USA. [Howerton, Devery] Ctr Dis Control & Prevent, Lab Practice Evaluat, Div Lab Syst, Atlanta, GA USA. [Howerton, Devery] Ctr Dis Control & Prevent, Genom Branch, Div Lab Syst, Atlanta, GA USA. [Snyder, Susan; Asch, Steven M.] VA Greater Los Angeles Healthcare Network, Los Angeles, CA USA. [Asch, Steven M.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Pinkerton, SD (reprint author), Med Coll Wisconsin, Dept Psychiat & Behav Med, Ctr AIDS Intervent Res, 2071 N Summit Ave, Milwaukee, WI 53202 USA. EM pinkrton@mcw.edu FU Centers for Disease Control and Prevention (CDC) [U65/CCU924523-01]; National Institute of Mental Health (NIMH) [P30-MH52776] FX This study was supported by grants U65/CCU924523-01 from the Centers for Disease Control and Prevention (CDC) and P30-MH52776 from the National Institute of Mental Health (NIMH). The findings and conclusions presented here are those of the authors and do not necessarily represent the views of the CDC or NIH. NR 10 TC 9 Z9 9 U1 0 U2 2 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1087-2914 J9 AIDS PATIENT CARE ST JI Aids Patient Care STDS PD JUL PY 2010 VL 24 IS 7 BP 409 EP 413 DI 10.1089/apc.2009.0348 PG 5 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 629UF UT WOS:000280224500002 PM 20578906 ER PT J AU Saha, S Jacobs, EA Moore, RD Beach, MC AF Saha, Somnath Jacobs, Elizabeth A. Moore, Richard D. Beach, Mary Catherine TI Trust in Physicians and Racial Disparities in HIV Care SO AIDS PATIENT CARE AND STDS LA English DT Article ID ACTIVE ANTIRETROVIRAL THERAPY; AFRICAN-AMERICANS; CONSPIRACY BELIEFS; MEDICATION ADHERENCE; INFECTED PATIENTS; EQUAL ACCESS; HEALTH-CARE; RACE/ETHNICITY; INSTRUMENTS; GOVERNMENT AB Mistrust among African Americans is often considered a potential source of racial disparities in HIV care. We sought to determine whether greater trust in one's provider among African-American patients mitigates racial disparities. We analyzed data from 1,104 African-American and 201 white patients participating in a cohort study at an urban, academic HIV clinic between 2005 and 2008. African Americans expressed lower levels of trust in their providers than did white patients (8.9 vs. 9.4 on a 0-10 scale; p<0.001). African Americans were also less likely than whites to be receiving antiretroviral therapy (ART) when eligible (85% vs. 92%; p = 0.02), to report complete ART adherence over the prior 3 days (83% vs. 89%; p = 0.005), and to have a suppressed viral load (40% vs. 47%; p = 0.04). Trust in one's provider was not associated with receiving ART or with viral suppression but was significantly associated with adherence. African Americans who expressed less than complete trust in their providers (0-9 of 10) had lower ART adherence than did whites (adjusted OR, 0.40; 95% CI, 0.25-0.66). For African Americans who expressed complete trust in their providers (10 of 10), the racial disparity in adherence was less prominent but still substantial (adjusted OR, 0.59; 95% CI, 0.36-0.95). Trust did not affect disparities in receipt of ART or viral suppression. Our findings suggest that enhancing trust in patient-provider relationships for African-American patients may help reduce disparities in ART adherence and the outcomes associated with improved adherence. C1 [Saha, Somnath] Oregon Hlth & Sci Univ, Div Gen Internal Med & Geriatr, Gen Internal Med Sect, Portland VA Med Ctr, Portland, OR 97239 USA. [Jacobs, Elizabeth A.] John H Stroger Jr Hosp Cook Cty, Div Gen Internal Med, Chicago, IL USA. [Jacobs, Elizabeth A.] Rush Univ, Med Ctr, Chicago, IL 60612 USA. [Moore, Richard D.; Beach, Mary Catherine] Johns Hopkins Univ, Dept Med, Baltimore, MD USA. RP Saha, S (reprint author), Oregon Hlth & Sci Univ, Div Gen Internal Med & Geriatr, Gen Internal Med Sect, Portland VA Med Ctr, 3710 SW US Vet Hosp Rd P3HSRD, Portland, OR 97239 USA. EM sahas@ohsu.edu FU NIMH NIH HHS [R34 MH089279] NR 32 TC 40 Z9 40 U1 3 U2 10 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1087-2914 J9 AIDS PATIENT CARE ST JI Aids Patient Care STDS PD JUL PY 2010 VL 24 IS 7 BP 415 EP 420 DI 10.1089/apc.2009.0288 PG 6 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 629UF UT WOS:000280224500003 PM 20578909 ER PT J AU Haber, MM Hunt, B Freston, JW Peura, DA Kovacs, TO Atkinson, S Hisada, M AF Haber, M. M. Hunt, B. Freston, J. W. Peura, D. A. Kovacs, T. O. Atkinson, S. Hisada, M. TI Changes of gastric histology in patients with erosive oesophagitis receiving long-term lansoprazole maintenance therapy SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID GASTROESOPHAGEAL-REFLUX DISEASE; HELICOBACTER-PYLORI INFECTION; PROTON-PUMP INHIBITORS; 20 MG; INTESTINAL METAPLASIA; DOSE LANSOPRAZOLE; CONTROLLED TRIAL; DOUBLE-BLIND; OMEPRAZOLE; SAFETY AB Background Changes in gastric histology associated with long-term maintenance therapy with lansoprazole for erosive oesophagitis have not been well described. Aim To evaluate the effect on gastric histology of long-term dose-titrated lansoprazole administered as maintenance therapy for up to 82 months in patients with erosive oesophagitis. Methods Sequential gastric biopsy specimens were obtained for evaluation of histological changes and Helicobacter pylori infection status. Results Active and chronic inflammation improved from baseline to final visit in a majority of patients receiving long-term therapy with lansoprazole, irrespective of baseline H. pylori infection status. Reductions in active inflammation in the gastric body and antrum were seen in 53% (17/32) and 67% (20/30) of H. pylori-positive patients, respectively, and in 88% (7/8) and 86% (12/14) of H. pylori-negative patients, respectively. Reductions in chronic inflammation in the gastric body and antrum were seen in 38% (12/32) and 47% (15/32) of H. pylori-positive patients, respectively, and in 58% (70/121) and 57% (68/120) of H. pylori-negative patients, respectively. No clinically meaningful increases in hyperplasia, dysplasia, neoplasia, intestinal metaplasia or atrophy were observed during the follow-up period. Conclusions Lansoprazole administered as maintenance therapy for up to 6 years in patients with erosive oesophagitis demonstrated gastric mucosal safety and was well tolerated. Aliment Pharmacol Ther 2010; 32: 83-96 C1 [Hunt, B.; Atkinson, S.; Hisada, M.] Takeda Global Res & Dev Ctr Inc, Deerfield, IL 60015 USA. [Haber, M. M.] Drexel Univ, Coll Med, Dept Pathol, Philadelphia, PA 19104 USA. [Freston, J. W.] Univ Connecticut, Ctr Hlth, Dept Med, Farmington, CT USA. [Peura, D. A.] Univ Virginia Hlth Syst, Div Gastroenterol & Hepatol, Charlottesville, VA USA. [Kovacs, T. O.] CURE Clin, VA Greater Healthcare Syst, Los Angeles, CA USA. RP Hisada, M (reprint author), Takeda Global Res & Dev Ctr Inc, 1 Takeda Pkwy, Deerfield, IL 60015 USA. EM michie.hisada@tgrd.com FU TGRD [M94-140]; Takeda Pharmaceuticals North America, Inc FX Declaration of personal interests: Dr Haber has served as a consultant for Takeda Global Research & Development Center, Inc. (TGRD), Deerfield, IL, USA [TAP Pharmaceutical Products Inc., is now a part of TGRD]. Dr Peura has served as a consultant for Takeda Global Research & Development Center, Inc. and as a member of the speaker's bureau for Takeda Pharmaceuticals North America, Inc. Dr Freston has served as a consultant for Takeda Global Research & Development Center, Inc, AstraZeneca, Takeda Pharmaceuticals North America, Inc., Glaxo-SmithKline, and EnteroMedics Inc. Dr Kovacs confirms that he has no conflicts of interest or disclosures. Dr Hisada, Ms. Hunt, and Dr Atkinson are employees of Takeda Global Research & Development Center, Inc. Declaration of funding interests: This study (M94-140) was funded in full by TGRD. Writing support was provided by Gill Gummer and Rx Communications (UK), and funded by Takeda Pharmaceuticals North America, Inc. The authors would like to thank the M94-140 investigators for participating in the study. Regrettably, Dr Haber passed away on Oct 4 after having overseen completion of this manuscript. NR 33 TC 6 Z9 6 U1 1 U2 2 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0269-2813 J9 ALIMENT PHARM THER JI Aliment. Pharmacol. Ther. PD JUL 1 PY 2010 VL 32 IS 1 BP 83 EP 96 DI 10.1111/j.1365-2036.2010.04310.x PG 14 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 606AY UT WOS:000278393900010 PM 20345509 ER PT J AU Amirzadeh, A Verma, P Lee, S Klaustermeyer, W AF Amirzadeh, Ali Verma, Prashant Lee, Sabrina Klaustermeyer, William TI Epinephrine auto-injector use and demographics in a Veterans Administration population SO ALLERGY AND ASTHMA PROCEEDINGS LA English DT Article; Proceedings Paper CT 66th Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology CY FEB 26-MAR 02, 2010 CL New Orleans, LA SP Amer Acad Allergy, Asthma & Immunol DE Anaphylaxis; demographics; epinephrine; EpiPen; quality control; twinject; use; veteran ID ANAPHYLAXIS AB The epinephrine auto-injector has been widely used over a long period of time. Certain aspects of this therapy and demographic data, however, have not been well studied. This study investigates patient use and understanding of epinephrine auto-injector use. As part of an ongoing quality assurance program, we evaluated 66 patients who had been given an epinephrine auto-injector and followed in the Allergy and Immunology Clinics at the West Los Angeles Veterans Medical Center. Data analyzed included patient demographics, medical indications for epinephrine auto-injector prescriptions, and the patient's understanding and use of the device. The mean age of our patients was 50 years. There were 44 men (66.7%) and 22 women (33%). Twenty-three patients were prescribed epinephrine auto-injector for adverse food reactions. Ninety-two percent (92%) of the patients knew how to use their epinephrine auto-injector properly, however, only 58% carried their device with them consistently. Of the patients, 91% understood why the auto-injector was prescribed. Of the total patients prescribed epinephrine auto-injector, 79% refilled their medication before the 1 year expiratidn date. Only 12% of the patients studied had required the use of their auto-injector. Most patients knew how and when to administer their epinephrine auto-injector. Despite detailed instructions in a specialty clinic only a slight majority carried it consistently. These data clearly indicate that further patient education or other measures are needed to improve compliance and effective use. (Allergy Asthma Proc 31:304-307, 2010; doi: 10.2500/aap.2010.31.3351) C1 [Amirzadeh, Ali; Verma, Prashant; Lee, Sabrina; Klaustermeyer, William] Univ Calif Los Angeles, Dept Med, Div Allergy & Immunol, Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Amirzadeh, A (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Dept Allergy & Immunol IIIR, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM aliamirzadeh@gmail.com NR 9 TC 3 Z9 3 U1 0 U2 0 PU OCEAN SIDE PUBLICATIONS INC PI PROVIDENCE PA 95 PITMAN ST, PROVIDENCE, RI 02906 USA SN 1088-5412 J9 ALLERGY ASTHMA PROC JI Allergy Asthma Proc. PD JUL-AUG PY 2010 VL 31 IS 4 BP 304 EP 307 DI 10.2500/aap.2010.31.3351 PG 4 WC Allergy SC Allergy GA 648KL UT WOS:000281692400006 PM 20819320 ER PT J AU Sano, M Egelko, S Ferris, S Kaye, J Hayes, TL Mundt, JC Donohue, M Walter, S Sun, S Sauceda-Cerda, L AF Sano, Mary Egelko, Susan Ferris, Steven Kaye, Jeffrey Hayes, Tamara L. Mundt, James C. Donohue, Michael Walter, Sarah Sun, Shelly Sauceda-Cerda, Luis TI Pilot Study to Show the Feasibility of a Multicenter Trial of Home-based Assessment of People Over 75 Years Old SO ALZHEIMER DISEASE & ASSOCIATED DISORDERS LA English DT Article DE alzheimer disease; prevention trials; home-based assessment ID PREVENTION INSTRUMENT PROJECT; MILD COGNITIVE IMPAIRMENT; CLINICAL-TRIALS; NEUROPSYCHOLOGICAL ASSESSMENT; ALZHEIMER-DISEASE; DEPRESSION; INVENTORY; DEMENTIA; SCALE AB This report describes a pilot study to evaluate feasibility of new home-based assessment technologies applicable to clinical trials for prevention of cognitive loss and Alzheimer disease. Methods: Community-dwelling nondemented individuals >= 75 years old were recruited and randomized to 1 of 3 assessment methodologies: (1) mail-in questionnaire/ live telephone interviews (MIP); (2) automated telephone with interactive voice recognition (IVR); and (3) internet-based computer Kiosk (KIO). Brief versions of cognitive and noncognitive outcomes were adapted to the different methodologies and administered at baseline and 1-month. An Efficiency measure, consisting of direct staff-to-participant time required to complete assessments, was also compared across arms. Results: Forty-eight out of 60 screened participants were randomized. The dropout rate across arms from randomization through 1-month was different: 33% for KIO, 25% for IVR, and 0% for MIP (Fisher Exact Test P = 0.04). Nearly all participants who completed baseline also completed 1-month assessment (38 out of 39). The 1-way ANOVA across arms for total staff-to-participant direct contact time (ie, training, baseline, and 1-month) was significant: F (2,33) = 4.588; P = 0.017, with lowest overall direct time in minutes for IVR (Mn - 44.4; SD = 21.5), followed by MIP (Mn = 74.9; SD = 29.9), followed by KIO (Mn = 129.4; SD = 117.0). Conclusions: In this sample of older individuals, a higher dropout rate occurred in those assigned to the high-technology assessment techniques; however, once participants had completed baseline in all 3 arms, they continued participation through 1 month. High-technology home-based assessment methods, which do not require live testers, began to emerge as more time-efficient over the brief time of this pilot, despite initial time-intensive participant training. C1 [Sano, Mary; Egelko, Susan] Mt Sinai Sch Med, New York, NY 10029 USA. [Ferris, Steven] NYU, Sch Med, New York, NY USA. [Sano, Mary; Egelko, Susan] James J Peters VAMC, Bronx, NY USA. [Ferris, Steven] Nathan S Kline Inst Psychiat Res, Orangeburg, NY USA. [Kaye, Jeffrey; Hayes, Tamara L.; Sauceda-Cerda, Luis] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Mundt, James C.] Healthcare Technol Syst, Madison, WI USA. [Donohue, Michael; Walter, Sarah; Sun, Shelly] UCSD, La Jolla, CA USA. RP Sano, M (reprint author), Mt Sinai Sch Med, New York, NY 10029 USA. EM mary.sano@mssm.edu OI Ferris, Steven/0000-0001-8641-6223; Kaye, Jeffrey/0000-0002-9971-3478 FU NIA [U01AG10483, P50AG005138, P30AG008051, P30AG024978, P30-AG024978, P30-AG08017]; Intel Corporation FX Supported by these NIA grants: U01AG10483, P50AG005138, P30AG008051, and P30AG024978. Development of the Kiosk and MedTracker was supported in part by grants from NIA (P30-AG024978; P30-AG08017) and Intel Corporation. NR 26 TC 4 Z9 4 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0893-0341 J9 ALZ DIS ASSOC DIS JI Alzheimer Dis. Assoc. Dis. PD JUL-SEP PY 2010 VL 24 IS 3 BP 256 EP 263 DI 10.1097/WAD.0b013e3181d7109f PG 8 WC Clinical Neurology; Pathology SC Neurosciences & Neurology; Pathology GA 643PJ UT WOS:000281310200007 PM 20592583 ER PT J AU Spatz, ES Ross, JS Desai, MM Canavan, ME Krumholz, HM AF Spatz, Erica S. Ross, Joseph S. Desai, Mayur M. Canavan, Maureen E. Krumholz, Harlan M. TI Beyond insurance coverage: Usual source of care in the treatment of hypertension and hypercholesterolemia. Data from the 2003-2006 National Health and Nutrition Examination Survey SO AMERICAN HEART JOURNAL LA English DT Article ID IMPROVING PRIMARY-CARE; CHRONIC ILLNESS; UNITED-STATES; CARDIOVASCULAR-DISEASE; CHOLESTEROL TREATMENT; US ADULTS; SERVICES; ACCESS; RISK; OUTCOMES AB Background Expanding insurance coverage, while necessary, may not be sufficient to ensure high-quality care for adults with cardiovascular disease. We sought to examine the association between having a usual source of care (USOC) and receiving medication treatment of hypertension and hypercholesterolemia. Methods Using the 2003-2006 National Health and Nutrition Examination Survey, we categorized USOC (a place to go when sick or need medical advice) and insurance status in adults >= 35 years old with an indication for medication treatment of hypertension (n = 3,142) and hypercholesterolemia (n = 1,134), determined using the Joint National Committee 7 and Adult Treatment Panel III recommendations, respectively. Multivariable logistic regression modeling was used to determine the independent effect of USOC on receiving treatment of hypertension and hypercholesterolemia, controlling for age, sex, race/ethnicity, insurance status, and comorbidities. Separate multivariable models were examined stratified by insurance status. Results Among subjects with an indication for treatment of hypertension and hypercholesterolemia, 32.4% and 42.0% were untreated, respectively. When compared with adults with a USOC, adults without a USOC were more likely to be untreated for hypertension (adjusted prevalence ratio [aPR] 2.43, 95% CI 1.88-2.85) and hypercholesterolemia (aPR 1.79, 95% CI 1.31-2.13). In stratified analyses among subjects with insurance, no USOC remained associated with being untreated (hypertension, aPR 2.58, 95% CI 1.88-3.08; hypercholesterolemia, aPR 1.65, 95% CI 0.97-2.18). Conclusions Absence of a USOC was associated with being untreated for hypertension and hypercholesterolemia, even among individuals with insurance, suggesting that efforts to improve chronic disease management should also facilitate access to a regular source of care. (Am Heart J 2010; 160: 115-21.) C1 [Spatz, Erica S.; Krumholz, Harlan M.] Yale Univ, Sch Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT 06520 USA. [Ross, Joseph S.] Mt Sinai Sch Med, Dept Geriatr & Palliat Med, New York, NY USA. [Ross, Joseph S.] James J Peters VA Med Ctr, HSR&D Res Enhancement Award Program, Bronx, NY USA. [Ross, Joseph S.] James J Peters VA Med Ctr, Geriatr Res Educ & Clin Ctr, Bronx, NY USA. [Desai, Mayur M.; Canavan, Maureen E.] Yale Univ, Sch Publ Hlth, Div Chron Dis Epidemiol, New Haven, CT 06520 USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Med, Sect Cardiolovasc Med, New Haven, CT 06520 USA. [Krumholz, Harlan M.] Yale Univ, Sch Epidemiol & Publ Hlth, Sect Hlth Policy & Adm, New Haven, CT 06520 USA. [Krumholz, Harlan M.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. RP Spatz, ES (reprint author), Yale Univ, Sch Med, Robert Wood Johnson Clin Scholars Program, 333 Cedar St,SHM IE 61, New Haven, CT 06520 USA. EM erica.spatz@yale.edu FU NIA NIH HHS [K08 AG032886-02, K08 AG032886] NR 41 TC 14 Z9 14 U1 0 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 JUL PY 2010 VL 160 IS 1 BP 115 EP 121 DI 10.1016/j.ahj.2010.04.013 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 619OV UT WOS:000279440400018 PM 20598981 ER PT J AU Donohue, JM Zhang, YT Lave, JR Gellad, WF Men, A Perera, S Hanlon, JT AF Donohue, Julie M. Zhang, Yuting Lave, Judith R. Gellad, Walid F. Men, Aiju Perera, Subashan Hanlon, Joseph T. TI The Medicare drug benefit (Part D) and treatment of heart failure in older adults SO AMERICAN HEART JOURNAL LA English DT Article ID RANDOMIZED-TRIAL; ELDERLY-PATIENTS; BETA-BLOCKERS; ADHERENCE; THERAPY; NONADHERENCE; MORTALITY; OUTCOMES; COST AB Background Adherence to pharmacotherapy for heart failure is poor among older adults in part because of high prescription drug costs. We examined the impact of improvements in drug coverage under Medicare Part D on utilization of, and adherence to, medications for heart failure in older adults. Methods We used a quasi-experimental approach to analyze pharmacy claims for 6,950 individuals aged >= 65 years with heart failure enrolled in a Medicare managed care organization 2 years before and after Part D's implementation. We compared prescription fill patterns among individuals who moved from limited (quarterly benefits caps of $150 or $350) or no drug coverage to Part D in 2006 with those who had generous employer-sponsored coverage throughout the study period. Results Individuals who previously lacked drug coverage filled approximately 6 more heart failure prescriptions annually after Part D (adjusted ratio of prescription counts = 1.36, 95% CI 1.29-1.44, P < .0001 relative to the comparison group). Those previously lacking drug coverage were more likely to fill prescriptions for an angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker plus a beta-blocker after Part D (adjusted ratio of odds ratios = 1.73, 95% CI 1.42-2.10, P < .0001) and more likely to be adherent to such pharmacotherapy (adjusted ratio of odds ratios = 2.95, 95% CI 1.85-4.69, P < .0001) relative to the comparison group. Conclusions Medicare Part D was associated with improved access to medications and adherence to pharmacotherapy in older adults with heart failure. (Am Heart J 2010; 160: 159-65.) C1 [Donohue, Julie M.; Zhang, Yuting; Lave, Judith R.; Men, Aiju] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Hlth Policy & Management, Pittsburgh, PA 15261 USA. [Gellad, Walid F.] Univ Pittsburgh, Dept Med Gen Internal Med, Pittsburgh, PA 15261 USA. [Gellad, Walid F.; Hanlon, Joseph T.] Pittsburgh Vet Affairs Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Gellad, Walid F.] RAND Corp, Pittsburgh, PA USA. [Perera, Subashan] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Pittsburgh, PA 15261 USA. [Perera, Subashan; Hanlon, Joseph T.] Univ Pittsburgh, Dept Geriatr Med, Pittsburgh, PA 15261 USA. [Hanlon, Joseph T.] Univ Pittsburgh, Sch Pharm, Dept Pharm, Pittsburgh, PA 15261 USA. [Hanlon, Joseph T.] Univ Pittsburgh, Sch Pharm, Dept Therapeut, Pittsburgh, PA 15261 USA. [Hanlon, Joseph T.] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15261 USA. [Hanlon, Joseph T.] Univ Pittsburgh, Clin & Translat Sci Inst, Pittsburgh, PA 15261 USA. [Hanlon, Joseph T.] Vet Affairs Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Donohue, JM (reprint author), Univ Pittsburgh, Grad Sch Publ Hlth, Dept Hlth Policy & Management, 130 DeSoto St,Crabtree Hall A613, Pittsburgh, PA 15261 USA. EM jdonohue@pitt.edu RI Max, Mad/E-5238-2010; Perera, Subashan/D-7603-2014 OI Max, Mad/0000-0001-6966-6829; Donohue, Julie/0000-0003-2418-6017; Zhang, Yuting/0000-0002-6460-6779 FU NCATS NIH HHS [KL2 TR000146]; NCRR NIH HHS [05 KL2 RR024154-04, KL2 RR024154, KL2 RR024154-04]; NIA NIH HHS [P30 AG024827] NR 28 TC 19 Z9 19 U1 1 U2 4 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 JUL PY 2010 VL 160 IS 1 BP 159 EP 165 DI 10.1016/j.ahj.2010.04.023 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 619OV UT WOS:000279440400024 PM 20598987 ER PT J AU Barg, FK Mavandadi, S Givens, JL Knott, K Zubritsky, C Oslin, DW AF Barg, Frances K. Mavandadi, Shahrzad Givens, Jane L. Knott, Kathryn Zubritsky, Cynthia Oslin, David W. TI When Late-Life Depression Improves: What Do Older Patients Say About Their Treatment? SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE Depression intervention; patient perception; intervention attributes; older adults; patient-centered care ID GERIATRIC DEPRESSION; PRIMARY-CARE; RANDOMIZED-TRIAL; MIXED-METHODS; PRISM-E; ADULTS; SCALE; PREFERENCES; DISABILITY; COMMUNITY AB Introduction: Experts speculate about the mechanisms through which depression interventions operate. However, little is known about what patients think are the "active ingredients" in depression treatment. Given the importance of patient-centered care, understanding this dimension of the provider-intervention-patient interaction provides a missing piece to designing interventions that are congruent with patients' beliefs and preferences about treatment initiation, treatment adherence, and treatment maintenance. Methods: The authors used a parallel mixed methods design to identify a purposive sample of 24 older adults with depression who participated in either an integrated care or an enhanced referral model of depression treatment. Open-ended semistructured interviews were used to identify patient perceptions about the benefits of depression treatment during the study. Quantitative assessments of depression status were made at the completion of participation in the treatment study and 6 months postparticipation. Results: Twelve of 24 participants achieved remission of their depression symptoms, with the remainder showing no improvement or a partial response to treatment. Participants who achieved and sustained a remission of their depression symptoms (N = 7) attributed their improvement to clear psychoeducational support with their depression care providers and described an ability to affect the outcome of their treatment. Participants who improved but then relapsed described their treatment in vague terms, referring to social aspects of participation. Participants who did not achieve remission ascribed recognition and treatment of their depression to forces outside themselves and described few details about their treatment. Conclusion: Clinicians should consider patient perceptions of the benefits of depression treatment as they discuss and implement therapeutic interventions with depressed older adults. (Am J Geriatr Psychiatry 2010; 18: 596-605) C1 [Barg, Frances K.; Knott, Kathryn] Univ Penn, Dept Family Med & Community Hlth, Philadelphia, PA 19104 USA. [Barg, Frances K.] Univ Penn, Dept Anthropol, Philadelphia, PA 19104 USA. [Mavandadi, Shahrzad; Oslin, David W.] Philadelphia Vet Affairs Med Ctr, MIRECC, Philadelphia, PA USA. [Givens, Jane L.] Harvard Univ, Sch Med, Inst Aging Res, Boston, MA USA. [Oslin, David W.] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. RP Barg, FK (reprint author), Univ Penn, Dept Family Med & Community Hlth, 2 Gates HUP,3400 Spruce St, Philadelphia, PA 19104 USA. EM bargf@uphs.upenn.edu FU Advanced Center for Intervention and Services Research; NIH/NIMH; P30-MH066270; Substance Abuse and Mental Health Services Administration (SAMHSA); Center for Mental Health Services (CMHS); Center for Substance Abuse Treatment (CSAT); Center for Substance Abuse and Prevention (CSAP); Department of Veterans Affairs (VA); Health Resources and Services Administration (HRSA); Centers for Medicare and Medicaid Services (CMS) FX This work was supported by the Advanced Center for Intervention and Services Research, NIH/NIMH, P30-MH066270, Oslin, PI. PRISM-E was a collaborative research study funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), including its three centers: Center for Mental Health Services (CMHS), Center for Substance Abuse Treatment (CSAT), and the Center for Substance Abuse and Prevention (CSAP). Additional support and funding was provided by the Department of Veterans Affairs (VA), the Health Resources and Services Administration (HRSA), and the Centers for Medicare and Medicaid Services (CMS). NR 34 TC 2 Z9 2 U1 0 U2 3 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 JUL PY 2010 VL 18 IS 7 BP 596 EP 605 DI 10.1097/JGP.0b013e3181b7f0f9 PG 10 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 615WP UT WOS:000279169100005 PM 20593539 ER PT J AU Sultzer, DL Melrose, RJ Harwood, DG Campa, O Mandelkern, MA AF Sultzer, David L. Melrose, Rebecca J. Harwood, Dylan G. Campa, Olivia Mandelkern, Mark A. TI Effect of Memantine Treatment on Regional Cortical Metabolism in Alzheimer's Disease SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE Alzheimer's disease; PET; therapeutics; memantine ID NEUROBEHAVIORAL RATING-SCALE; CEREBRAL GLUCOSE-METABOLISM; LONGITUDINAL PET EVALUATION; DEMENTIA; MODERATE; CORTEX; TRIAL; HYPOMETABOLISM; RIVASTIGMINE; PROGRESSION AB Objectives: Cortical systems involved in the response to medication treatment for Alzheimer's disease (AD) are poorly understood. Preclinical studies have demonstrated the effect of memantine on neuroreceptors and cell physiology, although the impact of treatment on cortical activity in vivo is not known. Design: (18)F-fluorodeoxyglucose positron emission tomography (PET) imaging and clinical assessment before and after open-label memantine treatment. Participants/Setting: Seventeen outpatients with probable AD on stable cholinesterase inhibitor medication. Intervention: Memantine up to 10 mg twice daily for 10 weeks. Measurements: Voxel-based analyses of change in cortical metabolic activity; Mattis Dementia Rating Scale (DRS), and Neurobehavioral Rating Scale (NRS). Results: Mean age was 81 years; mean Mini-Mental State Examination score was 19.4. Compared with baseline, metabolic activity was significantly higher after 10 weeks memantine treatment in two cortical regions bilaterally: the inferior temporal gyrus (BA 20) and the angular gyrus/supramarginal gyrus (BA 39, 40). There was no significant relationship between change in DRS score and change in cortical metabolism, although change in NRS score was associated with the extent of metabolic change in the right parietal and temporal cortex. Conclusion: Metabolic activity in bilateral inferior parietal and temporal cortex increases during 10 weeks of memantine treatment in patients with AD. PET imaging can reveal functional effects of medications on neural activity and may help to define critical mechanisms involved in drug treatment. (Am J Geriatr Psychiatry 2010; 18: 606-614) C1 [Sultzer, David L.; Melrose, Rebecca J.; Harwood, Dylan G.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. [Sultzer, David L.; Melrose, Rebecca J.; Harwood, Dylan G.; Campa, Olivia] VA Greater Los Angeles Healthcare Syst, Psychiat & Mental Hlth Serv, Irvine, CA USA. [Mandelkern, Mark A.] VA Greater Los Angeles Healthcare Syst, Nucl Med Serv, Irvine, CA USA. [Mandelkern, Mark A.] Univ Calif Irvine, Dept Phys, Irvine, CA 92717 USA. RP Sultzer, DL (reprint author), 3 South,116AE,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM dsultzer@ucla.edu FU Forest Research Institute; Department of Veterans Affairs; Eli Lilly; Astra Zeneca FX This work was supported by Forest Research Institute and the Department of Veterans Affairs.; Dr. Sultzer reports receiving consultation fees from Eli Lilly and Astra Zeneca. NR 37 TC 5 Z9 5 U1 2 U2 4 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 JUL PY 2010 VL 18 IS 7 BP 606 EP 614 DI 10.1097/JGP.0b013e3181ca3a4e PG 9 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 615WP UT WOS:000279169100006 PM 20220580 ER PT J AU Spiegel, BMR Bolus, R Desai, AA Zager, P Parker, T Moran, J Bolus, S Solomon, MD Khawar, O Gitlin, M Sul, H Talley, J Nissenson, A AF Spiegel, Brennan M. R. Bolus, Roger Desai, Amar A. Zager, Philip Parker, Tom Moran, John Bolus, Sally Solomon, Matthew D. Khawar, Osman Gitlin, Matthew Sul, Hack Talley, Jennifer Nissenson, Allen TI Dialysis Practices That Distinguish Top-Versus Bottom-Performing Facilities by Hemoglobin Outcomes SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE Dialysis; anemia; best practice; outcomes ID INCIDENT HEMODIALYSIS-PATIENTS; ANEMIA MANAGEMENT; MORTALITY; ASSOCIATION; MORBIDITY; ADEQUACY AB Background: Because there is wide variation in outcomes across dialysis facilities, it is possible that top-performing units use practices not shared by others. The Identifying Best Practices in Dialysis (IBPiD) Study seeks to identify practices that distinguish top-from bottom-performing facilities by key outcomes, including achievement of recommended hemoglobin targets. Study Design: Observational study with cross-sectional study ascertainment of predictors and outcomes. Predictors: Facility dialysis practices ascertained using practice surveys of dialysis staff who indicated their level of agreement that each practice occurs in their facility (1-6 on a Likert scale). Setting & Participants: 423 personnel in 90 dialysis facilities from 1 for-profit and 2 not-for-profit dialysis organizations. Outcomes: Percentage of patients per month per facility with hemoglobin levels of 11-12 g/dL. We divided facilities by median into top-versus bottom-performing groups and compared mean scores for each practice using t tests. We report practices that were statistically significant and achieved at least a medium effect size (ES) >= 0.4. Results: 17 of 155 tested predictors were significant. Achievement of hemoglobin level targets was related most strongly to the use of chairside computers (ES, 0.8 [95% CI, 0.4-1.4]), extent/quality of educational videos (ES, 0.6 [95% CI, 0.2-1.1]), frequency of calling per diem staff if short staffed (ES, 0.6 [95% CI, 0.21-1.1]), policy that nurses pass written competency examinations before hire (ES, 0.6 [95% CI, 0.2-1.0]), and technician cannulation mastery (ES, 0.6 [95% CI, 0.2-1.1]). Limitations: This is a cross-sectional study that can address only associations, not causations. Future research should measure the longitudinal predictive value of these practices. Conclusions: High-performing facilities report more effective education programs, better staff management, higher staff competency, and higher use of chairside computers, a potential marker of information technology proficiency. This suggests that hemoglobin level management is enhanced by processes reflecting a coordinated multidisciplinary environment. Am J Kidney Dis 56:86-94. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is a US Government Work. There are no restrictions on its use. C1 [Spiegel, Brennan M. R.] Univ Calif Los Angeles, VA Ctr Outcomes Res & Educ, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med,Dept Med, Los Angeles, CA 90073 USA. [Desai, Amar A.] Univ Calif San Francisco, Dept Med, San Francisco, CA USA. [Desai, Amar A.; Solomon, Matthew D.] Stanford Univ, Dept Med, Palo Alto, CA 94304 USA. [Zager, Philip] DCI, Nashville, TN USA. [Parker, Tom] Renal Ventures Managements LLC, Lakewood, CO USA. [Moran, John] Satellite Healthcare, Mountain View, CA USA. [Gitlin, Matthew] Amgen Inc, Thousand Oaks, CA 91320 USA. [Nissenson, Allen] DaVita Inc, Segundo, CA USA. RP Spiegel, BMR (reprint author), Univ Calif Los Angeles, VA Ctr Outcomes Res & Educ, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med,Dept Med, 11301 Wilshire Blvd,Bldg 115,Rm 215, Los Angeles, CA 90073 USA. EM bspiegel@mednet.ucla.edu FU Renal Physicians Association; American Nephrology Nurses Association; Amgen Inc FX This study was endorsed and supported by the Renal Physicians Association and American Nephrology Nurses Association. Special thanks to the participating dialysis organizations: Dialysis Clinic Inc, Renal Ventures Management LLC, and Satellite Healthcare. The opinions and assertions contained herein are the sole views of the authors and are not to be construed as official or as reflecting the views of the Department of Veteran Affairs.; Dr Spiegel, as the Principal Investigator of this investigator-initiated study, received a research grant from Amgen Inc, which markets erythropoiesis-stimulating agents. Dr Spiegel maintained full control over all aspects of the study design, implementation, data collection, data analysis, data interpretation, and manuscript preparation; he had full access to all data in the study and takes responsibility for the integrity of the data and accuracy of data analysis. Dr Gitlin is an employee of Amgen Inc. The other authors declare that they have no relevant financial interests. NR 18 TC 8 Z9 8 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 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD JUL PY 2010 VL 56 IS 1 BP 86 EP 94 DI 10.1053/j.ajkd.2010.02.346 PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 614OQ UT WOS:000279070000015 PM 20493604 ER PT J AU Lee, BY Wiringa, AE Bailey, RR Goyal, V Lewis, GJ Tsui, BYK Smith, KJ Muder, RR AF Lee, Bruce Y. Wiringa, Ann E. Bailey, Rachel R. Goyal, Vishal Lewis, G. Jonathan Tsui, Becky Y. K. Smith, Kenneth J. Muder, Robert R. TI Screening Cardiac Surgery Patients for MRSA: An Economic Computer Model SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID RESISTANT STAPHYLOCOCCUS-AUREUS; STERNAL WOUND-INFECTION; HOSPITAL-ACQUIRED INFECTION; SURGICAL SITE INFECTION; METHICILLIN-RESISTANT; NASAL CARRIAGE; INTRANASAL MUPIROCIN; POSTSTERNOTOMY MEDIASTINITIS; CLINICAL-FEATURES; HEART-SURGERY AB Objective: To estimate the economic value of preoperative methicillin-resistant Staphylococcus aureus (MRSA) screening and decolonization for cardiac surgery patients. Study Design: Monte Carlo decision-analytic computer simulation model. Methods: We developed a computer simulation model representing the decision of whether to perform preoperative MRSA screening and decolonizing those patients with a positive MRSA culture. Sensitivity analyses varied key input parameters including MRSA colonization prevalence, decolonization success rates, the number of surveillance sites, and screening/ decolonization costs. Separate analyses estimated the incremental cost-effectiveness ratio (ICER) of the screening and decolonization strategy from the third-party payer and hospital perspectives. Results: Even when MRSA colonization prevalence and decolonization success rate were as low as 1% and 25%, respectively, the ICER of implementing routine surveillance was well under $ 15,000 per quality-adjusted life-year from both the third-party payer and hospital perspectives. The surveillance strategy was economically dominant (less costly and more effective than no testing) for most scenarios explored. Conclusions: Our results suggest that routine preoperative MRSA screening of cardiac surgery patients could provide substantial economic value to third-party payers and hospitals over a wide range of MRSA colonization prevalence levels, decolonization success rates, and surveillance costs. Healthcare administrators, infection control specialists, and surgeons can compare their local conditions with our study's benchmarks to make decisions about whether to implement preoperative MRSA testing. Third-party payers may want to consider covering such a strategy. (Am J Manag Care. 2010; 16(7): e163-e173) C1 [Lee, Bruce Y.; Wiringa, Ann E.; Bailey, Rachel R.; Goyal, Vishal; Lewis, G. Jonathan; Tsui, Becky Y. K.] Univ Pittsburgh, Dept Biomed Informat, Pittsburgh, PA 15213 USA. [Lee, Bruce Y.; Wiringa, Ann E.; Bailey, Rachel R.; Goyal, Vishal; Lewis, G. Jonathan; Tsui, Becky Y. K.; Smith, Kenneth J.] Univ Pittsburgh, Sect Decis Sci & Clin Syst Modeling, Pittsburgh, PA 15213 USA. [Lee, Bruce Y.; Wiringa, Ann E.; Bailey, Rachel R.; Goyal, Vishal; Lewis, G. Jonathan; Tsui, Becky Y. K.] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15213 USA. [Muder, Robert R.] VA Pittsburgh Hlth Care Syst, Div Infect Dis, Pittsburgh, PA USA. RP Lee, BY (reprint author), Univ Pittsburgh, Dept Biomed Informat, 200 Meyran Ave,Ste 200, Pittsburgh, PA 15213 USA. EM byl1@pitt.edu FU National Institute of General Medical Sciences Models of Infectious Agent Study (MIDAS) [1U54GM088491-0109] FX This research was supported by National Institute of General Medical Sciences Models of Infectious Agent Study (MIDAS) Grant 1U54GM088491-0109. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. NR 71 TC 11 Z9 11 U1 0 U2 1 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD JUL PY 2010 VL 16 IS 7 BP E163 EP E173 PG 11 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 635DR UT WOS:000280636300009 PM 20645662 ER PT J AU Marchani, EE Bird, TD Steinbart, EJ Rosenthal, E Yu, CE Schellenberg, GD Wijsman, EM AF Marchani, Elizabeth E. Bird, Thomas D. Steinbart, Ellen J. Rosenthal, Elisabeth Yu, Chang-En Schellenberg, Gerard D. Wijsman, Ellen M. TI Evidence for Three Loci Modifying Age-at-Onset of Alzheimer's Disease in Early-Onset PS epsilon N2 Families SO AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS LA English DT Article DE genome-scan; modifier scan; quantitative trait; complex disease; dementia ID GENOME-WIDE ASSOCIATION; SERUM-AMYLOID-P; NEUROTROPHIC FACTOR BDNF; MONTE-CARLO SEGREGATION; POPULATION-BASED SAMPLE; LINKAGE ANALYSIS; APOLIPOPROTEIN-E; DUTCH POPULATION; OLIGOGENIC SEGREGATION; COMMUNITY POPULATION AB Families with early-onset Alzheimer's disease (AD) sharing a single PSEN2 mutation exhibit a wide range of age-at-onset, suggesting that modifier loci segregate within these families. While APOE is known to be an age-at-onset modifier, it does not explain all of this variation. We performed a genome scan within nine such families for loci influencing age-at-onset, while simultaneously controlling for variation in the primary PSEN2 mutation (N141I) and APOE. We found significant evidence of linkage between age-at-onset and chromosome 1q23.3 (P< 0.001) when analysis included all families, and to chromosomes 1q23.3 (P G 0.001), 17p13.2 (P=0.0002), 7q33 (P=0.017), and 11p14.2 (P = 0.017) in a single large pedigree. Simultaneous analysis of these four chromosomes maintained strong evidence of linkage to chromosomes 1q23.3 and 17p13.2 when all families were analyzed, and to chromosomes 1q23.3, 7q33, and 17p13.2 within the same single pedigree. Inclusion of major gene covariates proved essential to detect these linkage signals, as all linkage signals dissipated when PSEN2 and APOE were excluded from the model. The four chromosomal regions with evidence of linkage all coincide with previous linkage signals, associated SNPs, and/or candidate genes identified in independent AD study populations. This study establishes several candidate regions for further analysis and is consistent with an oligogenic model of AD risk and age-at-onset. More generally, this study also demonstrates the value of searching for modifier loci in existing datasets previously used to identify primary causal variants for complex disease traits. (C) 2010 Wiley-Liss, Inc. C1 [Marchani, Elizabeth E.; Bird, Thomas D.; Rosenthal, Elisabeth; Wijsman, Ellen M.] Univ Washington, Dept Med, Div Med Genet, Seattle, WA 98195 USA. [Bird, Thomas D.; Steinbart, Ellen J.; Yu, Chang-En] Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, Geriatr Res Educ & Clin Ctr, Seattle, WA USA. [Bird, Thomas D.; Steinbart, Ellen J.] Univ Washington, Dept Neurol, Seattle, WA 98195 USA. [Yu, Chang-En] Univ Washington, Dept Med, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. [Schellenberg, Gerard D.] Univ Penn, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA. [Wijsman, Ellen M.] Univ Washington, Dept Biostat, Seattle, WA 98195 USA. [Wijsman, Ellen M.] Univ Washington, Dept Genome Sci, Seattle, WA 98195 USA. RP Wijsman, EM (reprint author), Univ Washington, Dept Med, Div Med Genet, Box 357720, Seattle, WA 98195 USA. EM wijsman@u.washington.edu FU Veterans Affairs Research Funds; National Institute of Health (NIH) [AG05136, AG00258, GM46255] FX Grant sponsor: Veterans Affairs Research Funds; Grant sponsor: National Institute of Health (NIH); Grant numbers: AG05136, AG00258, GM46255. NR 96 TC 12 Z9 12 U1 1 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1552-4841 EI 1552-485X J9 AM J MED GENET B JI Am. J. Med. Genet. B PD JUL PY 2010 VL 153B IS 5 BP 1031 EP 1041 DI 10.1002/ajmg.b.31072 PG 11 WC Genetics & Heredity; Psychiatry SC Genetics & Heredity; Psychiatry GA 617CZ UT WOS:000279259700006 PM 20333730 ER PT J AU Bakris, GL Basile, JN Giles, TD Taylor, AA AF Bakris, George L. Basile, Jan N. Giles, Thomas D. Taylor, Addison A. TI The Role of Nitric Oxide in Improving Endothelial Function and Cardiovascular Health: Focus on Nebivolol SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE beta-Blockers; Endothelial function; Hypertension; Nebivolol; Nitric oxide; Vasodilating beta-blockers ID DEPENDENT VASCULAR RELAXATION; CENTRAL AORTIC PRESSURE; ESSENTIAL-HYPERTENSION; BLOOD-PRESSURE; BETA-BLOCKERS; ERECTILE DYSFUNCTION; INSULIN-RESISTANCE; RANDOMIZED-TRIAL; HEART-FAILURE; ATENOLOL AB Although beta-blockers have been endorsed by guidelines committees for the treatment of patients with hypertension, particularly those with significant CVD and high CVD risk, there are concerns about conventional beta-blockers related to poorer clinical outcomes compared with other classes of antihypertensive agents, as well as deleterious effects on quality of life and lipid and carbohydrate metabolism. beta-Blockers comprise a heterogeneous group of antihypertensive agents, including nonselective agents, cardioselective, nonvasodilating agents, and vasodilating agents that either combine beta-nonselectivity with alpha-blockade or possess cardioselectivity without alpha-blockade. The pharmacologic, mechanistic, and hemodynamic differences between conventional, nonvasodilating beta-blockers and vasodilating beta-blockers are discussed in this review, with a focus on the cardioselective vasodilating beta-blocker nebivolol. These differences may have important clinical implications, particularly in the treatment of complicated hypertension, such as that associated with patients with diabetes or the cardiometabolic syndrome, elderly patients, and African American patients, suggesting that mechanism of action may be an important consideration when choosing a beta-blocker. (C) 2010 Published by Elsevier Inc. . The American Journal of Medicine (2010) 123, S2-S8 C1 [Bakris, George L.] Univ Chicago, Med Ctr, Dept Med, Hypertens Dis Unit, Chicago, IL 60637 USA. [Basile, Jan N.] Med Univ S Carolina, Coll Med, Seinsheimer Cardiovasc Hlth Program, Charleston, SC 29425 USA. [Basile, Jan N.] Ralph H Johnson VA Med Ctr, Charleston, SC USA. [Giles, Thomas D.] Tulane Univ, Sch Med, Dept Med, New Orleans, LA 70112 USA. [Taylor, Addison A.] Baylor Coll Med, Dept Med, Houston, TX 77030 USA. [Taylor, Addison A.] Baylor Coll Med, Dept Pharmacol, Houston, TX 77030 USA. [Taylor, Addison A.] Baylor Coll Med, Dept Mol Physiol, Houston, TX 77030 USA. RP Giles, TD (reprint author), 109 Holly Dr, Metairie, LA 70005 USA. EM tgiles4@cox.net FU CVRx, Inc.; Forest Laboratories, Inc.; GlaxoSmithKline; Novartis AG; Abbott Laboratories; Bristol-Myers Squibb Company; Forest Research Institute, Inc.; Merck Co., Inc.; Pfizer Inc; sanofi-aventis FX The authors who contributed to this article have disclosed the following industry relationships:; George L. Bakris, MD, has worked as a consultant to Abbott Laboratories, Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership, Boehringer Ingelheim, CVRx, Inc., Forest Laboratories, Inc., Gilead Sciences, Inc., GlaxoSmithKline, Merck & Co., Inc., Novartis AG, Takeda Pharmaceuticals North America, Inc., and Walgreen Co.; and has received research/grant support from CVRx, Inc., Forest Laboratories, Inc., and GlaxoSmithKline.; Thomas D. Giles, MD, has worked as a consultant to Bristol-Myers Squibb Company, Daiichi-Sankyo Co. Ltd, Forest Laboratories, Inc., NicOx, Novartis AG, and sanofi-aventis; has received honoraria from Bristol-Myers Squibb Company, Daiichi-Sankyo Co. Ltd, Forest Laboratories Inc., NicOx, Novartis AG, and sanofi-aventis; and has received research/grant support from Forest Laboratories, Inc. and Novartis AG.; Addison A. Taylor, MD, PhD, is a member of the Speakers' Bureaus of Abbott Laboratories, Boehringer Ingelheim, Forest Laboratories, Inc., GlaxoSmithKline, Merck & Co., Inc., and Novartis AG; has worked as a consultant to Abbott Laboratories, Boehringer Ingelheim, Forest Laboratories, Inc., GlaxoSmithKline, Merck & Co., Inc., and Novartis AG; has served on the advisory boards of Abbott Laboratories, Boehringer Ingelheim, Forest Laboratories, Inc., GlaxoSmithKline, Merck & Co., Inc., and Novartis AG; and has received research/grant support from Abbott Laboratories, Bristol-Myers Squibb Company, Forest Research Institute, Inc. (a subsidiary of Forest Laboratories, Inc.), Merck & Co., Inc., Novartis AG, Pfizer Inc, and sanofi-aventis. NR 41 TC 8 Z9 8 U1 1 U2 3 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 JUL PY 2010 VL 123 IS 7 SU 1 BP S2 EP S8 DI 10.1016/j.amjmed.2010.04.012 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 614NO UT WOS:000279066500002 PM 20609695 ER PT J AU Basile, JN AF Basile, Jan N. TI One Size Does Not Fit All: The Role of Vasodilating beta-Blockers in Controlling Hypertension as a Means of Reducing Cardiovascular and Stroke Risk SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE beta-Blockers; Efficacy; Hypertension; Nebivolol; Tolerability; Vasodilating beta-blockers ID RANDOMIZED CONTROLLED-TRIAL; BLOOD-PRESSURE; 1ST-LINE THERAPY; HEART-FAILURE; NITRIC-OXIDE; NEBIVOLOL; METOPROLOL; ATENOLOL; CARVEDILOL; PREVENTION AB beta-Blockers have played a key role in the management of hypertension-related cardiovascular disease for decades, and continue to be recommended as a mainstay of therapy in national guidelines statements. Recent data have shown less optimal reductions in total mortality, CVD mortality, and CVD events with beta-blockers compared with renin-angiotensin system-blocking agents or calcium channel blockers. The beta-blocker class, however, spans a wide range of agents, and the growing concern about the risk-benefit profile of beta-blockers should not be generalized to later-generation vasodilating beta-blockers such as carvedilol and nebivolol. A growing database from hypertension studies confirms the clinical efficacy and safety of vasodilating beta-blockers, and outcome studies indicate that these agents can play an important role in global CVD reduction in patients with hypertensive or ischemic heart failure. (C) 2010 Elsevier Inc. All rights reserved. . The American Journal of Medicine (2010) 123, S9- S15 C1 [Basile, Jan N.] Med Univ S Carolina, Coll Med, Seinsheimer Cardiovasc Hlth Program, Charleston, SC 29425 USA. [Basile, Jan N.] Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Basile, JN (reprint author), Med Univ S Carolina, Coll Med, Seinsheimer Cardiovasc Hlth Program, 171 Ashley Ave, Charleston, SC 29425 USA. EM basilejn@musc.edu FU National Heart, Lung, and Blood Institute (NHLBI) FX Dr. Basile is supported by the National Heart, Lung, and Blood Institute (NHLBI) through funding for the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the Systolic Blood Pressure Intervention Trial (SPRINT). NR 39 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 0002-9343 J9 AM J MED JI Am. J. Med. PD JUL PY 2010 VL 123 IS 7 SU 1 BP S9 EP S15 DI 10.1016/j.amjmed.2010.04.013 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 614NO UT WOS:000279066500003 PM 20609697 ER PT J AU Zhao, T Li, JA Chen, AF AF Zhao, Ting Li, Jian Chen, Alex F. TI MicroRNA-34a induces endothelial progenitor cell senescence and impedes its angiogenesis via suppressing silent information regulator 1 SO AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM LA English DT Article ID CALORIE RESTRICTION; DOWN-REGULATION; EMERGING ROLES; GROWTH ARREST; MIR-34A; SIRT1; EXPRESSION; CANCER; DYSFUNCTION; PHENOTYPE AB Zhao T, Li J, Chen AF. MicroRNA-34a induces endothelial progenitor cell senescence and impedes its angiogenesis via suppressing silent information regulator 1. Am J Physiol Endocrinol Metab 299: E110-E116, 2010. First published April 27, 2010; doi:10.1152/ajpendo.00192.2010.-Endothelial progenitor cells (EPCs) play an important role in angiogenesis, which is essential for numerous physiological processes as well as tumor growth. Several microRNAs (miRNAs) have been reported to be involved in angiogenesis. MiR-34a, recently reported as a tumor suppressor, has been found to target silent information regulator 1 (Sirt1), leading to cell cycle arrest or apoptosis. However, the role of miR-34a in EPC-mediated angiogenesis was unknown. The present study tested the hypothesis that miR-34a inhibits EPC-mediated angiogenesis by inducing senescence via suppressing Sirt1. Bone marrow-derived EPCs from adult male Spraque-Dawley rats were used. Results of flow cytometry showed that EPCs after 7 days of culture expressed both stem cell markers CD34 and CD133 and endothelial cell markers VEGFR-2 (flk-1) and VE-cadherin. MiR-34a was expressed in normal EPCs, and overexpression of miR-34a via its mimic transfection significantly increased its expression and impaired in vitro EPC angiogenesis. MiR-34a overexpression led to a significantly increased EPC senescence, paralleled with an similar to 40% Sirt1 reduction. Furthermore, knockdown of Sirt1 by its siRNA resulted in diminished EPC angiogenesis and increased senescence. Finally, overexpression of miR-34a increased the level of Sirt1 effector-acetylated forkhead box O transcription factors 1 (FoxO1), an effect mimicked in EPCs following Sirt1 knockdown. In conclusion, miR-34a impairs EPC-mediated angiogenesis by induction of senescence via inhibiting Sirt1. C1 [Chen, Alex F.] Univ Pittsburgh, Sch Med, Dept Surg, Vasc Med Inst,VA Vasc Surg Res, Pittsburgh, PA 15240 USA. [Zhao, Ting; Chen, Alex F.] Univ Pittsburgh, Sch Med, McGowan Inst Regenerat Med, Pittsburgh, PA 15240 USA. [Zhao, Ting; Chen, Alex F.] Vet Affairs Pittsburgh Healthcare Syst, Vasc Surg Res, Pittsburgh, PA USA. [Zhao, Ting; Li, Jian] Chinese Acad Med Sci, Beijing Inst Geriatr, Beijing 100037, Peoples R China. [Zhao, Ting; Li, Jian] Peking Union Med Coll, Beijing 100021, Peoples R China. RP Chen, AF (reprint author), Univ Pittsburgh, Sch Med, Dept Surg, Vasc Med Inst,VA Vasc Surg Res, 2W109 151L-U,VAPHS,Univ Dr, Pittsburgh, PA 15240 USA. EM chena5@upmc.edu FU National Institute of General Medical Sciences [R01-GM-077352]; American Diabetes Association Research [7-08-RA-23]; National Basic Research Program of China [2006CB503910]; National High-Tech Research and Development Program of China [2006AA 02A 408] FX This work was supported by National Institute of General Medical Sciences Grant R01-GM-077352, American Diabetes Association Research Award 7-08-RA-23 (to Dr. A. F. Chen), and grants from National Basic Research Program of China (2006CB503910) and National High-Tech Research and Development Program of China (2006AA 02A 408; to Dr. J. Li). NR 41 TC 153 Z9 165 U1 0 U2 14 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1849 J9 AM J PHYSIOL-ENDOC M JI Am. J. Physiol.-Endocrinol. Metab. PD JUL PY 2010 VL 299 IS 1 BP E110 EP E116 DI 10.1152/ajpendo.00192.2010 PG 7 WC Endocrinology & Metabolism; Physiology SC Endocrinology & Metabolism; Physiology GA 609MH UT WOS:000278660200015 PM 20424141 ER PT J AU Haworth, RA Potter, KT Russell, DC AF Haworth, Robert A. Potter, Katherine T. Russell, Douglas C. TI Role of arachidonic acid, lipoxygenase, and mitochondrial depolarization in reperfusion arrhythmias SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE mitochondria; ischemia; reperfusion; reactive oxygen species; anion channels ID CA-2&-INDUCED MEMBRANE TRANSITION; ACUTE MYOCARDIAL-INFARCTION; FREE-FATTY-ACIDS; RAT HEART-CELLS; PERMEABILITY TRANSITION; INDUCED CARDIOPROTECTION; UNCOUPLING PROTEINS; LIPID-PEROXIDATION; CARDIAC MYOCYTES; ANION CHANNEL AB Haworth RA, Potter KT, Russell DC. Role of arachidonic acid, lipoxygenase, and mitochondrial depolarization in reperfusion arrhythmias. Am J Physiol Heart Circ Physiol 299: H165-H174, 2010. First published April 30, 2010; doi:10.1152/ajpheart.00906.2009.-We have sought evidence that arachidonic acid (AA) induces mitochondrial depolarization in isolated myocytes by a lipoxygenase (LOX)-dependent mechanism and that such depolarization might contribute to arrhythmogenesis following ischemia-reperfusion injury. A method was developed for measuring mitochondrial depolarization in isolated adult rat myocytes in suspension, using tetramethylrhodamine ethyl ester. The addition of AA to myocytes resulted in mitochondrial depolarization that was inhibited by the LOX inhibitor baicalein, by the reactive oxygen species (ROS) scavenger mercaptoproprionylglycine, and by the anion channel inhibitor diisothiocyanatostilbene-disulfonic acid (DIDS). AA induced mitochondrial uncoupling and mitochondrial ATPase activity in myocytes, but both were insensitive to baicalein. We conclude that the metabolic effect of AA in myocytes puts mitochondria into an energetically compromised state where membrane potential is easily changed by the DIDS-sensitive LOX/ROS-mediated opening of an inner membrane anion channel. In an in vivo anesthetized rat model of coronary artery occlusion, baicalein was found to strongly inhibit arrhythmias induced by ischemia-reperfusion injury. Arrhythmias following ischemia-reperfusion injury have been previously associated with DIDS-sensitive ROS-mediated mitochondrial depolarization, and free fatty acids including AA were previously found to accumulate during such injury. We therefore conclude that arrhythmias following ischemia-reperfusion injury might originate from mitochondrial depolarization mediated by LOX and AA. C1 [Haworth, Robert A.] Univ Wisconsin, Dept Surg, Ctr Clin Sci, Madison, WI 53792 USA. [Potter, Katherine T.; Russell, Douglas C.] Univ Wisconsin, Div Cardiovasc Med, Ctr Clin Sci, Madison, WI 53792 USA. [Russell, Douglas C.] William S Middleton Mem Vet Adm Med Ctr, Med Serv, Cardiol Sect, Madison, WI USA. RP Haworth, RA (reprint author), Univ Wisconsin, Dept Surg, Ctr Clin Sci, 600 Highland Ave, Madison, WI 53792 USA. EM haworth@surgery.wisc.edu FU William S. Middleton Memorial Veterans Hospital (Madison, WI); American Heart Association [0650147Z]; Cardiothoracic Division of the Department of Surgery FX This work was supported with resources from and the use of the facilities at the William S. Middleton Memorial Veterans Hospital (Madison, WI). This work was supported by an American Heart Association Grant-in-Aid 0650147Z (to R. A. Haworth) and by the Cardiothoracic Division of the Department of Surgery. NR 52 TC 6 Z9 8 U1 1 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 JUL PY 2010 VL 299 IS 1 BP H165 EP H174 DI 10.1152/ajpheart.00906.2009 PG 10 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 612HT UT WOS:000278888400022 PM 20435853 ER PT J AU Jones, JA Ruddy, JM Bouges, S Zavadzkas, JA Brinsa, TA Stroud, RE Mukherjee, R Spinale, FG Ikonomidis, JS AF Jones, Jeffrey A. Ruddy, Jean Marie Bouges, Shenikqua Zavadzkas, Juozas A. Brinsa, Theresa A. Stroud, Robert E. Mukherjee, Rupak Spinale, Francis G. Ikonomidis, John S. TI Alterations in membrane type-1 matrix metalloproteinase abundance after the induction of thoracic aortic aneurysm in a murine model SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE fibroblast; vascular remodeling; extracellular matrix; microbubble contrast ID TISSUE INHIBITOR; GENE-EXPRESSION; MT1-MMP; MATRIX-METALLOPROTEINASE-2; LOCALIZATION; INFLAMMATION; DEGRADATION; DEFICIENCY; ACTIVATION; FIBRILLIN AB Jones JA, Ruddy JM, Bouges S, Zavadzkas JA, Brinsa TA, Stroud RE, Mukherjee R, Spinale FG, Ikonomidis JS. Alterations in membrane type-1 matrix metalloproteinase abundance after the induction of thoracic aortic aneurysm in a murine model. Am J Physiol Heart Circ Physiol 299: H114-H124, 2010. First published April 23, 2010; doi:10.1152/ajpheart.00028.2010.-Thoracic aortic aneurysms (TAAs) develop as a result of dysregulated extracellular matrix remodeling mediated by several matrix metalloproteinases (MMPs). Membrane type-1 MMP (MT1-MMP) is the prototypical member of a unique family of membrane-bound MMPs, possessing multiple substrates and functions. The present study tested the hypothesis that MT1-MMP expression, abundance, and activity would be elevated during TAA development and that this protease is produced primarily by mesenchymal cells within the thoracic aorta. Descending thoracic aortas were harvested from C57BL/6J mice at multiple time points (2, 4, 8, and 16 wk, n = 15 each) post-TAA induction (0.5M CaCl(2), 15 min) and compared with reference controls (n = 15). The expression and abundance of MT1-MMP, MMP-2, and tissue inhibitor of metalloproteinase (TIMP)-2 were assessed by quantitative PCR and immunoblot analysis. MT1-MMP activity was determined by fluorescent peptide assay. MT1-MMP was localized within the aortic wall by immunohistochemistry. MT1-MMP abundance and localization in live animals (8 wk post-TAA induction vs. control) was determined by microultrasound imaging with an MT1-MMP-targeted microbubble contrast agent. Aortic diameter was increased 172 +/- 7% at 16 wk post-TAA induction (P < 0.05). MT1-MMP and MMP-2 mRNA levels were elevated at 2 wk post-TAA induction (P < 0.05). MT1-MMP protein abundance increased progressively to a maximum of 178 +/- 26% at 16 wk post-TAA induction, whereas MMP-2 and TIMP-2 peaked at 2 wk post-TAA induction (526 +/- 93% and 376 +/- 48%, respectively, P < 0.05). MT1-MMP colocalized with fibroblasts, and MT1-MMP-targeted contrast binding was elevated in 8-wk TAA-induced mice versus control mice (217 +/- 53% vs. 81 +/- 8%, P < 0.05). In conclusion, these novel results suggest that MT1-MMP plays a dynamic multifunctional role in TAA development and, therefore, may provide a significant target for therapeutic strategies. C1 [Jones, Jeffrey A.; Ruddy, Jean Marie; Bouges, Shenikqua; Zavadzkas, Juozas A.; Brinsa, Theresa A.; Stroud, Robert E.; Mukherjee, Rupak; Spinale, Francis G.; Ikonomidis, John S.] Med Univ S Carolina, Dept Surg, Div Cardiothorac Surg Res, Charleston, SC 29425 USA. [Jones, Jeffrey A.; Spinale, Francis G.] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Ikonomidis, JS (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, Dept Surg, 114 Doughty St,Ste 625, Charleston, SC 29425 USA. EM wilburnm@musc.edu FU Department of Veterans Affairs Career Development Award CDA-2; Merit Award; National Heart, Lung, and Blood Institute [HL-075488-05] FX This work was supported by Department of Veterans Affairs Career Development Award CDA-2 (to J. A. Jones) and a Merit Award (to F. G. Spinale) and by National Heart, Lung, and Blood Institute Grant HL-075488-05 (to J. S. Ikonomidis). NR 41 TC 8 Z9 10 U1 1 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 2010 VL 299 IS 1 BP H114 EP H124 DI 10.1152/ajpheart.00028.2010 PG 11 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 612HT UT WOS:000278888400017 PM 20418476 ER PT J AU Mukherjee, R Zavadzkas, JA Rivers, WT McLean, JE Chang, EI Bouges, S Matthews, RG Koval, CN Stroud, RE Spinale, FG AF Mukherjee, Rupak Zavadzkas, Juozas A. Rivers, William T. McLean, Julie E. Chang, Eileen I. Bouges, Shenikqua Matthews, Robert G. Koval, Christine N. Stroud, Robert E. Spinale, Francis G. TI Short-term disruption in regional left ventricular electrical conduction patterns increases interstitial matrix metalloproteinase activity SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE myocardium; interstitium ID MYOCARDIAL-INFARCTION; ATRIAL-FIBRILLATION; HEART; INDUCTION AB Mukherjee R, Zavadzkas JA, Rivers WT, McLean JE, Chang EI, Bouges S, Matthews RG, Koval CN, Stroud RE, Spinale FG. Short-term disruption in regional left ventricular electrical conduction patterns increases interstitial matrix metalloproteinase activity. Am J Physiol Heart Circ Physiol 299: H217-H224, 2010. First published May 14, 2010; doi: 10.1152/ajpheart.00065.2010.-Increased matrix metalloproteinase (MMP) abundance occurs with adverse left ventricular (LV) remodeling in a number of cardiac disease states, including those induced by long-standing arrhythmias. However, whether regionally contained aberrant electrical activation of the LV, with consequent dyskinesia, alters interstitial MMP activation remained unknown. Electrical activation of the LV of pigs (n = 10, 30-35 kg) was achieved by pacing (150 beats/min) at left atrial and LV sites such that normal atrioventricular activation (60 min) was followed by regional early LV activation for 60 min within 1.5 cm of the paced site and restoration of normal atrioventricular pacing for 120 min. Regional shortening (piezoelectric crystals) and interstitial MMP activity (microdialysis with MMP fluorogenic substrate) at the LV pacing site and a remote LV site were monitored at 30-min intervals. During aberrant electrical stimulation, interstitial MMP activity at the paced site was increased (122 +/- 4%) compared with the remote region (100%, P < 0.05). Restoration of atrioventricular pacing after the 60-min period of aberrant electrical activation normalized segmental shortening (8.5 +/- 0.4%), but MMP activity remained elevated (121 +/- 6%, P , 0.05). This study demonstrates that despite the restoration of mechanical function, disturbances in electrical conduction, in and of itself, can cause acute increases in regional in vivo MMP activation and, therefore, contribute to myocardial remodeling. C1 [Mukherjee, Rupak; Zavadzkas, Juozas A.; Rivers, William T.; McLean, Julie E.; Chang, Eileen I.; Bouges, Shenikqua; Matthews, Robert G.; Koval, Christine N.; Stroud, Robert E.; Spinale, Francis G.] Med Univ S Carolina, Div Cardiothorac Surg, Charleston, SC 29425 USA. [Spinale, Francis G.] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Mukherjee, R (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, Strom Thurmond Res Bldg,770 MUSC Complex,Suite 6, Charleston, SC 29425 USA. EM mukherr@musc.edu OI Chang, Eileen/0000-0002-3444-7260 FU National Heart, Lung, and Blood Institute [HL-45024, HL-97012, PO1-48788]; Veterans Affairs Merit Award FX This work was supported in part by National Heart, Lung, and Blood Institute Grants HL-45024, HL-97012, and PO1-48788 and by a Veterans Affairs Merit Award. NR 22 TC 2 Z9 2 U1 0 U2 2 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 2010 VL 299 IS 1 BP H217 EP H224 DI 10.1152/ajpheart.00065.2010 PG 8 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 612HT UT WOS:000278888400028 PM 20472759 ER PT J AU Batki, SL Dimmock, JA Ploutz-Snyder, R Carey, KB Maisto, SA Meszaros, ZS Cavallerano, MB Canfield, K Leontieva, L AF Batki, Steven L. Dimmock, J. A. Ploutz-Snyder, R. Carey, K. B. Maisto, S. A. Meszaros, Z. S. Cavallerano, M. B. Canfield, K. Leontieva, L. TI Nonalcohol Substance Use in Alcohol-Dependent Patients with Schizophrenia or Schizoaffective Disorder SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Meeting Abstract C1 [Batki, Steven L.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Batki, Steven L.] San Francisco VA Med Ctr, San Francisco, CA USA. [Batki, Steven L.] SUNY Upstate Med Univ Syracuse, New York, NY 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 1055-0496 J9 AM J ADDICTION JI Am. J. Addict. PD JUL-AUG PY 2010 VL 19 IS 4 MA 32 BP 378 EP 379 PG 2 WC Substance Abuse SC Substance Abuse GA 612QA UT WOS:000278914700039 ER PT J AU Snyder, CW Vandromme, MJ Tyra, SL Hawn, MT AF Snyder, Christopher W. Vandromme, Marianne J. Tyra, Sharon L. Hawn, Mary T. TI Retention of Colonoscopy Skills after Virtual Reality Simulator Training by Independent and Proctored Methods SO AMERICAN SURGEON LA English DT Article; Proceedings Paper CT Annual Scientific Meeting and Postgraduate Course Program of the Southeastern-Surgical-Congress CY FEB 20-23, 2010 CL Savannah, GA ID SURGICAL SKILLS; OPERATING-ROOM; PROFICIENCY AB Virtual reality (VR) simulators may enhance surgical resident colonoscopy skills, but the duration of skill retention and the effects of different simulator training methods are unknown. Medical students participating in a randomized trial of independent (automated simulator feedback only) versus proctored (human expert feedback plus simulator feedback) simulator training performed a standardized VR colonoscopy scenario at baseline, at the end of training (posttraining), and after a median 4.5 months without practice (retention). Performances were scored on a 10-point scale based on expert proficiency criteria and compared for the independent and proctored groups. Thirteen trainees (8 proctored, 5 independent) were included. Performance at retention testing was significantly better than baseline (median score 10 vs 5, P < 0.0001), and no different from posttraining (median score 10 vs 10, P = 0.19). Score changes from baseline to retention and from posttraining to retention were no different for the proctored and independent groups. Overinsufflation and excessive force were the most common reasons for nonproficiency at retention. After proficiency-based VR simulator training, colonoscopy skills are retained for several months, regardless of whether an independent or proctored approach is used. Error avoidance skills may not be retained as well as speed and efficiency skills. C1 [Snyder, Christopher W.; Vandromme, Marianne J.; Tyra, Sharon L.; Hawn, Mary T.] Univ Alabama, Dept Surg, Sect Gastrointestinal Surg, Birmingham, AL 35294 USA. [Hawn, Mary T.] Birmingham Vet Affairs Med Ctr, Ctr Surg Med Acute Care Res & Transit, Birmingham, AL USA. RP Hawn, MT (reprint author), Univ Alabama, Dept Surg, Sect Gastrointestinal Surg, 1922 7th Ave S,KB 428, Birmingham, AL 35294 USA. EM mhawn@uab.edu NR 14 TC 15 Z9 15 U1 1 U2 2 PU SOUTHEASTERN SURGICAL CONGRESS PI ATLANTA PA 141 WEST WIEUCA RD, STE B100, ATLANTA, GA 30342 USA SN 0003-1348 J9 AM SURGEON JI Am. Surg. PD JUL PY 2010 VL 76 IS 7 BP 743 EP 746 PG 4 WC Surgery SC Surgery GA 619GF UT WOS:000279416500017 PM 20698383 ER PT J AU Fink, AS Prochazka, AV Henderson, WG Bartenfeld, D Nyirenda, C Webb, A Berger, DH Itani, K Whitehill, T Edwards, J Wilson, M Karsonovich, C Parmelee, P AF Fink, Aaron S. Prochazka, Allan V. Henderson, William G. Bartenfeld, Debra Nyirenda, Carsie Webb, Alexandra Berger, David H. Itani, Kamal Whitehill, Thomas Edwards, James Wilson, Mark Karsonovich, Cynthia Parmelee, Patricia TI Enhancement of Surgical Informed Consent by Addition of Repeat Back A Multicenter, Randomized Controlled Clinical Trial SO ANNALS OF SURGERY LA English DT Article ID HEALTH LITERACY; PHYSICIAN COMMUNICATION; SHORT-FORM; PATIENT; ANXIETY; SCALE; CARE; SATISFACTION; STRATEGIES; MANAGEMENT AB Objective: In this randomized, controlled, unblinded trial, we sought to test Repeat Back's (RB) effect on comprehension following informed consent discussions. Summary Background Data: RB has been suggested as a method to improve patient comprehension when obtaining informed consent. In this technique, patients are asked to recount what they have been told in the informed consent discussion. Despite preliminary data, this practice has not been evaluated in any large scale study. Methods: This study was conducted in 7 Veterans Health Administration Medical Centers where informed consent is obtained using iMedConsent, the VA's computer based platform. Patients scheduled for elective surgeries were randomized to RB (a module added to the iMedConsent package) or standard iMedConsent (no RB). Comprehension was tested after the informed consent using procedure-specific questionnaires. Time stamps in the iMedConsent program estimated the time spent completing the informed consent process. Provider and patient satisfaction were measured using 5-point Likert scales. Statistical comparisons of groups were performed using t-tests and chi(2) tests. Results: A total of 575 patients were enrolled. In the RB group, providers spent 2.6 minutes longer (P < 0.0001) obtaining informed consent. The mean comprehension score was significantly higher in the RB group (71.4%) versus the no RB group (68.2%, P = 0.03); the effect was greatest in carotid endarterectomy patients (RB = 73.4% vs. no RB = 67.7%, P = 0.02). Quality of decision making was rated similarly. Providers were neutral to slightly favorable regarding RB. Conclusions: RB implemented within an electronic informed consent system improved patient comprehension. The additional time required was acceptable to providers. RB should be considered as an enhancement to surgical informed consent. C1 [Fink, Aaron S.; Bartenfeld, Debra; Webb, Alexandra] VAMC Atlanta, Surg Serv, Decatur, GA 30033 USA. [Fink, Aaron S.; Webb, Alexandra] Emory Univ, Sch Med, Dept Surg, Atlanta, GA 30322 USA. [Prochazka, Allan V.] Denver VAMC, Surg Serv, Denver, CO USA. [Prochazka, Allan V.; Henderson, William G.; Nyirenda, Carsie] Univ Colorado, Hlth Outcomes Program, Denver, CO 80202 USA. [Berger, David H.] Baylor Coll Med, Michael Bakey Dept Surg, Houston, TX 77030 USA. [Berger, David H.] Michael DeBakey VAMC, Houston, TX USA. [Itani, Kamal] Harvard Univ, Sch Med, Boston, MA USA. [Itani, Kamal] Boston Univ, Dept Surg, Boston, MA 02215 USA. [Itani, Kamal] Boston VAMC, Boston, MA USA. [Whitehill, Thomas] Univ Colorado, Dept Surg, Denver, CO 80202 USA. [Edwards, James] Oregon Hlth & Sci Univ, Dept Surg, Portland, OR 97201 USA. [Edwards, James] Portland VA Med Ctr, Portland, OR USA. [Wilson, Mark] Pittsburgh VAMC, Pittsburgh, PA USA. [Wilson, Mark] Univ Pittsburgh, Med Ctr, Dept Surg, Pittsburgh, PA USA. [Karsonovich, Cynthia] Tampa VAMC, Tampa, FL USA. [Karsonovich, Cynthia] Univ S Florida, Dept Surg, Tampa, FL 33620 USA. [Parmelee, Patricia] Univ Alabama, Dept Psychol, Tuscaloosa, AL 35487 USA. RP Fink, AS (reprint author), VAMC Atlanta, Surg Serv, 112,1670 Clairmont Rd, Decatur, GA 30033 USA. EM aaron.fink@va.gov FU Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service [IAF 05-308-01] FX Supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (Project no. IAF 05-308-01). NR 39 TC 35 Z9 35 U1 0 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 JUL PY 2010 VL 252 IS 1 BP 27 EP 36 DI 10.1097/SLA.0b013e3181e3ec61 PG 10 WC Surgery SC Surgery GA 612RW UT WOS:000278921200007 PM 20562609 ER PT J AU Bilimoria, KY Cohen, ME Ingraham, AM Bentrem, DJ Richards, K Hall, BL Ko, CY AF Bilimoria, Karl Y. Cohen, Mark E. Ingraham, Angela M. Bentrem, David J. Richards, Karen Hall, Bruce L. Ko, Clifford Y. TI Effect of Postdischarge Morbidity and Mortality on Comparisons of Hospital Surgical Quality SO ANNALS OF SURGERY LA English DT Article ID ADMINISTRATIVE DATA; HEALTH-CARE; IMPROVEMENT PROGRAM; RISK ADJUSTMENT; WOUND-INFECTION; PATIENT SAFETY; OF-CARE; SURGERY; DATABASES; OUTCOMES AB Background: Hospitals increasingly rely on surgical quality assessment programs that require considerable resources to capture outcomes after hospital discharge. However, it is unclear whether capturing postdischarge complications and deaths is important. Our objectives were (1) to determine the frequency of postdischarge complications and deaths and (2) to determine whether hospital rankings change with inclusion of postdischarge outcomes. Methods: From 181 hospitals participating in the American College of Surgeon's National Surgical Quality Improvement Program, 329,951 patients were identified (2006-2007). Mortality and 19 complications within 30 days of the index operation were categorized as occurring before or after discharge. Risk-adjusted hospital rankings were compared based on whether only predischarge (inpatient) versus both pre- and postdischarge (inpatient and outpatient within 30 days of operation) morbidity and mortality were included. Results: Postdischarge complications accounted for 32.9% of all complications. Certain complications occurred frequently after discharge: surgical site infections (66.0%), urinary tract infections (39.4%), pulmonary embolisms (42.2%), and deep venous thromboses (34.5%). Of all patients experiencing complications, 39.7% had only postdischarge complications. Of 5827 postoperative deaths, 23.6% occurred after discharge. Hospital quality rankings changed when postdischarge outcomes were excluded versus included for morbidity (median hospital rank change: 16 ranks; interquartile range, 7-36) and mortality (median hospital rank change: 14 ranks; interquartile range, 6-29), and there was disagreement in outlier status designations depending on whether postdischarge events were included (morbidity: kappa = 0.546; mortality: kappa = 0.507). Conclusions: A substantial proportion of postoperative complications and deaths occur after hospital discharge. Inclusion of postdischarge events considerably affects hospital quality rankings and outlier status designations. Quality improvement programs and research that do not consider postdischarge outcomes may offer incomplete information to hospitals, payers, providers, and patients. C1 [Bilimoria, Karl Y.; Cohen, Mark E.; Ingraham, Angela M.; Richards, Karen] Amer Coll Surg, Div Res & Optimal Patient Care, Chicago, IL 60611 USA. [Bilimoria, Karl Y.; Bentrem, David J.] Northwestern Univ, Dept Surg, Feinberg Sch Med, Chicago, IL 60611 USA. [Hall, Bruce L.] John Cochran Vet Affairs Med Ctr, Dept Surg, St Louis, MO USA. [Hall, Bruce L.] Washington Univ, Sch Med, Dept Surg, St Louis & Barnes Jewish Hosp, St Louis, MO 63110 USA. [Hall, Bruce L.] Washington Univ, Ctr Hlth Policy, St Louis, MO 63110 USA. [Hall, Bruce L.] Washington Univ, John M Olin Sch Business, St Louis, MO 63110 USA. [Ko, Clifford Y.] Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. [Ko, Clifford Y.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Bilimoria, KY (reprint author), Amer Coll Surg, Div Res & Optimal Patient Care, 633 N St Clair St,22nd Floor, Chicago, IL 60611 USA. EM kbilimoria@facs.org FU Northwestern University; Illinois Division of the American Cancer Society; Barnum Foundation FX Supported by a Priority Grant from Northwestern University and by a grant from the Illinois Division of the American Cancer Society and the Barnum Foundation (to D.J.B.). NR 50 TC 60 Z9 61 U1 2 U2 5 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 JUL PY 2010 VL 252 IS 1 BP 183 EP 190 DI 10.1097/SLA.0b013e3181e4846e PG 8 WC Surgery SC Surgery GA 612RW UT WOS:000278921200028 PM 20531000 ER PT J AU Wasif, N Maggard, MA Ko, CY Giuliano, AE AF Wasif, Nabil Maggard, Melinda A. Ko, Clifford Y. Giuliano, Armando E. TI Invasive Lobular vs. Ductal Breast Cancer: A Stage-Matched Comparison of Outcomes SO ANNALS OF SURGICAL ONCOLOGY LA English DT Article; Proceedings Paper CT Breast Cancer Symposium of the American-Society-of-Clinical-Oncology CY OCT 08-10, 2009 CL San Francisco, CA SP Amer Soc Clin Oncol ID SURGICAL ADJUVANT BREAST; CLINICAL-TRIALS; RECEPTOR STATUS; E-CADHERIN; CARCINOMA; THERAPY; CHEMOTHERAPY; SURVIVAL; FEATURES; DIAGNOSIS AB Invasive lobular breast cancer (ILC) is less common than invasive ductal breast cancer (IDC), more difficult to detect mammographically, and usually diagnosed at a later stage. Does delayed diagnosis of ILC affect survival? We used a national registry to compare outcomes of patients with stage-matched ILC and IDC. Query of the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) tumor registry identified 263,408 women diagnosed with IDC or ILC between 1993 and 2003. Survival of patients matched by T and N stage was compared using Kaplan-Meier curves and log-rank analysis. When compared with IDC, ILC was more likely to be > 2 cm (43.1 vs. 32.6%; P < 0.001), lymph node positive (36.8 vs. 34.4%; P < 0.001), and ER positive (93.1 vs. 75.6%; P < 0.001). The 5-year disease-specific survival (DSS) was significantly better for patients with ILC than for those with IDC, before (90 vs. 88%; P < 0.001) and after matching for stage T1N0 (98 vs. 96%; P < 0.001), T2N0 (94 vs. 88%; P < 0.001), and T3N0 (92 vs. 83%, P < 0.001). The 5-year DSS for patients with nodal metastasis of ILC vs. IDC was 89% vs. 88% (P = NS) for stage T1N1, 81 vs. 73% (P < 0.001) for T2N1, and 72 vs. 56% (P < 0.001) for T3N1. Multivariate analysis identified a 14% survival benefit for ILC (hazard ratio 0.86, 95% confidence interval 0.80-0.92). Stage-matched prognosis is better for patients with ILC than for those with IDC. Our findings support a different biology for ILC and are important for counseling and risk stratification. C1 [Wasif, Nabil; Giuliano, Armando E.] St Johns Hlth Ctr, John Wayne Canc Inst, Santa Monica, CA USA. [Maggard, Melinda A.; Ko, Clifford Y.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. [Wasif, Nabil] Mayo Clin, Dept Surg, Scottsdale, AZ USA. [Ko, Clifford Y.] Greater Los Angeles VA Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP Wasif, N (reprint author), St Johns Hlth Ctr, John Wayne Canc Inst, Santa Monica, CA USA. EM giulianoa@jwci.org NR 34 TC 60 Z9 62 U1 1 U2 2 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1068-9265 J9 ANN SURG ONCOL JI Ann. Surg. Oncol. PD JUL PY 2010 VL 17 IS 7 BP 1862 EP 1869 DI 10.1245/s10434-010-0953-z PG 8 WC Oncology; Surgery SC Oncology; Surgery GA 613ZN UT WOS:000279024200021 PM 20162457 ER PT J AU Miriovsky, BJ Michaud, K Thiele, GM O'Dell, JR Cannon, GW Kerr, G Richards, JS Johnson, D Caplan, L Reimold, A Hooker, R Mikuls, TR AF Miriovsky, Benjamin J. Michaud, Kaleb Thiele, Geoffrey M. O'Dell, James R. Cannon, Grant W. Kerr, Gail Richards, J. Steuart Johnson, Dannette Caplan, Liron Reimold, Andreas Hooker, Roderick Mikuls, Ted R. TI Anti-CCP antibody and rheumatoid factor concentrations predict greater disease activity in men with rheumatoid arthritis SO ANNALS OF THE RHEUMATIC DISEASES LA English DT Article ID CYCLIC CITRULLINATED PEPTIDE; PROTEIN ANTIBODIES; PROSPECTIVE COHORT; ASSOCIATION; PROGRESSION; HEALTH; VALIDATION; PHENOTYPE; CRITERIA; WOMEN AB Objective To examine associations of anti-cyclic citrullinated peptide (aCCP) antibody and rheumatoid factor (RF) concentrations with future disease activity in men with rheumatoid arthritis (RA). Methods Outcome measures were examined in male US veterans with RA and included (1) proportion of observations in remission (disease activity score (DAS28) <= 2.6); (2) remission for >= 3 consecutive months; and (3) area under the curve (AUC) for DAS28. The associations of autoantibody concentration (per 100 unit increments) with outcomes were examined using multivariate regression. Results 826 men with RA were included in the analysis; the mean (SD) age was 65 (10.5) years and follow-up was for 2.6 (1.3) years. Most were aCCP (75%) and RF (80%) positive. After multivariate adjustment, aCCP (OR 0.93; 95% CI 0.89 to 0.96) and RF concentrations (OR 0.92; 95% CI 0.90 to 0.94) were associated with a lower odds of remission, a lower proportion of observation in remission (p=0.017 and p=0.002, respectively) and greater AUC DAS28 (p=0.092 and p=0.007, respectively). Among patients with discordant autoantibody status, higher concentrations of both aCCP and RF trended towards an inverse association with remission (OR 0.93; 95% CI 0.83 to 1.05 and OR 0.80; 95% CI 0.59 to 1.10, respectively). Conclusions Higher aCCP concentrations (particularly in RF-positive patients) are associated with increased disease activity in US veterans with RA, indicating that aCCP concentration is predictive of future disease outcomes in men. C1 [Miriovsky, Benjamin J.; Michaud, Kaleb; Thiele, Geoffrey M.; O'Dell, James R.; Mikuls, Ted R.] Omaha VAMC, Omaha, NE USA. [Miriovsky, Benjamin J.; Michaud, Kaleb; Thiele, Geoffrey M.; O'Dell, James R.; Mikuls, Ted R.] Nebraska Arthrit Outcomes Res Ctr, Omaha, NE USA. [Cannon, Grant W.] George E Wahlen VAMC, Salt Lake City, UT USA. [Kerr, Gail; Richards, J. Steuart] VAMC, Washington, DC USA. [Johnson, Dannette] Jackson VAMC, Jackson, MS USA. [Caplan, Liron] Denver VAMC, Denver, CO USA. [Reimold, Andreas; Hooker, Roderick] Dallas VAMC, Dallas, TX USA. RP Mikuls, TR (reprint author), Univ Nebraska, Med Ctr, Dept Internal Med, Sect Rheumatol & Immunol, 986270 Nebraska Med Ctr, Omaha, NE 68198 USA. EM tmikuls@unmc.edu OI Thiele, Geoffrey/0000-0001-5688-8596 FU American College of Rheumatology (ACR) Research and Education Foundation; NIH/NIAMS [R03 AR054539]; Veterans Health Administration (VHA); Abbott Laboratories; Bristol-Myers Squibb; NIAMS [K23 AR050004]; VHA (VA Merit); VA HSRD FX BJM was supported by the Ephraim P Engleman Endowed Resident Reseach Preceptorship from the American College of Rheumatology (ACR) Research and Education Foundation. This work was funded by a grant from NIH/NIAMS (R03 AR054539, PI TRM). The VARA Registry has received research support from the Health Services Research & Development (HSR&D) Program of the Veterans Health Administration (VHA) in addition to unrestricted research funds from Abbott Laboratories and Bristol-Myers Squibb. TRM receives research support from NIAMS (K23 AR050004) and the VHA (VA Merit). LC is supported by a VA HSR&D Career Development Award. NR 27 TC 30 Z9 31 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 2010 VL 69 IS 7 BP 1292 EP 1297 DI 10.1136/ard.2009.122739 PG 6 WC Rheumatology SC Rheumatology GA 622MD UT WOS:000279667000008 PM 20439294 ER PT J AU Garcia, S Murray, STN Moritz, TE Pierpont, G Goldman, S Larsen, GC Littooy, F Ward, HB McFalls, EO AF Garcia, Santiago Murray, Sara T. N. Moritz, Thomas E. Pierpont, Gordon Goldman, Steven Larsen, Greg C. Littooy, Fred Ward, Herbert B. McFalls, Edward O. TI Culprit Coronary Lesions Requiring Percutaneous Coronary Intervention After Vascular Surgery Often Arise From In-Stent Restenosis of Bare Metal Stents SO ANNALS OF VASCULAR SURGERY LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; PERIPHERAL ARTERIAL-DISEASE; ELEVATED HOMOCYSTEINE LEVELS; ENDOTHELIAL DYSFUNCTION; REVASCULARIZATION; MORTALITY; ASSOCIATION; EVENTS; RISK AB Background: The natural history of coronary artery disease (CAD) after vascular surgery is poorly defined. The aim of this study was to determine the temporal change of coronary artery lesions requiring revascularization with a percutaneous coronary intervention (PCI) after elective vascular surgery and to determine the utility of preoperative biomarkers on predicting those patients at risk for new coronary lesions. Methods: The Coronary Artery Revascularization Prophylaxis Trial tested the long-term survival benefit of coronary artery revascularization before elective vascular surgery. Among randomized patients who subsequently required PCI after surgery, the stenosis of the culprit lesion from the follow-up angiogram was compared with the preoperative vessel stenosis at the identical site on the baseline angiogram. Results: A total of 30 patients underwent PCI for progressive symptoms at a median of 11.5 (interquartiles: 4.5-18.5) months postsurgery. Of 30 patients, 16 (53%) had nonobstructive CAD preoperatively (group 1) with a stenosis that increased from 17 +/- 6% to 91 +/- 2% (P < 0.01) and 14 (47%) had severe CAD at the culprit site preoperatively (group 2), with a stenosis that increased 89 +/- 2% (P = 0.15). The only biomarker that was an identifier of early coronary artery lesion formation in group 1 compared with group 2 patients was a higher baseline homocysteine level (14.6 +/- 1.4 vs. 10.6 +/- 0.7 mg/dL; P = 0.02). Conclusions: Culprit coronary artery lesions requiring PCI after an elective vascular operation often arise from in-stent restenosis. Therapies that either stabilize existing plaques or prevent restenosis, particularly among patients with elevated homocysteine levels, have the greatest promise for improving postoperative outcomes. C1 [Garcia, Santiago; Murray, Sara T. N.; Pierpont, Gordon; McFalls, Edward O.] Univ Minnesota, Div Cardiol, Minneapolis, MN USA. [Garcia, Santiago; Murray, Sara T. N.; Pierpont, Gordon; Ward, Herbert B.; McFalls, Edward O.] Minneapolis VA Med Ctr, Minneapolis, MN USA. [Ward, Herbert B.] Univ Minnesota, Div Cardiothorac Surg, Minneapolis, MN USA. [Moritz, Thomas E.] Cooperat Studies Program Coordinating Ctr, Hines, IL USA. [Littooy, Fred] VA Med Ctr Hines, Div Vasc Surg, Hines, IL USA. [Goldman, Steven] So Arizona VA Healthcare Syst, Div Cardiol, Tucson, AZ USA. [Goldman, Steven] Univ Arizona, Sarver Heart Ctr, Tucson, AZ USA. [Larsen, Greg C.] Portland VA Med Ctr, Div Cardiol, Portland, OR USA. RP McFalls, EO (reprint author), VA Med Ctr, Div Cardiol, 1 Vet Dr, Minneapolis, MN 55417 USA. EM mcfal001@umn.edu FU Department of Veterans Affairs Office of Research and Development FX Supported by the Cooperative Studies Program of the Department of Veterans Affairs Office of Research and Development. NR 23 TC 0 Z9 1 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0890-5096 J9 ANN VASC SURG JI Ann. Vasc. Surg. PD JUL PY 2010 VL 24 IS 5 BP 596 EP 601 DI 10.1016/j.avsg.2010.03.006 PG 6 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 611MP UT WOS:000278819800004 PM 20579583 ER PT J AU Sabbaghian, MS Rothberger, G Alongi, AP Gagner, JP Goldberg, JD Rolnitzky, L Chiriboga, L Hajdu, CH Zagzag, D Basch, R Shamamian, P AF Sabbaghian, M. Shirin Rothberger, Gary Alongi, Alexandra P. Gagner, Jean-Pierre Goldberg, Judith D. Rolnitzky, Linda Chiriboga, Luis Hajdu, Cristina H. Zagzag, David Basch, Ross Shamamian, Peter TI Levels of Elevated Circulating Endothelial Cell Decline after Tumor Resection in Patients with Pancreatic Ductal Adenocarcinoma SO ANTICANCER RESEARCH LA English DT Article DE Pancreatic cancer; endothelial cells; neovascularization; angiogenesis; placental growth factor ID PROGENITOR CELLS; GROWTH-FACTOR; COLORECTAL-CANCER; ANGIOGENESIS; NEOVASCULARIZATION; VASCULOGENESIS; MARKER; PRECURSORS; VEGF AB Aim: To evaluate circulating endothelial lineage cells (ELCs) as biomarkers of tumor neovascularization in patients with pancreatic ductal adenocarcinoma (PDAC). Materials and Methods: ELCs were isolated from the peripheral blood of patients with PDAC (n=14) or controls (n=17) before and after tumor resection/surgery and quantified using flow cytometry. Vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) were detected in tumor using immunohistochemistry and in plasma using an ELISA technique. Results: Circulating ELC levels were increased in patients with PDAC compared to controls. After PDAC resection, ELC levels declined. ELC level increases were associated with cancer recurrence. VEGF and PlGF were identified in cancer cells and exocrine pancreas cells. Only PlGF was detected in tumor-associated inflammatory cells. Plasma levels of PlGF were higher in patients with PDAC compared to controls. Conclusion: Circulating ELCs are a potential biomarker of PDAC neovascularization, and PlGF may be an important target in treatment of PDAC. C1 [Shamamian, Peter] Ralph H Johnson Vet Affairs Med Ctr, Surg Serv 112, Surg Serv, Charleston, SC 29401 USA. [Sabbaghian, M. Shirin; Rothberger, Gary; Alongi, Alexandra P.; Gagner, Jean-Pierre] NYU, Sch Med, Dept Surg, SA Localio Lab, New York, NY 10016 USA. [Goldberg, Judith D.; Rolnitzky, Linda] NYU, Sch Med, Div Biostat, New York, NY 10016 USA. [Chiriboga, Luis; Hajdu, Cristina H.; Zagzag, David; Basch, Ross] NYU, Sch Med, Dept Pathol, New York, NY 10016 USA. [Zagzag, David; Basch, Ross] NYU, Ctr Canc, New York, NY 10016 USA. [Shamamian, Peter] Med Univ S Carolina, Dept Surg, Charleston, SC 29425 USA. RP Shamamian, P (reprint author), Ralph H Johnson Vet Affairs Med Ctr, Surg Serv 112, Surg Serv, 109 Bee St, Charleston, SC 29401 USA. EM shamamia@musc.edu OI Chiriboga, Luis/0000-0002-2028-6873 FU S. Arthur Localio Professorship Fund; New York University Cancer Institute FX This work was supported, in part, by the S. Arthur Localio Professorship Fund and by a Translational Research Pilot Project Grant from the New York University Cancer Institute. NR 21 TC 7 Z9 7 U1 0 U2 3 PU INT INST ANTICANCER RESEARCH PI ATHENS PA EDITORIAL OFFICE 1ST KM KAPANDRITIOU-KALAMOU RD KAPANDRITI, PO BOX 22, ATHENS 19014, GREECE SN 0250-7005 J9 ANTICANCER RES JI Anticancer Res. PD JUL PY 2010 VL 30 IS 7 BP 2911 EP 2917 PG 7 WC Oncology SC Oncology GA 637DQ UT WOS:000280796400061 PM 20683032 ER PT J AU Morganroth, PA Kreider, ME Okawa, J Taylor, L Werth, VP AF Morganroth, Pamela A. Kreider, Mary Elizabeth Okawa, Joyce Taylor, Lynne Werth, Victoria P. TI Interstitial Lung Disease in Classic and Skin-Predominant Dermatomyositis A Retrospective Study With Screening Recommendations SO ARCHIVES OF DERMATOLOGY LA English DT Article ID CLINICALLY AMYOPATHIC DERMATOMYOSITIS; CONNECTIVE-TISSUE DISEASE; PULMONARY-FUNCTION TESTS; MYCOPHENOLATE-MOFETIL; RHEUMATOID-ARTHRITIS; POLYMYOSITIS; POLYMYOSITIS/DERMATOMYOSITIS; METHOTREXATE; SCLERODERMA; THERAPY AB Objectives: (1) To determine the prevalence of interstitial lung disease (ILD) and isolated low diffusing capacity for carbon monoxide (DLCO) in a large cohort of outpatients with dermatomyositis. (2) To compare the pulmonary abnormalities of patients with classic dermatomyositis and those with skin-predominant dermatomyositis. Design: Retrospective cohort study. Setting: University hospital outpatient dermatology referral center. Patients: Medical records of 91 outpatients with adult-onset dermatomyositis seen between May 26, 2006, and May 25, 2009, were reviewed. Main Outcome Measures: Presence of ILD on thin-slice chest computed tomographic (CT) scans and DLCO. Results: Of the 71 patients with dermatomyositis who had CT or DLCO data, 16 of 17 (23%; 95% confidence interval [CI], 13%-33%) had ILD as defined by CT results. All patients with ILD had a reduced DLCO, and the ILD prevalence was not different between patients with skin-predominant dermatomyositis (10 of 35 [29%]) and those with classic dermatomyositis (6 of 36 [17%]) (P=.27). Eighteen of 71 patients with dermatomyositis (25%; 95% CI, 15%-36%) (7 of 35 [20%] with skin-predominant dermatomyositis; 11 of 36 [31%] with classic dermatomyositis; P=.41) had a low DLCO in the absence of CT findings showing ILD. The prevalence of malignant disease was higher in patients with classic dermatomyositis than in those with skin-predominant dermatomyositis (P=.02), and no patients with skin-predominant dermatomyositis had internal malignant disease. Conclusions: Radiologic ILD and isolated DLCO reductions, which may signify early ILD or pulmonary hypertension, are common in dermatology outpatients with both classic and skin-predominant dermatomyositis. Because DLCO testing is both inexpensive and sensitive for pulmonary disease, it may be appropriate to screen all patients with dermatomyositis with serial DLCO measurements and base further testing on DLCO results. C1 [Morganroth, Pamela A.; Okawa, Joyce; Werth, Victoria P.] Philadelphia VA Med Ctr, Philadelphia, PA USA. [Morganroth, Pamela A.; Kreider, Mary Elizabeth; Okawa, Joyce; Werth, Victoria P.] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. [Kreider, Mary Elizabeth] Univ Penn, Div Pulm Med, Philadelphia, PA 19104 USA. [Taylor, Lynne] Univ Penn, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. [Morganroth, Pamela A.; Okawa, Joyce; Werth, Victoria P.] Univ Penn, Dept Dermatol, Philadelphia, PA 19104 USA. RP Werth, VP (reprint author), Hosp Univ Penn, Dept Dermatol, PCAM, Ste 1-330S,3400 Civ Ctr Blvd, Philadelphia, PA 19104 USA. EM werth@mail.med.upenn.edu FU Department of Veterans Health Administration; Office of Research Development; Biomedical Laboratory Research and Development; National Institutes of Health (NIH) [K24-AR 02207]; National Institute of Arthritis; Musculoskeletal and Skin Diseases (NIH) [5T32-AR007465-26] FX This study was supported in part by a Merit Review grant from the Department of Veterans Health Administration, Office of Research Development, Biomedical Laboratory Research and Development, and by the National Institutes of Health (NIH K24-AR 02207) to Dr Werth. The Dermatology Research Training Grant from the National Institutes of Health, National Institute of Arthritis, and Musculoskeletal and Skin Diseases (NIH 5T32-AR007465-26) provided support for Dr Morganroth. NR 29 TC 26 Z9 26 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-987X J9 ARCH DERMATOL JI Arch. Dermatol. PD JUL PY 2010 VL 146 IS 7 BP 729 EP 738 PG 10 WC Dermatology SC Dermatology GA 628BC UT WOS:000280088100005 PM 20644033 ER PT J AU Klein, R Rosenbach, M Kim, EJ Kim, B Werth, VP Dunham, J AF Klein, Rachel Rosenbach, Misha Kim, Ellen J. Kim, Brian Werth, Victoria P. Dunham, Jonathan TI Tumor Necrosis Factor Inhibitor-Associated Dermatomyositis SO ARCHIVES OF DERMATOLOGY LA English DT Article ID TNF-TARGETED THERAPIES; FACTOR-ALPHA; RHEUMATOID-ARTHRITIS; INFLAMMATORY MYOPATHIES; ANTIBODY; AUTOIMMUNITY; ETANERCEPT; ACTIVATION; MECHANISMS; RECEPTORS AB Background: Dermatomyositis is an autoimmune disease of unknown etiology characterized by inflammation of the skin and muscles. Several medications have been implicated in the development of dermatomyositis; however, the disease has rarely been linked to the use of tumor necrosis factor (TNF) inhibitors. We report 4 cases of dermatomyositis that developed or were exacerbated by exposure to the TNF inhibitors etanercept and adalimumab. Observation: Four patients with symptoms of inflammatory arthritis were treated with TNF inhibitors for a duration ranging from 2 months to 2 years. All 4 patients developed symptoms consistent with dermatomyositis, including inflammatory rash and muscle weakness. Their symptoms persisted after discontinuation of the treatment with the TNF inhibitors but responded to treatment with corticosteroids and immunosuppressive medications. Conclusions: Tumor necrosis factor inhibitors have been associated with the onset of a number of autoimmune disorders, most commonly vasculitis and a lupuslike syndrome. Rarely have they been associated with dermatomyositis. The 4 cases reported herein indicate that TNF inhibitor use can be associated with either induction or exacerbation of dermatomyositis. C1 [Dunham, Jonathan] Univ Penn, Sch Med, Dept Med, Perelman Ctr Adv Med,Div Rheumatol, Philadelphia, PA 19104 USA. [Klein, Rachel; Rosenbach, Misha; Kim, Ellen J.; Kim, Brian; Werth, Victoria P.] Univ Penn, Sch Med, Dept Dermatol, Philadelphia, PA 19104 USA. [Werth, Victoria P.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Dunham, J (reprint author), Univ Penn, Sch Med, Dept Med, Perelman Ctr Adv Med,Div Rheumatol, 1st Floor S Pavil,3400 Civ Ctr Blvd, Philadelphia, PA 19104 USA. EM Jonathan.Dunham@uphs.upenn.edu FU NIAMS NIH HHS [K24 AR002207, K24 AR002207-07] NR 23 TC 51 Z9 56 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-987X J9 ARCH DERMATOL JI Arch. Dermatol. PD JUL PY 2010 VL 146 IS 7 BP 780 EP 784 PG 5 WC Dermatology SC Dermatology GA 628BC UT WOS:000280088100014 PM 20644041 ER PT J AU Contreras, MA Ries, WL Shanmugarajan, S Arboleda, G Singh, I Singh, AK AF Contreras, Miguel Agustin Ries, William Louis Shanmugarajan, Srinivasan Arboleda, Gonzalo Singh, Inderjit Singh, Avtar Kaur TI Factors that affect postnatal bone growth retardation in the twitcher murine model of Krabbe disease SO BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR BASIS OF DISEASE LA English DT Article DE Galactosylsphingosine; Insulin-like growth factor-1; Krabbe disease; Lysosomal disorders; Osteopenia; Psychosine; Twitcher mice ID GLOBOID-CELL LEUKODYSTROPHY; PSYCHOSINE-INDUCED APOPTOSIS; TANDEM MASS-SPECTROMETRY; I IGF-I; SPHINGOSINE 1-PHOSPHATE; MOLECULAR-MECHANISM; STORAGE DISEASE; MUTANT TWITCHER; MOUSE; HORMONE AB Krabbe disease is an inherited lysosomal disorder in which galactosylsphingosine (psychosine) accumulates mainly in the central nervous system. To gain insight into the possible mechanism(s) that may be participating in the inhibition of the postnatal somatic growth described in the animal model of this disease (twitcher mouse, twi), we studied their femora. This study reports that twi femora are smaller than of those of wild type (wt), and present with abnormality of marrow cellularity, bone deposition (osteoblastic function), and osteoclastic activity. Furthermore, lipidomic analysis indicates altered sphingolipid homeostasis, but without significant changes in the levels of sphingolipid-derived intermediates of cell death (ceramide) or the levels of the osteoclast-osteoblast coupling factor (sphingosine-1-phosphate). However, there was significant accumulation of psychosine in the femora of adult twi animals as compared to wt, without induction of tumor necrosis factor-alpha or interleukin-6. Analysis of insulin-like growth factor-1 (IGF-1) plasma levels, a liver secreted hormone known to play a role in bone growth, indicated a drastic reduction in twi animals when compared to wt. To identify the cause of the decrease, we examined the IGF-1 mRNA expression and protein levels in the liver. The results indicated a significant reduction of IGF-1 mRNA as well as protein levels in the liver from twi as compared to wt littermates. Our data suggest that a combination of endogenous (psychosine) and endocrine (IGF-1) factors play a role in the inhibition of postnatal bone growth in twi mice; and further suggest that derangements of liver function may be contributing, at least in part, to this alteration. (C) 2010 Elsevier B.V. All rights reserved. C1 [Contreras, Miguel Agustin; Ries, William Louis; Shanmugarajan, Srinivasan; Arboleda, Gonzalo; Singh, Inderjit] Med Univ S Carolina, Darby Childrens Res Inst, Dept Pediat, Charleston, SC 29425 USA. [Singh, Avtar Kaur] Ralph H Johnson Vet Adm Med Ctr, Dept Pathol & Lab Med, Charleston, SC USA. RP Singh, AK (reprint author), Med Univ S Carolina, Darby Childrens Res Inst 516, 173 Ashley Ave, Charleston, SC 29425 USA. EM gharboledab@unal.edu.co; avtar.singh@med.va.gov FU National Center for Research Resources [C06 RR018823, C06 RR015455]; National Institutes of Health [NS-22576, NS-34741, NS-37766, NS-40810, AG-25307] FX The authors would like to thank Ms. Joyce Bryan, Dr. Narender Nath and the members of the Lipidomics Core Facility of the Medical University of South Carolina for the excellent technical assistance. This work was supported by Grants from the Extramural Research Facilities Program of the National Center for Research Resources (C06 RR018823 and C06 RR015455) and from the National Institutes of Health (NS-22576, NS-34741, NS-37766, NS-40810 and AG-25307). NR 73 TC 8 Z9 8 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0925-4439 EI 0006-3002 J9 BBA-MOL BASIS DIS JI Biochim. Biophys. Acta-Mol. Basis Dis. PD JUL-AUG PY 2010 VL 1802 IS 7-8 BP 601 EP 608 DI 10.1016/j.bbadis.2010.04.006 PG 8 WC Biochemistry & Molecular Biology; Biophysics; Cell Biology SC Biochemistry & Molecular Biology; Biophysics; Cell Biology GA 622HI UT WOS:000279651600003 PM 20441793 ER PT J AU Lee, J Cohen, MS Engel, SA Glahn, D Nuechterlein, KH Wynn, JK Green, MF AF Lee, Junghee Cohen, Mark S. Engel, Stephen A. Glahn, David Nuechterlein, Keith H. Wynn, Jonathan K. Green, Michael F. TI Regional Brain Activity During Early Visual Perception in Unaffected Siblings of Schizophrenia Patients SO BIOLOGICAL PSYCHIATRY LA English DT Article DE Backward masking; early visual perception; lateral occipital complex; schizophrenia; unaffected siblings ID BACKWARD-MASKING PERFORMANCE; INFORMATION-PROCESSING DEFICITS; MULTIPLE TRIAL TYPES; EVENT-RELATED FMRI; FUNCTIONAL MRI; SEPARATING PROCESSES; OCCIPITAL CORTEX; BIPOLAR DISORDER; ATTENTION; AWARENESS AB Background: Visual masking paradigms assess the early part of visual information processing, which may reflect vulnerability measures for schizophrenia. We examined the neural substrates of visual backward performance in unaffected sibling of schizophrenia patients using functional magnetic resonance imaging (fMRI). Methods: Twenty-one unaffected siblings of schizophrenia patients and 19 healthy controls performed a backward masking task and three functional localizer tasks to identify three visual processing regions of interest (ROI): lateral occipital complex (LO), the motion-sensitive area, and retinotopic areas. In the masking task, we systematically manipulated stimulus onset asynchronies (SOAs). We analyzed fMRI data in two complementary ways: 1) an ROI approach for three visual areas, and 2) a whole-brain analysis. Results: The groups did not differ in behavioral performance. For ROI analysis, both groups increased activation as SOAs increased in LO. Groups did not differ in activation levels of the three ROIs. For whole-brain analysis, controls increased activation as a function of SOAs, compared with siblings in several regions (i.e., anterior cingulate cortex, posterior cingulate cortex, inferior prefrontal cortex, inferior parietal lobule). Conclusions: The study found: 1) area LO showed sensitivity to the masking effect in both groups; 2) siblings did not differ from controls in activation of LO; and 3) groups differed significantly in several brain regions outside visual processing areas that have been related to attentional or re-entrant processes. These findings suggest that LO dysfunction may be a disease indicator rather than a risk indicator for schizophrenia. C1 [Lee, Junghee; Cohen, Mark S.; Nuechterlein, Keith H.; Wynn, Jonathan K.; Green, Michael F.] Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Los Angeles, CA 90095 USA. [Lee, Junghee; Wynn, Jonathan K.; Green, Michael F.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Engel, Stephen A.] Univ Minnesota, Calif Dept Psychol, Minneapolis, MN USA. [Glahn, David] Yale Univ, Sch Med, Olin Neuropsychiat Res Ctr, Inst Living, New Haven, CT USA. Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA. [Nuechterlein, Keith H.] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA. RP Lee, J (reprint author), Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, 300 Med Plaza,Suite 2200, Los Angeles, CA 90095 USA. EM jungheelee@ucla.edu RI Lee, Junghee/C-5226-2014; Wynn, Jonathan/H-3749-2014; Cohen, Mark/C-6610-2011 OI Lee, Junghee/0000-0001-9567-8700; Wynn, Jonathan/0000-0002-1763-8540; Cohen, Mark/0000-0001-6731-4053 FU National Institutes of Mental Health [MH43292, MH065707] FX Support for this study came from National Institutes of Mental Health Grant Nos. MH43292 and MH065707 (principal investigator: Michael F. Green, Ph.D.). We thank Poorang Non, Alex Korb, and Alisa Malin for assistance in data collection. NR 63 TC 10 Z9 10 U1 0 U2 4 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 2010 VL 68 IS 1 BP 78 EP 85 DI 10.1016/j.biopsych.2010.03.028 PG 8 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 616KH UT WOS:000279207800010 PM 20494338 ER PT J AU Mani, G Macias, CE Feldman, MD Marton, D Oh, S Agrawal, CM AF Mani, Gopinath Macias, Celia E. Feldman, Marc D. Marton, Denes Oh, Sunho Agrawal, C. Mauli TI Delivery of paclitaxel from cobalt-chromium alloy surfaces without polymeric carriers SO BIOMATERIALS LA English DT Article DE Drug-eluting stents; Drug delivery; Cobalt-Chromium alloy; Surface treatment; Surface modification ID SELF-ASSEMBLED MONOLAYERS; DRUG-ELUTING STENTS; BALLOON-EXPANDABLE-STENT; CORONARY-ARTERY DISEASE; IN-VITRO CONDITIONS; PORCINE MODEL; TITANIUM SURFACES; NEOINTIMAL HYPERPLASIA; INTIMAL HYPERPLASIA; RESTENOSIS AB Polymer-based carriers are commonly used to deliver drugs from stents. However, adverse responses to polymer coatings have raised serious concerns. This research is focused on delivering drugs from stents without using polymers or any carriers. Paclitaxel (PAT), an anti-restenotic drug, has strong adhesion towards a variety of material surfaces. In this study, we have utilized such natural adhesion property of PAT to attach these molecules directly to cobalt chromium (Co-Cr) alloy, an ultra-thin stent strut material. Four different groups of drug coated specimens were prepared by directly adding PAT to Co-Cr alloy surfaces: Group-A (PAT coated, unheated, and ethanol cleaned): Group-B (PAT coated, heat treated, and ethanol cleaned); Group-C (PAT coated, unheated, and not ethanol cleaned); and Group-D (PAT coated, heat treated and not ethanol cleaned). In vitro drug release of these specimens was investigated using high performance liquid chromatography. Groups A and B showed sustained PAT release for up to 56 days. A simple ethanol cleaning procedure after PAT deposition can remove the loosely bound drug crystals from the alloy surfaces and thereby allowing the remaining strongly bound drug molecules to be released at a sustained rate. The heat treatment after PAT coating further improved the stability of PAT on Co-Cr alloy and allowed the drug to be delivered at a much slower rate, especially during the initial 7 days. The specimens which were not cleaned in ethanol, Groups C and D, showed burst release. PAT coated Co-Cr alloy specimens were thoroughly characterized using scanning electron microscopy, atomic force microscopy, and X-ray photoelectron spectroscopy. These techniques were collectively useful in studying the morphology, distribution, and attachment of PAT molecules on Co-Cr alloy surfaces. Thus, this study suggests the potential for delivering paclitaxel from Co-Cr alloy surfaces without using any carriers. (C) 2010 Elsevier Ltd. All rights reserved. C1 [Mani, Gopinath; Macias, Celia E.; Feldman, Marc D.; Marton, Denes; Oh, Sunho; Agrawal, C. Mauli] Univ Texas San Antonio, Dept Biomed Engn, Coll Engn, San Antonio, TX 78249 USA. [Feldman, Marc D.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Div Cardiol, San Antonio, TX 78229 USA. [Feldman, Marc D.] Dept Vet Affairs S Texas Hlth Care Syst, San Antonio, TX 78229 USA. [Marton, Denes] Univ Texas Hlth Sci Ctr San Antonio, Dept Radiol, Sch Med, San Antonio, TX 78229 USA. RP Mani, G (reprint author), Univ Texas San Antonio, Dept Biomed Engn, Coll Engn, 1 UTSA Circle, San Antonio, TX 78249 USA. EM Gopinath.Mani@utsa.edu RI Marton, Denes/E-7759-2010 FU NIGMS NIH HHS [R25 GM060655] NR 66 TC 25 Z9 27 U1 0 U2 7 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0142-9612 J9 BIOMATERIALS JI Biomaterials PD JUL PY 2010 VL 31 IS 20 BP 5372 EP 5384 DI 10.1016/j.biomaterials.2010.03.043 PG 13 WC Engineering, Biomedical; Materials Science, Biomaterials SC Engineering; Materials Science GA 608GP UT WOS:000278571800010 PM 20398928 ER PT J AU Sonpavde, G Sternberg, CN AF Sonpavde, Guru Sternberg, Cora N. TI Neoadjuvant systemic therapy for urological malignancies SO BJU INTERNATIONAL LA English DT Review DE Prostate cancer; bladder cancer; renal cell carcinoma; neoadjuvant therapy; surgery ID RENAL-CELL CARCINOMA; LOCALIZED PROSTATE-CANCER; PHASE-II TRIAL; GEMCITABINE PLUS CISPLATIN; INVASIVE BLADDER-CANCER; ANDROGEN-DEPRIVATION THERAPY; RANDOMIZED CONTROLLED-TRIAL; INDIVIDUAL PATIENT DATA; POSITIVE BREAST-CANCER; RADICAL PROSTATECTOMY AB Neoadjuvant cisplatin-based combined chemotherapy is an established standard for muscle-invasive bladder cancer and pathological complete remission is an excellent intermediate surrogate endpoint for survival. Phase III trials are ongoing to elucidate the role of neoadjuvant combined androgen deprivation and docetaxel-based chemotherapy for localized high-risk prostate cancer. Neoadjuvant therapy with biological agents targeting angiogenesis preceding cytoreductive nephrectomy for metastatic renal cell carcinoma is a novel approach, although ongoing randomized trials are validating this paradigm and attempting to establish the timing and necessity of cytoreductive nephrectomy. Neoadjuvant trials provide a window of opportunity to evaluate and screen novel agents for biological activity by using brief therapy preceding surgery and provide a rationale to further develop the most promising agents in larger trials. The neoadjuvant therapy approach followed by surgery is acceptable and feasible with a wide array of agents in urological cancers and provides a paradigm for evaluating the activity, mechanism of action and resistance to new treatments. Urological cancers are initially characterized by localized presentation in the vast majority of cases, coupled with a substantial risk of distant relapses following surgical resection. Therefore, the paradigm of neoadjuvant therapy preceding surgery may expedite the development of novel systemic agents and improve outcomes. C1 [Sternberg, Cora N.] San Camillo Forlanini Hosp, Dept Med Oncol, Rome, Italy. [Sonpavde, Guru] Baylor Coll Med, Sect Med Oncol, Dept Med, Houston, TX 77030 USA. [Sonpavde, Guru] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Sternberg, CN (reprint author), San Camillo & Forlanini Hosp, Dept Med Oncol, Nuovo Padigl 4,Circonvallaz Gianicolense 87, I-00152 Rome, Italy. EM csternberg@scamilloforlanini.rm.it FU Eli Lilly; Pfizer; Bristol-Myers Squibb; Cytogen; AstraZeneca; Sanofi-Aventis; Cougar Biotech FX Guru Sonpavde receives research support from Eli Lilly, Pfizer, Bristol-Myers Squibb, Cytogen and AstraZeneca and is on the speakers' bureau for Pfizer, Novartis and Sanofi-Aventis.; Cora N. Sternberg has received research support from Eli Lilly, Sanofi-Aventis, Cougar Biotech, and is on the advisory board/consultant for Bayer, Novartis, GlaxoSmithKline and Pfizer. NR 131 TC 16 Z9 20 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1464-4096 EI 1464-410X J9 BJU INT JI BJU Int. PD JUL PY 2010 VL 106 IS 1 BP 6 EP 22 DI 10.1111/j.1464-410X.2010.09425.x PG 17 WC Urology & Nephrology SC Urology & Nephrology GA 607PA UT WOS:000278516600003 PM 20553475 ER PT J AU Cackowski, FC Anderson, JL Choksi, RJ Patrene, KD Ross, FP Stolz, B Shapiro, SD Windle, JJ Blair, HC Roodman, GD AF Cackowski, F. C. Anderson, J. L. Choksi, R. J. Patrene, K. D. Ross, F. P. Stolz, B. Shapiro, S. D. Windle, J. J. Blair, H. C. Roodman, G. D. TI PTHrP Stimulates Angiogenesis by Means of Osteoclast Derived MMP-9 SO BONE LA English DT Meeting Abstract CT 9th International Meeting on Cancer Induced Bone Disease CY OCT 28-31, 2009 CL Arlington, VA ID HORMONE-RELATED PEPTIDE; PROTEIN C1 [Cackowski, F. C.; Anderson, J. L.; Choksi, R. J.; Patrene, K. D.] Univ Pittsburgh, Dept Med, Div Hematol Oncol, Pittsburgh, PA USA. [Ross, F. P.] Washington Univ, Dept Pathol & Immunol, St Louis, MO USA. [Stolz, B.] Univ Pittsburgh, Dept Cell Biol & Physiol, Pittsburgh, PA USA. [Shapiro, S. D.] Univ Pittsburgh, Dept Med, Div Pulm Allergy & Crit Care Med, Pittsburgh, PA USA. [Windle, J. J.] Virginia Commonwealth Univ, Richmond, VA USA. [Blair, H. C.] Univ Pittsburgh, Dept Pathol, Pittsburgh, PA USA. [Roodman, G. D.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 4 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 8756-3282 J9 BONE JI Bone PD JUL PY 2010 VL 47 SU 2 BP S297 EP S298 DI 10.1016/j.bone.2010.01.244 PG 2 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 632SV UT WOS:000280449200070 ER PT J AU D'Souza, S Shiozawa, Y Galson, DL Taichman, R Roodman, G AF D'Souza, S. Shiozawa, Y. Galson, D. L. Taichman, R. Roodman, G. TI Annexin II and Annexin II Receptor Interactions Enhance Multiple Myeloma Growth in the Bone Marrow Microenvironment SO BONE LA English DT Meeting Abstract CT 9th International Meeting on Cancer Induced Bone Disease CY OCT 28-31, 2009 CL Arlington, VA C1 [D'Souza, S.; Galson, D. L.; Roodman, G.] Univ Pittsburgh, Sch Med, Dept Med, Bone Biol Ctr,UPMC, Pittsburgh, PA USA. [D'Souza, S.; Galson, D. L.; Roodman, G.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Shiozawa, Y.; Taichman, R.] Univ Michigan, Sch Dent, Dept Periodont & Oral Med, Ann Arbor, MI 48109 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 8756-3282 J9 BONE JI Bone PD JUL PY 2010 VL 47 SU 2 BP S284 EP S285 DI 10.1016/j.bone.2010.01.212 PG 2 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 632SV UT WOS:000280449200046 ER PT J AU D'Souza, S Del Prete, D Sammut, B Esteve, F Yu, S Xiao, G Galson, DL Roodman, G AF D'Souza, S. Del Prete, D. Sammut, B. Esteve, F. Yu, S. Xiao, G. Galson, D. L. Roodman, G. TI Multiple myeloma cell induction of Gfi-1 in stromal cells suppresses osteoblast differentiation in patients with myeloma SO BONE LA English DT Meeting Abstract CT 9th International Meeting on Cancer Induced Bone Disease CY OCT 28-31, 2009 CL Arlington, VA C1 Univ Pittsburgh, Dept Med, Bone Biol Ctr, UPMC,Sch Med, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA 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 8756-3282 J9 BONE JI Bone PD JUL PY 2010 VL 47 SU 2 BP S284 EP S284 DI 10.1016/j.bone.2010.01.211 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 632SV UT WOS:000280449200045 ER PT J AU Galor, A Feuer, W Kempen, JH Kacmaz, RO Liesegang, TL Suhler, EB Foster, CS Jabs, DA Levy-Clarke, GA Nussenblatt, RB Rosenbaum, JT Thorne, JE AF Galor, Anat Feuer, William Kempen, John H. Kacmaz, R. Oktay Liesegang, Teresa L. Suhler, Eric B. Foster, C. Stephen Jabs, Douglas A. Levy-Clarke, Grace A. Nussenblatt, Robert B. Rosenbaum, James T. Thorne, Jennifer E. TI Adverse effects of smoking on patients with ocular inflammation SO BRITISH JOURNAL OF OPHTHALMOLOGY LA English DT Article ID CIGARETTE-SMOKING; RISK-FACTORS; EYE DISEASE; THERAPY; UVEITIS; EPIDEMIOLOGY; EPISCLERITIS; PREVALENCE; PREDICTORS; SCLERITIS AB Background To evaluate how smoking affects the time to disease quiescence and time to disease recurrence in patients with ocular inflammation. Methods A retrospective cohort study of patients with ocular inflammation who were followed longitudinally and had smoking information available in the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study database. Results Among 2676 patients with active ocular inflammation, smokers were more likely to have bilateral ocular disease and poorer visual acuity on presentation compared with non-smokers and previous smokers. In a multivariate analysis, there was no statistically significant difference in the time to disease quiescence between groups. However, the median time to recurrence of ocular inflammation was statistically significantly longer for non-smokers (9.4 months) and for previous smokers (10.7 months) than for current smokers (7.8 months) (p=0.02). The RR of ocular inflammation recurrence was higher for smokers than for non-smokers (adjusted HR 1.19, 95% CI 1.03 to 1.37) and tended towards significance in previous smokers (adjusted HR 1.11, 95% CI 0.93 to 1.35). Conclusions Smoking was associated with an increased likelihood of bilateral ocular inflammation and reduced vision upon presentation, and an increased risk of recurrence compared with not smoking. These results suggest that patients with ocular inflammation should be counselled to stop smoking as part of routine management. C1 [Galor, Anat; Feuer, William] Univ Miami, Bascom Palmer Eye Inst, Coral Gables, FL 33124 USA. [Galor, Anat] Univ Penn, Dept Ophthalmol, Miami Vet Adm Med Ctr, Philadelphia, PA 19104 USA. [Kempen, John H.] Univ Penn, Dept Ophthalmol, Ocular Inflammat Serv, Philadelphia, PA 19104 USA. [Kempen, John H.] Univ Penn, Dept Ophthalmol, Ctr Prevent Ophthalmol & Biostat, Philadelphia, PA 19104 USA. [Kempen, John H.] Univ Penn, Dept Biostat & Epidemiol, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. [Kacmaz, R. Oktay; Foster, C. Stephen] Massachusetts Eye Res & Surg Inst, Cambridge, MA USA. [Liesegang, Teresa L.; Suhler, Eric B.; Rosenbaum, James T.] Oregon Hlth & Sci Univ, Dept Ophthalmol, Portland, OR 97201 USA. [Suhler, Eric B.] Portland VA Med Ctr, Portland, OR USA. [Foster, C. Stephen] Harvard Univ, Sch Med, Dept Ophthalmol, Boston, MA USA. [Jabs, Douglas A.] Mt Sinai Sch Med, Dept Ophthalmol, New York, NY 10029 USA. [Jabs, Douglas A.] Mt Sinai Sch Med, Dept Med, New York, NY 10029 USA. [Jabs, Douglas A.; Thorne, Jennifer E.] Johns Hopkins Univ, Dept Epidemiol, Bloomberg Sch Publ Hlth, Baltimore, MD USA. [Levy-Clarke, Grace A.; Nussenblatt, Robert B.] NEI, Immunol Lab, Bethesda, MD 20892 USA. [Levy-Clarke, Grace A.] St Lukes Cataract & Laser Inst, Tarpon Springs, FL USA. [Rosenbaum, James T.] Oregon Hlth & Sci Univ, Dept Med, Portland, OR 97201 USA. [Thorne, Jennifer E.] Johns Hopkins Univ, Sch Med, Dept Ophthalmol, Baltimore, MD 21205 USA. RP Thorne, JE (reprint author), Wilmer Eye Inst, 550 N Broadway,Suite 700, Baltimore, MD 21287 USA. EM jthorne@jhmi.edu FU National Eye Institute [EY014943]; Bascom Palmer Eye Institute [P30 EY014801]; Research to Prevent Blindness; Paul and Evanina Mackall Foundation; US Department of Veterans' Affairs; National Eye Institute FX This study was supported primarily by National Eye Institute Grant EY014943 (to JHK). Data analysis was supported by core center grant P30 EY014801 (Bascom Palmer Eye Institute), from the National Eye Institute, unrestricted funds from Research to Prevent Blindness, and the Paul and Evanina Mackall Foundation. JHK is a Research to Prevent Blindness James S. Adams Special Scholar Award recipient. DAJ and JTR are Research to Prevent Blindness Senior Scientific Investigator Award recipients. JET is a Research to Prevent Blindness Harrington Special Scholar Award recipient. GAL-C was previously supported by, and RBN continues to be supported by, intramural funds of the National Eye Institute. AG and EBS receive support from the US Department of Veterans' Affairs. NR 23 TC 17 Z9 17 U1 0 U2 2 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0007-1161 J9 BRIT J OPHTHALMOL JI Br. J. Ophthalmol. PD JUL PY 2010 VL 94 IS 7 BP 848 EP 853 DI 10.1136/bjo.2009.174466 PG 6 WC Ophthalmology SC Ophthalmology GA 621GR UT WOS:000279564400008 PM 20606023 ER PT J AU Dy, SM Lorenz, KA ONeill, SM Asch, SM Walling, AM Tisnado, D Antonio, AL Malin, JL AF Dy, Sydney M. Lorenz, Karl A. ONeill, Sean M. Asch, Steven M. Walling, Anne M. Tisnado, Diana Antonio, Anna Liza Malin, Jennifer L. TI Cancer Quality-ASSIST Supportive Oncology Quality Indicator Set Feasibility, Reliability, and Validity Testing SO CANCER LA English DT Article DE supportive oncology; quality indicators; pain; dysprea; care planning ID EVIDENCE-BASED RECOMMENDATIONS; HOSPICE CARE; LIFE; PERFORMANCE; END AB BACKGROUND: Although measuring the quality of symptom management and end-of-life care could help provide a basis for improving supportive care for advanced cancer, few quality indicators in this area have been rigorously developed or evaluated. METHODS: The authors conducted a pilot evaluation of a comprehensive set of 92 supportive oncology quality indicators, Cancer Quality-ASSIST, including outpatient and hospital indicators for symptoms commonly related to cancer and its treatment and information and care planning. They operationalized the indicators and developed an electronic abstraction tool and extensive guidelines and training materials. Quality assurance nurses abstracted the medical records for 356 advanced cancer patients in 2 settings: a Veterans Administration hospital and an academic hospital and cancer center. The authors evaluated the indicators' feasibility, inter-rater reliability, and validity. RESULTS: The authors successfully evaluated 78 indicators across the domains; results were similar in the 2 settings. They could not feasibly evaluate 3 indicators because of low prevalence; 22 indicators had significant inter-rater reliability issues, 9 had significant validity issues, and 3 had both reliability and validity issues, leaving a set of 41 indicators most promising for further testing and use in this population, with an overall kappa score of 0.85 for specified care. CONCLUSIONS: Of 92 Cancer Quality-ASSIST quality indicators for symptoms, treatment toxicity, and information and care planning, 41 were sufficiently feasible, reliable, and valid to be used for patients with advanced cancer in these settings. This set of indicators shows promise for describing key supportive care processes in advanced cancer. Cancer 2010;116:3267-75. (C) 2010 American Cancer Society. C1 [Dy, Sydney M.] Johns Hopkins Sch Med, Dept Hlth Policy & Management, Baltimore, MD 21205 USA. [Dy, Sydney M.] Johns Hopkins Sch Med, Dept Oncol, Baltimore, MD 21205 USA. [Dy, Sydney M.] Johns Hopkins Sch Med, Dept Med, Baltimore, MD 21205 USA. [Lorenz, Karl A.; Asch, Steven M.; Malin, Jennifer L.] Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, RAND Hlth, Los Angeles, CA 90095 USA. [ONeill, Sean M.] Univ Calif Los Angeles, David Geffen Sch Med, RAND Pardee Grad Sch, Los Angeles, CA 90095 USA. [Walling, Anne M.; Tisnado, Diana] Univ Calif Los Angeles, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA USA. [Antonio, Anna Liza] Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. RP Dy, SM (reprint author), Johns Hopkins Sch Med, Dept Hlth Policy & Management, Room 609,624 N Broadway, Baltimore, MD 21205 USA. EM sdy@jhsph.edu OI O'Neill, Sean/0000-0001-7759-8942 FU Department of Veterans Affairs, Veterans Health Administration, and Health Services Research and Development Service [SHP 08-196]; Agency for Healthcare Research and Quality [290-2005-00341]; US Department of Health and Human Services FX Supported by the Department of Veterans Affairs, Veterans Health Administration, and Health Services Research and Development Service SHP 08-196, and under Contract No. 290-2005-00341 from the Agency for Healthcare Research and Quality, the US Department of Health and Human Services, as part of the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) program. NR 23 TC 27 Z9 27 U1 0 U2 6 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER-AM CANCER SOC JI Cancer PD JUL 1 PY 2010 VL 116 IS 13 BP 3267 EP 3275 DI 10.1002/cncr.25109 PG 9 WC Oncology SC Oncology GA 616KS UT WOS:000279208900027 PM 20564637 ER PT J AU Valente, SM AF Valente, Sharon M. TI Oncology Nurses' Knowledge of Suicide Evaluation and Prevention SO CANCER NURSING LA English DT Article DE Knowledge; Nurses; Suicide; Suicide prevention ID LONG-TERM; CANCER; RISK; CARE; INTENT AB Background: Cancer patients can present with a risk of suicide, making it important for oncology nurses to be knowledge about the high-risk factors for suicide in this population and to be competent in suicide detection and management. Objective: The aim of this study was to describe oncology nurses' identification of risk factors, knowledge, and skill at suicide evaluation and prevention based on evaluation of a vignette and to describe nurses' assessments and interventions for suicidal patients. Methods: As part of a larger exploratory, national study, clinical oncology nurses (n = 1200) from the Oncology Nurses Society responded to a knowledge survey; a total of 454 evaluable questionnaires (37% response rate) were returned. Results: Nurses reviewed a vignette of a suicidal patient and correctly identified these risk factors: widower (69.8%), wishes he/she were dead (82.8%), and gives away prized possessions (79.6%). Few nurses knew that ethnicity (0.4%), age (13.2%), or sex (16.4%) indicated suicide risk. Nurses incorrectly believed that worrying, crying, and executive position indicated suicide risk (40.6Y42%). Most nurses rated themselves as having little to some skill and knowledge of suicide evaluation. Conclusion: Oncology nurses were able to identify certain behavioral risk factors at acceptable rates but not demographic risk factors. Implications for Practice: Oncology nurses are likely to interact with patients at suicide risk and would benefit from knowledge about behavioral and demographic risk factors that contribute to an oncology patient becoming high risk for suicide. Such knowledge could contribute to overall patient safety. C1 [Valente, Sharon M.] Vet Adm Greater Los Angeles Healthcare Syst, Res & Educ, Los Angeles, CA USA. RP Valente, SM (reprint author), 346 N Bowling Green Way, Los Angeles, CA 90049 USA. EM sharon.valente@va.gov FU Oncology Nurses Society/Bristol FX Funding: Oncology Nurses Society/Bristol. NR 24 TC 4 Z9 4 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0162-220X J9 CANCER NURS JI Cancer Nurs. PD JUL-AUG PY 2010 VL 33 IS 4 BP 290 EP 295 DI 10.1097/NCC.0b013e3181cc4f33 PG 6 WC Oncology; Nursing SC Oncology; Nursing GA 614KZ UT WOS:000279058900005 PM 20467313 ER PT J AU Armstrong, EJ Shunk, KA AF Armstrong, Ehrin J. Shunk, Kendrick A. TI Coronary Guidewire Circumcision During Use of a Gopher Support Catheter: Potential Adverse Interaction with Polymer-Jacketed Wire Design SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE percutaneous coronary intervention; complications adult cath/intervention; angiography; coronary ID ANGIOPLASTY GUIDEWIRE; TRANSCATHETER RETRIEVAL; ATHERECTOMY; EQUIPMENT; REMOVAL AB Support catheters with a threaded, distal tip may be useful for crossing recalcitrant coronary lesions. The interaction between the Gopher support catheter and polymer-coated coronary guidewires may, however, result in circumferential stripping of polymer from the guidewire, with resulting wire damage or fracture. We report two cases of polymer-coated guidewire damage with use of a Gopher support catheter, suggesting that these two devices should not be used together. (C) 2010 Wiley-Liss, Inc. C1 [Shunk, Kendrick A.] San Francisco VA Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, Div Cardiol, San Francisco, CA 94143 USA. RP Shunk, KA (reprint author), San Francisco VA Med Ctr, Cardiol 111C,4150 Clement St, San Francisco, CA 94121 USA. EM kendrick.shunk@va.gov NR 10 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 2010 VL 76 IS 1 BP 112 EP 116 DI 10.1002/ccd.22477 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 623PO UT WOS:000279754500021 PM 20578095 ER PT J AU Feng, P Wang, H Feldman, RS Pribitkin, EA Breslin, PAS AF Feng, Pu Wang, Hong Feldman, Roy S. Pribitkin, Edmund A. Breslin, Paul A. S. TI The T Cells in Peripheral Taste Tissue of Healthy Human Adults: Predominant Memory T Cells and Th-1 Cells SO CHEMICAL SENSES LA English DT Article DE lymphocyte subset; memory T cells; regulatory T cells; taste tissue; Th1 cells ID ORAL LICHEN-PLANUS; GAMMA-DELTA; OCULAR SURFACE; INTESTINAL INFLAMMATION; UP-REGULATION; HUMAN NAIVE; EXPRESSION; RECEPTOR; LYMPHOCYTES; CHEMOKINE AB A healthy taste system is important to the maintenance of nutrition and overall quality of life, and taste disorders are associated with many inflammatory states. We previously determined the immune cells in normal human gustatory tissue; they are predominantly dendritic cells and CD4 T cells with a few macrophages and B lymphocytes present. There are, however, few reports of the subtypes of resident lymphocytes in or near taste tissues. The present study further characterized the distribution and population of the major subtypes of T cells in situ within biopsies of healthy human fungiform papillae (FP). Immunohistochemical analyses indicated that T-helper (Th)1 cells (CCR5+) were more predominant in FP than Th2 T cells (CCR4+). CD45RO+ memory T cells were the principal T cells in gustatory tissue, whereas CD45RA+ naive T cells were uncommon. Regarding subcompartments of the tissue, most intraepithelial lymphocytes of FPs were gamma/delta T cells, whereas the major subtype of lymphocytes in the lamina propria were alpha/beta T cells. Regulatory T cells that express CTLA-4 (CD152) and interleukin-2 receptors (IL-2R, CD25) were found at low levels in FP. The T cells stand ready to respond to inflammatory and infectious insults and may play a role in the taste alterations observed during acute and chronic inflammatory states. C1 [Feng, Pu; Wang, Hong; Feldman, Roy S.; Pribitkin, Edmund A.; Breslin, Paul A. S.] Monell Chem Senses Ctr, Philadelphia, PA 19104 USA. [Feldman, Roy S.] Vet Affairs Med Ctr, Dent Serv, Philadelphia, PA USA. [Feldman, Roy S.; Breslin, Paul A. S.] Univ Penn, Sch Dent Med, Philadelphia, PA 19104 USA. [Pribitkin, Edmund A.] Thomas Jefferson Univ, Philadelphia, PA 19107 USA. [Breslin, Paul A. S.] Rutgers State Univ, Dept Nutr Sci, Sch Environm & Biol Sci, New Brunswick, NJ 08903 USA. RP Feng, P (reprint author), Monell Chem Senses Ctr, 3500 Market St, Philadelphia, PA 19104 USA. EM pfeng@monell.org FU National Institutes of Health [DC 02995, P50 DC 06760] FX This work was supported by National Institutes of Health [DC 02995 and P50 DC 06760 to P.A.S.B]. NR 44 TC 4 Z9 4 U1 0 U2 4 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0379-864X J9 CHEM SENSES JI Chem. Senses PD JUL PY 2010 VL 35 IS 6 BP 501 EP 509 DI 10.1093/chemse/bjq040 PG 9 WC Behavioral Sciences; Food Science & Technology; Neurosciences; Physiology SC Behavioral Sciences; Food Science & Technology; Neurosciences & Neurology; Physiology GA 613HX UT WOS:000278971100005 PM 20457570 ER PT J AU Maddox, TM Ross, C Tavel, HM Lyons, EE Tillquist, M Ho, PM Rumsfeld, JS Margolis, KL O'Connor, PJ Selby, JV Magid, DJ AF Maddox, Thomas M. Ross, Colleen Tavel, Heather M. Lyons, Ella E. Tillquist, Maggie Ho, P. Michael Rumsfeld, John S. Margolis, Karen L. O'Connor, Patrick J. Selby, Joe V. Magid, David J. TI Blood Pressure Trajectories and Associations With Treatment Intensification, Medication Adherence, and Outcomes Among Newly Diagnosed Coronary Artery Disease Patients SO CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES LA English DT Article DE hypertension; epidemiology; health services research; myocardial infarction; mortality ID NONADHERENCE; HYPERTENSION; PREVENTION; CARE AB Background-Blood pressure (BP) control among coronary artery disease patients remains suboptimal in clinical practice, potentially due to gaps in treatment intensification and medication adherence. However, longitudinal studies evaluating these relationships and outcomes are limited. Methods and Results-We assessed BP trajectories among health maintenance organization patients with hypertension and incident coronary artery disease. BP trajectories were modeled over the year after coronary artery disease diagnosis, stratified by target BP goal. Treatment intensification (increase in BP therapies in the setting of an elevated BP), medication adherence (percentage of days covered with BP therapies), and outcomes (all-cause mortality, myocardial infarction, and revascularization) were evaluated in multivariable models: 9569 patients had a <140/90 mm Hg BP target and 12 861 had a <130/80 mm Hg BP target. Within each group, 4 trajectories were identified: good, borderline, improved, and poor control. After adjustment, increasing BP treatment intensity was significantly associated with better BP trajectories in both groups. Medication adherence had inconsistent effects. There were no significant differences in combined outcomes by BP trajectory, but among the diabetes and renal disease cohort, borderline control patients were less likely to have myocardial infarction (odds ratio, 0.61; 95% confidence interval, 0.40-0.93), and good control patients were less likely to have myocardial infarction (odds ratio, 0.53; 95% confidence interval, 0.34-0.84) or a revascularization procedure (odds ratio, 0.66; 95% confidence interval, 0.47-0.93) compared with poor control patients. Conclusions-In this health maintenance organization population, treatment intensification but not medication adherence significantly affects BP trajectories in the year after coronary artery disease diagnosis. Better BP trajectories are associated with lower rates of myocardial infarction and revascularization. (Circ Cardiovasc Qual Outcomes. 2010;3:347-357.) C1 [Maddox, Thomas M.] Univ Colorado Denver, Denver VAMC, Cardiol Sect 111B, Denver, CO 80220 USA. [Ross, Colleen; Tavel, Heather M.; Lyons, Ella E.; Magid, David J.] Kaiser Permanente Colorado, Inst Hlth Res, Denver, CO USA. [Tillquist, Maggie] Univ Colorado Denver, Sch Med, Denver, CO 80220 USA. [Margolis, Karen L.; O'Connor, Patrick J.] Hlth Partners Res Fdn, Minneapolis, MN USA. [Selby, Joe V.] Kaiser Permanente No Calif, Oakland, CA USA. RP Maddox, TM (reprint author), Univ Colorado Denver, Denver VAMC, Cardiol Sect 111B, 1055 Clermont St, Denver, CO 80220 USA. EM thomas.maddox@va.gov FU National Heart Lung and Blood Institute [U19 HL91179-01]; VA Health Services Research and Development FX This study was supported by a grant made to the Cardiovascular Research Network (CVRN) from the National Heart Lung and Blood Institute under cooperative agreement U19 HL91179-01.; Drs Maddox and Ho are supported by VA Health Services Research and Development Career Development Awards. Dr Ho is a consultant for Wellpoint, Inc. NR 17 TC 19 Z9 19 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1941-7713 J9 CIRC-CARDIOVASC QUAL JI Circ.-Cardiovasc. Qual. Outcomes PD JUL PY 2010 VL 3 IS 4 BP 347 EP 357 DI 10.1161/CIRCOUTCOMES.110.957308 PG 11 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 628NC UT WOS:000280125900004 PM 20488918 ER PT J AU Katon, W Lin, EHB Von Korff, M Ciechanowski, P Ludman, E Young, B Rutter, C Oliver, M McGregor, M AF Katon, Wayne Lin, Elizabeth H. B. Von Korff, Michael Ciechanowski, Paul Ludman, Evette Young, Bessie Rutter, Carolyn Oliver, Malia McGregor, Mary TI Integrating depression and chronic disease care among patients with diabetes and/or coronary heart disease: The design of the TEAMcare study SO CONTEMPORARY CLINICAL TRIALS LA English DT Article DE Diabetes; Depression; Coronary heart disease; TEAMcare study ID RANDOMIZED CONTROLLED-TRIAL; LONGER-TERM OUTCOMES; COLLABORATIVE CARE; COST-EFFECTIVENESS; MAJOR DEPRESSION; MYOCARDIAL-INFARCTION; CHRONIC ILLNESS; COMORBID DEPRESSION; MEDICAL ILLNESS; OLDER PATIENTS AB Diabetes and coronary heart disease (CHD) are two of the most prevalent medical illnesses in the US population and comorbid depression occurs in up to 20% of these patients. Guidelines for management of diabetes and CHD overlap for healthy lifestyle and disease-control recommendations. However, the majority of patients with these medical illnesses have been shown to have inadequate control of key risk factors such as blood pressure, LDL cholesterol, or blood sugar. Comorbid depression has been shown to adversely affect self-care of diabetes and CHD, and is associated with an increased risk of complications and mortality. Interventions that have improved quality and outcomes of depression care alone in patients with diabetes and CHD have not demonstrated benefits in self-care, improved disease control or morbidity and mortality. This paper describes the design and development of a new biopsychosocial intervention (TEAMcare) aimed at improving both medical disease control and depression in patients with poor control of diabetes and/or CHD who met the criteria for comorbid depression. A team approach is used with a nurse interventionist who receives weekly psychiatric and primary care physician caseload supervision in order to enhance treatment by the primary care physician. This intervention is being tested in an NIMH-funded randomized controlled trial in a large integrated health plan. (C) 2010 Elsevier Inc. All rights reserved. C1 [Katon, Wayne; Ciechanowski, Paul] Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Lin, Elizabeth H. B.; Von Korff, Michael; Ludman, Evette; Rutter, Carolyn; Oliver, Malia; McGregor, Mary] Grp Hlth Res Inst, Seattle, WA USA. [Young, Bessie] Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. [Young, Bessie] Vet Affairs Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. RP Katon, W (reprint author), Univ Washington, Sch Med, Dept Psychiat & Behav Sci, 1959 NE Pacific St,Box 356560, Seattle, WA 98195 USA. EM wkaton@uw.edu FU National Institute of Mental Health [MH41739, K24 MH069741] FX This research was supported by grants from the National Institute of Mental Health to Dr. Katon (MH41739 and K24 MH069741). NR 61 TC 41 Z9 41 U1 1 U2 12 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1551-7144 J9 CONTEMP CLIN TRIALS JI Contemp. Clin. Trials PD JUL PY 2010 VL 31 IS 4 BP 312 EP 322 DI 10.1016/j.cct.2010.03.009 PG 11 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 627HX UT WOS:000280031200008 PM 20350619 ER PT J AU Jarrett, RB Thase, ME AF Jarrett, Robin B. Thase, Michael E. TI Comparative efficacy and durability of continuation phase cognitive therapy for preventing recurrent depression: Design of a double-blinded, fluoxetine- and pill placebo-controlled, randomized trial with 2-year follow-up SO CONTEMPORARY CLINICAL TRIALS LA English DT Article DE Relapse prevention; Recurrent depression; Cognitive therapy; Fluoxetine; Longitudinal follow-up ID PSYCHOMETRIC PROPERTIES; UNIPOLAR DEPRESSION; RELAPSE PREVENTION; RATING-SCALE; PSYCHOTHERAPY; INVENTORY; MOOD; QUALITY; ANTIDEPRESSANTS; PHARMACOTHERAPY AB Background: Major Depressive Disorder (MDD) is highly prevalent and associated with disability and chronicity. Although cognitive therapy (CT) is an effective short-term treatment for MDD, a significant proportion of responders subsequently suffer relapses or recurrences. Purpose: This design prospectively evaluates: 1) a method to discriminate CT-treated responders at lower vs. higher risk for relapse; and 2) the subsequent durability of 8-month continuation phase therapies in randomized higher risk responders followed for an additional 24 months. The primary prediction is: after protocol treatments are stopped, higher risk patients randomly assigned to continuation phase CT (C-CT) will have a lower risk of relapse/ recurrence than those randomized to fluoxetine (FLX). Methods: Outpatients, aged 18 to 70 years, with recurrent MDD received 12-14 weeks of CT provided by 15 experienced therapists from two sites. Responders (i.e., no MOD and 17-item Hamilton Rating Scale for Depression <= 12) were stratified into higher and lower risk groups based on stability of remission during the last 6 weeks of CT. The lower risk group entered follow-up for 32 months; the higher risk group was randomized to 8 months of continuation phase therapy with either C-CT or clinical management plus either double-blinded FLX or pill placebo. Following the continuation phase, higher risk patients were followed by blinded evaluators for 24 months. Results: The trial began in 2000. Enrollment is complete (n = 523). The follow-up continues. Conclusions: The trial evaluates the preventive effects and durability of acute and continuation phase treatments in the largest known sample of CT responders collected worldwide. (C) 2010 Published by Elsevier Inc. C1 [Jarrett, Robin B.] Univ Texas SW Med Ctr Dallas, Dept Psychiat, Dallas, TX 75390 USA. [Thase, Michael E.] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. [Thase, Michael E.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. [Thase, Michael E.] Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15260 USA. RP Jarrett, RB (reprint author), Univ Texas SW Med Ctr Dallas, Dept Psychiat, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. EM Robin.Jarrett@UTSouthwestern.edu; Thase@Mail.Med.UPenn.edu FU National Institute of Mental Health [K24-MH001571, R01 MH-58397, R01 MH-69219, R01 MH-58356, R01 MH-69618] FX This report was supported by Grants Number K24-MH001571, R01 MH-58397, R01 MH-69219 (to Robin B. Jarrett, Ph.D.) and R01 MH-58356 and R01 MH-69618 (to Michael E. Thase, M.D.) from the National Institute of Mental Health. We appreciate the support of our NIMH Program Officer, Jane Pearson, Ph.D., throughout this investigation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National institute of Mental Health (NIMH) or the National Institutes of Health (NIH). We also wish to acknowledge the unrestricted support of Eli Lilly and Company, who provided the fluoxetine and matched pill placebo until 2006. Thereafter, study materials were purchased and prepared to appear identical for both sites by the pharmacy at the University of Texas Southwestern Medical Center at Dallas. NR 66 TC 22 Z9 22 U1 4 U2 12 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1551-7144 J9 CONTEMP CLIN TRIALS JI Contemp. Clin. Trials PD JUL PY 2010 VL 31 IS 4 BP 355 EP 377 DI 10.1016/j.cct.2010.04.004 PG 23 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 627HX UT WOS:000280031200012 PM 20451668 ER PT J AU Davis, RC Castellani, LW Hosseini, M Ben-Zeev, O Mao, HZ Weinstein, MM Jung, DY Jun, JY Kim, JK Lusis, AJ Peterfy, M AF Davis, Richard C. Castellani, Lawrence W. Hosseini, Maryam Ben-Zeev, Osnat Mao, Hui Z. Weinstein, Michael M. Jung, Dae Young Jun, John Y. Kim, Jason K. Lusis, Aldons J. Peterfy, Miklos TI Early Hepatic Insulin Resistance Precedes the Onset of Diabetes in Obese C57BLKS-db/db Mice SO DIABETES LA English DT Article ID LEPTIN RECEPTOR GENE; IN-VIVO; EXPRESSION PROFILES; MOUSE STRAIN; DB/DB MICE; RAT-LIVER; FATTY; MUSCLE; SUSCEPTIBILITY; MUTATIONS AB OBJECTIVE-To identify metabolic derangements contributing to diabetes susceptibility in the leptin receptor-deficient obese C57BLKS/J-db/db (BKS-db) mouse strain. RESEARCH DESIGN AND METHODS-Young BKS-db mice were used to identify metabolic pathways contributing to the development of diabetes. Using the diabetes-resistant B6-db strain as a comparison, in vivo and in vitro approaches were applied to identify metabolic and molecular differences between the two strains. RESULTS-Despite higher plasma insulin levels, BKS-db mice exhibit lower lipogenic gene expression, rate of lipogenesis, hepatic triglyceride and glycogen content, and impaired insulin suppression of gluconeogenic genes. Hepatic insulin receptor substrate (IRS)-1 and IRS-2 expression and insulin-stimulated Akt-phosphorylation are decreased in BKS-db primary hepatocytes. Hyperinsulinemic-euglycemic clamp studies indicate that in contrast to hepatic insulin resistance, skeletal muscle is more insulin sensitive in BKS-db than in B6-db mice. We also demonstrate that elevated plasma triglyceride levels in BKS-db mice are associated with reduced triglyceride clearance due to lower lipase activities. CONCLUSIONS-Our study demonstrates the presence of metabolic derangements in BKS-db before the onset of beta-cell failure and identifies early hepatic insulin resistance as a component of the BKS-db phenotype. We propose that defects in hepatic insulin signaling contribute to the development of diabetes in the BKS-db mouse strain. Diabetes 59:1616-1625, 2010 C1 [Davis, Richard C.; Castellani, Lawrence W.; Hosseini, Maryam; Ben-Zeev, Osnat; Weinstein, Michael M.; Lusis, Aldons J.; Peterfy, Miklos] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. [Hosseini, Maryam; Ben-Zeev, Osnat; Mao, Hui Z.; Peterfy, Miklos] VA Greater Los Angeles Healthcare Syst, Lipid Res Lab, Los Angeles, CA USA. [Hosseini, Maryam; Mao, Hui Z.; Peterfy, Miklos] Cedars Sinai Med Ctr, Inst Med Genet, Los Angeles, CA 90048 USA. [Jung, Dae Young; Kim, Jason K.] Univ Massachusetts, Sch Med, Program Mol Med, Div Endocrinol Metab & Diabet, Worcester, MA USA. [Jung, Dae Young; Jun, John Y.; Kim, Jason K.] Penn State Univ, Sch Med, Dept Cellular & Mol Physiol, Hershey, PA USA. [Kim, Jason K.] Univ Massachusetts, Sch Med, Dept Med, Div Endocrinol Metab & Diabet, Worcester, MA USA. RP Peterfy, M (reprint author), Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. EM mpeterfy@ucla.edu FU National Institutes of Health [DK071673, DK80756]; Cedars-Sinai Medical Center; American Diabetes Association [1-05-RA-96, 7-07-RA-80] FX This work was supported by National Institutes of Health Grants DK071673 and DK80756, the Cedars-Sinai Medical Center, and American Diabetes Association Grants 1-05-RA-96 and 7-07-RA-80. NR 47 TC 32 Z9 33 U1 1 U2 6 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD JUL PY 2010 VL 59 IS 7 BP 1616 EP 1625 DI 10.2337/db09-0878 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 621WD UT WOS:000279615100009 PM 20393148 ER PT J AU German, JP Wisse, BE Thaler, JP Oh-I, S Sarruf, DA Ogimoto, K Kaiyala, KJ Fischer, JD Matsen, ME Taborsky, GJ Schwartz, MW Morton, GJ AF German, Jonathan P. Wisse, Brent E. Thaler, Joshua P. Oh-I, Shinsuke Sarruf, David A. Ogimoto, Kayoko Kaiyala, Karl J. Fischer, Jonathan D. Matsen, Miles E. Taborsky, Gerald J., Jr. Schwartz, Michael W. Morton, Gregory J. TI Leptin Deficiency Causes Insulin Resistance Induced by Uncontrolled Diabetes SO DIABETES LA English DT Article ID EURODIAB PROSPECTIVE COMPLICATIONS; ENERGY-EXPENDITURE; GENE-EXPRESSION; RISK-FACTORS; TYPE-1; HYPERGLYCEMIA; SENSITIVITY; PLASMA; MICE; RATS AB OBJECTIVE-Depletion of body fat stores during uncontrolled, insulin-deficient diabetes (uDM) results in markedly reduced plasma leptin levels. This study investigated the role of leptin deficiency in the genesis of severe insulin resistance and related metabolic and neuroendocrine derangements induced by uDM. RESEARCH DESIGN AND METHODS-Adult male Wistar rats remained nondiabetic or were injected with the beta-cell toxin, streptozotocin (STZ) to induce uDM and subsequently underwent subcutaneous implantation of an osmotic minipump containing either vehicle or leptin at a dose (150 mu g/kg/day) designed to replace leptin at nondiabetic plasma levels. To control for leptin effects on food intake, another group of STZ-injected animals were pair fed to the intake of those receiving leptin. Food intake, body weight, and blood glucose levels were measured daily, with body composition and indirect calorimetry performed on day 11, and an insulin tolerance test to measure insulin sensitivity performed on day 16. Plasma hormone and substrate levels, hepatic gluconeogenic gene expression, and measures of tissue insulin signal transduction were also measured. RESULTS-Physiologic leptin replacement prevented insulin resistance in uDM via a mechanism unrelated to changes in food intake or body weight. This effect was associated with reduced total body fat and hepatic triglyceride content, preservation of lean mass, and improved insulin signal transduction via the insulin receptor substrate-phosphatidylinositol-3-hydroxy kinase pathway in the liver, but not in skeletal muscle or adipose tissue. Although physiologic leptin replacement lowered blood glucose levels only slightly, it fully normalized elevated plasma glucagon and corticosterone levels and reversed the increased hepatic expression of gluconeogenic enzymes characteristic of rats with uDM. CONCLUSIONS-We conclude that leptin deficiency plays a key role in the pathogenesis of severe insulin resistance and related endocrine disorders in uDM. Treatment of diabetes in humans may benefit from correction of leptin deficiency as well as insulin deficiency. Diabetes 59:1626-1634, 2010 C1 [German, Jonathan P.; Wisse, Brent E.; Thaler, Joshua P.; Oh-I, Shinsuke; Sarruf, David A.; Ogimoto, Kayoko; Fischer, Jonathan D.; Matsen, Miles E.; Schwartz, Michael W.; Morton, Gregory J.] Univ Washington, Dept Med, Diabet & Obes Ctr Excellence, Seattle, WA 98195 USA. [Kaiyala, Karl J.] Univ Washington, Sch Dent, Dept Dent Publ Hlth Sci, Seattle, WA 98195 USA. [Taborsky, Gerald J., Jr.] VA Puget Sound Hlth Care Syst, Dept Vet Affairs Med Ctr, Seattle, WA USA. RP Morton, GJ (reprint author), Univ Washington, Dept Med, Diabet & Obes Ctr Excellence, Seattle, WA 98195 USA. EM gjmorton@u.washington.edu RI Schwartz, Michael/H-9950-2012 FU National Institutes of Health [DK-083042, DK-052989, DK-050154-13]; Clinical Nutrition Research Unit at the University of Washington [DK-035816]; AstraZeneca; American Heart Association FX This work was supported by National Institutes of Health (grants DK-083042 and DK-052989 to M.W.S. and DK-050154-13 to G.J.T.), by the Clinical Nutrition Research Unit (grant DK-035816) at the University of Washington, by research funding from AstraZeneca, and by a Scientist Development Grant from the American Heart Association (to G.J.M.). NR 50 TC 58 Z9 64 U1 1 U2 8 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD JUL PY 2010 VL 59 IS 7 BP 1626 EP 1634 DI 10.2337/db09-1918 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 621WD UT WOS:000279615100010 PM 20424233 ER PT J AU Lee, CG Fujimoto, WY Brunzell, JD Kahn, SE McNeely, MJ Leonetti, DL Boyko, EJ AF Lee, Christine G. Fujimoto, Wilfred Y. Brunzell, John D. Kahn, Steven E. McNeely, Marguerite J. Leonetti, Donna L. Boyko, Edward J. TI Intra-abdominal fat accumulation is greatest at younger ages in Japanese-American adults SO DIABETES RESEARCH AND CLINICAL PRACTICE LA English DT Article DE Aging; Intra-abdominal fat; Adiposity; Japanese-American; Longitudinal ID IMPAIRED GLUCOSE-TOLERANCE; VISCERAL ADIPOSITY; BODY-COMPOSITION; COMPUTED-TOMOGRAPHY; INSULIN-RESISTANCE; RISK-FACTORS; MEN; WEIGHT; ASSOCIATION; OVERWEIGHT AB Aims: We evaluated whether changes over 10-11 years in weight, subcutaneous abdominal fat (SQAF), and intra-abdominal fat (IAF) differ by age and contrasted age-related adiposity changes by gender. Methods: This is a prospective cohort study of non-diabetic, Japanese-American men and women aged 34-74 years. IAF and SQAF were measured by CT scan at baseline and 10-11-year follow-up visits. Results: The youngest participants gained the most weight, SQAF and IAF over 10-11 years. Older age at baseline was associated with significantly less change in weight (beta-coefficient: -0.19, 95% CI -0.22, -0.15), SQAF (beta-coefficient: -0.07, 95% CI -0.11, -0.02) and IAF (beta-coefficient: -0.74, 95% CI -1.03, -0.45) that persisted even after adjustments for sex, smoking, caloric intake, adiposity at baseline, and change in physical activity. Age was positively correlated with change in SQAF (beta-coefficient: 0.14, 95% CI 0.10, 0.18) and IAF (beta-coefficient: 0.51, 95% CI 0.21, 0.81) in separate models after further adjustment for weight change. Gender did not alter the associations between adiposity change and age. Conclusions: Men and women gained the greatest absolute amount of weight, SQAF, and IAF at younger ages; however, older adults with comparable weight changes had relatively greater fat accumulation within IAF and SQAF depots. (C) 2010 Elsevier Ireland Ltd. All rights reserved. C1 [Lee, Christine G.] Oregon Hlth & Sci Univ, Dept Med, Div Endocrinol Diabet Clin Nutr, Portland, OR 97239 USA. [Fujimoto, Wilfred Y.; Brunzell, John D.; Kahn, Steven E.] Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. [Kahn, Steven E.; Boyko, Edward J.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [McNeely, Marguerite J.; Boyko, Edward J.] Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA USA. [Leonetti, Donna L.] Univ Washington, Dept Anthropol, Seattle, WA 98195 USA. RP Lee, CG (reprint author), Oregon Hlth & Sci Univ, Dept Med, Div Endocrinol Diabet Clin Nutr, 3181 SW Sam Jackson Pk Rd,CR113, Portland, OR 97239 USA. EM leechr@ohsu.edu OI Kahn, Steven/0000-0001-7307-9002; Boyko, Edward/0000-0002-3695-192X FU National Institutes of Health [DK-31170, HL-49293, DK-02654]; Diabetes and Endocrinology Research Center [DK-17047]; Clinical Nutrition Research Unit [DK-35816]; General Clinical Research Center at the University of Washington [RR-00037]; Medical Research Service of the Department of Veterans Affairs FX This work was supported by National Institutes of Health Grants DK-31170, HL-49293, and DK-02654; by facilities and services provided by the Diabetes and Endocrinology Research Center (DK-17047), Clinical Nutrition Research Unit (DK-35816), and the General Clinical Research Center (RR-00037) at the University of Washington, and by the Medical Research Service of the Department of Veterans Affairs. These data have been presented at the following meetings: American Federation for Medical Research Western Regional Meeting, Carmel, CA, January 2009 and 11th Symposium of the International Diabetes Epidemiology Group, Montreal, CAN, October 2009.; All authors have been involved in one or more of the following study activities: design, data collection, data analysis, and manuscript preparation. We are grateful to the King County Japanese-American Community for support and cooperation. NR 26 TC 8 Z9 8 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 JUL PY 2010 VL 89 IS 1 BP 58 EP 64 DI 10.1016/j.diabres.2010.03.006 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 626GI UT WOS:000279953900009 PM 20392506 ER PT J AU Boyko, EJ Doheny, RA McNeely, MJ Kahn, SE Leonetti, DL Fujimoto, WY AF Boyko, Edward J. Doheny, Rebecca A. McNeely, Marguerite J. Kahn, Steven E. Leonetti, Donna L. Fujimoto, Wilfred Y. TI Latent class analysis of the metabolic syndrome SO DIABETES RESEARCH AND CLINICAL PRACTICE LA English DT Article DE Metabolic syndrome; Latent class analysis; Intra-abdominal fat; Waist circumference; Japanese-American ID INSULIN-RESISTANCE SYNDROME; DIABETES-MELLITUS; ADIPOSE-TISSUE; RISK-FACTORS; SYNDROME-X; DIAGNOSIS; OBESITY; DEFINITION; STATEMENT; MEN AB Attempts to explain the associations among metabolic syndrome (MetS) features using factor analysis to identify unobserved potential causes have resulted in inconsistent findings. We examined whether an unobserved categorical factor explains the associations among MetS features using latent class analysis. A cross-sectional analysis of 499 nondiabetic Japanese-Americans who underwent measurements of fasting blood, waist circumference (WC) and CT-measured intra-abdominal fat (IAF) area was conducted. MetS components were defined by IDF criteria. IAF and fasting serum insulin (FI) were dichotomized at the 75(th) percentile. Latent two- and three-class models were fit that included hypertension, dyslipidemia, hyperglycemia, and either WC, IAF, or FI for a total of six models. A three-class latent model fit the data well, while a two-class model did not. In the three-class model, one latent class was strongly associated with all MetS components, while another was associated with hyperglycemia and hypertension only. IAF was associated with only one latent class. Latent class analysis supports the presence of an unobserved factor linked to the co-occurrence of MetS features. One class of this factor was associated with hypertension and hyperglycemia but not central adiposity or FI, suggesting another pathway for observed MetS features. Published by Elsevier Ireland Ltd. C1 [Boyko, Edward J.; Kahn, Steven E.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Boyko, Edward J.; Doheny, Rebecca A.; McNeely, Marguerite J.] Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA USA. [Kahn, Steven E.; Fujimoto, Wilfred Y.] Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. [Leonetti, Donna L.] Univ Washington, Dept Anthropol, Seattle, WA 98195 USA. RP Boyko, EJ (reprint author), 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM eboyko@u.washington.edu OI Kahn, Steven/0000-0001-7307-9002; Boyko, Edward/0000-0002-3695-192X FU National Institutes of Health [DK-31170, HL-49293, DK-02654, DK-17047, DK-35816, RR-00037]; Diabetes and Endocrinology Research Center [DK-17047]; Clinical Nutrition Research Unit [DK-35816]; General Clinical Research Center at the University of Washington [RR-00037]; VA Puget Sound Health Care System, Seattle, Washington; King County Japanese-American Community FX Grant Support: National Institutes of Health Grants DK-31170, HL-49293, DK-02654, DK-17047, DK-35816, and RR-00037.; This work was supported by National Institutes of Health Grants DK-31170, HL-49293, and DK-02654; by facilities and services provided by the Diabetes and Endocrinology Research Center (DK-17047), Clinical Nutrition Research Unit (DK-35816), and the General Clinical Research Center (RR-00037) at the University of Washington, and by resources from the VA Puget Sound Health Care System, Seattle, Washington. We are grateful to the King County Japanese-American Community for support and cooperation. NR 26 TC 3 Z9 3 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 JUL PY 2010 VL 89 IS 1 BP 88 EP 93 DI 10.1016/j.diabres.2010.02.013 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 626GI UT WOS:000279953900013 PM 20211506 ER PT J AU Rolandsson, O Palmer, JP AF Rolandsson, O. Palmer, J. P. TI Latent autoimmune diabetes in adults (LADA) is dead: long live autoimmune diabetes! SO DIABETOLOGIA LA English DT Editorial Material DE Aetiology; Autoimmunity; Classification; Type 1 diabetes; Type 2 diabetes ID GLUTAMIC-ACID DECARBOXYLASE; IA-2 AUTOANTIBODIES; GENERAL-POPULATION; INSULIN-RESISTANCE; GAD ANTIBODIES; ISLET PROTEINS; TYPE-1; ONSET; DIAGNOSIS; CHILDREN C1 [Rolandsson, O.] Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden. [Palmer, J. P.] Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Rolandsson, O (reprint author), Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden. EM olov.rolandsson@fammed.umu.se NR 44 TC 29 Z9 31 U1 0 U2 6 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD JUL PY 2010 VL 53 IS 7 BP 1250 EP 1253 DI 10.1007/s00125-010-1713-0 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 602DM UT WOS:000278118700002 PM 20336277 ER PT J AU Srivastava, S Nadelman, C AF Srivastava, Sucheta Nadelman, Celina TI Synchronous Ipsilateral Warthin Tumor Encased by a Separate Mucoepidermoid Carcinoma of the Parotid Gland: A Case Report and Review of the Literature SO DIAGNOSTIC CYTOPATHOLOGY LA English DT Review DE mucoepidermoid carcinoma; Warthin tumor; chronic sialadenitis; FNA; cytology; ipsilateral synchronous distinct neoplasms; parotid gland ID FINE-NEEDLE-ASPIRATION; MAJOR SALIVARY-GLANDS; CHRONIC SIALADENITIS; PLEOMORPHIC ADENOMA; MULTIPLE TUMORS; BIOPSY; DIAGNOSIS; LESIONS; BENIGN; CYTOLOGY AB Fine-needle aspiration (FNA) is a cost effective and low morbidity procedure in the initial assessment of salivary gland tumors. However, cytological assessment of ipsilateral synchronous tumors (which make up less than 0.3% of all salivary gland neoplasms) may pose diagnostic challenges. Therefore, a wholesome approach, including FNA with clinical and radiological correlation, is of utmost importance. Here, we report a unique case of Warthin tumor encased by a separate high-grade mucoepidermoid carcinoma that was first diagnosed on FNA. Another striking feature seen was the presence of chronic sialadenitis in the surrounding nonneoplastic salivary gland. The presence of two different neoplasms in the background of chronic sialadenitis raises the question of a possible causal relationship. Traditionally, there has been diagnostic difficulty, when dealing with synchronous tumors of the salivary gland and the background of chronic sialadenitis may further complicate the diagnosis. FNA is very helpful and can give important cues to the diagnosis. Diagn. Cytopathol. 2010;38:533-537. (C) 2009 Wiley-Liss, Inc. C1 [Srivastava, Sucheta] LAC USC Med Ctr, Dept Pathol & Lab Med, Pathol Resident PGY 1, Los Angeles, CA 90033 USA. [Nadelman, Celina] W Los Angeles VA Med Ctr, Dept Pathol & Lab Med, Los Angeles, CA USA. RP Srivastava, S (reprint author), LAC USC Med Ctr, Dept Pathol & Lab Med, Pathol Resident PGY 1, Los Angeles, CA 90033 USA. EM sasrivas@usc.edu NR 40 TC 3 Z9 3 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 8755-1039 J9 DIAGN CYTOPATHOL JI Diagn. Cytopathol. PD JUL PY 2010 VL 38 IS 7 BP 533 EP 537 DI 10.1002/dc.21267 PG 5 WC Medical Laboratory Technology; Pathology SC Medical Laboratory Technology; Pathology GA 620RM UT WOS:000279517000015 PM 20027619 ER PT J AU Nordenstedt, H White, DL El-Serag, HB AF Nordenstedt, Helena White, Donna L. El-Serag, Hashem B. TI The changing pattern of epidemiology in hepatocellular carcinoma SO DIGESTIVE AND LIVER DISEASE LA English DT Article DE Cirrhosis; Epidemiology; GLOBOCAN; Hepatitis; Liver cancer AB Primary liver cancer (PLC) represents approximately 4% of all new cancer cases diagnosed worldwide. The purpose of this review is to describe some of the latest international patterns in PLC incidence and mortality, as well as to give an overview of the main etiological factors. We used two databases, GLOBOCAN 2002 and the World Health Organization (WHO) mortality database to analyze the incidence and mortality rates for PLC in several regions around the world. The highest age adjusted incidence rates (>20 per 100,000) were reported from countries in Southeast Asia and sub-Saharan Africa that are endemic for HBV infection. Countries in Southern Europe have medium-high incidence rates, while low-incidence areas (<5 per 100,000) include South and Central America, and the rest of Europe. Cirrhosis is present in about 80-90% of HCC patients and is thereby the largest single risk factor. Main risk factors include HBV, HCV, aflatoxin and possibly obesity and diabetes. Together HBV and HCV account for 80-90% of all HCC worldwide. HBV continues to be the major HCC risk factor worldwide, although its importance will most likely decrease during the coming decades due to the widespread use of the HBV vaccine in the newborns. HCV has been the dominant viral cause in HCC in North America, some Western countries and Japan. Obesity and diabetes are increasing at a fast pace throughout the world, and if they are proven to be HCC risk factors, they would account for more HCC cases in the future. (C) 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. C1 [Nordenstedt, Helena] Karolinska Inst, Stockholm, Sweden. [White, Donna L.; El-Serag, Hashem B.] Michael E DeBakey VA Med Ctr, Houston, TX USA. [White, Donna L.; El-Serag, Hashem B.] Baylor Coll Med, Gastroenterol Sect, Houston, TX 77030 USA. [White, Donna L.; El-Serag, Hashem B.] Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. RP El-Serag, HB (reprint author), Michael E DeBakey Vet Affairs Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu FU Bayer HealthCare FX The corresponding author has received a fee from Bayer HealthCare for his contribution to this supplement. Bayer HealthCare played no role in the preparation, review, or approval of the manuscript. The co-authors have no conflict of interest to report. NR 55 TC 228 Z9 232 U1 2 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1590-8658 EI 1878-3562 J9 DIGEST LIVER DIS JI Dig. Liver Dis. PD JUL PY 2010 VL 42 SU 3 BP S206 EP S214 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA V45NY UT WOS:000209824500001 PM 20547305 ER PT J AU Korsten, MA Spungen, AM Rosman, AR Ancha, HR Post, JB Shaw, S Hunt, KK Williams, R Bauman, WA AF Korsten, M. A. Spungen, A. M. Rosman, A. R. Ancha, H. R. Post, J. B. Shaw, S. Hunt, K. K. Williams, R., III Bauman, W. A. TI A Prospective Assessment of Renal Impairment After Preparation for Colonoscopy: Oral Sodium Phosphate Appears to Be Safe in Well-Hydrated Subjects with Normal Renal Status SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE Colonoscopy; Preparation; Efficacy; Kidney failure; PEG; Oral sodium phosphate solution ID CONTRAST-INDUCED NEPHROPATHY; PHOSPHOSODA BOWEL PREPARATION; POLYETHYLENE-GLYCOL SOLUTION; RANDOMIZED CONTROLLED-TRIAL; GLOMERULAR-FILTRATION-RATE; FATAL HYPERPHOSPHATEMIA; SERUM CREATININE; KIDNEY INJURY; FAILURE; QUALITY AB The outcome of colonoscopy is highly dependent upon the quality of bowel cleansing prior to the procedure. Oral sodium phosphate solutions (OSPS) or preparations containing polyethylene glycol (PEG) are generally employed. However, the safety of administering OSPS prior to colonoscopy has been questioned because of the potential for renal failure. To compare rates of renal failure after OSPS and PEG in a randomized, prospective trial and to assess the quality of colonoscopy after these two bowel preparations. Subjects with eGFR a parts per thousand yen 60 ml/min/1.73 m(2) and expressed willingness to adhere to hydration recommendations were randomized to OSPS or PEG solutions. Renal function was assessed 1 week prior to, immediately prior to, and 1 week after colonoscopy. No subject had acute kidney failure after OSPS or PEG. OSPS was associated with significant increases in the serum phosphate and sodium levels and significant decreases in the calcium and potassium levels. These values returned to normal limits in all subjects by 1 week after colonoscopy. The quality of colonic cleansing was superior after OSPS than after PEG (Ottawa score 2.5 +/- A 2.2 vs. 3.5 +/- A 2.3, respectively, P < 0.05). The detection of one or more adenomatous polyps was higher after OSPS than after PEG. Renal failure was not detected after the use of OSPS for colonoscopy preparation in subjects with recently documented normal renal function who were able to consume the required amounts of water after each dose. However, based on the number of subjects studied, the theoretical risk of this complication is still between 0 and 6.3%. Thus, it is appreciated that only a very large prospective trial would have yielded a more accurate estimate of the likelihood of renal compromise after OSPS. Despite this caveat, OSPS has advantages over PEG in terms of the adequacy of colonic visualization and the number of polyps detected. C1 [Korsten, M. A.; Spungen, A. M.; Rosman, A. R.; Ancha, H. R.; Post, J. B.; Shaw, S.; Hunt, K. K.; Williams, R., III; Bauman, W. A.] James J Peters VA Med Ctr, RR&D Ctr Excellence Med Consequences SCI, Bronx, NY USA. [Korsten, M. A.; Rosman, A. R.; Ancha, H. R.; Shaw, S.; Hunt, K. K.] James J Peters VA Med Ctr, GI Program, Bronx, NY USA. [Korsten, M. A.; Rosman, A. R.; Ancha, H. R.; Post, J. B.; Shaw, S.; Hunt, K. K.; Bauman, W. A.] James J Peters VA Med Ctr, Med Serv, Bronx, NY USA. [Korsten, M. A.; Spungen, A. M.; Rosman, A. R.; Post, J. B.; Shaw, S.; Hunt, K. K.; Bauman, W. A.] Mt Sinai Sch Med, Dept Med, New York, NY USA. [Spungen, A. M.; Bauman, W. A.] Mt Sinai Sch Med, Dept Rehabil Med, New York, NY USA. RP Korsten, MA (reprint author), James J Peters VA Med Ctr, RR&D Ctr Excellence Med Consequences SCI, Bronx, NY USA. EM mark.korsten@va.gov FU Department of Veterans Affairs FX The funds for carrying out this research were provided solely by the Department of Veterans Affairs. No pharmaceutical company involved in the manufacture of purgative products supported this work. NR 48 TC 14 Z9 16 U1 0 U2 7 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD JUL PY 2010 VL 55 IS 7 BP 2021 EP 2029 DI 10.1007/s10620-009-1013-z PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 612LP UT WOS:000278900200029 PM 19834806 ER PT J AU Ellis, C AF Ellis, Charles TI Stroke in young adults SO DISABILITY AND HEALTH JOURNAL LA English DT Article DE Young stroke; Costs; Length of stay ID INTERNATIONAL-CLASSIFICATION; DISEASES; ICD-9-CM AB Background: Stroke among young adults is generally considered a rare event, although few studies have considered national data. Objective: The objective of this paper was to profile stroke in young adults in the United States using a national dataset. Methods: Data from the 2007 Nationwide Inpatient Sample were examined to estimate the number of patients, mean length of stay, mean costs, and discharge disposition of young adults (aged 18-44 y) with a diagnosis of stroke. Results: Estimates indicate that 41,587 (or 4.9%) of individuals experiencing a stroke in 2007 were young adults: 32,438 had an ischemic stroke, 4662 had a subarachnoid hemorrhage, and 4487 had an intracerebral hemorrhage. The average length of stay was 4.7 days for ischemic stroke, 11.6 days for subarachnoid hemorrhage, and 11.2 days for intracerebral hemorrhage. Approximately 5% (2013) of young adults died of stroke. Most young adults were discharged routinely to home at an average cost associated with their hospital stay of $34,886 for ischemic stroke, $146,307 for subarachnoid hemorrhage, and $94,482 for intracerebral hemorrhage. Conclusions: A substantial number of young adults experience stroke in the United States at costs that are higher than those for stroke patients overall. (C) 2010 Elsevier Inc. All rights reserved. C1 [Ellis, Charles] Med Univ S Carolina, Dept Hlth Profess, Charleston, SC 29425 USA. [Ellis, Charles] Ralph H Johnson VA Med Center, Ctr Dis Prevent & Hlth Intervent Diverse Populat, Charleston, SC 29401 USA. RP Ellis, C (reprint author), 77 President St, Charleston, SC USA. EM ellisc@musc.edu FU Center for Disease Prevention and Health Interventions FX This work represents work supported by the use of facilities at the Charleston, SC, Center for Disease Prevention and Health Interventions for Diverse Populations. NR 11 TC 6 Z9 8 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1936-6574 J9 DISABIL HEALTH J JI Disabil. Health J. PD JUL PY 2010 VL 3 IS 3 BP 222 EP 224 DI 10.1016/j.dhjo.2010.01.001 PG 3 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health; Rehabilitation SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Rehabilitation GA 668QP UT WOS:000283285000010 PM 21122787 ER PT J AU Baldwin, ML Marcus, SC De Simone, J AF Baldwin, Marjorie L. Marcus, Steven C. De Simone, Jeffrey TI Job loss discrimination and former substance use disorders SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE Substance use disorders; Job loss; Labor market discrimination ID LABOR-MARKET DISCRIMINATION; ILLICIT DRUG-USE; DSM-IV ALCOHOL; UNITED-STATES; COCAINE USE; DISABILITIES; ABUSE; MEN; EMPLOYMENT; MARIJUANA AB Persons with former alcohol or drug use disorders are protected from labor market discrimination by the Americans with Disabilities Act of 1990. They have been neglected, however, in empirical studies of labor market discrimination following implementation of the Act. We apply econometric techniques used to study other disabled groups to determine if there are significant differences in employment outcomes for persons with and without former substance use disorders and, if so, what part of these differences potentially can be attributed to employer discrimination. There are no significant differences in employment rates between persons with and without former substance use disorders, and among those who are employed no significant differences in rates of full-time employment. But persons with former substance use disorders report significantly higher rates of involuntary job loss within the previous year. Part of the differential remains unexplained after controlling for other factors that affect employment outcomes, suggesting employer discrimination may be one cause of poor job stability among this group. Certain identifiable subgroups with low levels of human capital are particularly susceptible to substance-related discrimination. (c) 2010 Elsevier Ireland Ltd. All rights reserved. C1 [Baldwin, Marjorie L.] Arizona State Univ, WP Carey Sch Business, Sch Hlth Management & Policy, Tempe, AZ 85287 USA. [Marcus, Steven C.] Univ Penn, Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. [Marcus, Steven C.] Univ Penn, Sch Social Policy & Practice, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. [Marcus, Steven C.] Univ Penn, Leonard Davis Inst Hlth Econ, Ctr Hlth Equ Res Er Promot, Philadelphia, PA 19104 USA. [De Simone, Jeffrey] Univ Texas Arlington, NBER, Arlington, TX 76019 USA. [De Simone, Jeffrey] Univ Texas Arlington, Dept Econ, Arlington, TX 76019 USA. RP Baldwin, ML (reprint author), Arizona State Univ, WP Carey Sch Business, Sch Hlth Management & Policy, Box 874506, Tempe, AZ 85287 USA. EM Marjorie.Baldwin@asu.edu FU National Institute of Drug and Alcohol Abuse (NIDA) [R03 DA019860-01]; Ortho-McNeil Janssen FX This research was supported by grant # R03 DA019860-01 from the National Institute of Drug and Alcohol Abuse (NIDA). NIDA had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.; Dr. Marcus has received grants from Ortho-McNeil Janssen and has been a consultant to Eli Lilly and Company, Bristol Myers Squibb, Astra Zeneca, and Pfizer. NR 26 TC 11 Z9 12 U1 1 U2 6 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0376-8716 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD JUL 1 PY 2010 VL 110 IS 1-2 BP 1 EP 7 DI 10.1016/j.drugalcdep.2010.01.018 PG 7 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 621KQ UT WOS:000279577200001 PM 20347233 ER PT J AU Obika, M Trence, DL AF Obika, Mikako Trence, Dace L. TI COMPARISON OF TYPE 2 DIABETES CARE IN THE UNITED STATES AND JAPAN SO ENDOCRINE PRACTICE LA English DT Editorial Material ID GLUCOSE-TOLERANCE; RISK-FACTORS; MELLITUS; OBESITY; PREVALENCE; MICROALBUMINURIA; SUSCEPTIBILITY; COMPLICATIONS; OVERWEIGHT; ADULTS C1 [Obika, Mikako] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Lab Med, Okayama 7008558, Japan. [Obika, Mikako] Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. [Trence, Dace L.] Univ Washington, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. RP Obika, M (reprint author), Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Lab Med, 2-5-1 Shikata Cho, Okayama 7008558, Japan. EM mika_obika@yahoo.co.jp NR 34 TC 1 Z9 1 U1 0 U2 1 PU AMER ASSOC CLIN ENDOCRINOL PI JACKSONVILLE PA 1000 RIVERSIDE AVE, STE 205, JACKSONVILLE, FL 32204 USA SN 1530-891X J9 ENDOCR PRACT JI Endocr. Pract. PD JUL-AUG PY 2010 VL 16 IS 4 BP 707 EP 711 DI 10.4158/EP09312.CO PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 642BJ UT WOS:000281177600024 PM 20350922 ER PT J AU Khodr, CE Clark, S Bokov, AF Richardson, A Strong, R Hurley, DL Phelps, CJ AF Khodr, Christina E. Clark, Sara Bokov, Alex F. Richardson, Arlan Strong, Randy Hurley, David L. Phelps, Carol J. TI Early Postnatal Administration of Growth Hormone Increases Tuberoinfundibular Dopaminergic Neuron Numbers in Ames Dwarf Mice SO ENDOCRINOLOGY LA English DT Article ID TYROSINE-HYDROXYLASE; PROLACTIN GENE; NEUROTROPHIC SIGNALS; TARGETED DISRUPTION; PITUITARY PROLACTIN; CELL-PROLIFERATION; LONG-TERM; ADULT; RAT; DIFFERENTIATION AB Hypothalamic tuberoinfundibular dopaminergic (TIDA) neurons secrete dopamine, which inhibits pituitary prolactin (PRL) secretion. PRL has demonstrated neurotrophic effects on TIDA neuron development in PRL-, GH-, and TSH-deficient Ames (df/df) and Snell (dw/dw) dwarf mice. However, both PRL and PRL receptor knockout mice exhibit normal-sized TIDA neuron numbers, implying GH and/or TSH influence TIDA neuron development. The current study investigated the effect of porcine (p) GH on TIDA neuron development in Ames dwarf hypothalamus. Normal (DF/df) and dwarf mice were treated daily with pGH or saline beginning at 3 d of age for a period of 42 d. After treatment, brains were analyzed using catecholamine histofluorescence, tyrosine hydroxylase immunocytochemistry, and bromodeoxyuridine (BrdU) immunocytochemistry to detect BrdU incorporation. DF/df males and df/df treated with pGH experienced increased (P <= 0.01) weight gain compared with those treated with saline. DF/df had greater (P <= 0.01) TIDA neuron numbers than df/df, regardless of treatment. TIDA neuron number in pGH-treated df/df was greater (P <= 0.01) than in saline-treated df/df. Zona incerta and periventricular dopamine neurons were not affected by treatment or genotype. There was no effect of genotype or treatment on BrdU incorporation in the arcuate nucleus, median eminence, or periventricular region surrounding the third ventricle. Saline-treated df/df experienced decreased (P <= 0.05) dentate gyrus BrdU incorporation compared with saline-treated DF/df. In the lateral ventricle, pGH-treated males had greater BrdU immunoreactivity than pGH-treated females. The results show an effect of pGH on TIDA neuron development, although this effect is less potent than that of PRL, and likely GH-induced preservation of TIDA neurons rather than generation of new TIDA neurons via neurogenesis. (Endocrinology 151: 3277-3285, 2010) C1 [Khodr, Christina E.; Clark, Sara; Hurley, David L.; Phelps, Carol J.] Tulane Univ, Sch Med, Neurosci Program, New Orleans, LA 70112 USA. [Bokov, Alex F.; Richardson, Arlan; Strong, Randy] Univ Texas Hlth Sci Ctr San Antonio, Sam & Ann Barshop Inst Longev & Aging Studies, San Antonio, TX 78245 USA. [Richardson, Arlan; Strong, Randy] S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. [Richardson, Arlan] Univ Texas Hlth Sci Ctr San Antonio, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. [Bokov, Alex F.] Univ Texas Hlth Sci Ctr San Antonio, Dept Epidemiol & Biostat, San Antonio, TX 78229 USA. RP Hurley, DL (reprint author), E Tennessee State Univ, Bill Gatton Coll Pharm, Dept Pharmaceut Sci, POB 70594, Johnson City, TN 37614 USA. EM hurleyd@etsu.edu FU Louisiana BORSF Board of Regents; National Science Foundation [IBN-0350537]; Public Health Service [NS25987] FX This work was supported by Louisiana BORSF Board of Regents Support Fund grant (to C.E.K.), National Science Foundation Grant IBN-0350537 (to D.L.H.), and Public Health Service Grant NS25987 (to C.J.P.). NR 49 TC 4 Z9 4 U1 0 U2 0 PU ENDOCRINE SOC PI WASHINGTON PA 2055 L ST NW, SUITE 600, WASHINGTON, DC 20036 USA SN 0013-7227 EI 1945-7170 J9 ENDOCRINOLOGY JI Endocrinology PD JUL PY 2010 VL 151 IS 7 BP 3277 EP 3285 DI 10.1210/en.2009-1482 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 614IK UT WOS:000279049300031 PM 20463054 ER PT J AU Mowry, SE Tang, C Sadeghi, A Wang, MB AF Mowry, Sarah E. Tang, Christopher Sadeghi, Ahmad Wang, Marilene B. TI Standard chemoradiation versus intensity-modulated chemoradiation: a quality of life assessment in oropharyngeal cancer patients SO EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY LA English DT Article DE IMRT; Chemoradiation; Oropharyngeal cancer; Quality of life ID PHASE-II TRIAL; NECK-CANCER; RADIATION-THERAPY; CONVENTIONAL RADIOTHERAPY; CARCINOMA; HEAD; CHEMOTHERAPY; XEROSTOMIA; SURGERY; HEALTH AB This study is based on the context that many patients with advanced oropharyngeal carcinoma are being treated with primary chemoradiation. The aims of this study are to identify differences in quality of life (QOL) between patients with advanced oropharyngeal cancer following traditional chemoradiation versus chemotherapy with intensity-modulated radiation therapy (CIMRT). This research is designed on a cohort study from an academic tertiary referral center. Fifty patients were identified from an institutional database of patients who had undergone primary chemotherapy and radiation (traditional or IMRT) for advanced oropharyngeal carcinoma. Patients responded via mail using the University of Washington quality of life instrument version 4. Statistical analysis of data was performed using Chi-square and Wilcoxon tests. The results comprise the responses of 17 CRT (57%) and 14 CIMRT (70%) patients. The patients completed the survey between 9 and 44 months following end of treatment. When adjusted for tumor stage and time since treatment, CIMRT patients reported improved appearance (p = 0.05), chewing (p = 0.02), and mood (p = 0.01). There was a trend toward significance for improved activity (p = 0.07), recreation (p = 0.07), and anxiety (p = 0.08). There were no differences between the two groups for saliva, taste, shoulder function, speech, and swallowing. But there was a trend for significance for improved overall QOL in patients who had undergone CIMRT (p = 0.06). In conclusion, CIMRT results in improved QOL for some domains but surprisingly not for swallowing or saliva. Patients undergoing CIMRT also report slightly better QOL overall when compared to patients receiving more traditional forms of radiation therapy. C1 [Mowry, Sarah E.; Tang, Christopher; Wang, Marilene B.] Univ Calif Los Angeles, David Geffen Sch Med, Div Head & Neck Surg, Los Angeles, CA 90095 USA. [Sadeghi, Ahmad] VA Greater Los Angeles Healthcare Syst, Dept Radiat Oncol, Los Angeles, CA USA. [Wang, Marilene B.] VA Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP Mowry, SE (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Head & Neck Surg, 62-132 CHS,BOX 951624, Los Angeles, CA 90095 USA. EM Smowry1978@gmail.com NR 17 TC 13 Z9 13 U1 1 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0937-4477 J9 EUR ARCH OTO-RHINO-L JI Eur. Arch. Oto-Rhino-Laryn. PD JUL PY 2010 VL 267 IS 7 BP 1111 EP 1116 DI 10.1007/s00405-009-1183-5 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 599UR UT WOS:000277939700015 PM 20039175 ER PT J AU Sonnenberg, A AF Sonnenberg, Amnon TI The validity of hospital discharge data Response SO EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY LA English DT Letter C1 [Sonnenberg, Amnon] Portland VA Med Ctr, Portland, OR 97239 USA. [Sonnenberg, Amnon] Oregon Hlth & Sci Univ, Portland, OR 97239 USA. RP Sonnenberg, A (reprint author), Portland VA Med Ctr, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM sonnenbe@ohsu.edu 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 0954-691X J9 EUR J GASTROEN HEPAT JI Eur. J. Gastroenterol. Hepatol. PD JUL PY 2010 VL 22 IS 7 BP 900 EP 900 DI 10.1097/MEG.0b013e3283349e5e PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 608FZ UT WOS:000278569900026 ER PT J AU Massie, BM AF Massie, Barry M. TI Is the effect of angiotensin receptor blockade in patients with heart failure modified by treatment with aspirin? The answer is not so clear! SO EUROPEAN JOURNAL OF HEART FAILURE LA English DT Editorial Material ID CONVERTING-ENZYME-INHIBITORS; VENTRICULAR SYSTOLIC FUNCTION; ANTIPLATELET THERAPY; RANDOMIZED-TRIAL; CANDESARTAN; WARFARIN; WATCH C1 Univ Calif San Francisco, San Francisco Vet Adm Med Ctr, Cardiol Div 111C, San Francisco, CA 94121 USA. RP Massie, BM (reprint author), Univ Calif San Francisco, San Francisco Vet Adm Med Ctr, Cardiol Div 111C, 4150 Clement St, San Francisco, CA 94121 USA. EM barry.massie@va.gov NR 17 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1388-9842 J9 EUR J HEART FAIL JI Eur. J. Heart Fail. PD JUL PY 2010 VL 12 IS 7 BP 639 EP 641 DI 10.1093/eurjhf/hfq096 PG 3 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 616CR UT WOS:000279186300001 PM 20576831 ER PT J AU Li, Y Peng, ZC Xiao, B Houser, CR AF Li, Yi Peng, Zechun Xiao, Bo Houser, Carolyn R. TI Activation of ERK by spontaneous seizures in neural progenitors of the dentate gyrus in a mouse model of epilepsy SO EXPERIMENTAL NEUROLOGY LA English DT Article DE Extracellular signal-regulated kinase (ERK); Hippocampus; Dentate gyrus; Subgranular zone; Neurogenesis; Brain lipid binding protein (BLBP); Spontaneous seizure; Pilocarpine; Epilepsy ID SIGNAL-REGULATED KINASE; ADULT HIPPOCAMPAL NEUROGENESIS; TEMPORAL-LOBE EPILEPSY; GRANULE CELL NEUROGENESIS; STATUS EPILEPTICUS; RAT HIPPOCAMPUS; STEM-CELL; PROTEIN-KINASE; FUNCTIONAL-INTEGRATION; SUBVENTRICULAR ZONE AB Cellular changes that are associated with spontaneous seizures in temporal lobe epilepsy are not well understood but could influence ongoing epilepsy-related processes. In order to identify cell signaling events that could occur at the time of spontaneous seizures, the localization of phosphorylated extracellular signal-regulated kinase (PERK) was studied in a pilocarpine mouse model of epilepsy at very short intervals (1.5-2.5 min) after detection of a spontaneous seizure. Within the hippocampal formation, immunolabeling of pERK was evident in a subpopulation of cells in the subgranular zone (SGZ) of the dentate gyrus at these short intervals. Many of these cells had a long vertical process and resembled radial glia, while others had short processes and were oriented horizontally. Labeling with a series of developmental markers demonstrated that virtually all pERK-labeled cells were neural progenitor cells (NPCs). A high percentage (similar to 80%) of the pERK-labeled cells was labeled with either glial fibrillary acidic protein or brain lipid binding protein, indicating that these cells were radial glia-like NPCs. A smaller percentage of labeled cells expressed NeuroD, suggesting that they were later-developing NPCs that were assuming a neuronal identity. Early expression of pERK was not detected in immature neurons. Double labeling with proliferation markers demonstrated that approximately 30% of pERK-labeled NPCs expressed Mcm2, indicating that they were actively proliferating. Furthermore, virtually all radial glia-like NPCs that were in the proliferative cycle expressed pERK. These findings suggest that spontaneous seizures and associated ERK activation could contribute to the proliferation of radial glia-like NPCs in this epilepsy model. (C) 2010 Elsevier Inc. All rights reserved. C1 [Li, Yi; Peng, Zechun; Houser, Carolyn R.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. [Li, Yi; Xiao, Bo] Cent S Univ, Xiang Ya Hosp, Dept Neurol, Changsha 410008, Hunan, Peoples R China. [Houser, Carolyn R.] Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90095 USA. [Houser, Carolyn R.] 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, CHS 73-235,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM houser@mednet.ucla.edu FU Veterans Affairs Medical Research; National Institutes of Health [NS046524]; P.R. China Scholarship Council; Ministry of Health, P.R. China [2007(353)] FX This work was supported by Veterans Affairs Medical Research Funds (C.R.H.), National Institutes of Health Grant NS046524 (C.R.H.), a joint PhD program fellowship provided by the P.R. China Scholarship Council (Y. L) and the Ministry of Health Grant 2007(353), P.R. China (B.X.). We thank Christine Huang and Yliana Cetina for expert assistance with tissue preparation. NR 67 TC 19 Z9 20 U1 0 U2 7 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0014-4886 J9 EXP NEUROL JI Exp. Neurol. PD JUL PY 2010 VL 224 IS 1 SI SI BP 133 EP 145 DI 10.1016/j.expneurol.2010.03.003 PG 13 WC Neurosciences SC Neurosciences & Neurology GA 615IO UT WOS:000279128400016 PM 20226181 ER PT J AU Xu, RJ Sun, W Jin, JF Obeid, LM Mao, CG AF Xu, Ruijuan Sun, Wei Jin, Junfei Obeid, Lina M. Mao, Cungui TI Role of alkaline ceramidases in the generation of sphingosine and its phosphate in erythrocytes SO FASEB JOURNAL LA English DT Article DE ceramide; erythroid cells; S1P; and S1P lyase ID MOLECULAR-CLONING; NEUTRAL CERAMIDASE; ACID CERAMIDASE; FARBER-DISEASE; SPHINGOSINE-1-PHOSPHATE LYASE; FUNCTIONAL-CHARACTERIZATION; CELLS; GENE; SPHINGOMYELINASE; DIFFERENTIATION AB Plasma sphingosine-1-phosphate (S1P) has been suggested to mainly originate from erythrocytes; however, within the erythrocyte, how sphingosine (SPH) generation-the precursor to S1P-is controlled is unknown. SPH is only generated from the hydrolysis of ceramides via ceramidases. Five human ceramidases have been identified: 1 acid, 1 neutral, and 3 alkaline ceramidases (ACER1, ACER2, and ACER3). Here, we demonstrate that only alkaline ceramidase activity is expressed in erythrocytes and that it is instrumental for SPH generation. Erythrocytes have alkaline but not acid or neutral ceramidase activity on D-e-C(18:1)-ceramide, a common substrate of ceramidases. Not only alkaline ceramidase activity but also the generation of SPH and S1P are increased during erythroid differentiation in K562 erythroleukemic cells. Such SPH and S1P increases were inhibited by the alkaline ceramidase inhibitor D-e-MAPP, suggesting that alkaline ceramidases have a role in the generation of SPH and S1P in erythroid cells. Alkaline ceramidase activity is highly expressed in mouse erythrocytes, and intravenous administration of D-e-MAPP decreased both SPH and S1P in erythrocytes and plasma. Collectively, these results suggest that alkaline ceramidase activity is important for the generation of SPH, the S1P precursor in erythrocytes.-Xu, R., Sun, W., Jin, J., Obeid, L. M., Mao, C. Role of alkaline ceramidases in the generation of sphingosine and its phosphate in erythrocytes. FASEB J. 24, 2507-2515 (2010). www.fasebj.org C1 [Mao, Cungui] Med Univ S Carolina, Dept Med, Div Gen Internal Med, Charleston, SC 29425 USA. [Obeid, Lina M.; Mao, Cungui] Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. [Obeid, Lina M.] Med Univ S Carolina, Ralph H Johnson Vet Adm Hosp, Charleston, SC 29425 USA. RP Mao, CG (reprint author), Med Univ S Carolina, Dept Med, Div Gen Internal Med, 114 Doughty St,Rm 646,STB,POB 250779, Charleston, SC 29425 USA. EM maoc@musc.edu OI obeid, lina/0000-0002-0734-0847 FU U.S. National Institutes of Health [R01CA104834, P20RR017677, GM062887]; Veterans Affairs merit award FX This work was supported by U.S. National Institutes of Health grants R01CA104834 (C.M.), P20RR017677 (C.M.), and GM062887 (L.M.O.), and a Veterans Affairs merit award (L.M.O.). The authors thank Dr. Jennifer Schnellmann for English proofreading and editing of the manuscript. NR 39 TC 20 Z9 20 U1 0 U2 4 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 2010 VL 24 IS 7 BP 2507 EP 2515 DI 10.1096/fj.09-153635 PG 9 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 618HV UT WOS:000279343600037 PM 20207939 ER PT J AU Seminowicz, DA Labus, JS Bueller, JA Tillisch, K Naliboff, BD Bushnell, MC Mayer, EA AF Seminowicz, David A. Labus, Jennifer S. Bueller, Joshua A. Tillisch, Kirsten Naliboff, Bruce D. Bushnell, M. Catherine Mayer, Emeran A. TI Regional Gray Matter Density Changes in Brains of Patients With Irritable Bowel Syndrome SO GASTROENTEROLOGY LA English DT Article DE Neuroimaging; Voxel-Based Morphometry; VBM; Neural ID CHRONIC BACK-PAIN; AUTOMATED 3-D EXTRACTION; VOXEL-BASED MORPHOMETRY; VISCERAL PAIN; MRI DATA; MIGRAINE; FIBROMYALGIA; INTENSITY; CORTEX; REGISTRATION AB BACKGROUND & AIMS: Several studies have examined structural brain changes associated with chronic pain syndromes, including irritable bowel syndrome (IBS), but study sample sizes have been small and heterogeneous. METHODS: We used magnetic resonance imaging-based techniques, voxel-based morphometry, and cortical thickness analysis to examine brain anatomical differences in a relatively large, tightly screened sample of IBS patients (n = 55); we compared data with that from healthy persons (controls; n = 48). RESULTS: IBS was associated with decreased gray matter density (GMD) in widespread areas of the brain, including medial prefrontal and ventrolateral prefrontal cortex, posterior parietal cortex, ventral striatum, and thalamus. Compared with controls, we observed increased GMD in patients with IBS in the pregenual anterior cingulate cortex and the orbitofrontal cortex, as well as trends in the posterior insula/secondary somatosensory cortex, (para) hippocampus, and left dorsolateral prefrontal cortex. In accounting for anxiety and depression, we found that several of the regions involved in affective processing no longer differed between patients with IBS and controls, whereas the differences in prefrontal and posterior parietal cortices remained. The areas of decreased GMD associated with IBS were largely consistent across clinical subgroups, based on predominant bowel habit and pain predominance of symptoms. No overall or regional differences were observed in cortical thickness between patients with IBS and controls. CONCLUSIONS: Changes in density of gray matter among regions involved in cognitive/evaluative functions are specifically observed in patients with IBS, whereas changes in other areas of the brain can be explained by levels of anxiety and depression. C1 [Seminowicz, David A.; Bushnell, M. Catherine] McGill Univ, Alan Edwards Ctr Res Pain, Montreal, PQ H3A 2B2, Canada. [Labus, Jennifer S.; Bueller, Joshua A.; Tillisch, Kirsten; Naliboff, Bruce D.; Mayer, Emeran A.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Ctr Neurobiol Stress, Los Angeles, CA 90095 USA. [Labus, Jennifer S.; Bueller, Joshua A.; Tillisch, Kirsten; Naliboff, Bruce D.; Mayer, Emeran A.] VA Greater Angeles Hlth Care Syst, Los Angeles, CA USA. RP Seminowicz, DA (reprint author), McGill Univ, Alan Edwards Ctr Res Pain, Room M-19 Strathcona Anat & Dent,3640 Univ St, Montreal, PQ H3A 2B2, Canada. EM david.seminowicz@mcgill.ca RI Seminowicz, David/F-8732-2015 OI Seminowicz, David/0000-0003-3111-3756 FU Avera Pharmaceuticals; GlaxoSmithKline; National Institutes of Health [DK 64530, AT 00268, DK 48351, DK 073451-01, DK 071626-04, DK 084169-01]; Canadian Institute of Health Research FX E.A.M. has received research support from Avera Pharmaceuticals and GlaxoSmithKline. The remaining authors disclose no conflicts.; This work was supported by National Institutes of Health grants DK 64530 (E. A. M.), AT 00268 (E. A. M.), and DK 48351 (E. A. M.), DK 073451-01 (K. T.), DK 071626-04 (J.S.L.), DK 084169-01 (J.S.L.). D. A. S. was supported by a fellowship from the Canadian Institute of Health Research. NR 53 TC 106 Z9 111 U1 0 U2 13 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 JUL PY 2010 VL 139 IS 1 BP 48 EP U82 DI 10.1053/j.gastro.2010.03.049 PG 12 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 617ZQ UT WOS:000279321000015 PM 20347816 ER PT J AU Morasco, BJ Huckans, M Loftis, JM Woodhouse, J Seelye, A Turk, DC Hauser, P AF Morasco, Benjamin J. Huckans, Marilyn Loftis, Jennifer M. Woodhouse, Jonathan Seelye, Adriana Turk, Dennis C. Hauser, Peter TI Predictors of pain intensity and pain functioning in patients with the hepatitis C virus SO GENERAL HOSPITAL PSYCHIATRY LA English DT Article DE Chronic pain; Hepatitis C virus; Depression; Biopsychosocial model ID SUBSTANCE USE DISORDERS; METHADONE-MAINTENANCE; PSYCHIATRIC-DISORDERS; PERSISTENT PAIN; UNITED-STATES; INFECTION; PREVALENCE; DEPRESSION; POPULATION; VETERANS AB Objective: To examine the relationships among biological and psychological variables with pain intensity and pain functioning in patients with the hepatitis C virus (HCV). Methods: Participants were 49 patients with HCV who completed well-validated assessments of pain intensity and pain functioning. Participants also completed measures of psychological functioning, and medical records were reviewed. Results: Thirty-three (67.3%) of 49 participants had a current diagnosis for a pain-related condition. Regression analyses were conducted to examine variables associated with pain intensity and pain functioning. The psychosocial variables, particularly depression severity, accounted for an additional 21% of the variance in average pain intensity (P=.002) and 33% of the variance in pain functioning (P<.001). These results remained significant even after controlling for demographic characteristics, opioid prescription status and disease-related variables. Conclusion: These results provide preliminary support for the role of biological and psychological factors in the development and exacerbation of pain in HCV patients. Future studies should include a more comprehensive assessment of pain-related factors and examine their associations with additional disease-related and biological variables. Developing a better understanding of the factors associated with pain in HCV patients will help to inform future interventions for chronic pain in this patient population. Published by Elsevier Inc. C1 [Morasco, Benjamin J.; Huckans, Marilyn; Loftis, Jennifer M.; Woodhouse, Jonathan; Seelye, Adriana; Hauser, Peter] Portland VA Med Ctr, Mental Hlth & Clin Neurosci Div, Portland, OR 97239 USA. [Morasco, Benjamin J.; Huckans, Marilyn; Loftis, Jennifer M.; Woodhouse, Jonathan; Seelye, Adriana; Hauser, Peter] Portland VA Med Ctr, NW Hepatitis C Resource Ctr, Portland, OR 97239 USA. [Morasco, Benjamin J.; Huckans, Marilyn; Loftis, Jennifer M.; Hauser, Peter] Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA. [Huckans, Marilyn; Loftis, Jennifer M.; Hauser, Peter] Portland VA Med Ctr, Div Res, Portland, OR 97239 USA. [Woodhouse, Jonathan] George Fox Univ, Dept Psychol, Newberg, OR USA. [Seelye, Adriana] Washington State Univ, Dept Psychol, Pullman, WA 99164 USA. [Turk, Dennis C.] Univ Washington, Sch Med, Dept Anesthesiol & Pain Med, Seattle, WA USA. RP Morasco, BJ (reprint author), Portland VA Med Ctr R&D99, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM benjamin.morasco@va.gov FU VA Career Development Award; Northwest Health Foundation; National Institute on Drug Abuse [K23DA023467] FX This study was supported in part by a VA Career Development Award and Northwest Health Foundation grant awarded to Dr. Huckans. Dr. Morasco was supported by award K23DA023467 from the National Institute on Drug Abuse. The content of this manuscript is the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs or the National Institute on Drug Abuse. NR 42 TC 13 Z9 13 U1 0 U2 1 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 2010 VL 32 IS 4 BP 413 EP 418 DI 10.1016/j.genhosppsych.2010.03.010 PG 6 WC Psychiatry SC Psychiatry GA 631ZQ UT WOS:000280389800009 PM 20633746 ER PT J AU Werner, RM Bradlow, ET AF Werner, Rachel M. Bradlow, Eric T. TI Public Reporting On Hospital Process Improvements Is Linked To Better Patient Outcomes SO HEALTH AFFAIRS LA English DT Article ID PAY-FOR-PERFORMANCE; CARE AB The Centers for Medicare and Medicaid Services publicly reports so-called process performance at all U. S. hospitals, such as whether certain recommended treatments are given to specific types of patients. We examined whether hospital performance on key process indicators improved during the three years since this reporting began. We also studied whether or not these changes improved patient outcomes or yielded other quality improvements, such as reduced hospital readmission rates. We found that, from 2004 to 2006, hospital process performance improved and was associated with better patient and quality outcomes. Most notably, for acute myocardial infarction, performance improvements were associated with declines in mortality rates, lengths-of-stay, and readmission rates. Although we cannot conclude that public reporting caused the improvement in processes or outcomes, these results are encouraging, since improving process performance may improve quality more broadly. C1 [Werner, Rachel M.] Ctr Hlth Equ Res, Philadelphia, PA USA. [Werner, Rachel M.] VA Med Ctr, Philadelphia, PA USA. [Werner, Rachel M.; Bradlow, Eric T.] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Werner, RM (reprint author), Ctr Hlth Equ Res, Philadelphia, PA USA. EM rwerner@upenn.edu FU Veterans Affairs Health Services Research and Development Career Development Award; Pennsylvania Department of Health FX The authors thank David Asch for comments on an earlier draft of this paper and Janell Olah for research assistance. Rachel Werner is supported by a Veterans Affairs Health Services Research and Development Career Development Award. This project was funded, in part, under a grant from the Pennsylvania Department of Health, which specifically disclaims responsibility for any analyses, interpretations, or conclusions. NR 10 TC 44 Z9 44 U1 2 U2 9 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 2010 VL 29 IS 7 BP 1319 EP 1324 DI 10.1377/hlthaff.2008.0770 PG 6 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 621EP UT WOS:000279557600008 PM 20606180 ER PT J AU Zeitzew, SL AF Zeitzew, Steven L. TI Paying For Health Care That Is Not Cost-Effective SO HEALTH AFFAIRS LA English DT Letter C1 US Dept Vet Affairs, W Los Angeles Healthcare Ctr, Los Angeles, CA USA. RP Zeitzew, SL (reprint author), US Dept Vet Affairs, W Los Angeles Healthcare Ctr, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 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 2010 VL 29 IS 7 BP 1417 EP 1417 DI 10.1377/hlthaff.2010.0476 PG 1 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 621EP UT WOS:000279557600031 PM 20606202 ER PT J AU Zarraga, IG MacMurdy, K Raitt, M AF Zarraga, Ignatius Gerardo MacMurdy, Karen Raitt, Merritt TI Unusual migration of an abandoned fractured lead SO HEART RHYTHM LA English DT Editorial Material DE Pacemaker lead; Fracture; Migration C1 [Zarraga, Ignatius Gerardo] Oregon Hlth & Sci Univ, Portland, OR 97239 USA. [MacMurdy, Karen; Raitt, Merritt] Portland VA Med Ctr, Portland, OR USA. RP Zarraga, IG (reprint author), Oregon Hlth & Sci Univ, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM zarragai@ohsu.edu OI Raitt, Merritt/0000-0001-5638-7732 NR 5 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 1547-5271 J9 HEART RHYTHM JI Heart Rhythm PD JUL PY 2010 VL 7 IS 7 BP 1004 EP 1005 DI 10.1016/j.hrthm.2009.10.026 PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 617VQ UT WOS:000279310400031 PM 20056497 ER PT J AU Lampert, R Hayes, DL Annas, GJ Farley, MA Goldstein, NE Hamilton, RM Kay, GN Kramer, DB Mueller, PS Padeletti, L Pozuelo, L Schoenfeld, MH Vardas, PE Wiegand, DL Zellner, R AF Lampert, Rachel Hayes, David L. Annas, George J. Farley, Margaret A. Goldstein, Nathan E. Hamilton, Robert M. Kay, G. Neal Kramer, Daniel B. Mueller, Paul S. Padeletti, Luigi Pozuelo, Leo Schoenfeld, Mark H. Vardas, Panos E. Wiegand, Debra L. Zellner, Richard TI HRS Expert Consensus Statement on the Management of Cardiovascular Implantable Electronic Devices (CIEDs) in patients nearing end of life or requesting withdrawal of therapy SO HEART RHYTHM LA English DT Article ID TERMINALLY-ILL PATIENTS; OF-LIFE; CARDIOVERTER-DEFIBRILLATORS; SUSTAINING TREATMENT; PALLIATIVE CARE; HEART-FAILURE; OLDER-ADULTS; TREATMENT PREFERENCES; DECISION-MAKING; HEALTH C1 [Lampert, Rachel; Schoenfeld, Mark H.] Yale Univ, Sch Med, New Haven, CT 06520 USA. [Hayes, David L.; Mueller, Paul S.] Mayo Clin, Rochester, MN USA. [Annas, George J.] Boston Univ, Sch Publ Hlth, Boston, MA USA. [Farley, Margaret A.] Yale Univ, Sch Divin, New Haven, CT 06520 USA. [Goldstein, Nathan E.] Mt Sinai Sch Med, New York, NY USA. [Goldstein, Nathan E.] James J Peters VA Med Ctr, Bronx, NY USA. [Hamilton, Robert M.] Hosp Sick Children, Toronto, ON M5G 1X8, Canada. [Kay, G. Neal] Univ Alabama, Birmingham, AL USA. [Kramer, Daniel B.] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. [Padeletti, Luigi] Univ Florence, Inst Cardiol, Florence, Italy. [Pozuelo, Leo] Cleveland Clin, Cleveland, OH 44106 USA. [Vardas, Panos E.] Herakl Univ Hosp, Iraklion, Greece. [Wiegand, Debra L.] Univ Maryland, Sch Nursing, Baltimore, MD 21201 USA. [Zellner, Richard] Case Western Reserve Univ, Bioeth Dept, Cleveland, OH 44106 USA. RP Lampert, R (reprint author), Yale Univ, Sch Med, New Haven, CT 06520 USA. OI Annas, George/0000-0001-5836-7831 NR 107 TC 156 Z9 156 U1 0 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1547-5271 J9 HEART RHYTHM JI Heart Rhythm PD JUL PY 2010 VL 7 IS 7 BP 1008 EP 1026 DI 10.1016/j.hrthm.2010.04.033 PG 19 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 617VQ UT WOS:000279310400032 PM 20471915 ER PT J AU Davila, JA Morgan, RO Richardson, PA Du, XL McGlynn, KA El-Serag, HB AF Davila, Jessica A. Morgan, Robert O. Richardson, Peter A. Du, Xianglin L. McGlynn, Katherine A. El-Serag, Hashem B. TI Use of Surveillance for Hepatocellular Carcinoma Among Patients With Cirrhosis in the United States SO HEPATOLOGY LA English DT Article ID PRIMARY LIVER-CANCER; HEPATITIS-C; INCREASING INCIDENCE; VIRAL-HEPATITIS; SURVIVAL; EXPERIENCE; MANAGEMENT; INFECTION; VETERANS; IMPROVE AB Surveillance for hepatocellular carcinoma (HCC) in patients with cirrhosis is recommended but may not be performed. The extent and determinants of HCC surveillance are unknown. We conducted a population-based United States cohort study of patients over 65 years of age to examine use and determinants of prediagnosis surveillance in patients with HCC who were previously diagnosed with cirrhosis. Patients diagnosed with HCC during 1994-2002 were identified from the linked Surveillance, Epidemiology, and End-Results registry Medicare databases. We identified alpha-fetoprotein (AFP) and ultrasound tests performed for HCC surveillance, and examined factors associated with surveillance. We identified 1,873 HCC patients with a prior diagnosis of cirrhosis. In the 3 years before HCC, 17% received regular surveillance and 38% received inconsistent surveillance. In a subset of 541 patients in whom cirrhosis was recorded for 3 or more years prior to HCC, only 29% received routine surveillance and 33% received inconsistent surveillance. Among all patients who received regular surveillance, approximately 52% received both AFP and ultrasound, 46% received AFP only, and 2% received ultrasound only. Patients receiving regular surveillance were more likely to have lived in urban areas and had higher incomes than those who did not receive surveillance. Before diagnosis, approximately 48% of patients were seen by a gastroenterologist/hepatologist or by a physician with an academic affiliation; they were approximately 4.5-fold and 2.8-fold, respectively, more likely to receive regular surveillance than those seen by a primary care physician only. Geographic variation in surveillance was observed and explained by patient and physician factors. Conclusion: Less than 20% of patients with cirrhosis who developed HCC received regular surveillance. Gastroenterologists/hepatologists or physicians with an academic affiliation are more likely to perform surveillance. (HEPATOLOGY: 2010;52:132-141) C1 [Davila, Jessica A.; Morgan, Robert O.; Richardson, Peter A.; El-Serag, Hashem B.] Houston VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Sect Hlth Serv Res, Houston, TX USA. [El-Serag, Hashem B.] Houston VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Gastroenterol Sect, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. [Du, Xianglin L.] Univ Texas Houston, Sch Publ Hlth, Dept Epidemiol, Houston, TX USA. [McGlynn, Katherine A.] NCI, Div Canc Epidemiol & Genet, US Dept HHS, Bethesda, MD 20892 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 FU American Cancer Society [RSGPB-07-010-01-CPHPS, NCI R01 125487, DK K24 04107]; Houston VA Health Services Research and Development Center of Excellence [HEP90-029] FX Supported in part by grants from the American Cancer Society (RSGPB-07-010-01-CPHPS to J. A. D.; NCI R01 125487 and DK K24 04107 to H. B. E-S.) and the Houston VA Health Services Research and Development Center of Excellence (HEP90-029). NR 38 TC 155 Z9 156 U1 0 U2 3 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 2010 VL 52 IS 1 BP 132 EP 141 DI 10.1002/hep.23615 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 619DK UT WOS:000279409200015 PM 20578139 ER PT J AU Walsh, JE Clark, AM Day, TA Gillespie, MB Young, MRI AF Walsh, Jarrett E. Clark, Anna-Maria Day, Terry A. Gillespie, M. Boyd Young, M. Rita I. TI Use of alpha,25-Dihydroxyvitamin D-3 treatment to stimulate immune infiltration into head and neck squamous cell carcinoma SO HUMAN IMMUNOLOGY LA English DT Article DE Head and neck cancer; Head and neck squamous cell carcinoma; Recurrence; T-cell, vitamin D ID ENDOTHELIAL GROWTH-FACTOR; DENDRITIC CELLS; CANCER PATIENTS; PERIPHERAL-BLOOD; 1-ALPHA,25-DIHYDROXYVITAMIN D-3; MONONUCLEAR-CELL; PROGENITOR CELLS; T-LYMPHOCYTES; CD34(+) CELLS; TUMOR-CELLS AB Prior studies have shown that treatment of head and neck squamous cell carcinoma (HNSCC) patients with 1 alpha,25-dihydroxyvitamin D-3 [1,25(OH)(2)D-3] reduced intratumoral levels of immune inhibitory CD34(+) progenitor cells while increasing levels of mature progeny dendritic cells. This finding was extended to a pilot study to determine whether 1,25(OH)(2)D-3 treatment concurrently increases levels of intratumoral CD4(+) and CD8(+) T cells, increases intratumoral levels of immune cells expressing the early activation marker CD69, and prolongs time to HNSCC recurrence. The clinical trial comprised 16 patients with newly diagnosed HNSCC being untreated and 16 patients being treated with 1,25(OH)(2)D-3 during the 3-week interval between cancer diagnosis and surgical treatment. Immunologic effects of treatment were monitored by immunohistochemical analyses of surgically removed HNSCC. Clinical effectiveness of 1,25(OH)(2)D-3 treatment in this study was measured by the time to HNSCC recurrence. HNSCC tissues of patients who received treatment with 1,25(OH)(2)D-3 contained increased levels of CD4(+) cells and, more significantly, CD8(+) T cells. Also prominent was an increase in cells expressing the lymphoid activation marker CD69. Results of this pilot study suggest that patients treated with 1,25(OH)(2)D-3 had a lengthier time to tumor recurrence compared with patients who were not treated before surgery. Published by Elsevier Inc. on behalf of American Society for Histocompatibility and Immunogenetics. C1 [Walsh, Jarrett E.; Clark, Anna-Maria; Young, M. Rita I.] Ralph H Johnson Vet Affairs Med Ctr, Res Serv, Charleston, SC USA. [Walsh, Jarrett E.; Clark, Anna-Maria; Day, Terry A.; Gillespie, M. Boyd; Young, M. Rita I.] Dept Otolaryngol Head & Neck Surg, Charleston, SC USA. [Young, M. Rita I.] Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. RP Young, MRI (reprint author), Ralph H Johnson Vet Affairs Med Ctr, Res Serv, Charleston, SC USA. EM rita.young@va.gov FU Clinical Science and Biomedical Laboratory Research and Development Services of the Department of Veterans Affairs; National Institutes of Health [R01CA85266, R01CA128837] FX The authors thank Bridgette Ransom, Kiwana Gibbs, and Kim Sutton for their technical contributions to the described analyses. These studies were supported by the Clinical Science and Biomedical Laboratory Research and Development Services of the Department of Veterans Affairs and by grants R01CA85266 and R01CA128837 from the National Institutes of Health to MRIY. NR 37 TC 22 Z9 22 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0198-8859 J9 HUM IMMUNOL JI Hum. Immunol. PD JUL PY 2010 VL 71 IS 7 BP 659 EP 665 DI 10.1016/j.humimm.2010.04.008 PG 7 WC Immunology SC Immunology GA 620IO UT WOS:000279493000003 PM 20438786 ER PT J AU Chirinos, JA Segers, P De Buyzere, ML Kronmal, RA Raja, MW De Bacquer, D Claessens, T Gillebert, TC St John-Sutton, M Rietzschel, ER AF Chirinos, Julio A. Segers, Patrick De Buyzere, Marc L. Kronmal, Richard A. Raja, Muhammad W. De Bacquer, Dirk Claessens, Tom Gillebert, Thierry C. St John-Sutton, Martin Rietzschel, Ernst R. TI Left Ventricular Mass Allometric Scaling, Normative Values, Effect of Obesity, and Prognostic Performance SO HYPERTENSION LA English DT Article DE left ventricular mass; body size; allometric ID POPULATION-ATTRIBUTABLE RISK; BODY-SIZE; NORMOTENSIVE CHILDREN; HEART-RATE; HYPERTROPHY; ASSOCIATION; IMPACT; ATHEROSCLEROSIS; OVERWEIGHT; GEOMETRY AB The need for left ventricular mass (LVM) normalization to body size is well recognized. Currently used allometric exponents to normalize LVM may not account for the confounding effect of sex. Because sex is a strong determinant of body size and LVM, we hypothesized that these are subject to potential bias. We analyzed data from 7528 subjects enrolled in the Asklepios Study (n = 2524) and the Multiethnic Study of Atherosclerosis (limited access data set; n = 5,004) to assess metric relationships between LVM and body size, generate normative data for indexed LVM, and compare the ability of normalization methods to predict cardiovascular events. The allometric exponent that adequately described the LVM-body height relationship was 1.7 in both studies and significantly different from both the unity and 2.7, whereas the LVM-body surface area relationship was approximately linear. LVM/height(2.7) consistently demonstrated important residual relationships with body height and systematically misclassified subjects regarding the presence of LVH. LVH defined by LVM/height(1.7) was more sensitive than LVM/body surface area to identify obesity-related LVH and was most consistently associated with cardiovascular events and all-cause death. In contrast to current assumptions, LVM/height(2.7) is not an adequate method to normalize LVM for body size. We provide more appropriate normalization methods, normative data by 2D echocardiography and gradient-echo cardiac MRI, and cutoffs for defining LVH, along with prognostic validation data. (Hypertension. 2010; 56: 91-98.) C1 [Chirinos, Julio A.; Raja, Muhammad W.; St John-Sutton, Martin] Univ Penn, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. [Segers, Patrick; Claessens, Tom] Univ Ghent, Inst Biomed Technol, B-9000 Ghent, Belgium. [De Buyzere, Marc L.; Gillebert, Thierry C.; Rietzschel, Ernst R.] Univ Ghent, Dept Cardiovasc Dis, B-9000 Ghent, Belgium. [De Bacquer, Dirk; Rietzschel, Ernst R.] Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium. [Kronmal, Richard A.] Univ Washington, Sch Publ Hlth, Seattle, WA 98195 USA. RP Chirinos, JA (reprint author), Univ & Woodland Ave,Room 8B111, Philadelphia, PA 19104 USA. EM Julio.chirinos@uphs.upenn.edu RI Claessens, Tom/B-2737-2009 OI Claessens, Tom/0000-0002-3182-6820; Gillebert, Thierry/0000-0002-3832-919X FU Fonds voor Wetenschappelijk Onderzoek Vlaanderen [G.0.838.10]; National Heart, Lung, and Blood Institute FX The Asklepios Study was funded by Fonds voor Wetenschappelijk Onderzoek Vlaanderen grant G.0.838.10. MESA is conducted/supported by the National Heart, Lung, and Blood Institute in collaboration with MESA investigators. NR 24 TC 97 Z9 97 U1 2 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0194-911X J9 HYPERTENSION JI Hypertension PD JUL 1 PY 2010 VL 56 IS 1 BP 91 EP U137 DI 10.1161/HYPERTENSIONAHA.110.150250 PG 16 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 611XX UT WOS:000278859300018 PM 20458004 ER PT J AU Heliot, R Orsborn, AL Ganguly, K Carmena, JM AF Heliot, Rodolphe Orsborn, Amy L. Ganguly, Karunesh Carmena, Jose M. TI System Architecture for Stiffness Control in Brain-Machine Interfaces SO IEEE TRANSACTIONS ON SYSTEMS MAN AND CYBERNETICS PART A-SYSTEMS AND HUMANS LA English DT Article DE Brain-machine interfaces (BMIs); impedance control; musculoskeletal model; optimal control ID MULTIJOINT ARM MOVEMENTS; MACACA-MULATTA FORELIMB; DIRECT CORTICAL CONTROL; END-POINT STIFFNESS; IMPEDANCE CONTROL; MOTOR CORTEX; MUSCULOSKELETAL MODEL; MUSCLE ACTIVATION; UNSTABLE DYNAMICS; ELBOW MUSCLES AB Brain-machine interfaces (BMIs) provide a versatile tool for rehabilitation of severely disabled people. Current BMI systems focus on the control of kinematic variables. However, this approach limits the application space of BMI technology to simulated environments. Real-world rehabilitation robots, on the other hand, must operate in a variety of complex physical situations. BMI systems that are aimed toward prostheses must, then, control interaction forces with their environments. In this paper, we design a BMI-driven architecture that provides a critical link between neuronal ensemble activity and real-world dynamics. In particular, our system allows simultaneous estimation of kinematic and stiffness variables of a prosthetic device. This approach is achieved by recording instantaneous activities from cortical neural ensembles that input to a musculoskeletal model of the arm, from which limb kinematics and dynamics are estimated and converted into control signals of a prosthetic device. Using real neural and behavioral data from nonhuman primates, we show that our architecture can accurately predict kinematic and stiffness variables in different dynamic situations. This architecture has strong implications in the development of the next generation of neural prosthetics that will restore motor function in neurologically impaired patients. Moreover, it demonstrates a novel framework for studying how the brain learns and adapts to new environments. C1 [Heliot, Rodolphe; Orsborn, Amy L.] Univ Calif Berkeley, Dept Elect Engn & Comp Sci, Brain Machine Interface Syst Lab, Berkeley, CA 94720 USA. [Carmena, Jose M.] Univ Calif Berkeley, Program Cognit Sci, Berkeley, CA 94720 USA. [Ganguly, Karunesh; Carmena, Jose M.] Univ Calif Berkeley, Helen Wills Neurosci Inst, Berkeley, CA 94720 USA. [Orsborn, Amy L.] Univ Calif Berkeley, Joint Grad Grp Bioengn, Berkeley, CA 94729 USA. [Ganguly, Karunesh] San Francisco VA Med Ctr, Neurol & Rehabil Serv, San Francisco, CA 94121 USA. [Ganguly, Karunesh] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. RP Heliot, R (reprint author), Univ Calif Berkeley, Dept Elect Engn & Comp Sci, Brain Machine Interface Syst Lab, Berkeley, CA 94720 USA. EM heliot@berkeley.edu; amyorsborn@berkeley.edu; carmena@eecs.berkeley.edu FU French "Delegation generale pour l'armement" [PDE 07C0067]; National Science Foundation; American Heart Association; Christopher and Dana Reeve Foundation FX The work of R. Heliot was supported in part by the French "Delegation generale pour l'armement" under Grant PDE 07C0067. The work of A. L. Orsborn was supported in part by the National Science Foundation Graduate Fellowship. The work of K. Ganguly was supported in part by the American Heart Association. The work of J. M. Carmena was supported in part by the Christopher and Dana Reeve Foundation. NR 47 TC 4 Z9 4 U1 2 U2 9 PU IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC PI PISCATAWAY PA 445 HOES LANE, PISCATAWAY, NJ 08855-4141 USA SN 1083-4427 J9 IEEE T SYST MAN CY A JI IEEE Trans. Syst. Man Cybern. Paart A-Syst. Hum. PD JUL PY 2010 VL 40 IS 4 BP 732 EP 742 DI 10.1109/TSMCA.2010.2044410 PG 11 WC Computer Science, Cybernetics; Computer Science, Theory & Methods SC Computer Science GA 611KN UT WOS:000278814100008 ER PT J AU Garcia-Williams, AG Miller, LJ Burkitt, KH Cuerdon, T Jain, R Fine, MJ Jernigan, JA Sinkowitz-Cochran, RL AF Garcia-Williams, Amanda G. Miller, LaToya J. Burkitt, Kelly H. Cuerdon, Timothy Jain, Rajiv Fine, Michael J. Jernigan, John A. Sinkowitz-Cochran, Ronda L. TI Beyond beta: Lessons Learned from Implementation of the Department of Veterans Affairs Methicillin-Resistant Staphylococcus aureus Prevention Initiative SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID BLOOD-STREAM INFECTIONS; INTERVENTION; REDUCE; ICU AB To describe the key strategies and potential pitfalls involved with implementing the Department of Veterans Affairs (VA) Methicillin-Resistant Staphylococcus aureus (MRSA) Prevention Initiative in a qualitative evaluation, we conducted in-depth interviews with MRSA Prevention Coordinators at 17 VA beta sites at 2 time points during program implementation. Infect Control Hosp Epidemiol 2010; 31(7):763-765 C1 [Garcia-Williams, Amanda G.; Jernigan, John A.; Sinkowitz-Cochran, Ronda L.] Ctr Dis Control & Prevent, Div Healthcare Qual Promot, Atlanta, GA 30333 USA. [Burkitt, Kelly H.; Fine, Michael J.] Univ Pittsburgh, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Miller, LaToya J.; Jain, Rajiv] Univ Pittsburgh, Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Fine, Michael J.] Univ Pittsburgh, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. Vet Affairs Cent Off, Off Qual & Performance, Washington, DC USA. RP Sinkowitz-Cochran, RL (reprint author), Ctr Dis Control & Prevent, Div Healthcare Qual Promot, 1600 Clifton Rd,MS A-31, Atlanta, GA 30333 USA. EM RLS7@cdc.gov NR 9 TC 4 Z9 4 U1 0 U2 1 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 2010 VL 31 IS 7 BP 763 EP 765 DI 10.1086/653818 PG 3 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 605VB UT WOS:000278374000016 PM 20509763 ER PT J AU Goo, YA Tsai, YSS Liu, AY Goodlett, DR Yang, CC AF Goo, Young Ah Tsai, Yihsuan S. Liu, Alvin Y. Goodlett, David R. Yang, Claire C. TI Urinary Proteomics Evaluation in Interstitial Cystitis/Painful Bladder Syndrome: A Pilot Study SO INTERNATIONAL BRAZ J UROL LA English DT Article DE interstitial cystitis; painful bladder syndrome; urine proteomics ID CHRONIC PELVIC PAIN; EPIDERMAL-GROWTH-FACTOR; ANTIPROLIFERATIVE FACTOR; HUMAN PROSTATE; PROTEIN; EXPRESSION; MARKERS AB Purpose: Interstitial cystitis/painful bladder syndrome (IC/PBS) is characterized by chronic pain, pressure and discomfort felt in the pelvis or bladder. An in-depth shotgun proteomics study was carried out to profile the urinary proteome of women with IC/PBS to identify possible specific proteins and networks associated with IC/PBS. Materials and Methods: Urine samples from ten female IC/PBS patients and ten female asymptomatic, healthy control subjects were analyzed in quadruplicate by liquid chromatography-tandem mass spectrometry (LC-MS/MS) on a hybrid linear ion trap-orbitrap mass spectrometer. Gas-phase fractionation (GPF) was used to enhance protein identification. Differences in protein quantity were determined by peptide spectral counting. Results: alpha-1B-glycoprotein (A1BG) and orosomucoid-1 (ORM1) were detected in all IC/PBS patients, and 60% of these patients had elevated expression of these two proteins compared to control subjects. Transthyretin (TTR) and hemopexin (HPX) were detected in all control individuals, but >= 60% of the IC/PBS patients had decreased expression levels of these two proteins. Enrichment functional analysis showed cell adhesion and response to stimuli were down-regulated whereas response to inflammation, wounding, and tissue degradation were up-regulated in IC/PBS. Activation of neurophysiological processes in synaptic inhibition, and lack of DNA damage repair may also be key components of IC/PBS. Conclusion: There are qualitative and quantitative differences between the urinary proteomes of women with and without IC/PBS. We identified a number of proteins as well as pathways/networks that might contribute to the pathology of IC/PBS or result from perturbations induced by this condition. C1 [Liu, Alvin Y.; Yang, Claire C.] Univ Washington, Dept Urol, Seattle, WA 98195 USA. [Goo, Young Ah; Tsai, Yihsuan S.; Goodlett, David R.] Univ Washington, Dept Med Chem, Seattle, WA 98195 USA. [Liu, Alvin Y.] Univ Washington, Inst Stem Cell & Regenerat Med, Seattle, WA 98195 USA. [Yang, Claire C.] Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. [Goodlett, David R.] Inst Syst Biol, Seattle, WA USA. RP Yang, CC (reprint author), Univ Washington, Dept Urol, Box 356510, Seattle, WA 98195 USA. EM cyang@uw.edu RI Tsai, Yihsuan/I-1924-2013 OI Tsai, Yihsuan/0000-0003-2107-4300 FU National Institute of Diabetes and Digestive and Kidney Diseases [U01 DK065202]; National Institute of Environmental Health Sciences [5P30ES007033-12]; National Center For Research Resources [1S10RR023044-01]; Robert Wood Johnson Foundation [64189] FX This work was supported by: National Institute of Diabetes and Digestive and Kidney Diseases U01 DK065202; National Institute of Environmental Health Sciences 5P30ES007033-12; National Center For Research Resources 1S10RR023044-01, and Robert Wood Johnson Foundation 64189. NR 31 TC 16 Z9 16 U1 0 U2 1 PU BRAZILIAN SOC UROL PI RIO DE JANEIRO PA RUA BAMBINA, 153, RIO DE JANEIRO, 2251-050, BRAZIL SN 1677-5538 J9 INT BRAZ J UROL JI Int. Braz J Urol PD JUL-AUG PY 2010 VL 36 IS 4 BP 464 EP 478 DI 10.1590/S1677-55382010000400010 PG 15 WC Urology & Nephrology SC Urology & Nephrology GA 668RZ UT WOS:000283288700014 PM 20815953 ER PT J AU Hakeem, A Bhatti, S Karmali, KN Dillie, KS Cook, JR Xu, JQ Samad, Z Chang, SM AF Hakeem, Abdul Bhatti, Sabha Karmali, Kunal N. Dillie, Kathryn S. Cook, Jeffrey R. Xu, Jiaqiong Samad, Zainab Chang, Su Min TI Renal Function and Risk Stratification of Diabetic and Nondiabetic Patients Undergoing Evaluation for Coronary Artery Disease SO JACC-CARDIOVASCULAR IMAGING LA English DT Article DE diabetic; renal function; risk stratification ID CHRONIC KIDNEY-DISEASE; GLOMERULAR-FILTRATION-RATE; EMISSION COMPUTED-TOMOGRAPHY; INCREMENTAL PROGNOSTIC VALUE; SILENT-MYOCARDIAL-ISCHEMIA; HIGH BLOOD-PRESSURE; CARDIOVASCULAR-DISEASE; ALL-CAUSE; GENERAL-POPULATION; PERFUSION SPECT AB OBJECTIVES The aim of this study was to evaluate the impact of renal function by estimated glomerular filtration rate (eGFR) on risk stratification of diabetic and nondiabetic patients undergoing myocardial perfusion imaging (MPI) by single-photon emission computed tomography for suspected ischemia. BACKGROUND Coronary artery disease is the leading cause of death among diabetic persons; however, diabetic persons are a very heterogeneous group in terms of cardiovascular risk, necessitating further risk stratification. METHODS Patients (n = 1,747, age 65 +/- 10 years, 37% diabetic) undergoing MPI were followed for cardiac death (CD) for a mean of 2.15 +/- 0.8 years. Chronic kidney disease (CKD) was defined by an eGFR <60 ml/min. RESULTS In the presence of a normal scan, annual CD rate was 0.9% for those with no diabetes mellitus (DM) and no CKD, 0.5% in the DM alone group, 2.35% in CKD alone, and 2.9% in those with both DM and CKD (p < 0.001). Patients with DM+CKD had a 2.7-fold risk of CD compared with no DM no CKD (p = 0.001) after controlling for age, ejection fraction, history of coronary artery disease, and other risk factors. The risk of CD increased as a function of the presence and severity of perfusion defects, regardless of CKD or DM status. Presence of CKD conferred a several-fold higher risk of CD for the various strata of perfusion defects. Log-rank test for difference in probability of CD was nonsignificant for comparison between patients with no DM no CKD and those with DM alone (p = 0.73) but was significant for comparison between patients with no DM no CKD and patients with CKD alone (p < 0.001) or DM+CKD (p < 0.001). CONCLUSIONS MPI and eGFR provide valuable risk stratification for diabetic and nondiabetic patients. Diabetic patients without CKD seem to have similar short-term cardiac outcomes compared with nondiabetic patients. Underlying CKD seems to identify a high-risk subgroup of diabetic patients. (J Am Coll Cardiol Img 2010;3:734-45) (c) 2010 by the American College of Cardiology Foundation C1 [Hakeem, Abdul; Bhatti, Sabha] Univ Cincinnati, Coll Med, Div Cardiovasc Dis, Cincinnati, OH USA. [Karmali, Kunal N.; Cook, Jeffrey R.] Univ Wisconsin Hosp & Clin, Dept Internal Med, Madison, WI 53792 USA. [Karmali, Kunal N.; Cook, Jeffrey R.] Univ Wisconsin Hosp & Clin, William S Middleton Mem Vet Adm Hosp, Madison, WI 53792 USA. [Dillie, Kathryn S.] Wisconsin Affiliated Hosp, Coll Med, Milwaukee, WI USA. [Xu, Jiaqiong] Methodist Hosp, Res Inst, Ctr Biostat, Houston, TX 77030 USA. [Samad, Zainab] Duke Univ, Med Ctr, Div Cardiol, Durham, NC 27710 USA. [Chang, Su Min] Methodist Hosp, DeBakey Heart & Vasc Ctr, Houston, TX 77030 USA. RP Hakeem, A (reprint author), Univ Cincinnati Hosp, Acad Hlth Ctr, 231 Albert Sabin Way,POB 670542, Cincinnati, OH 45257 USA. EM ahakeem@gmail.com NR 42 TC 17 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 1936-878X J9 JACC-CARDIOVASC IMAG JI JACC-Cardiovasc. Imag. PD JUL PY 2010 VL 3 IS 7 BP 734 EP 745 DI 10.1016/j.jcmg.2010.06.001 PG 12 WC Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging SC Cardiovascular System & Cardiology; Radiology, Nuclear Medicine & Medical Imaging GA 647OB UT WOS:000281626700009 PM 20633852 ER PT J AU Kellogg, DL Zhao, JL Wu, YB Johnson, JM AF Kellogg, Dean L., Jr. Zhao, Joan L. Wu, Yubo Johnson, John M. TI VIP/PACAP receptor mediation of cutaneous active vasodilation during heat stress in humans SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE laser-Doppler flowmetry; VPAC2; PAC1; thermoregulation; microdialysis ID VASOACTIVE-INTESTINAL-PEPTIDE; CYCLASE-ACTIVATING POLYPEPTIDE; HUMAN-SKIN; CYSTIC-FIBROSIS; CARDIOVASCULAR ADJUSTMENTS; VASCULAR-RESPONSES; VPAC RECEPTORS; MESSENGER-RNA; SWEAT GLANDS; BLOOD-FLOW AB Kellogg DL Jr, Zhao JL, Wu Y, Johnson JM. VIP/PACAP receptor mediation of cutaneous active vasodilation during heat stress in humans. J Appl Physiol 109: 95-100, 2010. First published April 15, 2010; doi:10.1152/japplphysiol.01187.2009.-Vasoactive intestinal peptide (VIP) is implicated in cutaneous active vasodilation in humans. VIP and the closely related pituitary adenylate cyclase activating peptide (PACAP) act through several receptor types: VIP through VPAC1 and VPAC2 receptors and PACAP through VPAC1, VPAC2, and PAC1 receptors. We examined participation of VPAC2 and/or PAC1 receptors in cutaneous vasodilation during heat stress by testing the effects of their specific blockade with PACAP6-38. PACAP6-38 dissolved in Ringer's was administered by intradermal microdialysis at one forearm site while a control site received Ringer's solution. Skin blood flow was monitored by laser-Doppler flowmetry (LDF). Blood pressure was monitored noninvasively and cutaneous vascular conductance (CVC) calculated. A 5- to 10-min baseline period was followed by similar to 70 min of PACAP6-38 (100 mu M) perfusion at one site in normothermia and a 3-min period of body cooling. Whole body heating was then performed to engage cutaneous active vasodilation and was maintained until CVC had plateaued at an elevated level at all sites for 5-10 min. Finally, 58 mM sodium nitroprusside was perfused through both microdialysis sites to effect maximal vasodilation. No CVC differences were found between control and PACAP6-38-treated sites during normothermia (19 +/- 3%max untreated vs. 20 +/- 3%max, PACAP6-38 treated; P > 0.05 between sites) or cold stress (11 +/- 2%max untreated vs. 10 +/- 2%max, PACAP6-38 treated, P > 0.05 between sites). PACAP6-38 attenuated the increase in CVC during whole body heating when compared with untreated sites (59 +/- 3%max untreated vs. 46 +/- 3%max, PACAP6-38 treated, P < 0.05). We conclude that VPAC2 and/or PAC1 receptor activation is involved in cutaneous active vasodilation in humans. C1 [Kellogg, Dean L., Jr.; Zhao, Joan L.; Wu, Yubo] Univ Texas Hlth Sci Ctr San Antonio, Div Geriatr & Gerontol, Dept Med, San Antonio, TX 78229 USA. [Kellogg, Dean L., Jr.; Johnson, John M.] Univ Texas Hlth Sci Ctr San Antonio, Dept Physiol, San Antonio, TX 78229 USA. [Kellogg, Dean L., Jr.; Zhao, Joan L.; Wu, Yubo] Univ Texas Hlth Sci Ctr San Antonio, Ctr Geriatr Res Educ & Clin, Dept Vet Affairs, Audie L Murphy Mem Vet Hosp Div, San Antonio, TX 78229 USA. RP Kellogg, DL (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Div Geriatr & Gerontol, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM kelloggd@uthscsa.edu FU National Heart, Lung, and Blood Institute [HL-065599] FX This work was supported in part by National Heart, Lung, and Blood Institute Grant HL-065599. NR 54 TC 19 Z9 20 U1 0 U2 2 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 2010 VL 109 IS 1 BP 95 EP 100 DI 10.1152/japplphysiol.01187.2009 PG 6 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 617OY UT WOS:000279291500013 PM 20395540 ER PT J AU Pai, S Ledoux, WR AF Pai, Shruti Ledoux, William R. TI The Effect of Target Strain Error on Plantar Tissue Stress SO JOURNAL OF BIOMECHANICAL ENGINEERING-TRANSACTIONS OF THE ASME LA English DT Article DE overshoot; diabetes; subcutaneous; soft tissue; viscoelastic ID VISCOELASTIC PROPERTIES; RELAXATION; LIGAMENTS; PAD AB Accurate quantification of soft tissue properties, specifically the stress relaxation behavior of viscoelastic tissues such as plantar tissue, requires precise testing under physiologically relevant loading. However limitations of testing equipment often result in target strain errors that can contribute to large stress errors and confound comparative results to an unknown extent. Previous investigations have modeled this artifact, but they have been unable to obtain empirical data to validate their models. Moreover, there are no studies that address this issue for plantar tissue. The purpose of this research was to directly measure the difference in peak force for a series of small target strain errors within the range of our typical stress relaxation experiments for the subcutaneous plantar soft tissue. Five plantar tissue specimens were tested to seven incremental target strain error levels of 0.9%, 0.6%, 0.3%, 0.0%, 0.3%, 0.6%, and 0.9%, so as to undershoot and overshoot the target displacement in 0.3% increments. The imposed straits errors were accurately attained using a special compensation feature of our materials testing software that can drive the actuator to within 0% (1-2 mu m) of the target level for cyclic tests. Since stress relaxation tests are not cyclic, we emulated the ramp portion of our stress relaxation tests with 5 Hz triangle waves. The average total stress variation for all specimens was 25 +/- 5%, with the highest and lowest stresses corresponding to the largest and smallest strain errors 40.9% and 0.9%, respectively. A strain overshoot of 0.3%, the target strain error observed in our typical stress relaxation experiments, corresponded to an average stress overshoot of 3 +/- 1%. Plantar tissue in compression is sensitive to small target strain errors that can result its stress errors that are several fold larger The extent to which the overshoot may affect the peak stress will likely differ in magnitude for other soft tissues and loading modes. [DOI: 10.1115/1.4001398] C1 [Pai, Shruti; Ledoux, William R.] VA RR&D Ctr Excellence Limb Loss Prevent & Prosth, Seattle, WA 98108 USA. [Pai, Shruti; Ledoux, William R.] Univ Washington, Dept Mech Engn, Seattle, WA 98195 USA. [Pai, Shruti; Ledoux, William R.] VA Puget Sound, Seattle, WA 98108 USA. [Ledoux, William R.] Univ Washington, Dept Orthopaed & Sports Med, Seattle, WA 98195 USA. RP Ledoux, WR (reprint author), VA RR&D Ctr Excellence Limb Loss Prevent & Prosth, Seattle, WA 98108 USA. EM shruti.pai@gmail.com; wrledoux@u.washington.edu RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 FU NIH [1R01 DK75633-03]; Department of Veterans Affairs, RRD Service FX This study was supported by NIH under Grant No. 1R01 DK75633-03 and the Department of Veterans Affairs, RR&D Service. NR 14 TC 4 Z9 4 U1 0 U2 1 PU ASME-AMER SOC MECHANICAL ENG PI NEW YORK PA THREE PARK AVE, NEW YORK, NY 10016-5990 USA SN 0148-0731 J9 J BIOMECH ENG-T ASME JI J. Biomech. Eng.-Trans. ASME PD JUL PY 2010 VL 132 IS 7 AR 071001 DI 10.1115/1.4001398 PG 4 WC Biophysics; Engineering, Biomedical SC Biophysics; Engineering GA 622AW UT WOS:000279631400001 PM 20590279 ER PT J AU Dossa, T Arabian, A Windle, JJ Dedhar, S Teitelbaum, SL Ross, FP Roodman, GD St-Arnaud, R AF Dossa, Tanya Arabian, Alice Windle, Jolene J. Dedhar, Shoukat Teitelbaum, Steven L. Ross, F. Patrick Roodman, G. David St-Arnaud, Rene TI Osteoclast-Specific Inactivation of the Integrin-Linked Kinase (ILK) Inhibits Bone Resorption SO JOURNAL OF CELLULAR BIOCHEMISTRY LA English DT Article DE INTEGRIN-LINKED KINASE; INTEGRINS; OSTEOCLAST ID TUMOR-SUPPRESSOR PTEN; PROTEIN-KINASE; MICE LACKING; ACTIVATION; PROMOTER; BIOLOGY; B/AKT; ROLES AB Bone resorption requires the adhesion of osteoclasts to extracellular matrix (ECM) components, a process mediated by the alpha(v)beta(3) integrin. Following engagement with the ECM, integrin receptors signal via multiple downstream effectors, including the integrin-linked kinase (ILK). In order to characterize the physiological role of ILK in bone resorption, we generated mice with an osteoclast-specific Ilk gene ablation by mating mice with a floxed Ilk allele with TRAP-Cre transgenic mice. The TRAP-Cre mice specifically excised floxed alleles in osteoclasts, as revealed by crossing them with the ROSA26R reporter strain. Osteoclast-specific Ilk mutant mice appeared phenotypically normal, but histomorphometric analysis of the proximal tibia revealed an increase in bone volume and trabecular thickness. Osteoclast-specific Ilk ablation was associated with an increase in osteoclastogenesis both in vitro and in vivo. However, the mutant osteoclasts displayed a decrease in resorption activity as assessed by reduced pit formation on dentin slices in vitro and decreased serum concentrations of the C-terminal telopeptide of collagen in vivo. Interestingly, compound heterozygous mice in which one allele of Ilk and one allele of the beta(3) integrin gene were inactivated (ILK+/-; beta(+/-)(3)) also had increased trabecular thickness, confirming that beta(3) integrin and Ilk form part of the same genetic cascade. Our results show that ILK is important for the function, but not the differentiation, of osteoclasts. J. Cell. Biochem. 110: 960-967, 2010. (C) 2010 Wiley-Liss. Inc. C1 [Dossa, Tanya; Arabian, Alice; St-Arnaud, Rene] Shriners Hosp Children, Genet Unit, Montreal, PQ H3G 1A6, Canada. [Dossa, Tanya; St-Arnaud, Rene] McGill Univ, Dept Human Genet, Montreal, PQ H3A 2T5, Canada. [Windle, Jolene J.] Virginia Commonwealth Univ, Richmond, VA 23298 USA. [Dedhar, Shoukat] British Columbia Canc Agcy, Vancouver, BC V6H 3Z6, Canada. [Dedhar, Shoukat] Vancouver Hosp, Jack Bell Res Ctr, Vancouver, BC V6H 3Z6, Canada. [Dedhar, Shoukat] Univ British Columbia, Dept Biochem & Mol Biol, Vancouver, BC V6T 1Z3, Canada. [Teitelbaum, Steven L.; Ross, F. Patrick] Washington Univ, Sch Med, Dept Pathol, St Louis, MO 63110 USA. [Roodman, G. David] Univ Pittsburgh, Dept Med Hematol Oncol, Pittsburgh, PA 15232 USA. [Roodman, G. David] VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. [St-Arnaud, Rene] McGill Univ, Dept Surg, Montreal, PQ H3A 2T5, Canada. [St-Arnaud, Rene] McGill Univ, Dept Med, Montreal, PQ H3A 2T5, Canada. RP St-Arnaud, R (reprint author), Shriners Hosp Children, Genet Unit, 1529 Cedar Ave, Montreal, PQ H3G 1A6, Canada. EM rst-arnaud@shriners.mcgill.ca OI Windle, Jolene/0000-0001-6690-385X; Teitelbaum, Steven/0000-0002-4054-6679 FU Shriners of North America FX Grant sponsor: Shriners of North America. NR 33 TC 9 Z9 9 U1 0 U2 6 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0730-2312 EI 1097-4644 J9 J CELL BIOCHEM JI J. Cell. Biochem. PD JUL 1 PY 2010 VL 110 IS 4 BP 960 EP 967 DI 10.1002/jcb.22609 PG 8 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 619OS UT WOS:000279440100018 PM 20564195 ER PT J AU Brent, GA AF Brent, Gregory A. TI The Impact of Perchlorate Exposure in Early Pregnancy: Is It Safe to Drink the Water? SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Editorial Material ID UNITED-STATES; URINARY PERCHLORATE; THYROID-FUNCTION; IODINE; HEALTH; WOMEN C1 [Brent, Gregory A.] Vet Affairs Greater Los Angeles Healthcare Syst, Endocrinol & Diabet Div, Los Angeles, CA 90073 USA. [Brent, Gregory A.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90073 USA. [Brent, Gregory A.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Physiol, Los Angeles, CA 90073 USA. RP Brent, GA (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Endocrinol & Diabet Div, 111D,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM gbrent@ucla.edu FU NCI NIH HHS [R01 CA089364, R01 CA89364] NR 20 TC 6 Z9 6 U1 0 U2 4 PU ENDOCRINE SOC PI WASHINGTON PA 2055 L ST NW, SUITE 600, WASHINGTON, DC 20036 USA SN 0021-972X EI 1945-7197 J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD JUL PY 2010 VL 95 IS 7 BP 3154 EP 3157 DI 10.1210/jc.2010-0979 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 621OS UT WOS:000279589600011 PM 20610607 ER PT J AU Bloch, MJ Basile, JN AF Bloch, Michael J. Basile, Jan N. TI Is There Accord in ACCORD? Lower Blood Pressure Targets in Type 2 Diabetes Does Not Lead to Fewer Cardiovascular Events Except for Reductions in Stroke SO JOURNAL OF CLINICAL HYPERTENSION LA English DT Editorial Material ID MICROVASCULAR COMPLICATIONS; RISK; MELLITUS; HOT C1 [Bloch, Michael J.] St Marys Reg Med Ctr, Risk Reduct Ctr, Reno, NV 89503 USA. [Bloch, Michael J.] St Marys Reg Med Ctr, Vasc Inst, Reno, NV 89503 USA. [Bloch, Michael J.] Univ Nevada, Sch Med, Dept Med, Reno, NV 89557 USA. [Basile, Jan N.] Med Univ S Carolina, Div Gen Internal Med Geriat, Seinsheimer Cardiovasc Hlth Program, Charleston, SC USA. [Basile, Jan N.] Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Bloch, MJ (reprint author), St Marys Reg Med Ctr, Risk Reduct Ctr, 645 N Arlington St,Suite 460, Reno, NV 89503 USA. EM mbloch@aol.com NR 8 TC 5 Z9 5 U1 0 U2 0 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1524-6175 J9 J CLIN HYPERTENS JI J. Clin. Hypertens. PD JUL PY 2010 VL 12 IS 7 BP 472 EP 477 DI 10.1111/j.1751-7176.2010.00333.x PG 6 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 622NC UT WOS:000279669500002 PM 20629807 ER PT J AU Olfson, M Marcus, SC Doshi, JA AF Olfson, Mark Marcus, Steven C. Doshi, Jalpa A. TI Continuity of Care After Inpatient Discharge of Patients With Schizophrenia in the Medicaid Program: A Retrospective Longitudinal Cohort Analysis SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID MENTAL-HEALTH-CARE; PSYCHIATRIC-HOSPITALIZATION; FOLLOW-UP; PREDICTORS; REHOSPITALIZATION; APPOINTMENTS; RECIDIVISM; STRATEGIES; PATTERNS; ILLNESS AB Objective: This study seeks to identify patient, facility, county, and state policy factors associated with timely schizophrenia-related outpatient treatment following hospital discharge. Method: A retrospective longitudinal cohort analysis was performed of 2003 national Medicaid claims data supplemented with the American Hospital Association facility survey, the Area Resource File, and a Substance Abuse and Mental Health Services Administration Medicaid policy report The analysis focuses on treatment episodes of adults, aged 20 to 63 years, who received inpatient care for ICD-9-CM-diagnosed schizophrenia (59,567 total treatment episodes). Rate and adjusted odds ratio (AOR) of schizophrenia-related outpatient visits within 7 days and 30 days following hospital discharge are assessed. Results: Of the 59,567 hospital discharges, 41 7% received schizophrenia-related outpatient visits in 7 days and 59 3% in 30 days following hospital discharge The adjusted odds of 30-day follow-up outpatient visits were significantly related to pread-mission outpatient mental health visits (AOR = 3.72, 99% CI, 3.44-4 03), depot (AOR = 2 83, 99% CI, 2 53-3.18) or oral (AOR = 1.73; 99% CI, 1 62-1.84) antipsychotics as compared with no antipsychotics, and absence of a substance use disorder diagnosis (AOR = 1.35, 99% CI, 1 25-1 45). General hospital as compared with a psychiatric hospital treatment (AOR = 1.32; 99% CI, 1 14-1 54) and patient residence in a county with a larger number of psychiatrists per capita (AOR = 1 27, 99% CI, 1.08-1.50) were related to receiving follow-up outpatient visits. By contrast, residence in a county with a high poverty rate (AOR = 0.60; 99% CI, 0.54-0 67) and treatment in a state with prior authorization requirements for < 12 annual outpatient visits (AOR = 0.69, 99% CI, 063-0.75) reduced the odds of follow-up care. Conclusions: Patient characteristics, clinical management, geographical resource availability, and the mental health policy environment all appear to shape access to care following hospital discharge in the community treatment of adult schizophrenia. J Clin, Psychiatry 2010, 71(7):831-838 ea (C) Copyright 2010 Physicians Postgraduate Press, Inc C1 [Olfson, Mark] Columbia Univ, Dept Psychiat, New York State Psychiat Inst, Coll Phys & Surg, New York, NY 10032 USA. [Marcus, Steven C.] Univ Penn, Ctr Hlth Equ Res & Promot, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. [Marcus, Steven C.] Univ Penn, Sch Social Policy & Practice, Philadelphia, PA 19104 USA. [Doshi, Jalpa A.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Doshi, Jalpa A.] Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. RP Olfson, M (reprint author), Columbia Univ, Dept Psychiat, New York State Psychiat Inst, Coll Phys & Surg, 1051 Riverside Dr,Unit 24, New York, NY 10032 USA. RI McCarthy, Jodie/B-5760-2012 FU Bristol-Myers Squibb; Eli Lilly, Indianapolis, Indiana FX Dr Olfson has received grant/research support from Bristol-Myers Squibb and Eli Lilly Dr Marcus is a consultant for Eli Lilly Dr Doshi is a consultant for Eli Lilly and Bristol-Myers Squibb; This research was funded by a grant to Columbia University from Eli Lilly, Indianapolis, Indiana, Dr Olfson, principal investigator NR 35 TC 27 Z9 27 U1 0 U2 6 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PD JUL PY 2010 VL 71 IS 7 BP 831 EP 838 DI 10.4088/JCP.10m05969yel PG 8 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 633AC UT WOS:000280470700003 PM 20441730 ER PT J AU Morland, LA Greene, CJ Rosen, CS Foy, D Reilly, P Shore, J He, QM Frueh, BC AF Morland, Leslie A. Greene, Carolyn J. Rosen, Craig S. Foy, David Reilly, Patrick Shore, Jay He, Qimei Frueh, B. Christopher TI Telemedicine for Anger Management Therapy in a Rural Population of Combat Veterans With Posttraumatic Stress Disorder: A Randomized Noninferiority Trial SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID US VETERANS; TELEPSYCHIATRY; PSYCHOTHERAPY; AFGHANISTAN; DEPRESSION; ALLIANCE; VIETNAM; ISSUES; PTSD; IRAQ AB Objective: To demonstrate the noninferiority of a telemedicine modality, videoteleconferencing, compared to traditional in-person service delivery of a group psychotherapy intervention for rural combat veterans with posttraumatic stress disorder (PTSD). Method: A randomized controlled noninferiority trial of 125 male veterans with PTSD (according to DSM criteria on the Clinician-Administered PTSD Scale) and anger difficulties was conducted at 3 Veterans Affairs outpatient clinics. Participants were randomly assigned to receive anger management therapy delivered in a group setting with the therapist either in-person (n=64) or via videoteleconferencing (n=61). Participants were assessed at baseline, midtreatment (3 weeks), posttreatment (6 weeks), and 3 and 6 months posttreatment The primary clinical outcome was reduction of anger difficulties, as measured by the anger expression and trait anger subscales of the State-Trait Anger Expression Inventory-2 (STAXI-2) and by the Novaco Anger Scale total score (NAS-T). Data were collected from August 2005 to October 2008. Results: Participants in both groups showed significant and clinically meaningful reductions in anger symptoms, with posttreatment and 3 and 6 months posttreatment effect sizes ranging from 12 to .63 Using a noninferiority margin of 2 points for STAXI-2 subscales anger expression and trait anger and 4 points for NAS-T outcomes, participants in the videoteleconferencing condition demonstrated a reduction in anger symptoms similar ("non-inferior") to symptom reductions in the in-person groups. Additionally, no significant between-group differences were found on process variables, including attrition, adherence, satisfaction, and treatment expectancy Participants in the in-person condition reported significantly higher group therapy alliance. Conclusions: Clinical and process outcomes indicate delivering cognitive-behavioral group treatment for PTSD-related anger problems via videoteleconferencing is an effective and feasible way to increase access to evidence-based care for veterans residing in rural or remote locations Trial Registration: clinicaltrials gov Identifier NCT00122109 J Clin Psychiatry 2010,71(7).855-863 (C) Copyright 2010 Physicians Postgraduate Press, Inc C1 [Morland, Leslie A.; Greene, Carolyn J.] Pacific Isl Healthcare Syst, Natl Ctr PTSD, Pacific Isl Div, Dept Vet Affairs, Honolulu, HI 96819 USA. [He, Qimei] Pacific Hlth Res Inst, Honolulu, HI USA. [Greene, Carolyn J.; Rosen, Craig S.] Palo Alto Healthcare Syst, Natl Ctr PTSD, Disseminat & Training Div, Dept Vet Affairs, Palo Alto, CA USA. [Rosen, Craig S.] Stanford Univ, Sch Med, Dept Psychiat & Behav Sci, Palo Alto, CA 94304 USA. [Foy, David] Pepperdine Univ, Grad Sch Educ & Psychol, Malibu, CA 90265 USA. [Reilly, Patrick] San Francisco VA Med Ctr, San Francisco, CA USA. [Shore, Jay] Univ Colorado, Ctr Amer Indian Native Mental Hlth, Denver, CO 80202 USA. [Shore, Jay] Univ Colorado, Ctr Alaska Native Mental Hlth, Denver, CO 80202 USA. [Shore, Jay] Off Rural Hlth, Dept Vet Affairs, Vet Rural Hlth Resource Ctr Western Reg, Denver, CO USA. [Frueh, B. Christopher] Menninger Clin, Houston, TX USA. [Frueh, B. Christopher] Baylor Coll Med, Houston, TX 77030 USA. RP Morland, LA (reprint author), Pacific Isl Healthcare Syst, Natl Ctr PTSD, Pacific Isl Div, Dept Vet Affairs, 3375 Koapaka St,Suite I-560, Honolulu, HI 96819 USA. FU Veterans Affairs Health Services Research and Development [TEL 03-080-3]; Office of Research and Development, Medical Research Service, Department of Veterans Affairs FX This work was partially supported by grant TEL 03-080-3 from the Veterans Affairs Health Services Research and Development This work was also supported by the Office of Research and Development, Medical Research Service, Department of Veterans Affairs NR 42 TC 108 Z9 109 U1 5 U2 22 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PD JUL PY 2010 VL 71 IS 7 BP 855 EP 863 DI 10.4088/JCP.09m05604blu PG 9 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 633AC UT WOS:000280470700005 PM 20122374 ER PT J AU Zisook, S Kasckow, JW Lanouette, NM Golshan, S Fellows, I Vahia, I Mohamed, S Rao, S AF Zisook, Sidney Kasckow, John W. Lanouette, Nicole M. Golshan, Shahrokh Fellows, Ian Vahia, Ipsit Mohamed, Somaia Rao, Sanjai TI Augmentation With Citalopram for Suicidal Ideation in Middle-Aged and Older Outpatients With Schizophrenia and Schizoaffective Disorder Who Have Subthreshold Depressive Symptoms: A Randomized Controlled Trial SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW; SEROTONIN REUPTAKE INHIBITORS; CLINICAL-TRIALS; DSM-IV; RISK; SCALE; ANTIDEPRESSANTS; ASSOCIATION; PLACEBO; ADULTS AB Objective: To examine the effects of citalopram augmentation of antipsychotic on suicidal ideation in middle-aged and older people with schizophrenia and subthreshold depressive symptoms. Method: In this placebo-controlled trial conducted from September 1, 2001, to August 31, 2007, 198 outpatients 40 years old with DSM-IV-diagnosed schizophrenia or schizoaffective disorder and subthreshold depressive symptoms were randomly assigned to flexible-dose citalopram (n = 104) or placebo (n = 94) augmentation of their antipsychotic for 12 weeks. Depression was measured with the Hamilton Depression Rating Scale (HDRS) and Calgary Depression Rating Scale (CDRS) Primary suicidal ideation measures were the Clinical Global Impressions-Seventy of Suicide scale (CGI-SS) and the InterSePT Scale for Suicidal Thinking (ISST), secondary outcomes were the Scale for Suicidal Ideation (SSI), Beck Hopelessness Scale (RIIS), HDRS Item 3, and CDRS item 8 Results: Compared to placebo, at the final visit, citalopram was associated with lower BHS scores (4.21 vs 4 98, P < .05) and lower likelihood of having suicidal ideation on the ISST (17 7% vs 38 7%, P < 005) and HDRS Item 3 (14 4% vs 22 6%, P < 05) Among the 114 participants with no baseline suicidal ideation, there were no significant differences between citalopram and placebo regarding "emergent" ideation on either primary outcome Among the 55 participants with baseline suicidal ideation, fewer treated with citalopram had endpoint ideation on the ISST (286% vs 66 7%, P<.05). Significantly more depression responders than nonresponders went from having baseline suicidal ideation to no suicidal ideation on both the ISST (75 0% vs 31 4%, P < 05) and CGI-SS (84 6% vs 31 3%, P < 05) Conclusions: Treatment-emergent suicidal ideation was no more common with citalopram than placebo In participants with baseline suicidal ideation, citalopram reduced suicidal ideation, especially in those whose depressive symptoms responded to treatment C1 [Zisook, Sidney; Golshan, Shahrokh; Fellows, Ian] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92161 USA. [Zisook, Sidney; Lanouette, Nicole M.; Vahia, Ipsit; Rao, Sanjai] Vet Affairs San Diego Hlth Care Syst, San Diego, CA USA. [Kasckow, John W.] Univ Pittsburgh, Dept Psychiat, Vet Affairs Pittsburgh Hlth Care Syst, Western Psychiat Inst & Clin,MIRECC,Med Ctr, Pittsburgh, PA 15260 USA. [Mohamed, Somaia] VISN 1 MIRECC, Vet Affairs NE Program Evaluat Ctr, New Haven, CT USA. [Mohamed, Somaia] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA. RP Zisook, S (reprint author), Univ Calif San Diego, Dept Psychiat, 3350 La Jolla Village Dr, San Diego, CA 92161 USA. FU PenLab; AstraZeneca; Citalopram Augmentation of Older Patients with Schizophrenia [RO-1 MH 063931]; National Institute of Mental Health [MH66248, MH19934, P30 MH080002]; Department of Veterans Affairs [R01 MH6398]; VISN 4 MIRECC; VISN 4 CPPF FX Dr Zisook has received grant/research support from PenLab and has received honoraria from GlaxoSmithKline Dr Kasckow has received grant/research support from AstraZeneca Dr Rao is on the speakers/advisory boards for Bristol-Myers Squibb, Eli Lilly, and AstraZeneca Drs Lanouette, Golshan, Vahia, and Mohamed and Mr Fellows have no personal affiliations or financial relationships with any commercial interest to disclose relative to the article; This work was supported by RO-1 MH 063931 Citalopram Augmentation of Older Patients with Schizophrenia (Dr Zisook, PI), National Institute of Mental Health grants MH66248, MH19934, P30 MH080002, and the Department of Veterans Affairs Dr Kasckow was supported by R01 MH6398, the VISN 4 MIRECC, and a VISN 4 CPPF award NR 49 TC 15 Z9 15 U1 3 U2 9 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PD JUL PY 2010 VL 71 IS 7 BP 915 EP 922 DI 10.4088/JCP.09m05699gre PG 8 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 633AC UT WOS:000280470700012 PM 20361918 ER PT J AU Rhodes, KV Cerulli, C Dichter, ME Kothari, CL Barg, FK AF Rhodes, Karin V. Cerulli, Catherine Dichter, Melissa E. Kothari, Catherine L. Barg, Frances K. TI "I Didn't Want To Put Them Through That": The Influence Of Children on Victim Decision-making in Intimate Partner Violence Cases SO JOURNAL OF FAMILY VIOLENCE LA English DT Article DE Intimate partner violence; Domestic violence; Child exposure; Decision-making; Barriers to help-seeking ID DOMESTIC VIOLENCE; EXPOSURE; FAMILY AB For mothers, intimate partner violence (IPV) presents a concern not only for their own well-being but also for that of their children who are exposed to the violence and its aftermath. In focus groups with adult women (N = 39) across three jurisdictions who had experienced legal system intervention for IPV victimization, mothers raised unsolicited concerns about the negative effects of IPV exposure on their children. These comments were not prompted by the facilitator but were raised by women in all seven of the focus groups during discussions about motivations and barriers to participation in prosecution of their abusive partners. The overall message was that victims with children felt very conflicted. Children both facilitate and inhibit leaving the abusive relationship. Mothers wanted to spare their children from harmful effects of violence but also wanted to keep their families together and protect their children from potential agitation and instability caused by legal system involvement. Participants described how fears and threats of involvement from child protective services inhibited help-seeking while simultaneously voicing a desire for services that would help their children. More research is needed to help service providers understand the quagmire mothers who are victims of IPV encounter regarding their children's wellbeing. C1 [Rhodes, Karin V.] Univ Penn, Div Emergency Care Policy & Res, Dept Emergency Med, Philadelphia, PA 19014 USA. [Rhodes, Karin V.] Univ Penn, Sch Social Policy & Practice, Philadelphia, PA 19014 USA. [Cerulli, Catherine] Univ Rochester, Med Ctr, Dept Psychiat, Rochester, NY 14642 USA. [Dichter, Melissa E.] Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. [Kothari, Catherine L.] Michigan State Univ, Kalamazoo Ctr Med Studies, Kalamazoo, MI USA. [Barg, Frances K.] Univ Penn, Philadelphia, PA 19104 USA. RP Rhodes, KV (reprint author), Univ Penn, Div Emergency Care Policy & Res, Dept Emergency Med, 3815 Walnut St, Philadelphia, PA 19014 USA. EM kvr@sp2.upenn.edu OI Kothari, Catherine/0000-0001-8072-8920 NR 30 TC 18 Z9 18 U1 2 U2 10 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0885-7482 J9 J FAM VIOLENCE JI J. Fam. Violence PD JUL PY 2010 VL 25 IS 5 BP 485 EP 493 DI 10.1007/s10896-010-9310-z PG 9 WC Psychology, Clinical; Family Studies SC Psychology; Family Studies GA 596XW UT WOS:000277720200004 ER PT J AU Griffin, JM Partin, MR Noorbaloochi, S Grill, JP Saha, S Snyder, A Nugent, S Simon, AB Gralnek, I Provenzale, D van Ryn, M AF Griffin, Joan M. Partin, Melissa R. Noorbaloochi, Siamak Grill, Joseph P. Saha, Somnath Snyder, Annamay Nugent, Sean Simon, Alisha Baines Gralnek, Ian Provenzale, Dawn van Ryn, Michelle TI Variation in Estimates of Limited Health Literacy by Assessment Instruments and Non-Response Bias SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE health literacy; veterans; prevalence; measurement; non-response bias; REALM; S-TOFHLA ID ELDERLY PERSONS; CARE; PREVALENCE; QUESTIONS; ENROLLEES AB This paper compares estimates of poor health literacy using two widely used assessment tools and assesses the effect of non-response on these estimates. A total of 4,868 veterans receiving care at four VA medical facilities between 2004 and 2005 were stratified by age and facility and randomly selected for recruitment. Interviewers collected demographic information and conducted assessments of health literacy (both REALM and S-TOFHLA) from 1,796 participants. Prevalence estimates for each assessment were computed. Non-respondents received a brief proxy questionnaire with demographic and self-report literacy questions to assess non-response bias. Available administrative data for non-participants were also used to assess non-response bias. Among the 1,796 patients assessed using the S-TOFHLA, 8% had inadequate and 7% had marginal skills. For the REALM, 4% were categorized with 6th grade skills and 17% with 7-8th grade skills. Adjusting for non-response bias increased the S-TOFHLA prevalence estimates for inadequate and marginal skills to 9.3% and 11.8%, respectively, and the REALM estimates for a parts per thousand currency sign6th and 7-8th grade skills to 5.4% and 33.8%, respectively. Estimates of poor health literacy varied by the assessment used, especially after adjusting for non-response bias. Researchers and clinicians should consider the possible limitations of each assessment when considering the most suitable tool for their purposes. C1 [Griffin, Joan M.; Partin, Melissa R.; Noorbaloochi, Siamak; Grill, Joseph P.; Snyder, Annamay; Nugent, Sean; Simon, Alisha Baines] Minneapolis VA Med Ctr, Ctr Chron Dis Outcomes Res, Minneapolis, MN USA. [Griffin, Joan M.; Partin, Melissa R.; Noorbaloochi, Siamak] Univ Minnesota, Sch Med, Dept Gen Internal Med, Minneapolis, MN 55455 USA. [Saha, Somnath] Portland VA Med Ctr, Columbia Ctr Study Chron Comorbid Mental & Phys D, Portland, OR USA. [Gralnek, Ian] Technion Israel Inst Technol, Bruce Rappaport Fac Med, Dept Gastroenterol, GI Outcomes Unit, IL-31096 Haifa, Israel. [Provenzale, Dawn] Durham VA Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC USA. [van Ryn, Michelle] Univ Minnesota, Sch Med, Dept Family Med & Community Hlth, Minneapolis, MN 55455 USA. RP Griffin, JM (reprint author), Minneapolis VA Med Ctr 152 3E 109, Ctr Chron Dis Outcomes Res, 1 Vet Dr, Minneapolis, MN 55417 USA. EM joan.griffin2@va.gov RI Griffin, Jillian/F-9415-2010; VAN RYN, MICHELLE/B-1664-2010 FU Department of Veterans Affairs; VA Health Services Research and Development Service [CRI-03-151-1]; VA Merit Review Entry Program (MREP); VA HSR&D Advanced Research Career Development Award; [IIS 01-191-1] FX This research was supported by the Department of Veterans Affairs, including a grant from VA Health Services Research and Development Service (CRI-03-151-1). Dr. Griffin also received support as a VA Merit Review Entry Program (MREP) awardee. Dr. Gralnek was supported by a VA HSR&D Advanced Research Career Development Award and IIS 01-191-1. The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs or the United States Government. Part of this work was presented at the 24th Annual VA Health Services Research Meeting, Crystal City, VA, February 17, 2006. The authors wish to thank all the veteran participants for their time and the study interviewers for their commitment to this project. NR 38 TC 23 Z9 23 U1 1 U2 3 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 JUL PY 2010 VL 25 IS 7 BP 675 EP 681 DI 10.1007/s11606-010-1304-2 PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 607RR UT WOS:000278524700012 PM 20224964 ER PT J AU Nigam, V Sievers, HH Jensen, BC Sier, HA Simpson, PC Srivastava, D Mohamed, SA AF Nigam, Vishal Sievers, Hans H. Jensen, Brian C. Sier, Holger A. Simpson, Paul C. Srivastava, Deepak Mohamed, Salah A. TI Altered MicroRNAs in Bicuspid Aortic Valve: A Comparison Between Stenotic and Insufficient Valves SO JOURNAL OF HEART VALVE DISEASE LA English DT Article ID MUSCLE-SPECIFIC MICRORNA; INTERSTITIAL-CELLS; XENOPUS SMAD7; EXPRESSION; DISEASE; MUTATIONS; NOTCH1; HEART; CALCIFICATION; CARDIOGENESIS AB Background and aim of the study: Bicuspid aortic valve (BAV), the most common form of congenital heart disease, is a leading cause of aortic stenosis (AS) and aortic insufficiency (AI). AS is typically caused by calcific valve disease. Recently, microRNAs (miRNAs) have been shown to modulate gene expression. The study aim was to examine the miRNAs that were altered in the aortic valve leaflets of patients with AS compared to those in patients with AI. In-vitro experiments were also carried out to determine if these miRNAs could modulate calcification-related genes. Methods: Aortic valve samples (fused and unfused leaflets) were collected from nine male patients (mean age 44.9 +/- 13.8 years) undergoing aortic valve replacement (AVR). PIQOR (TM) miRXplore Microarrays containing 1,421 miRNAs were used and hybridized to fused leaflet samples labeled with Cy5; unfused samples were used as controls and labeled with Cy3. A quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was performed to validate the miRNA array results. Cultured human aortic valve interstitial cells (AVICs) were treated with miRNA mimics, and qRT-PCR was carried out to determine any changes in mRNAs. Results: By microarray analysis, seven miRNAs were shown to be statistically different between the AS and AI patients. In the stenotic samples, the MiR-26a and miR-195 levels were shown (by qRT-PCR) to be reduced by 65% and 59%, respectively (p <0.05), and MiR-30b to be reduced by 62% (p <0.06). Human AVICs treated with miR-26a or miR-30b mimics showed decreased mRNA levels of calcification-related genes. MiR-26a repressed BMP2 by 36%, alkaline phosphatase (ALPL) by 38%, and SMAD1 by 26%, while MiR-30b reduced the expression of SMAD1 by 18% and of SMAD3 by 12%. In contrast, miR-195-treated AVICs had increased mRNA levels of calcification-related genes, such as BMP2 by 68% and RUNX2 by 11%. Conclusion: MiR-26a, miR-30b, and miR-195 were each decreased in the aortic valves of patients requiring AVR due to AS, compared to those requiring replacement due to AI. These miRNAs appear to modulate calcification-related genes in vitro. C1 [Sievers, Hans H.; Sier, Holger A.; Mohamed, Salah A.] Univ Clin Schleswig Holstein, Dept Cardiac Surg, D-23538 Lubeck, Germany. [Nigam, Vishal; Srivastava, Deepak] Univ Calif San Francisco, Dept Pediat Cardiol, San Francisco, CA 94143 USA. [Nigam, Vishal; Srivastava, Deepak] Univ Calif San Francisco, Gladstone Inst Cardiovasc Dis, San Francisco, CA 94143 USA. [Jensen, Brian C.; Simpson, Paul C.] San Francisco VA Med Ctr, Cardiol Sect, San Francisco, CA USA. [Jensen, Brian C.; Simpson, Paul C.] San Francisco VA Med Ctr, Res Serv, San Francisco, CA USA. [Jensen, Brian C.; Simpson, Paul C.] Univ Calif San Francisco, Dept Med Cardiol, San Francisco, CA 94143 USA. [Jensen, Brian C.; Simpson, Paul C.] Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco, CA 94143 USA. RP Mohamed, SA (reprint author), Univ Clin Schleswig Holstein, Dept Cardiac Surg, Campus Lubeck,Ratzeburger Allee 160, D-23538 Lubeck, Germany. EM salah.mohamed@uni-luebeck.de FU NIH [K08 HL086775-01] FX The authors thank the members of their respective laboratories for helpful discussions. Dr. Nigam designed and performed the qPCR and in-vitro experiments, Drs. Sievers and Sier assisted with the patient valve collection, and Drs. Jensen and Simpson provided access to the Cardiac Tissue Bank at UCSF, from which the aortic valve leaflets used for AVIC culture were obtained. Dr. Nigam received funding from NIH grant K08 HL086775-01. NR 28 TC 42 Z9 43 U1 0 U2 1 PU I C R PUBLISHERS PI NORTHWOOD PA CRISPIN HOUSE, 12/A SOUTH APPROACH, MOOR PARK, NORTHWOOD HA6 2ET, ENGLAND SN 0966-8519 J9 J HEART VALVE DIS JI J. Heart Valve Dis. PD JUL PY 2010 VL 19 IS 4 BP 459 EP 465 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 694FR UT WOS:000285280900009 PM 20845893 ER PT J AU Patel, P Dhaliwal, G Rajamanickam, A Gebresalassie, S Harte, B AF Patel, Preethi Dhaliwal, Gurpreet Rajamanickam, Anitha Gebresalassie, Surafel Harte, Brian TI Continuing Medical Education Program in the Journal of Hospital Medicine SO JOURNAL OF HOSPITAL MEDICINE LA English DT Editorial Material C1 [Patel, Preethi; Rajamanickam, Anitha; Harte, Brian] Cleveland Clin Fdn, Dept Hosp Med, Cleveland, OH 44195 USA. [Dhaliwal, Gurpreet] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Dhaliwal, Gurpreet] San Francisco VA Med Ctr, Dept Med, San Francisco, CA USA. [Gebresalassie, Surafel] Cleveland Clin Fdn, Dept Hypertens & Nephrol, Cleveland, OH 44195 USA. RP Patel, P (reprint author), Cleveland Clin Fdn, Dept Hosp Med, 9500 Euclid Ave, Cleveland, OH 44195 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 1553-5592 J9 J HOSP MED JI J. Hosp. Med. PD JUL-AUG PY 2010 VL 5 IS 6 BP 365 EP 365 DI 10.1002/jhm.837 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 643JD UT WOS:000281290600011 ER PT J AU Patel, P Dhaliwal, G Rajamanickam, A Gehresalassie, S Harte, B AF Patel, Preethi Dhaliwal, Gurpreet Rajamanickam, Anitha Gehresalassie, Surafel Harte, Brian TI Unscripted SO JOURNAL OF HOSPITAL MEDICINE LA English DT Editorial Material ID THROMBOTIC THROMBOCYTOPENIC PURPURA; HEMOLYTIC-UREMIC SYNDROME; MICROANGIOPATHY C1 [Patel, Preethi; Rajamanickam, Anitha; Harte, Brian] Cleveland Clin Fdn, Dept Hosp Med, Cleveland, OH 44195 USA. [Dhaliwal, Gurpreet] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Dhaliwal, Gurpreet] San Francisco VA Med Ctr, Dept Med, San Francisco, CA USA. [Gehresalassie, Surafel] Cleveland Clin Fdn, Dept Hypertens & Nephrol, Cleveland, OH 44195 USA. RP Patel, P (reprint author), Desk M2,9500 Euclid Ave, Cleveland, OH 44195 USA. EM patelp3@ccf.org NR 13 TC 0 Z9 0 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 2010 VL 5 IS 6 BP 366 EP 370 DI 10.1002/jhm.806 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 643JD UT WOS:000281290600012 PM 20803678 ER PT J AU Singhal, A Nagarajan, R Hinkin, CH Kumar, R Sayre, J Elderkin-Thompson, V Huda, A Gupta, RK Han, SH Thomas, MA AF Singhal, Aparna Nagarajan, Rajakumar Hinkin, Charles H. Kumar, Rajesh Sayre, James Elderkin-Thompson, Virginia Huda, Amir Gupta, Rakesh K. Han, Steven-Huy Thomas, M. Albert TI Two-Dimensional MR Spectroscopy of Minimal Hepatic Encephalopathy and Neuropsychological Correlates In Vivo SO JOURNAL OF MAGNETIC RESONANCE IMAGING LA English DT Article; Proceedings Paper CT 17th Annual Meeting of the International-Society-of-Magnetic-Resonance-in-Medicine CY APR 18-24, 2009 CL Honolulu, HI SP Int Soc Magnet Resonance Med DE MRI; MRS; COSY; neuropsychological scores; liver disease ID MAGNETIC-RESONANCE-SPECTROSCOPY; LOCALIZED H-1-NMR SPECTROSCOPY; INDUCED BRAIN EDEMA; LIVER-TRANSPLANTATION; BASAL GANGLIA; PORTACAVAL ANASTOMOSIS; TAURINE TRANSPORTER; SIGNAL INTENSITY; GLOBUS-PALLIDUS; CEREBRAL EDEMA AB Purpose: To evaluate regional cerebral metabolic and structural changes in patients with minimal hepatic encephalopathy (MHE) using two-dimensional (2D) MR spectroscopy (MRS) and T(1)-weighted MRI, to correlate the observed MR changes with neuropsychological (NP) test scores, and to compare the diagnostic accuracy of MRI, 2D MRS, and NP tests in discriminating between patients and healthy subjects. Materials and Methods: Thirty-three MHE patients and 30 healthy controls were investigated. The 2D localized correlated spectroscopy (L-COSY) was performed in the frontal and occipital brain on a 1.5 Testa (T) MR scanner. The NP test battery included 15 tests, grouped into 6 cognitive domains. Globus pallidus signal intensities were calculated from T(1)-weighted images. Results: The 2D MRS showed significant differences in ratios of the following metabolite(s) peaks with respect to creatine (Cr): decreased myo-inositol (mI), choline (Ch), mICh, and increased (glutamate plus glutamine) (Glx) in patients compared with healthy subjects in both occipital and frontal lobes. Frontal lobe taurine also showed a decline in patients. The NP test results revealed declines in cognitive speed, motor function, executive function, and global cognitive status. Significant correlations were found between the altered metabolites and NP tests. Alteration in the mICh/Cr ratio was noted as a powerful discriminant between healthy subjects and the patients. Conclusion: The study demonstrates that relative metabolite levels determined by 2D MRS, in particular mICh/Cr, provide the best diagnostic prediction for MHE. The results suggest that depletions of myo-inositol, choline and taurine with respect to creatine correlate with measures of neuropsychological impairment. C1 [Singhal, Aparna; Nagarajan, Rajakumar; Sayre, James; Huda, Amir; Thomas, M. Albert] Univ Calif Los Angeles, David Geffen Sch Med, Dept Radiol Sci, Los Angeles, CA 90095 USA. [Hinkin, Charles H.; Elderkin-Thompson, Virginia; Thomas, M. Albert] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat, Los Angeles, CA 90095 USA. [Hinkin, Charles H.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Kumar, Rajesh] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. [Sayre, James] Univ Calif Los Angeles, David Geffen Sch Med, Dept Publ Hlth Biostat, Los Angeles, CA 90095 USA. [Huda, Amir] Calif State Univ Fresno, Dept Phys, Fresno, CA 93740 USA. [Gupta, Rakesh K.] Sanjay Gandhi Postgrad Inst Med Sci, Dept Radiol, Lucknow, Uttar Pradesh, India. [Han, Steven-Huy] Univ Calif Los Angeles, David Geffen Sch Med, Dept Hepatol, Los Angeles, CA 90095 USA. RP Thomas, MA (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Radiol Sci, CHS BL 428,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM athomas@mednet.ucla.edu RI Thomas, m. albert/A-6176-2012; Nagarajan, Rajakumar/A-7179-2013; Huda, Amir/I-5987-2015 OI Huda, Amir/0000-0002-0171-3796 FU NIMH NIH HHS [1R01MH06569501A1] NR 54 TC 19 Z9 22 U1 0 U2 5 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1053-1807 J9 J MAGN RESON IMAGING JI J. Magn. Reson. Imaging PD JUL PY 2010 VL 32 IS 1 BP 35 EP 43 DI 10.1002/jmri.22216 PG 9 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 619ON UT WOS:000279439600004 PM 20578008 ER PT J AU Kernisan, LP Sudore, RL Knight, SJ AF Kernisan, Leslie P. Sudore, Rebecca L. Knight, Sara J. TI Information-Seeking at a Caregiving Website: A Qualitative Analysis SO JOURNAL OF MEDICAL INTERNET RESEARCH LA English DT Article DE Caregivers; Internet; consumer health information ID FAMILY CAREGIVERS; HEALTH-CARE; FOCUS GROUPS; WEB; ONLINE; INTERNET; NEEDS; CREDIBILITY; SURVIVORS; SUPPORT AB Background: The Internet is widely used for health information, yet little is known about the online activity of family caregivers of elders, a rapidly growing group. In order to better understand the online information-seeking activity of "e-caregivers" and other visitors at a caregiving website, we undertook a qualitative analysis of survey data from a website marketed as a comprehensive resource for adults caring for aging parents. Objective: The objectives were to better understand what types of information are sought by those visiting a website focused on elder-care issues and to identify overarching themes that might inform future development of Internet resources related to caregiving and aging. Methods: From March 2008 to March 2009, a 5-question pop-up survey was offered 9662 times and completed 2161 times. For 1838 respondents, included was a free text answer to the question "What were you looking for?" and 1467 offered relevant and detailed responses. The survey also asked about satisfaction with the site, gender of the respondent, and relationship to the individual being cared for. Content analysis was used to develop a coding dictionary, to code responses into information-seeking categories, and to identify overarching themes. Results: Of the respondents (76% of whom were female), 50% indicated they were caring for parents, 17% for themselves only, and 31% for others. Over half (57%) reported finding what they were looking for, and 46% stated they were extremely likely to recommend the website. Frequently mentioned information-seeking categories included "health information," "practical caregiving," and "support." Respondents also requested information related to housing, legal, insurance, and financial issues. Many responses referred to multiple comorbid conditions and complex caregiving situations. Overarching themes included (1) a desire for assistance with a wide range of practical skills and information and (2) help interpreting symptoms and behavior, such as knowing what life impacts to expect over the course of a health condition or treatment. Conclusion: Visitors to a website targeting adults caring for aging parents reported seeking both general information on caregiving and specific assistance with the complex custodial, medical, emotional, and financial aspects of caregiving. Visitors requested both information to build caregiving skills as well as assistance in interpreting and knowing what to expect from symptoms, health conditions, and changes in behavior and relationships. Many desired communication with and support from other caregivers. Health care providers and eHealth developers should expect that many caregivers of elders are using the Internet as a resource. Further research and development is needed to fully realize the Internet's potential for education and support of caregivers. C1 [Kernisan, Leslie P.] Univ Calif San Francisco, Div Geriatr, San Francisco VA Med Ctr, San Francisco, CA 94121 USA. [Sudore, Rebecca L.; Knight, Sara J.] San Francisco VA Med Ctr, Interdisciplinary Program Improve Care Vet Comple, San Francisco, CA USA. RP Kernisan, LP (reprint author), Univ Calif San Francisco, Div Geriatr, San Francisco VA Med Ctr, 4150 Clement St,181G, San Francisco, CA 94121 USA. EM lkernisan@gmail.com FU VA Quality Scholars; National Institute on Aging, National Institutes of Health; VA Career Development Award; Pfizer; Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development Service FX We are grateful to Caring.com, who shared their deidentified data with us at no cost. Caring.com did not otherwise provide any funding or support for this project, and the company was not involved in the study design, analysis, or drafting of the manuscript. Dr Kernisan was supported by a VA Quality Scholars fellowship, followed by a T32 research fellowship grant from the National Institute on Aging, National Institutes of Health. Dr Sudore was supported by a VA Career Development Award and a Pfizer Clear Health Communication Fellowship. Dr Knight was supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development Service. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. NR 41 TC 23 Z9 23 U1 3 U2 19 PU JOURNAL MEDICAL INTERNET RESEARCH PI TORONTO PA TORONTO GENERAL HOSPITAL, R FRASER ELLIOTT BLDG, 4TH FL, R 4S435, 190 ELIZABETH ST, TORONTO, ON M5G 2C4, CANADA SN 1438-8871 J9 J MED INTERNET RES JI J. Med. Internet Res. PD JUL-SEP PY 2010 VL 12 IS 3 AR e31 DI 10.2196/jmir.1548 PG 13 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA 661VW UT WOS:000282761500004 PM 20675292 ER PT J AU Heinlen, LD Ritterhouse, LL McClain, MT Keith, MP Neas, BR Harley, JB James, JA AF Heinlen, Latisha D. Ritterhouse, Lauren L. McClain, Micah T. Keith, Michael P. Neas, Barbara R. Harley, John B. James, Judith A. TI Ribosomal P autoantibodies are present before SLE onset and are directed against non-C-terminal peptides SO JOURNAL OF MOLECULAR MEDICINE-JMM LA English DT Article DE Lupus; Antibodies; Autoimmunity; Ribosomal P; Epitope ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; PROTEIN ANTIBODIES; REVISED CRITERIA; ASSOCIATION; DIAGNOSIS; DISEASE; EPITOPE; CLASSIFICATION; AUTOIMMUNITY; EVENTS AB Autoantibodies to ribosomal P (ribo P) are found in 15-30% of systemic lupus erythematosus (SLE) patients and are highly specific for SLE. The goal of this study is to assess the temporal association of anti-ribosomal P (anti-P) responses with SLE disease onset, as well as to characterize select humoral ribo P epitopes targeted in early, pre-diagnostic SLE samples. Patients with stored serial serum samples available prior to SLE diagnosis were identified from a military cohort. Each sample was tested for antibodies against ribo P utilizing standard C terminus ribo P enzyme-linked immunosorbent assays (ELISA) and a solid phase, bead-based assay with affinity-purified ribo P proteins. In this study, antibodies to ribo P were more common in African American SLE patients (p = 0.026), and anti-P-positive patients comprised a group with more measured autoantibody specificities than did other SLE patients (3.5 vs 2.2, p < 0.05). Antibodies against ribo P were present on average 1.7 years before SLE diagnosis and were detected an average of 1.08 years earlier in pre-diagnostic SLE samples using affinity-purified whole protein rather than C-terminal peptide alone (p = 0.0019). Furthermore, 61% of anti-P-positive patients initially had antibodies to aa 99-113, a known ribosomal P0 antigenic target, at a time point when no antibodies to the clinically used C terminus were detected. Our findings provide evidence that antibodies against ribosomal P frequently develop before clinical SLE diagnosis and are more broadly reactive than previously thought by targeting regions outside of the C terminus. C1 [Heinlen, Latisha D.; Ritterhouse, Lauren L.; McClain, Micah T.; Harley, John B.; James, Judith A.] Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. [Heinlen, Latisha D.; Ritterhouse, Lauren L.; Neas, Barbara R.; Harley, John B.; James, Judith A.] Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK 73104 USA. [Keith, Michael P.] Natl Naval Med Ctr, Bethesda, MD 20889 USA. [Keith, Michael P.] Walter Reed Army Med Ctr, Washington, DC 20307 USA. [Harley, John B.] US Dept Vet Affairs, Med Ctr, Oklahoma City, OK 73104 USA. RP James, JA (reprint author), Oklahoma Med Res Fdn, 825 NE 13th St, Oklahoma City, OK 73104 USA. EM Judith-James@omrf.org FU National Institutes of Health [AI82714, AI31584, AR58554, AR45451, AI47575, AR53483, AR48045, AR45084, AR45231, AR42460, AR48940, AI24717, RR20143, RR15577, RR14467]; Presbyterian Health Foundation; Lou Kerr Chair in Biomedical Research; Kirkland Foundation; US Department of Veteran Affairs FX The authors would like to thank Yasmin Akbarali MS, Roy Rindler MD, Tara Bruner PA-C, and Gabriel Vidal for their technical assistance and Scott Stewart MS for his statistical analysis assistance. This work has been supported by the National Institutes of Health (AI82714, AI31584, AR58554, AR45451, AI47575, AR53483, AR48045, AR45084, AR45231, AR42460, AR48940, AI24717, RR20143, RR15577, and RR14467), the Presbyterian Health Foundation, the Lou Kerr Chair in Biomedical Research, the Kirkland Foundation, and the US Department of Veteran Affairs. The opinions and assertions contained herein are private views of the authors and are not to be construed as official or as reflecting the views of the Army, Navy, or the Department of Defense. NR 32 TC 21 Z9 21 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0946-2716 J9 J MOL MED JI J. Mol. Med. PD JUL PY 2010 VL 88 IS 7 BP 719 EP 727 DI 10.1007/s00109-010-0618-1 PG 9 WC Genetics & Heredity; Medicine, Research & Experimental SC Genetics & Heredity; Research & Experimental Medicine GA 602DY UT WOS:000278119900009 PM 20396862 ER PT J AU Casarett, DJ AF Casarett, David J. TI Introduction: Finding the Future of International Palliative Care SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Editorial Material C1 [Casarett, David J.] Dept Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. [Casarett, David J.] Univ Penn, Philadelphia, PA 19104 USA. RP Casarett, DJ (reprint author), Dept Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, 3615 Chestnut St, Philadelphia, PA 19104 USA. EM casarett@med.upenn.edu 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 0885-3924 J9 J PAIN SYMPTOM MANAG JI J. Pain Symptom Manage. PD JUL PY 2010 VL 40 IS 1 BP 1 EP 2 DI 10.1016/j.jpainsymman.2010.05.001 PG 2 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 629PA UT WOS:000280210900001 PM 20619202 ER PT J AU Kelley, AS Morrison, RS Wenger, NS Ettner, SL Sarkisian, CA AF Kelley, Amy S. Morrison, R. Sean Wenger, Neil S. Ettner, Susan L. Sarkisian, Catherine A. TI Determinants of Treatment Intensity for Patients with Serious Illness: A New Conceptual Framework SO JOURNAL OF PALLIATIVE MEDICINE LA English DT Article ID OF-LIFE CARE; ILL HOSPITALIZED ADULTS; DECISION-MAKING; HEALTH-CARE; HOSPICE USE; MEDICARE EXPENDITURES; REGIONAL-VARIATIONS; TREATMENT PREFERENCES; ETHNIC-DIFFERENCES; PALLIATIVE CARE AB Background: Research during the past few decades has greatly advanced our understanding of the cost, quality, and variability of medical care at the end of life. The current health-care policy debate has focused considerable attention on the unsustainable rate of spending and wide regional variation associated with medical treatments in the last year of life. New initiatives aim to standardize quality and reduce over-utilization at the end of life. We argue, however, that focusing exclusively on medical treatment at the end of life is not likely to lead to effective health-care policy reform or reduce costs. Specifically, end-of-life policy initiatives face the challenges of political feasibility, inaccurate prognostication, and gaps in the existing literature. Objectives: With the ultimate aim of improving the quality and efficiency of care, we propose a research and policy agenda guided by a new conceptual framework of factors associated with treatment intensity for patients with serious and complicated medical illness. This model not only expands the population of interest to include all adults with serious illness, but also provides a blueprint for the thorough investigation of the diverse and interconnected determinants of treatment intensity. Conclusions: The new conceptual framework presented in this paper can be used to develop future research and policy initiatives designed to improve the quality and efficiency of care for adults with serious illness. C1 [Kelley, Amy S.; Morrison, R. Sean] Mt Sinai Sch Med, Brookdale Dept Geriatr & Palliat Med, New York, NY 10029 USA. [Kelley, Amy S.; Morrison, R. Sean] Mt Sinai Sch Med, Hertzberg Palliat Care Inst, New York, NY 10029 USA. [Morrison, R. Sean] James J Peters VA Med Ctr, Bronx, NY USA. [Wenger, Neil S.; Ettner, Susan L.] Univ Calif Los Angeles, David Geffen Sch Med, Div GIM HSR, Los Angeles, CA 90095 USA. [Sarkisian, Catherine A.] Univ Calif Los Angeles, David Geffen Sch Med, Div Genatr, Dept Med, Los Angeles, CA 90095 USA. [Sarkisian, Catherine A.] VA Greater Angeles Healthcare Syst, Genatr Res Educ Clin Ctr, Los Angeles, CA USA. RP Kelley, AS (reprint author), Mt Sinai Sch Med, Brookdale Dept Geriatr & Palliat Med, 1 Gustave Levy Pl, New York, NY 10029 USA. EM amy.kelley@mssm.edu FU NIA NIH HHS [K24 AG022345] NR 82 TC 27 Z9 27 U1 3 U2 11 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 JUL PY 2010 VL 13 IS 7 BP 807 EP 813 DI 10.1089/jpm.2010.0007 PG 7 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 626PG UT WOS:000279977300012 PM 20636149 ER PT J AU Yung, VY Walling, AM Min, LL Wenger, NS Ganz, DA AF Yung, Victoria Y. Walling, Anne M. Min, Lillian Wenger, Neil S. Ganz, David A. TI Documentation of Advance Care Planning for Community-Dwelling Elders SO JOURNAL OF PALLIATIVE MEDICINE LA English DT Article ID VULNERABLE OLDER-PEOPLE; OF-LIFE CARE; DIRECTIVES; QUALITY; INTERVENTION; ORDERS AB Background: Advance planning for end-of-life care has gained acceptance, but actual end-of-life care is often incongruent with patients' previously stated goals. We assessed the flow of advance care planning information from patients to medical records in a community sample of older adults to better understand why advance care planning is not more successful. Methods: Our study used structured interview and medical record data from community-dwelling older patients in two previous studies: Assessing Care of Vulnerable Elders (ACOVE)-1 (245 patients age >= 65 years and screened for high risk of death/functional decline in 1998-1999) and ACOVE-2 (566 patients age >= 75 who screened positive for falls/mobility disorders, incontinence, and/or dementia in 2002-2003). We compared interview data on patients' preferences, advance directives, and surrogate decision-makers with findings from the medical record. Results: In ACOVE-1, 38% of surveyed patients had thought about limiting the aggressiveness of medical care; 24% of surveyed patients stated that they had spoken to their doctor about this. The vast majority of patients (88%-93%) preferred to die rather than remain permanently in a coma, on a ventilator, or tube fed. Regardless of patients' specific preferences, 15%-22% of patients had preference information in their medical record. Among patients who reported that they had completed an advance directive and had given it to their health-care provider, 15% (ACOVE-1) and 47% (ACOVE-2) had advance directive information in the medical record. Among patients who had not completed an advance directive but had given surrogate decision-maker information to their provider, 0% (ACOVE-1) and 16% (ACOVE-2) had documentation of a surrogate decision-maker in the medical record. Conclusions: Community-dwelling elders' preferences for end-of-life care are not consistent with documentation in their medical records. Electronic health records and standardized data collection for end-of-life care could begin to ameliorate this problem. C1 [Yung, Victoria Y.; Walling, Anne M.; Min, Lillian; Wenger, Neil S.; Ganz, David A.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Ganz, David A.] Vet Affairs Greater Angeles Healthcare Syst, Hlth Serv Res & Dev Ctr Excellence, Los Angeles, CA USA. [Ganz, David A.] Vet Affairs Greater Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Los Angeles, CA USA. [Walling, Anne M.; Wenger, Neil S.] Univ Calif Los Angeles, Healthcare Eth Ctr, Los Angeles, CA USA. RP Ganz, DA (reprint author), VA Greater Angeles Healthcare Syst 11G, 11301 Wilshire Blvd,Bldg 220,Room 313, Los Angeles, CA 90073 USA. EM dganz@mednet.ucla.edu FU NIA/AFAR & Lillian R. Gleitsman Medical Student Training in Aging Research; National Research Service [T32 PE19001]; UCLA Specialty Training & Advanced Research; Agency for Healthcare Research and Quality [R21 HS017621-01]; National Institute on Aging-UCLA [K12 AG001004]; U.S. Department of Veterans Affairs, Veterans Health Administration; VA Health Services Research & Development (HSR&D) Service through the VA Greater Los Angeles HSR&D Center of Excellence [VA CD2 08-012-1]; Pfizer Inc. FX The authors thank Carol Roth for guidance regarding the ACOVE medical record reviews, Caren Kamberg and Patty Smith for administrative assistance, and anonymous peer reviewers for their thoughtful feedback on the manuscript. Ms. Yung was supported by the NIA/AFAR & Lillian R. Gleitsman Medical Student Training in Aging Research Program. Dr. Walling was supported by National Research Service Award Training Grant T32 PE19001 and the UCLA Specialty Training & Advanced Research Program. Dr. Min was supported by grants from the Agency for Healthcare Research and Quality (R21 HS017621-01) and National Institute on Aging-UCLA (K12 AG001004). Dr. Ganz was supported by the U.S. Department of Veterans Affairs, Veterans Health Administration, VA Health Services Research & Development (HSR&D) Service through the VA Greater Los Angeles HSR&D Center of Excellence (Project no. VA CD2 08-012-1). Data analyzed in this manuscript were collected as part of the Assessing Care of Vulnerable Elders and Assessing Care of Vulnerable Elders-2 projects, which were supported by Pfizer Inc. The funders mentioned played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the National Institutes of Health, the Agency for Healthcare Research and Quality, or the U.S. Department of Veterans Affairs. NR 23 TC 18 Z9 18 U1 1 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 JUL PY 2010 VL 13 IS 7 BP 861 EP 867 DI 10.1089/jpm.2009.0341 PG 7 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 626PG UT WOS:000279977300021 PM 20618087 ER PT J AU Jonker, MA Osterby, KR Vermeulen, LC Kleppin, SM Kudsk, KA AF Jonker, Mark A. Osterby, Kurt R. Vermeulen, Lee C. Kleppin, Susan M. Kudsk, Kenneth A. TI Does Low-Dose Heparin Maintain Central Venous Access Device Patency? A Comparison of Heparin Versus Saline During a Period of Heparin Shortage SO JOURNAL OF PARENTERAL AND ENTERAL NUTRITION LA English DT Article DE central venous access; thrombosis; adults; heparin flush; alteplase ID CATHETER CLOTS; DRUG SHORTAGES; THROMBOCYTOPENIA; ALTEPLASE; FLUSH; COMPLICATIONS; METAANALYSIS; EFFICACY; SODIUM; TRIAL AB Background: A common problem that complicates use of central venous access devices (CVADs) is occlusion by thrombosis. Alteplase, a recombinant tissue plasminogen activator, is used to restore line patency when thrombosis occurs. Heparin flush is commonly used to prevent this complication, but the effectiveness of this practice is unclear. A recent heparin shortage allowed examination of heparin effectiveness in reducing CVAD thrombosis. Methods: A retrospective cohort study was performed by querying a pharmacy database for alteplase use for CVAD thrombosis in adult patients during periods when heparin flushes (10 units/mL) were used and when saline flushes were used instead because of a nationwide heparin shortage. The number of patients receiving alteplase, the number of doses administered, and the total amount of alteplase used were compared over 1-month intervals of heparin flush use and 1-month intervals of saline flush use. Patient days and critical care patient days were compared between these time intervals. Peripherally inserted central catheter (PICC) line placements and replacements between time periods of heparin and saline flush were also compared. Results: Significant increases in the number of patients receiving alteplase (P = .04), the number of alteplase doses administered (P = .04), and total dose of alteplase used (P = .05) occurred during the heparin shortage. No significant differences in patient population were observed. The percentage of PICC line replacements also increased significantly (P < .05) when heparin was not available. Conclusions: Heparin flush (10 units/mL) decreases thrombotic occlusions of CVADs, resulting in decreased alteplase use and fewer PICC line replacements. (JPEN J Parenter Enteral Nutr. 2010; 34: 444-449) C1 [Kudsk, Kenneth A.] William S Middleton Mem Vet Adm Med Ctr, Vet Adm Surg Serv, Madison, WI USA. [Jonker, Mark A.; Kudsk, Kenneth A.] Univ Wisconsin, Dept Surg, Sch Med & Publ Hlth, Madison, WI USA. [Osterby, Kurt R.; Vermeulen, Lee C.] Univ Wisconsin, Hosp & Clin, Dept Pharm, Madison, WI 53792 USA. [Vermeulen, Lee C.] Univ Wisconsin, Sch Pharm, Madison, WI 53706 USA. [Kleppin, Susan M.] Waukesha Mem Hosp, Dept Pharm, Waukesha, WI USA. RP Kudsk, KA (reprint author), 600 Highland Ave,H4-736 CSC, Madison, WI 53792 USA. EM kudsk@surgery.wisc.edu NR 27 TC 7 Z9 11 U1 3 U2 16 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0148-6071 J9 JPEN-PARENTER ENTER JI J. Parenter. Enter. Nutr. PD JUL PY 2010 VL 34 IS 4 BP 444 EP 449 DI 10.1177/0148607110362082 PG 6 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 638HN UT WOS:000280884300011 PM 20631392 ER PT J AU Wanner, J Long, ME Teng, EJ AF Wanner, Jill Long, Mary E. Teng, Ellen J. TI Multi-component Treatment for Posttraumatic Nightmares in Vietnam Veterans: Two Case Studies SO JOURNAL OF PSYCHIATRIC PRACTICE LA English DT Article DE posttraumatic stress disorder (PTSD); imagery rescripting; nightmares; Veterans; treatment ID IMAGERY REHEARSAL THERAPY; STRESS-DISORDER; PSYCHOMETRIC PROPERTIES; PTSD; TRAUMA; PSYCHOTHERAPY; IRAQ AB Posttraumatic nightmares (PTNMs) are trauma-related distressing dreams that cause a person to wake up. PTNMs can be a devastating addition to the clinical picture of posttraumatic stress disorder (PTSD), because they can result in increased levels of PTSD symptoms and overall distress and decreased sleep; they are also often resistant to typical PTSD treatments. While specialized treatments have been developed and empirically examined in the civilian population, these treatments have not been thoroughly explored with the Veteran population, despite the fact that 50%-88% of Vietnam Veterans experience chronic PTNMs. This article presents two case reports involving Vietnam Veterans. These reports describe the initial investigation of a variant of a treatment that has been successful in treating chronic PTNMs in the civilian population and has been modified to meet the needs of the Veteran population. Analyses revealed that both Veterans reported moderate reductions in sleep disturbances over the course of treatment, as well as clinically significant reductions in PTSD and depressive symptoms across assessments. These preliminary findings provide encouraging data that warrant further study. Limitations and future research are discussed. (Journal of Psychiatric Practice 2010;16:243-249) C1 [Long, Mary E.] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Menninger Dept Psychiat & Behav Sci,Houston Ctr Q, Vet Affairs S Cent Mental Illness Res Educ & Clin, Houston, TX 77030 USA. RP Long, ME (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Menninger Dept Psychiat & Behav Sci,Houston Ctr Q, Vet Affairs S Cent Mental Illness Res Educ & Clin, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM melong6@gmail.com FU South Central Mental Illness, Research, Education and Clinical Center (MIRECC); Houston VA HSR&D Center of Excellence [HFP90-020]; Office of Academic Affiliations, Department of Veterans Affairs FX This research was supported by start-up funds to Mary E. Long, Ph.D. from the South Central Mental Illness, Research, Education and Clinical Center (MIRECC) as part of the VA Special MIRECC Fellowship Program in Advanced Psychiatry and Psychology. This work was also supported in part by the Houston VA HSR&D Center of Excellence (HFP90-020) and the Office of Academic Affiliations, Department of Veterans Affairs. The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs. NR 32 TC 3 Z9 3 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1527-4160 J9 J PSYCHIATR PRACT JI J. Psychiatr. Pract. PD JUL PY 2010 VL 16 IS 4 BP 243 EP 249 DI 10.1097/01.pra.0000386910.31817.b5 PG 7 WC Psychiatry SC Psychiatry GA 628EM UT WOS:000280097200005 PM 20644359 ER PT J AU Li, G Shofer, JB Rhew, IC Kukull, WA Peskind, ER McCormick, W Bowen, JD Schellenberg, GD Crane, PK Breitner, JCS Larson, EB AF Li, Ge Shofer, Jane B. Rhew, Isaac C. Kukull, Walter A. Peskind, Elaine R. McCormick, Wayne Bowen, James D. Schellenberg, Gerard D. Crane, Paul K. Breitner, John C. S. Larson, Eric B. TI Age-Varying Association Between Statin Use and Incident Alzheimer's Disease SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE statin; old age; APOE genotype; Alzheimer's disease ID PROSPECTIVE COHORT; APOLIPOPROTEIN-E; DEMENTIA; RISK; ALLELE; SIMVASTATIN; THERAPY; HEALTH; TRIAL; LIFE AB OBJECTIVES: To determine whether risk reduction of statins for Alzheimer's disease (AD) varies by age or presence of apolipoprotein E (APOE) epsilon 4 allele. DESIGN: A cohort of cognitively intact elderly participants was assessed biennially for dementia and AD. SETTING: Community based. PARTICIPANTS: Three thousand three hundred ninety-two members of a health maintenance organization (HMO) aged 65 and older and without dementia. MEASUREMENTS: Statin use was identified from the HMO pharmacy database, and proportional hazards models were applied with statin use as a time-dependent covariate to assess the association between statins and AD and the modifying effects of age and the APOE epsilon 4 allele. RESULTS: Over an average of 6.1 years of follow-up of 3,099 participants, 263 participants developed probable AD. The adjusted hazard ratio (aHR) for statin use was 0.62 (95% confidence interval (CI) = 0.40-0.97) for AD in models including demographic characteristics and vascular risk factors as covariates. The strength of the association between statins and AD diminished with age (statin-by-age at entry interaction P = .04); the aHR in those younger than 80 was 0.44 (95% CI = 0.25-0.78), versus 1.22 (95% CI = 0.61-2.42) for aged 80 and older. The interaction term for statin use-by-APOE epsilon 4 was not significant (P = .65). CONCLUSION: This enlarged study confirms earlier findings that statin therapy in early old age, but not in late age, may be associated with a lower risk of AD. The relationship between statin use and AD was consistent across APOE genotypes. J Am Geriatr Soc 58: 1311-1317, 2010. C1 [Li, Ge; Peskind, Elaine R.] VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. [Li, Ge; Shofer, Jane B.; Peskind, Elaine R.; Breitner, John C. S.] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Rhew, Isaac C.; Kukull, Walter A.] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. [McCormick, Wayne; Crane, Paul K.; Larson, Eric B.] Univ Washington, Dept Med, Seattle, WA 98195 USA. [Bowen, James D.] Swedish Med Ctr, Swedish Neurosci Inst, Seattle, WA USA. [Breitner, John C. S.] VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. [Schellenberg, Gerard D.] Univ Penn, Philadelphia, PA 19104 USA. [Larson, Eric B.] Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA USA. RP Li, G (reprint author), VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Mail Code S-116 6EMIRECC,1660 S Columbian Way, 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 National Institute of Aging [AG20020, AG06781, AG16976, AG05136]; Department of Veterans Affairs; Friends of Alzheimer's Research FX This study was supported by Grants AG20020, AG06781, AG16976, and AG05136 from the National Institute of Aging, by the Department of Veterans Affairs, and by the Friends of Alzheimer's Research. NR 25 TC 52 Z9 53 U1 0 U2 5 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 JUL PY 2010 VL 58 IS 7 BP 1311 EP 1317 DI 10.1111/j.1532-5415.2010.02906.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 619RS UT WOS:000279448500011 PM 20533968 ER PT J AU Basnayake, K Ying, WZ Wang, PX Sanders, PW AF Basnayake, Kolitha Ying, Wei-Zhong Wang, Pei-Xuan Sanders, Paul W. TI Immunoglobulin Light Chains Activate Tubular Epithelial Cells through Redox Signaling SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID MOLECULAR-WEIGHT PROTEINS; BENCE-JONES PROTEINS; NF-KAPPA-B; TYROSINE KINASE; HYDROGEN-PEROXIDE; MULTIPLE-MYELOMA; CAST NEPHROPATHY; REACTIVE OXYGEN; KIDNEY; SRC AB The renal proximal tubule metabolizes circulating low-molecular-weight proteins such as Ig free light chains. In the setting of plasma cell dyscrasias, the burden of filtered protein can be very high. Endocytosis of certain nephrotoxic light chains induces H(2)O(2) production and monocyte chemoattractant protein-1 (MCP-1) release, leading to recruitment of inflammatory cells and interstitial fibrosis, but how these processes are linked mechanistically is not well understood. This study investigated the relationship between H(2)O(2) generated after light chain endocytosis by human proximal tubular (HK-2) cells and activation of c-Src, a redox-sensitive tyrosine kinase. HK-2 cells exposed to two different light chains upregulated c-Src activity, which increased the production of MCP-1. In parallel, we observed a time-dependent oxidation of c-Src. Inhibition of c-Src activity and silencing c-Src expression abrogated the light chain induced MCP-1 response, but had no effect on H(2)O(2), indicating that production of H(2)O(2) is upstream of c-Src in the signaling cascade. Silencing megalin and cubilin expression inhibited the MCP-1 response, whereas extracellular catalase did not, indicating that endocytosis is required and that intracellular generation of reactive oxygen species activates c-Src. These data show that intracellular H(2)O(2) induced by endocytosis of monoclonal free light chains oxidizes and activates c-Src, which promotes release of MCP-1. C1 [Sanders, Paul W.] Univ Alabama, Div Nephrol, Dept Med, Nephrol Res & Training Ctr, Birmingham, AL 35294 USA. [Basnayake, Kolitha] Univ Birmingham, Birmingham, W Midlands, England. [Sanders, Paul W.] Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Sanders, PW (reprint author), Univ Alabama, Div Nephrol, Dept Med, Nephrol Res & Training Ctr, 642 Lyons Harrison Res Bldg,1530,3rd Ave S, Birmingham, AL 35294 USA. OI Sanders, Paul/0000-0002-2915-5714 FU National Institutes of Health [R01 DK46199, P30 DK079337]; Office of Research and Development, Medical Research Service, Department of Veterans Affairs; Dr Basnayake's clinical fellowship FX Portions of the data contained within this manuscript have been submitted in abstract form to the 42nd Annual Meeting and Scientific Exposition of the American Society of Nephrology; October 27 through November 1, 2009, San Diego, CA National Institutes of Health grant (R01 DK46199) and P30 DK079337 (George M. O'Brien Kidney and Urological Research Centers Program) and the Office of Research and Development, Medical Research Service, Department of Veterans Affairs, supported this research. We thank the Binding Site Ltd. for then unrestricted support of Dr Basnayake's clinical fellowship and their expertise in protein chemistry NR 49 TC 24 Z9 25 U1 2 U2 4 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 JUL PY 2010 VL 21 IS 7 BP 1165 EP 1173 DI 10.1681/ASN.2009101089 PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 632SD UT WOS:000280447100017 PM 20558542 ER PT J AU Prakash, S Rodriguez, RA Austin, PC Saskin, R Fernandez, A Moist, LM O'Hare, AM AF Prakash, Suma Rodriguez, Rudolph A. Austin, Peter C. Saskin, Refik Fernandez, Alicia Moist, Louise M. O'Hare, Ann M. TI Racial Composition of Residential Areas Associates with Access to Pre-ESRD Nephrology Care SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID CHRONIC KIDNEY-DISEASE; STAGE RENAL-DISEASE; DISPARITIES GEOCODING PROJECT; NEIGHBORHOOD POVERTY; PERITONEAL-DIALYSIS; UNITED-STATES; ARTERIOVENOUS-FISTULAS; REPLACEMENT THERAPY; MORTALITY; TRANSPLANTATION AB Referral to a nephrologist before initiation of chronic dialysis occurs less frequently for blacks than whites, but the reasons for this disparity are incompletely understood. Here, we examined the contribution of racial composition by zip code on access and quality of nephrology care before initiation of renal replacement therapy (RRT). We retrospectively studied a cohort study of 92,000 white and black adults who initiated RRT in the United States between June 1, 2005, and October 5, 2006. The percentage of patients without pre-ESRD nephrology care ranged from 30% among those who lived in zip codes with <5% black residents to 41% among those who lived in areas with >50% black residents In adjusted analyses, as the percentage of blacks in residential areas increased, the likelihood of not receiving pre-ESRD nephrology care increased. Among patients who received nephrology care, the quality of care (timing of care and proportion of patients who received a pre-emptive renal transplant, who initiated therapy with peritoneal dialysis, or who had a permanent hemodialysis access) did not differ by the racial composition of their residential area. In conclusion, racial composition of residential areas associates with access to nephrology care but not with quality of the nephrology care received. C1 [Prakash, Suma] Univ Toronto, Dept Med, Toronto, ON, Canada. VA Puget Sound Healthcare Syst, Div Nephrol, Dept Med, Seattle, WA USA. [Rodriguez, Rudolph A.; O'Hare, Ann M.] Univ Washington, Seattle, WA 98195 USA. [Austin, Peter C.] Univ Toronto, Dept Hlth Policy Management & Evaluat, Toronto, ON, Canada. [Austin, Peter C.; Saskin, Refik] Inst Clin Evaluat Sci, Toronto, ON, Canada. [Fernandez, Alicia] Univ Calif San Francisco, Dept Med, San Francisco, CA USA. [Moist, Louise M.] Univ Western Ontario, Dept Med, Div Nephrol, London, ON, Canada. RP Prakash, S (reprint author), Univ Toronto, Dept Med, Toronto, ON, Canada. OI Austin, Peter/0000-0003-3337-233X FU Heart and Stroke Foundation of Ontario; National Institutes of Health/National Centre for Research Resources [K23121218342]; National Institute of Aging [K23AG28980] FX S P received a travel grant to present an abstract from this work at the World Congress of Nephrology ni Milan, Italy, in May 2009 P C.A is supported by a Career Investigator Award from the Heart and Stroke Foundation of Ontario A F is supported by a K23121218342 award from the National Institutes of Health/National Centre for Research Resources A M 0 is supported by a Beeson Career Development Award front the National Institute of Aging (K23AG28980) and receives royalties from UpToDate and an honorarium from the Japanese Society for Foot Care NR 47 TC 28 Z9 28 U1 0 U2 3 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1046-6673 EI 1533-3450 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD JUL PY 2010 VL 21 IS 7 BP 1192 EP 1199 DI 10.1681/ASN.2009101008 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 632SD UT WOS:000280447100020 PM 20558541 ER PT J AU Pa, J Possin, KL Wilson, SM Quitania, LC Kramer, JH Boxer, AL Weiner, MW Johnson, JK AF Pa, Judy Possin, Katherine L. Wilson, Stephen M. Quitania, Lovingly C. Kramer, Joel H. Boxer, Adam L. Weiner, Michael W. Johnson, Julene K. TI Gray matter correlates of set-shifting among neurodegenerative disease, mild cognitive impairment, and healthy older adults SO JOURNAL OF THE INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY LA English DT Article DE D-KEFS; Design fluency; Trail making test; Color word interference; Executive function; Voxel-based morphometry ID CARD SORTING TEST; FRONTOTEMPORAL LOBAR DEGENERATION; LATERAL PREFRONTAL CORTEX; FRONTAL-LOBE; PARKINSONS-DISEASE; SWITCHING DEFICITS; BASAL GANGLIA; HUNTINGTONS-DISEASE; ALZHEIMERS-DISEASE; TEST-PERFORMANCE AB There is increasing recognition that set-shifting, a form of cognitive control, is mediated by different neural structures. However, these regions have not yet been carefully identified as many studies do not account for the influence of component processes (e.g., motor speed). We investieated gray matter correlates of set-shifting while controlling for component processes. Using the Design Fluency (DE), Trail Making Test (TMT), and Color Word Interference (CWI) subtests from the Delis-Kaplan Executive Function System (D-KEFS), we investigated the correlation between set-shifting performance and gray matter volume in 160 subjects with neurodegenerative disease, mild cognitive impairment, and healthy older adults using voxel-based morphometry. All three set-shifting tasks correlated with multiple, widespread gray matter regions. After controlling for the component processes, set-shifting performance correlated with focal regions in prefrontal and posterior parietal cortices. We also identified bilateral prefrontal cortex and the right posterior parietal lobe as common sites for set-shifting across the three tasks. There was a high degree of multicollinearity between the set-shifting conditions and the component processes of TMT and CWI, suggesting DF may better isolate set-shifting regions. Overall, these findings highlight the neuroanatomical correlates of set-shifting and the importance of controlling for component processes when investigating complex cognitive tasks. (JINS, 2010, 16, 640-650.) C1 [Pa, Judy; Possin, Katherine L.; Wilson, Stephen M.; Kramer, Joel H.; Boxer, Adam L.; Johnson, Julene K.] Univ Calif San Francisco, Dept Neurol, Alzheimer Dis Res Ctr, San Francisco, CA 94143 USA. [Quitania, Lovingly C.] Univ Calif Davis, Dept Neurol, Alzheimer Dis Ctr, Davis, CA 95616 USA. [Weiner, Michael W.] San Francisco VA Med Ctr, Ctr Imaging Neurodegenerat Dis, San Francisco, CA USA. [Johnson, Julene K.] Univ Calif San Francisco, Inst Hlth & Aging, San Francisco, CA 94143 USA. RP Pa, J (reprint author), UCSF Mission Bay, Genentech Hall,Room N474,600 16th St, San Francisco, CA 94158 USA. EM judy.pa@ucsf.edu FU National Institute on Aging (NIA) [R01-AG022538, R01-AG010897, K01-AG034175-01, K23-AG0300601, P01-AG1972403, P50-AG0300601]; John D. French Foundation FX This work was supported by National Institute on Aging (NIA) R01-AG022538, R01-AG010897, K01-AG034175-01, K23-AG0300601, P01-AG1972403, and P50-AG0300601, and John D. French Foundation. NR 71 TC 24 Z9 24 U1 4 U2 9 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA SN 1355-6177 J9 J INT NEUROPSYCH SOC JI J. Int. Neuropsychol. Soc. PD JUL PY 2010 VL 16 IS 4 BP 640 EP 650 DI 10.1017/S1355617710000408 PG 11 WC Clinical Neurology; Neurosciences; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 619HE UT WOS:000279419100008 PM 20374676 ER PT J AU Sun, K Zhang, ZH Suzuki, T Wenk, JF Stander, N Einstein, DR Saloner, DA Wallace, AW Guccione, JM Ratcliffe, MB AF Sun, Kay Zhang, Zhihong Suzuki, Takamaro Wenk, Jonathan F. Stander, Nielen Einstein, Daniel R. Saloner, David A. Wallace, Arthur W. Guccione, Julius M. Ratcliffe, Mark B. TI Dor procedure for dyskinetic anteroapical myocardial infarction fails to improve contractility in the border zone SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article ID LEFT-VENTRICULAR ANEURYSM; FINITE-ELEMENT MODEL; ENDOVENTRICULAR PATCH PLASTY; CANINE LEFT-VENTRICLE; MATRIX METALLOPROTEINASE-2; MECHANICAL DYSFUNCTION; ACTIVE CONTRACTION; CARDIAC-MUSCLE; RECONSTRUCTION; STRESS AB Background: Endoventricular patch plasty (Dor) is used to reduce left ventricular volume after myocardial infarction and subsequent left ventricular remodeling. Methods and Results: End-diastolic and end-systolic pressure-volume and Starling relationships were measured, and magnetic resonance images with noninvasive tags were used to calculate 3-dimensional myocardial strain in 6 sheep 2 weeks before and 2 and 6 weeks after the Dor procedure. These experimental results were previously reported. The imaging data from 1 sheep were incomplete. Animal specific finite element models were created from the remaining 5 animals using magnetic resonance images and left ventricular pressure obtained at early diastolic filling. Finite element models were optimized with 3-dimensional strain and used to determine systolic material properties, T(max,skinned-fiber), and diastolic and systolic stress in remote myocardium and border zone. Six weeks after the Dor procedure, end-diastolic and end-systolic stress in the border zone were substantially reduced. However, although there was a slight increase in Tmax, skinned-fiber in the border zone near the myocardial infarction at 6 weeks, the change was not significant. Conclusions: The Dor procedure decreases end-diastolic and end-systolic stress but fails to improve contractility in the infarct border zone. Future work should focus on measures that will enhance border zone function alone or in combination with surgical remodeling. (J Thorac Cardiovasc Surg 2010; 140: 233-9) C1 [Sun, Kay; Zhang, Zhihong; Suzuki, Takamaro; Wenk, Jonathan F.; Guccione, Julius M.; Ratcliffe, Mark B.] Univ Calif San Francisco, Dept Surg, San Francisco, CA 94143 USA. [Guccione, Julius M.; Ratcliffe, Mark B.] Univ Calif San Francisco, Dept Bioengn, San Francisco, CA 94143 USA. [Wallace, Arthur W.] Univ Calif San Francisco, Dept Anesthesia, San Francisco, CA 94143 USA. [Saloner, David A.] Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. [Sun, Kay; Zhang, Zhihong; Suzuki, Takamaro; Wenk, Jonathan F.; Saloner, David A.; Wallace, Arthur W.; Guccione, Julius M.; Ratcliffe, Mark B.] Vet Affairs Med Ctr, San Francisco, CA 94121 USA. [Stander, Nielen] Livermore Software Technol Corp, Livermore, CA USA. [Einstein, Daniel R.] Pacific NW Natl Lab, Olympia, WA USA. RP Ratcliffe, MB (reprint author), San Francisco VA Med Ctr, Surg Serv 112, 4150 Clement St, San Francisco, CA 94121 USA. EM mark.ratcliffe@med.va.gov FU National Institutes of Health [R01-HL-77921, R01-HL-63348] FX This study was supported by National Institutes of Health grant R01-HL-77921 (to Dr Guccione), VA Merit Review (to Dr Wallace), and R01-HL-63348 (to Dr Ratcliffe). NR 38 TC 15 Z9 15 U1 0 U2 2 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 JUL PY 2010 VL 140 IS 1 BP 233 EP U269 DI 10.1016/j.jtcvs.2009.11.055 PG 11 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 612QG UT WOS:000278915600038 PM 20299030 ER PT J AU Ramsey, SD Zeliadt, SB Arora, NK Blough, DK Penson, DF Oakley-Girvan, I Hamilton, AS Van Den Eeden, SK Fedorenko, CR Potosky, AL AF Ramsey, Scott D. Zeliadt, Steven B. Arora, Neeraj K. Blough, David K. Penson, David F. Oakley-Girvan, Ingrid Hamilton, Ann S. Van Den Eeden, Stephen K. Fedorenko, Catherine R. Potosky, Arnold L. TI Unanticipated and Underappreciated Outcomes During Management of Local Stage Prostate Cancer: A Prospective Survey SO JOURNAL OF UROLOGY LA English DT Article DE prostatic neoplasms; surgical procedures, operative; information services ID QUALITY-OF-LIFE; ANDROGEN DEPRIVATION; TREATMENT DECISIONS; MEN; REGRET; BRACHYTHERAPY; RADIOTHERAPY; SATISFACTION; SURGERY AB Purpose: Due to the complexity of factors that must be considered when choosing a therapy for prostate cancer, we hypothesized that many men will find that certain factors such as side effects gain or lose importance after therapy relative to their expectations before therapy. Materials and Methods: We conducted a prospective survey of men deciding on a therapy for local stage prostate cancer in 3 geographic regions. Men were asked to rate the importance of 11 personal factors before starting therapy and again 6 months after therapy. Results: Among 448 eligible men completing the most common treatment options, overall satisfaction with treatment choice was high across all therapies. While most men changed rankings of importance in at least 1 of the 11 factors, the majority of pre-post evaluations were highly consistent. In adjusted analyses the 2 factors that emerged as significantly underappreciated for all major prostate cancer treatments were 1) the impact of treatment on usual daily activities, and 2) the recommendations of friends and relatives who were affected with prostate cancer. Conclusions: Initial patient expectations of the importance of the majority of factors related to prostate cancer treatment are generally accurate. Better counseling may improve the accuracy of patient expectations of the personal burden of treatment, and their evaluation of the advice of affected friends and relatives. C1 [Ramsey, Scott D.; Zeliadt, Steven B.; Fedorenko, Catherine R.] Fred Hutchinson Canc Res Ctr, Seattle, WA 98109 USA. [Blough, David K.] VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Ctr Excellence, Seattle, WA USA. [Blough, David K.] Univ Washington, Sch Pharm, Seattle, WA 98195 USA. [Arora, Neeraj K.] NCI, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA. [Penson, David F.] Vanderbilt Univ, Med Ctr, Nashville, TN USA. [Hamilton, Ann S.] Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA 90033 USA. [Potosky, Arnold L.] Georgetown Univ, Lombardi Comprehens Canc Ctr, Washington, DC USA. [Van Den Eeden, Stephen K.] Kaiser Permanente, Div Res, Oakland, CA USA. RP Ramsey, SD (reprint author), Fred Hutchinson Canc Res Ctr, 1100 Fairview Ave N,M3-B232, Seattle, WA 98109 USA. EM sramsey@fhcrc.org NR 21 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 JUL PY 2010 VL 184 IS 1 BP 120 EP 125 DI 10.1016/j.juro.2010.03.023 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 609FW UT WOS:000278642300040 PM 20478590 ER PT J AU Wieland, D Boland, R Baskins, J Kinosian, B AF Wieland, Darryl Boland, Rebecca Baskins, Judith Kinosian, Bruce TI Five-Year Survival in a Program of All-Inclusive Care For Elderly Compared With Alternative Institutional and Home- and Community-Based Care SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article DE Comparative effectiveness research; Risk stratification; Long-term care; Dual eligibles ID SERVICES AB Community-based services are preferred to institutional care for people requiring long-term care (LTC). States are increasing their Medicaid waiver programs, although Program of All-Inclusive Care For Elderly (PACE)-prepaid, community-based comprehensive care-is available in 31 states. Despite emerging alternatives, little is known about their comparative effectiveness. Methods. For a two-county region of South Carolina, we contrast long-term survival among entrants (n = 2040) to an aged and disabled waiver program, PACE, and nursing homes (NHs), stratifying for risk. Participants were followed for 5 years or until death; those lost to follow-up or surviving less than 5 years as on August 8, 2005 were censored. Analyses included admission descriptive statistics and Kaplan Meier curves. To address cohort risk imbalance, we employed an established mortality risk index, which showed external validity in waiver, PACE, and NH cohorts (log-rank tests = 105.42, 28.72, and 52.23, respectively, all p<.001; c-statistics = .67, .58, .65, p<.001). Results. Compared with waiver (n = 1,018) and NH (n = 468) admissions, PACE participants (n = 554) were older, more cognitively impaired, and had intermediate activities of daily living dependency. PACE mortality risk (72.6% high-to-intermediate) was greater than in waiver (58.8%), and similar to NH (71.6%). Median NH survival was 2.3 years. Median PACE survival was 4.2 years versus 3.5 in waiver (unstratified, log rank = .394; p = .53), but accounting for risk, PACE's advantage is significant (log rank = 5.941 (1); p = .015). Compared with waiver, higher risk admissions to PACE were most likely to benefit (moderate: PACE median survival = 4.7 years vs waiver 3.4; high risk: 3.0 vs 2.0). Conclusion. Long-term outcomes of LTC alternatives warrant greater research and policy attention. C1 [Wieland, Darryl] Univ S Carolina, Div Geriatr, Dept Med, Sch Med, Columbia, SC 29208 USA. [Wieland, Darryl; Boland, Rebecca; Baskins, Judith] Palmetto Hlth Richland, Div Geriatr Serv, Columbia, SC USA. [Kinosian, Bruce] Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. [Kinosian, Bruce] Univ Penn, Dept Med, Philadelphia, PA 19104 USA. RP Wieland, D (reprint author), 3010 Farrow Rd,300A, Columbia, SC 29203 USA. EM darryl.wieland@palmettohealth.org NR 13 TC 12 Z9 12 U1 3 U2 7 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 2010 VL 65 IS 7 BP 721 EP 726 DI 10.1093/gerona/glq040 PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 615CN UT WOS:000279109500005 PM 20354065 ER PT J AU Ross, JS Maynard, C Krumholz, HM Sun, HL Rumsfeld, JS Normand, SLT Wang, Y Fihn, SD AF Ross, Joseph S. Maynard, Charles Krumholz, Harlan M. Sun, Haili Rumsfeld, John S. Normand, Sharon-Lise T. Wang, Yun Fihn, Stephan D. TI Use of Administrative Claims Models to Assess 30-Day Mortality Among Veterans Health Administration Hospitals SO MEDICAL CARE LA English DT Article DE acute myocardial infarction; heart failure; pneumonia; mortality; risk adjustment; veterans ID ACUTE MYOCARDIAL-INFARCTION; RISK ADJUSTMENT; CARE QUALITY; SYSTEM; RATES AB Background: The Centers for Medicare and Medicaid Services (CMS) publicly reports hospital-specific risk-standardized, 30-day, all-cause, mortality rates (RSMRs) for all hospitalizations among fee-for-service Medicare beneficiaries for acute myocardial infarction (AMI), heart failure (HF), and pneumonia at non-Federal hospitals. Objective: To examine the performance of the statistical models used by CMS among veterans at least 65 years of age hospitalized for AMI, HF, and pneumonia in Veterans Health Administration (VHA) hospitals. Research Design: Cross-sectional analysis of VHA administrative claims data between October 1, 2006 and September 30, 2009. Subjects: Thirteen thousand forty-six veterans hospitalized for AMI among 123 VHA hospitals; 26,379 veterans hospitalized for HF among 124 VHA hospitals; and 31,126 veterans hospitalized for pneumonia among 124 VHA hospitals. Measures: Hospital-specific RSMR for AMI, HF, and pneumonia hospitalizations calculated using hierarchical generalized linear models. Results: Median number of AMI hospitalizations per VHA hospital was 87. Average AMI RSMR was 14.3% [95% confidence interval (CI), 13.9%-14.6%] with modest heterogeneity among VHA hospitals (RSMR range: 8.4%-20.3%). The c-statistic for the AMI RSMR statistical model was 0.79. Median number of HF hospitalizations was 188. Average HF RSMR was 10.1% (95% CI, 9.9%-10.4%) with modest heterogeneity (RSMR range: 6.1%-14.9%). The c-statistic for the HF RSMR statistical model was 0.73. Median number of pneumonia hospitalizations was 221.5. Average pneumonia RSMR was 13.0% (95% CI, 12.7%-13.3%) with modest heterogeneity (RSMR range: 9.0%-18.4%). The c-statistic for the pneumonia RSMR statistical model was 0.72. Conclusions: The statistical models used by CMS to estimate RSMRs for AMI, HF, and pneumonia hospitalizations at non-Federal hospitals demonstrate similar discrimination when applied to VHA hospitals. C1 [Ross, Joseph S.] James J Peters Vet Adm Med Ctr, HSR&D Res Enhancement Award Program, Bronx, NY 10468 USA. [Ross, Joseph S.] James J Peters Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY 10468 USA. [Ross, Joseph S.] Mt Sinai Sch Med, Dept Geriatr & Palliat Med, New York, NY USA. [Maynard, Charles; Sun, Haili; Fihn, Stephan D.] Puget Sound Hlth Care Syst, VA NW Hlth Serv Res & Dev Ctr Excellence, Seattle, WA USA. [Krumholz, Harlan M.; Wang, Yun] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Sect Cardiovasc Med, New Haven, CT USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT 06510 USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Div Hlth Policy & Adm, New Haven, CT 06510 USA. [Rumsfeld, John S.] Denver VA Med Ctr, Denver, CO USA. [Rumsfeld, John S.] Univ Colorado Hlth Sci Ctr, Dept Med, Div Cardiol, Denver, CO USA. [Normand, Sharon-Lise T.] Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA. [Normand, Sharon-Lise T.] Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. [Fihn, Stephan D.] Univ Washington, Dept Med, Seattle, WA USA. RP Ross, JS (reprint author), James J Peters Vet Adm Med Ctr, HSR&D Res Enhancement Award Program, 130 W Kingsbridge Rd,Room 4A-17, Bronx, NY 10468 USA. EM joseph.ross@mssm.edu RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 FU NIA NIH HHS [K08 AG032886, K08 AG032886-02] NR 22 TC 11 Z9 11 U1 0 U2 0 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 JUL PY 2010 VL 48 IS 7 BP 652 EP 658 DI 10.1097/MLR.0b013e3181dbe35d PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 619KD UT WOS:000279428200013 PM 20548253 ER PT J AU Kramer, BJ Finke, B Saliba, D Jouldjian, S Yano, EM AF Kramer, B. Josea Finke, Bruce Saliba, Debra Jouldjian, Stella Yano, Elizabeth M. TI Fostering Closer Alignment of the Veterans Health Administration and the Indian Health Service SO MILITARY MEDICINE LA English DT Editorial Material ID CARE C1 [Kramer, B. Josea; Saliba, Debra; Jouldjian, Stella] VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Sepulveda, CA 91343 USA. [Kramer, B. Josea; Saliba, Debra] Univ Calif Los Angeles, David Geffen Sch Med, Div Geriatr, Los Angeles, CA 90095 USA. [Finke, Bruce] Indian Hlth Serv, Nashville Area, Nashville, TN 37214 USA. [Saliba, Debra; Yano, Elizabeth M.] VA Greater Los Angeles Healthcare Syst, Ctr Study Healthcare Provider Behav, Sepulveda, CA 91343 USA. [Saliba, Debra] RAND Corp, Santa Monica, CA 90401 USA. RP Kramer, BJ (reprint author), VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, 16111 Plummer St,11E, Sepulveda, CA 91343 USA. NR 10 TC 1 Z9 1 U1 2 U2 2 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 JUL PY 2010 VL 175 IS 7 BP 463 EP 465 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 624EN UT WOS:000279799200002 PM 20684447 ER PT J AU Kramarenko, II Bunni, MA Raymond, JR Garnovskaya, MN AF Kramarenko, Inga I. Bunni, Marlene A. Raymond, John R. Garnovskaya, Maria N. TI Bradykinin B-2 Receptor Interacts with Integrin alpha 5 beta 1 to Transactivate Epidermal Growth Factor Receptor in Kidney Cells SO MOLECULAR PHARMACOLOGY LA English DT Article ID MEDULLARY COLLECTING DUCT; PROTEIN-COUPLED RECEPTORS; FOCAL ADHESION KINASE; SIGNAL-TRANSDUCTION; EGF RECEPTOR; TYROSINE KINASES; MATRIX; ACTIVATION; MIGRATION; BINDING AB We have shown previously that the vasoactive peptide bradykinin (BK) stimulates proliferation of a cultured murine cell model of the inner medullary collecting duct (mIMCD-3 cells) via transactivation of epidermal growth factor receptor (EGFR) by a mechanism that involves matrix metalloproteinases (collagenase- 2 and -3). Because collagenases lack an integral membrane domain, we hypothesized that receptors for extracellular matrix proteins, integrins, may play a role in BK-induced signaling by targeting collagenases to the membrane, thus forming a functional signaling complex. BK-induced phosphorylation of extracellular signal-regulated protein kinase (ERK) in mIMCD-3 cells was reduced by similar to 65% by synthetic peptides containing an Arg-Gly-Asp sequence, supporting roles for integrins in BK-induced signaling. Neutralizing antibody against alpha 5 beta 1 integrin partially (similar to 60%) blocked BK-induced ERK activation but did not affect EGF-induced ERK activation. Silencing of alpha 5 and beta 1 expression by transfecting cells with small interfering RNAs (siRNA) significantly decreased BK-induced ERK activation (similar to 80%) and EGFR phosphorylation (similar to 50%). This effect was even more pronounced in cells that were cotransfected with siRNAs directed against both collagenases and alpha 5 beta 1 integrin. On the basis of our results, we suggested that integrin alpha 5 beta 1 is involved in BK-induced signaling in mIMCD-3 cells. Using immunoprecipitation/Western blotting, we demonstrated association of BK B-2 receptor with alpha 5 beta 1 integrin upon BK treatment. Furthermore, BK induced association of alpha 5 beta 1 integrin with EGFR. These data provide the first evidence that specific integrins are involved in BK B-2 receptor-induced signaling in kidney cells, and ultimately might lead to development of new strategies for treatment of renal tubulointerstitial fibrosis. C1 [Garnovskaya, Maria N.] Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Med Serv, Charleston, SC 29425 USA. Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Res Serv, Charleston, SC 29425 USA. RP Garnovskaya, MN (reprint author), Med Univ S Carolina, Dept Med, Div Nephrol, 96 Jonathan Lucas St,MSC 629, Charleston, SC 29425 USA. EM garnovsk@musc.edu FU National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases [DK52448]; National Institutes of Health National Institute of General Medical Sciences [GM3909]; Department of Veterans Affairs Merit and Research Enhancement Award Program; American Heart Association [0655445U]; Medical University of South Carolina Division of Nephrology and Dialysis Clinics, Incorporated FX This work was supported by the National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases [Grant DK52448], the National Institutes of Health National Institute of General Medical Sciences [Grant GM3909], the Department of Veterans Affairs Merit and Research Enhancement Award Program ( to J.R.R. and M.N.G.), the American Heart Association [Grant-in-Aid 0655445U], and a laboratory endowment jointly supported by the Medical University of South Carolina Division of Nephrology and Dialysis Clinics, Incorporated. NR 35 TC 10 Z9 10 U1 0 U2 0 PU AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3995 USA SN 0026-895X J9 MOL PHARMACOL JI Mol. Pharmacol. PD JUL PY 2010 VL 78 IS 1 BP 126 EP 134 DI 10.1124/mol.110.064840 PG 9 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 612XO UT WOS:000278939300013 PM 20385709 ER PT J AU Ma'ayan, A He, JC AF Ma'ayan, Avi He, John C. TI Protein Kinase Target Discovery From Genome-Wide Messenger RNA Expression Profiling SO MOUNT SINAI JOURNAL OF MEDICINE LA English DT Article DE cell signaling; ChIP-X enrichment analysis; computational systems biology; mRNA profiling; promoter analysis; regulatory mechanisms; transcription factors ID NETWORKS; PROTEOMICS; CELLS AB Genome-wide messenger RNA profiling provides a snapshot of the global state of the cell under different experimental conditions such as diseased versus normal cellular states. However, because measurements are in the form of quantitative changes in messenger RNA levels, such experimental data does not provide direct understanding of the regulatory molecular mechanisms responsible for the observed changes. Identifying potential cell signaling regulatory mechanisms responsible for changes in gene expression under different experimental conditions or in different tissues has been the focus of many computational systems biology studies. Most popular approaches include promoter analysis, gene ontology, or pathway enrichment analysis, as well as reverse engineering of networks from messenger RNA expression data. Here we present a rational approach for identifying and ranking protein kinases that are likely responsible for observed changes in gene expression. By combining promoter analysis; data from various chromatin immunoprecipitation studies such as chromatin immunoprecipitation sequencing, chromatin immunoprecipitation coupled with paired-end (Nag, and chromatin immunoprecipitation-on-chip; protein-protein interactions; and kinase-protein phosphorylation reactions collected from the literature, we can identify and rank candidate protein kinases for knock-down, or other types of functional validations, based on genome-wide changes in gene expression. We describe how protein kinase candidate identification and ranking can be made robust by cross-validation with phosphoproteomics data as well as through a literature-based text-mining approach. In conclusion, data integration can produce robust candidate rankings for understanding cell regulation through identification of protein kinases responsible for gene expression changes, and thus rapidly advancing drug target discovery and unraveling drug mechanisms of action. Mt Sinai J Med 77:345-349, 2010. (C) 2010 Mount Sinai School of Medicine C1 [Ma'ayan, Avi; He, John C.] Mt Sinai Sch Med, Dept Pharmacol & Syst Therapeut, New York, NY 10029 USA. [Ma'ayan, Avi] Mt Sinai Sch Med, Syst Biol Ctr New York, New York, NY USA. [Ma'ayan, Avi] Mt Sinai Sch Med, Expt Therapeut Inst, New York, NY USA. [He, John C.] Mt Sinai Sch Med, Dept Med, New York, NY USA. [He, John C.] James J Peters VA Med Ctr, Bronx, NY USA. RP Ma'ayan, A (reprint author), Mt Sinai Sch Med, Dept Pharmacol & Syst Therapeut, New York, NY 10029 USA. EM avi.maayan@mssm.edu FU NIH [R01-DK088541, R01-DK078897, P50-GM071558-01A27398] FX The research presented is supported by NIH grants R01-DK088541 to JCH and AM, R01-DK078897 to JCH, and P50-GM071558-01A27398 to AM. NR 21 TC 3 Z9 3 U1 0 U2 1 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0027-2507 J9 MT SINAI J MED JI Mt. Sinai J. Med. PD JUL-AUG PY 2010 VL 77 IS 4 BP 345 EP 349 DI 10.1002/msj.20192 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 632MF UT WOS:000280428100004 PM 20687179 ER PT J AU Wang, S Jacobs, D Andrews, H Tsai, WY Luo, XD Bergmann, C Sano, M AF Wang, Sophia Jacobs, Diane Andrews, Howard Tsai, Wei-Yann Luo, Xiaodong Bergmann, Christine Sano, Mary TI Cardiovascular risk and memory in non-demented elderly women SO NEUROBIOLOGY OF AGING LA English DT Article DE Cognitive aging; Memory; Neuropsychological assessment; Cardiac ID CORONARY-HEART-DISEASE; ALZHEIMERS-DISEASE; METABOLIC SYNDROME; PROFILE AB Objective: To determine whether cardiovascular (CV) risk is associated with subtle memory deficits in non-demented, healthy older women with a family history of Alzheimer disease (AD). Methods: Baseline data of 375 participants from a randomized, double-blind placebo-controlled primary prevention trial to test the efficacy of hormone replacement therapy in delaying AD and cognitive decline were analyzed. All subjects were women over 65 with a family history of AD who had normal cognition and no active heart disease at baseline. A baseline memory composite score was calculated, consisting of immediate and delayed recall of verbal and nonverbal material. Multiple linear regression was performed to examine the association of relative CV risk with memory functioning; age, ethnicity and education level were included as covariates. Results: Mean baseline memory composite score was significantly higher in those with low relative CHD risk than those with high relative CHD risk. Conclusion: These findings suggest that subtle elevation of CHD risk may negatively affect memory functioning even in otherwise healthy, non-demented older women without a history of heart disease. (C) 2008 Elsevier Inc. All rights reserved. C1 [Wang, Sophia; Jacobs, Diane; Luo, Xiaodong; Bergmann, Christine; Sano, Mary] Mt Sinai Sch Med, Dept Psychiat, Alzheimer Dis Res Ctr, New York, NY 10029 USA. [Wang, Sophia; Jacobs, Diane; Luo, Xiaodong; Bergmann, Christine; Sano, Mary] James J Peters VAMC, Dept Psychiat, Bronx, NY 10468 USA. [Andrews, Howard; Tsai, Wei-Yann] Columbia Univ, Mailman Sch Publ Hlth, New York, NY 10032 USA. RP Wang, S (reprint author), James J Peters VAMC, Dept Psychiat, 130 W Kingsbridge Rd,Room 1F01C, Bronx, NY 10468 USA. EM sophia.wang@mssm.edu; mary.sano@mssm.edu FU National Institute of Aging [R01 AG15922] FX This study was supported by National Institute of Aging (R01 AG15922). NR 10 TC 4 Z9 4 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD JUL PY 2010 VL 31 IS 7 BP 1250 EP 1253 DI 10.1016/j.neurobiolaging.2008.08.007 PG 4 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 606PD UT WOS:000278438300017 PM 18805604 ER PT J AU Willette, AA Bendlin, BB McLaren, DG Canu, E Kastman, EK Kosmatka, KJ Xu, G Field, AS Alexander, AL Colman, RJ Weindruch, RH Coe, CL Johnson, SC AF Willette, A. A. Bendlin, B. B. McLaren, D. G. Canu, E. Kastman, E. K. Kosmatka, K. J. Xu, G. Field, A. S. Alexander, A. L. Colman, R. J. Weindruch, R. H. Coe, C. L. Johnson, S. C. TI Age-related changes in neural volume and microstructure associated with interleukin-6 are ameliorated by a calorie-restricted diet in old rhesus monkeys SO NEUROIMAGE LA English DT Article DE Monkey; Voxel-based morphometry; Calorie restriction; Aging; Interleukin-6; Atrophy ID VOXEL-BASED MORPHOMETRY; ALZHEIMERS-DISEASE; IN-VIVO; SICKNESS BEHAVIOR; ADIPOSE-TISSUE; CHRONIC NEURODEGENERATION; INFLAMMATORY BIOMARKERS; FRACTIONAL ANISOTROPY; GENE-EXPRESSION; MATTER VOLUME AB Systemic levels of proinflammatory cytokines such as interleukin-6 (IL-6) increase in old age and may contribute to neural atrophy in humans. We investigated IL-6 associations with age in T1-weighted segments and microstructural diffusion indices using MRI in aged rhesus monkeys (Macaca mulatto). Further, we determined if long-term 30% calorie restriction (CR) reduced IL-6 and attenuated its association with lower tissue volume and density. Voxel-based morphometry (VBM) and diffusion-weighted voxelwise analyses were conducted. IL-6 was associated with less global gray and white matter (GM and WM), as well as smaller parietal and temporal GM volumes. Lower fractional anisotropy (FA) was associated with higher IL-6 levels along the corpus callosum and various cortical and subcortical tracts. Higher IL-6 concentrations across subjects were also associated with increased mean diffusivity (MD) throughout many brain regions. particularly in corpus callosum, cingulum, and parietal, frontal, and prefrontal areas. CR monkeys had significantly lower IL-6 and less associated atrophy. An IL-6 x CR interaction across modalities also indicated that CR mitigated IL-6 related changes in several brain regions compared to controls. Peripheral IL-6 levels were correlated with atrophy in regions sensitive to aging, and this relationship was decreased by CR. Published by Elsevier Inc. C1 [Bendlin, B. B.; McLaren, D. G.; Canu, E.; Kastman, E. K.; Xu, G.; Weindruch, R. H.; Johnson, S. C.] William S Middleton Mem Vet Adm Med Ctr, Geriatr Res Educ & Clin Ctr, Madison, WI 53705 USA. [Willette, A. A.] Dept Psychol, Harlow Primate Lab, Madison, WI 53715 USA. [McLaren, D. G.] Univ Wisconsin, Neurosci Training Program, Madison, WI 53706 USA. [Bendlin, B. B.; McLaren, D. G.; Kastman, E. K.; Kosmatka, K. J.; Weindruch, R. H.; Johnson, S. C.] Univ Wisconsin, Dept Med, Madison, WI 53705 USA. [Alexander, A. L.] Univ Wisconsin, Waisman Imaging Ctr, Madison, WI 53705 USA. [Field, A. S.; Weindruch, R. H.] Univ Wisconsin, Dept Radiol, Madison, WI 53792 USA. [Colman, R. J.; Johnson, S. C.] Wisconsin Natl Primate Res Ctr, Madison, WI 53715 USA. RP Johnson, SC (reprint author), D4225 Vet Adm Hosp, Geriatr Res Educ & Clin Ctr, 2500 Overlook Terrace, Madison, WI 53705 USA. EM scj@medicine.wisc.edu RI McLaren, Donald/G-9906-2011; Kastman, Erik/N-6645-2016; Canu, Elisa/K-1423-2016 OI Kastman, Erik/0000-0001-7221-9042; Bendlin, Barbara/0000-0002-0580-9875; Canu, Elisa/0000-0001-5804-3378 FU National Institutes of Health [RR000167, AG011915, AG000213, GM007507, MH085051, MH062015]; Ford Foundation; Marian S. Schwartz fellowship; National Science Foundation; William S. Middleton Memorial Veterans Hospital, Madison, WI, USA FX The assistance of Michele E. Fitzgerald, Ron Fisher, Scott T. Baum, Josh Smith, Mary Lou Voytko, and the Waisman Center for Brain Imaging is greatly appreciated. GRECC manuscript number: 2010-XX. This study was supported in part by the National Institutes of Health grants RR000167, AG011915, AG000213, GM007507, MH085051, and MH062015. The study was also supported with resources and use of facilities at the William S. Middleton Memorial Veterans Hospital, Madison, WI, USA. A.A.W. was supported by a pre-doctoral fellowship from the Ford Foundation, and professional funding from a Marian S. Schwartz fellowship and National Science Foundation-Alliances for Graduate Education and the Professoriate award. NR 70 TC 31 Z9 31 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 1053-8119 J9 NEUROIMAGE JI Neuroimage PD JUL 1 PY 2010 VL 51 IS 3 BP 987 EP 994 DI 10.1016/j.neuroimage.2010.03.015 PG 8 WC Neurosciences; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging GA 594JF UT WOS:000277532900005 PM 20298794 ER PT J AU Thompson, EM Dosa, E Kraemer, DF Neuwelt, EA AF Thompson, Eric M. Dosa, Edit Kraemer, Dale F. Neuwelt, Edward A. TI Treatment With Bevacizumab Plus Carboplatin for Recurrent Malignant Glioma SO NEUROSURGERY LA English DT Article DE Bevacizumab; Carboplatin; Imaging response; Recurrent malignant glioma; Toxicity ID HIGH-GRADE GLIOMAS; PHASE-II; INTRAVENOUS CARBOPLATIN; BRAIN-TUMORS; IRINOTECAN; SURVIVAL; CANCER; CHEMOTHERAPY; AGREEMENT; EFFICACY AB OBJECTIVE: To estimate overall survival (OS), progression-free survival (PFS), imaging responses, and toxicities of bevacizumab plus carboplatin for the treatment of recurrent malignant glioma. The secondary objective was to estimate the agreement between postcontrast T1-weighted and T2-weighted magnetic resonance imaging. METHODS: A retrospective analysis of 9 patients who received bevacizumab (10 mg/kg intravenously) and carboplatin (AUC 5 intravenously) for recurrent malignant glioma (World Health Organization grades III and IV) is presented. Eight of 9 patients received this regimen at first recurrence. RESULTS: The median age and Karnofsky performance score were 51 years and 70, respectively. For the 5 patients with grade III gliomas, the median PFS was 126 days, whereas median OS was not attained at 517 days of follow-up. Six-month PFS was 40%, whereas 6-month OS was 60%. For the 4 patients with grade IV gliomas, the median PFS was 216 days, whereas the median OS was not attained at 482 days of follow-up. Six-month PFS was 50%, whereas 6-month OS was 75%. The agreement between contrast-enhanced T1-weighted and T2-weighted images to determine recurrence was moderate (kappa = 0.5714). Three patients had grade 3 and 4 toxicities including hyponatremia and thrombocytopenia. CONCLUSION: Patients who received the combination of bevacizumab plus carboplatin for recurrent malignant glioma had reasonable PFS, OS, and toxicities. The median OS in our series is promising at well over 1 year. Agreement between postcontrast T1- and T2-weighted images is only moderate in the context of bevacizumab therapy. C1 [Neuwelt, Edward A.] Oregon Hlth & Sci Univ, Dept Neurol, Blood Brain Barrier Program, Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. [Neuwelt, Edward A.] Oregon Hlth & Sci Univ, Dept Neurol Surg, Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. [Kraemer, Dale F.] Oregon Hlth & Sci Univ, Dept Med Informat Clin Epidemiol & Hlth & Prevent, Dept Pharm Practice, Oregon State Univ,Coll Med, Portland, OR 97239 USA. RP Neuwelt, EA (reprint author), Oregon Hlth & Sci Univ, Dept Neurol, Blood Brain Barrier Program, Portland Vet Affairs Med Ctr, 3181 Sam Jackson Pkwy Rd,L603, Portland, OR 97239 USA. EM neuwelte@ohsu.edu FU National Institutes of Health, National Institute of Neurological Disorders and Stroke [NS33618, NS34608, NS44687]; Department of Veterans Affairs FX Supported by National Institutes of Health grants NS33618, NS34608, and NS44687 from the National Institute of Neurological Disorders and Stroke (E.A.N.). This work was supported in part by the Department of Veterans Affairs (E.A.N.). The authors have no personal financial or institutional interest in any of the drugs or materials described in this article. NR 32 TC 12 Z9 12 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0148-396X J9 NEUROSURGERY JI Neurosurgery PD JUL PY 2010 VL 67 IS 1 BP 87 EP 93 DI 10.1227/01.NEU.0000370918.51053.BC PG 7 WC Clinical Neurology; Surgery SC Neurosciences & Neurology; Surgery GA 612CW UT WOS:000278875400024 PM 20559095 ER PT J AU Rhee, JS Weaver, EM Park, SS Baker, SR Hilger, PA Kriet, JD Murakami, C Senior, BA Rosenfeld, RM DiVittorio, D AF Rhee, John S. Weaver, Edward M. Park, Stephen S. Baker, Shan R. Hilger, Peter A. Kriet, J. David Murakami, Craig Senior, Brent A. Rosenfeld, Richard M. DiVittorio, Danielle TI Clinical consensus statement: Diagnosis and management of nasal valve compromise SO OTOLARYNGOLOGY-HEAD AND NECK SURGERY LA English DT Article ID CHEST PHYSICIANS; AMERICAN-COLLEGE AB OBJECTIVE: To create a clinical consensus statement to address ambiguities and disparities in the diagnosis and management of nasal valve compromise (NVC). SUBJECTS AND METHODS: An updated systematic review of the literature was conducted. In addition, a Modified Delphi Method was used to refine expert opinion and facilitate a consensus position. RESULTS: After two rounds of surveys and conference calls, 36 items reached consensus, six items reached near consensus, and 10 items reached no consensus. The categories that had the greatest percentage of consensus or near consensus items were as follows: definition, history and physical examination, outcome measures, and management. Conversely, the categories with greater percentage of no consensus items were adjunctive tests and coding. CONCLUSION: The consensus panel agreed that NVC is a distinct clinical entity that is best evaluated with history and physical examination findings. Endoscopy and photography are useful but not routinely indicated, whereas radiographic studies are not useful in evaluating NVC. Other objective nasal outcome measures may not be useful or accepted for NVC. Nasal steroid medication is not useful for treatment of NVC in the absence of rhinitis, and mechanical treatments may be useful in selected patients. Surgical treatment is the primary mode of treatment of NVC, but bill coding remains ambiguous and confusing. (C) 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved. C1 [Rhee, John S.] Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, Milwaukee, WI 53226 USA. [Weaver, Edward M.] VA Puget Sound Healthcare Syst, Seattle, WA USA. [Weaver, Edward M.] Univ Washington, Dept Otolaryngol Head & Neck Surg, Sch Med, Seattle, WA 98195 USA. [Park, Stephen S.] Univ Virginia Hlth Syst, Dept Otolaryngol, Charlottesville, VA USA. [Baker, Shan R.] Univ Michigan, Ctr Facial Cosmet Surg, Livonia, MI USA. [Hilger, Peter A.] Univ Minnesota, Dept Otolaryngol Head & Neck Surg, Minneapolis, MN USA. [Kriet, J. David] Univ Kansas, Dept Otolaryngol Head & Neck Surg, Kansas City, KS USA. [Murakami, Craig] Virginia Mason Med Ctr, Seattle, WA 98101 USA. [Senior, Brent A.] Univ N Carolina, Div Otolaryngol Head & Neck Surg, Chapel Hill, NC USA. [Rosenfeld, Richard M.] Suny Downstate Med Ctr, Dept Otolaryngol, Brooklyn, NY 11203 USA. [Rosenfeld, Richard M.] Long Isl Coll Hosp, Brooklyn, NY 11201 USA. [DiVittorio, Danielle] Amer Acad Otolaryngol Head & Neck Surg, Alexandria, VA USA. RP Rhee, JS (reprint author), Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, 9200 W Wisconsin Ave, Milwaukee, WI 53226 USA. EM jrhee@mcw.edu FU American Academy of Otolaryngology-Head and Neck Surgery FX Funded by the American Academy of Otolaryngology-Head and Neck Surgery (role: study design and conduct; collection, analysis, and interpretation of the data; and writing or approval of the manuscript.) NR 11 TC 41 Z9 41 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0194-5998 J9 OTOLARYNG HEAD NECK JI Otolaryngol. Head Neck Surg. PD JUL PY 2010 VL 143 IS 1 BP 48 EP 59 DI 10.1016/j.otohns.2010.04.019 PG 12 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 617DW UT WOS:000279262100009 PM 20620619 ER PT J AU Adelstein, EC Shalaby, A Saba, S AF Adelstein, Evan C. Shalaby, Alaa Saba, Samir TI Response to Cardiac Resynchronization Therapy in Patients with Heart Failure and Renal Insufficiency SO PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY LA English DT Article DE cardiac resynchronization; renal insufficiency; heart failure; implantable cardioverter-defibrillator ID GLOMERULAR-FILTRATION-RATE; CARDIOVASCULAR-DISEASE; SERUM CREATININE; MEDICAL THERAPY; COMPANION TRIAL; MORTALITY; DEFIBRILLATOR AB Methods: We analyzed 787 CRT-defibrillator (CRT-D) recipients with a glomerular filtration rate (GFR) measured prior to implant. Patients were grouped by GFR (in mL/min/1.73 m2): >= 60 (n = 376), 30-59 (n = 347), and < 30 (n = 64). Overall survival, changes in left ventricular (LV) ejection fraction and LV end-systolic diameter, and GFR change at 3-6 months were compared among CRT-D groups and with a control cohort (n = 88), also stratified by GFR, in whom LV lead implant was unsuccessful and a standard defibrillator (SD) was placed. All patients met clinical criteria for CRT-D. Results: Among CRT-D recipients, overall survival improved incrementally with higher baseline GFR (for each 10 mL/min/1.73 m2 increase, corrected hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.13-1.30, P < 0.0001). Survival among SD and CRT-D patients within GFR < 30 and GFR >= 60 groups was similar, whereas CRT-D recipients with GFR 30-59 had significantly better survival compared to SD counterparts (HR 2.23, 95% CI 1.34-3.70; P = 0.002). This survival benefit was associated with improved renal and cardiac function. CRT recipients with GFR >= 60 derived significant echocardiographic benefit but experienced a GFR decline, whereas those with GFR < 30 had no echocardiographic benefit but did improve GFR. Conclusions: CRT may provide the largest survival benefit in HF patients with moderate RI, perhaps by improving GFR and LV function. Severe baseline RI predicts poor survival and limited echocardiographic improvement despite a modest GFR increase, such that CRT may not benefit those with GFR < 30 mL/min/1.73 m2. CRT recipients with normal renal function derive echocardiographic benefit but no overall survival advantage. (PACE 2010; 850-859). C1 [Adelstein, Evan C.; Saba, Samir] Univ Pittsburgh, Med Ctr, Electrophysiol Sect, Cardiovasc Inst, Pittsburgh, PA USA. [Shalaby, Alaa] VA Pittsburgh Healthcare Syst, Div Cardiol, Pittsburgh, PA USA. RP Adelstein, EC (reprint author), 200 Lothrop St,PUH B535, Pittsburgh, PA 15213 USA. EM adelsteinec@upmc.edu NR 26 TC 26 Z9 26 U1 0 U2 0 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0147-8389 J9 PACE JI PACE-Pacing Clin. Electrophysiol. PD JUL PY 2010 VL 33 IS 7 BP 850 EP 859 DI 10.1111/j.1540-8159.2010.02705.x PG 10 WC Cardiac & Cardiovascular Systems; Engineering, Biomedical SC Cardiovascular System & Cardiology; Engineering GA 619ST UT WOS:000279451300014 PM 20202138 ER PT J AU Galvin, JE Duda, JE Kaufer, DI Lippa, CF Taylor, A Zarit, SH AF Galvin, James E. Duda, John E. Kaufer, Daniel I. Lippa, Carol F. Taylor, Angela Zarit, Steven H. TI Lewy body dementia: The caregiver experience of clinical care SO PARKINSONISM & RELATED DISORDERS LA English DT Article DE Lewy body dementia; Caregiver experiences; Diagnosis ID GENERAL-PRACTITIONERS; PARKINSONS-DISEASE; ALZHEIMER-DISEASE; BODIES; DIAGNOSIS; MANAGEMENT; CRITERIA; RIVASTIGMINE; DLB AB Background: Lewy body dementia (LBD) is the second most common cause of dementia, however, little is known about how the clinical diagnosis of LBD is obtained in the community or the caregiver experience while seeking the diagnosis. Methods: The Lewy Body Dementia Association (www.LBDA.org) conducted a web-based survey of 962 caregivers over a 6-month period. Results: The mean age of respondents was 55.9y; 88% were female and 64% had daily contact with patients. The mean age of LBD patients was 75.4y; 62% were male and 46% lived with a caregiver. The most common presentation of symptoms as reported by LBD caregivers was cognitive (48%), motor (39%) or both (13%). The first diagnoses given to the patients were Parkinson disease or other movement disorder (39%), Alzheimer disease or other cognitive disorder (36%), or mental illness (24%). Fifty percent of patients saw >3 doctors for more than 10 visits over the course of 1 year before an LBD diagnosis was established. Neurologists diagnosed most cases (62%), while primary care providers diagnosed only 6% of cases. No differences were found between the presentation of disease and the number of physicians, number of office visits, length of time to establish diagnosis, or type of doctor who finally made an LBD diagnosis. Caregivers viewed physicians as knowledgeable about disease manifestations and treatment options, but not about disease course/prognosis and available community resources and referrals. Conclusions: These data highlight a need for increasing physician awareness and knowledge of LBD, which will facilitate accurate diagnosis and treatment. Community resources such as the Lewy Body Dementia Association may serve this end, while also providing practical information and support for caregivers. (C) 2010 Elsevier Ltd. All rights reserved. C1 [Galvin, James E.] NYU, Ctr Excellence Brain Aging, Langone Sch Med, Dept Neurol, New York, NY 10016 USA. [Duda, John E.] Philadelphia VA Med Ctr, PADRECC, Philadelphia, PA USA. [Duda, John E.] Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. [Kaufer, Daniel I.] Univ N Carolina, Dept Neurol, Chapel Hill, NC USA. [Lippa, Carol F.] Drexel Univ, Dept Neurol, Coll Med, Philadelphia, PA 19104 USA. [Taylor, Angela] Lewy Body Dementia Assoc, Atlanta, GA USA. [Zarit, Steven H.] Penn State Univ, Dept Psychol, University Pk, PA 16802 USA. RP Galvin, JE (reprint author), NYU, Ctr Excellence Brain Aging, Langone Sch Med, Dept Neurol, 145 E 32nd St,2nd Floor, New York, NY 10016 USA. EM James.Galvin@nyumc.org FU Lewy Body Dementia Association FX The authors thank the LBD patients and their caregivers for their time in completing this survey. The study was supported by the Lewy Body Dementia Association (www.LBDA.org). NR 21 TC 7 Z9 7 U1 1 U2 9 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1353-8020 J9 PARKINSONISM RELAT D JI Parkinsonism Relat. Disord. PD JUL PY 2010 VL 16 IS 6 BP 388 EP 392 DI 10.1016/j.parkreldis.2010.03.007 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 620TF UT WOS:000279522100006 PM 20434939 ER PT J AU Kim, MM Metlay, J Cohen, A Feldman, H Hennessy, S Kimmel, S Strom, B Doshi, JA AF Kim, Michelle M. Metlay, Joshua Cohen, Abigail Feldman, Harold Hennessy, Sean Kimmel, Stephen Strom, Brian Doshi, Jalpa A. TI Hospitalization costs associated with warfarin-related bleeding events among older community-dwelling adults SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Article DE costs; warfarin; warfarin management; patient safety; adverse events; elderly ID ADVERSE DRUG EVENTS; COMPLICATIONS; CARE; RISK AB Purpose A prior paper from this study demonstrated that patient report of receiving medication instructions from health care professionals is associated with reduced risk of warfarin-related bleeding hospitalizations. The objective of this analysis was to describe the hospitalization costs due to warfarin-related bleeding events in older community-dwelling adults and to estimate the hospitalization costs avoided due to the receipt of medication instruction from different sources. Methods We estimated the expected hospitalization costs associated with four instruction sources based on the respective incidence rate of observed hospitalizations and mean hospitalization cost for warfarin-related bleeding episodes from a prospective cohort study of beneficiaries of the Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PACE). We estimated hospitalization costs avoided due to each instruction source compared to no instructions using the payer's perspective. We conducted probabilistic sensitivity analysis to account for uncertainty in our parameters. Results One hundred twenty-six warfarin-related bleeding hospitalizations occurred during the observation period with a mean cost of $10 819 (SD: $11 536). The mean expected hospitalization cost from a warfarin-related bleeding hospitalization without instruction was $835 per year per person. Hospitalization costs avoided with instruction from a health care professional ranged from $443 to $481 per year per person. Conclusions The costs per hospitalization associated with warfarin-related bleeding events are substantial. Instructions for warfarin management from a health care professional may reduce the number of warfarin-related bleeding hospitalizations and associated costs. Investments in interventions to improve communication regarding warfarin management may be justified economically based on the potential cost savings estimated in this study. Copyright (C) 2010 John Wiley & Sons, Ltd. C1 [Metlay, Joshua; Doshi, Jalpa A.] Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. [Kim, Michelle M.] Univ Penn, Wharton Sch Business, Dept Hlth Care Management, Philadelphia, PA 19104 USA. [Metlay, Joshua; Cohen, Abigail; Feldman, Harold; Hennessy, Sean; Kimmel, Stephen; Strom, Brian] Univ Penn, Sch Med, Dept Biostat & Epidemiol, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. [Metlay, Joshua; Doshi, Jalpa A.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Metlay, Joshua] Ctr Hlth Equ Res & Promot, Dept Vet Affairs, Philadelphia, PA USA. [Cohen, Abigail] Univ Sci Philadelphia, Dept Hlth Policy & Publ Hlth, Philadelphia, PA USA. [Feldman, Harold] Univ Penn, Sch Med, Div Renal Electrolyte & Hypertens, Philadelphia, PA 19104 USA. [Kimmel, Stephen] Univ Penn, Sch Med, Div Cardiovasc Med, Philadelphia, PA 19104 USA. RP Doshi, JA (reprint author), Univ Penn, Sch Med, Div Gen Internal Med, 1222 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM jdoshi@mail.med.upenn.edu RI Cohen, Abigail/K-9180-2013 OI Cohen, Abigail/0000-0002-7425-7218 FU Agency for Healthcare Research and Quality [P01-HS11530]; National Institute of Aging [1R01-AG024451-01] FX This study was supported by grant P01-HS11530 from the Agency for Healthcare Research and Quality and grant 1R01-AG024451-01 from the National Institute of Aging. NR 15 TC 22 Z9 22 U1 0 U2 3 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 JUL PY 2010 VL 19 IS 7 BP 731 EP 736 DI 10.1002/pds.1953 PG 6 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA 626YM UT WOS:000280004500010 PM 20583203 ER PT J AU Maggard, MA Harness, NG Chang, WT Parikh, JA Asch, SM Nuckols, TK AF Maggard, Melinda A. Harness, Neil G. Chang, Walter T. Parikh, Janak A. Asch, Steven M. Nuckols, Teryl K. CA Carpal Tunnel Quality Grp TI Indications for Performing Carpal Tunnel Surgery: Clinical Quality Measures SO PLASTIC AND RECONSTRUCTIVE SURGERY LA English DT Article ID APPROPRIATENESS METHOD; OUTCOMES; RELEASE; CARE; TRIAL; GUIDELINES; SEVERITY; SYMPTOMS; CRITERIA; THERAPY AB Background: Rates of carpal tunnel surgery vary for unclear reasons. In this study, the authors developed measures determining when surgery is necessary (benefits exceed risks), inappropriate (risks outweigh benefits), or optional. Methods: Measures were developed using a modified-Delphi panel. Clinical scenarios were defined incorporating symptom severity, symptom duration, clinical probability of carpal tunnel syndrome, electrodiagnostic testing, and nonoperative treatment response. A multidisciplinary panel of 11 carpal tunnel syndrome experts rated appropriateness of surgery for each scenario on a scale ranging from 1 to 9 scale (7 to 9, surgery is necessary; 1 to 3, surgery is inappropriate). Results: Of 90 scenarios (36 for mild, 36 for moderate, and 18 for severe symptoms), panelists judged carpal tunnel surgery as necessary for 16, inappropriate for 37, and optional for 37 scenarios. For mild symptoms, surgery is generally necessary when clinical probability of carpal tunnel syndrome is high, there is a positive electrodiagnostic test, and there has been unsuccessful nonoperative treatment. For moderate symptoms, surgery is generally necessary with a positive electrodiagnostic test involving two or more of the following: high clinical probability, unsuccessful nonoperative treatment, and symptoms lasting longer than 12 months. Surgery is generally inappropriate for mild to moderate symptoms involving two or more of the following: low clinical probability, no electrodiagnostic confirmation, and nonoperative treatment not attempted. For severe symptoms, surgery is generally necessary with a positive electrodiagnostic test or unsuccessful nonoperative treatment. Conclusions: These are the first formal measures assessing appropriateness of carpal tunnel surgery. Applying these measures can identify underuse (failure to provide necessary care) and overuse (providing inappropriate care), giving insight into variations in receipt of this procedure. (Plast. Reconstr. Surg. 126: 169, 2010.) C1 [Maggard, Melinda A.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA 90095 USA. Olive View UCLA, Sylmar, CA USA. Kaiser Permanente, Fontana Med Ctr, Dept Hand Surg, Fontana, CA USA. Kaiser Permanente, Yorba Linda Med Off, Dept Hand Surg, Yorba Linda, CA USA. RAND Corp, Santa Monica, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Maggard, MA (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, CHS 72-215,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM mmaggard@mednet.ucla.edu FU California Commission on Health and Safety and Workers' Compensation FX This project was supported by equal contributions from the California Commission on Health and Safety and Workers' Compensation, a state-sponsored joint labor/management body charged with overseeing the health and safety and workers' compensation systems in California and recommending administrative or legislative modifications to improve their operation; and from Zenith Insurance, a workers' compensation insurance company based in Woodland Hills, California. The funders played no role in the design, execution, or reporting of the study. NR 41 TC 12 Z9 13 U1 2 U2 8 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 JUL PY 2010 VL 126 IS 1 BP 169 EP 179 DI 10.1097/PRS.0b013e3181da8685 PG 11 WC Surgery SC Surgery GA 614ZD UT WOS:000279097500021 PM 20595866 ER PT J AU Buchholz, JR Malte, CA Calsyn, DA Baer, JS Nichol, P Kivlahan, DR Caldeiro, RM Saxon, AJ AF Buchholz, Jonathan R. Malte, Carol A. Calsyn, Donald A. Baer, John S. Nichol, Paul Kivlahan, Daniel R. Caldeiro, Ryan M. Saxon, Andrew J. TI Associations of Housing Status With Substance Abuse Treatment and Service Use Outcomes Among Veterans SO PSYCHIATRIC SERVICES LA English DT Article ID ADDICTION SEVERITY INDEX; HOMELESS PERSONS; RANDOMIZED-TRIAL; DISORDERS; ALCOHOL; CARE AB Objective: This secondary analysis evaluated the prevalence and stability of homelessness over one year among veterans entering substance abuse treatment and explored associations among housing status, treatment outcomes, and Veterans Affairs (VA) service utilization. Methods: Participants in a trial of on-site primary care for veterans entering substance abuse treatment (N=622) were placed in four groups based on housing status: housed at baseline and final follow-up (41%), homeless at baseline and final follow-up (27%), housed at baseline but homeless at final follow-up (8%), and homeless at baseline but housed at final follow-up (24%). Groups were compared on treatment retention, changes in Addiction Severity Index (ASI) composite scores, and VA service utilization and costs. Results: Treatment retention and changes in ASI alcohol composites did not differ between groups. Compared with scores in the consistently housed group, the ASI drug composites improved less over time in the consistently homeless group (p=.031) and the ASI psychiatric composites improved less in the group housed at baseline and homeless at final follow-up (p=.019). All homeless groups were more likely than the consistently housed group to have inpatient admissions and incurred higher total treatment costs. The consistently homeless group was more likely to use emergency care than the consistently housed group. Conclusions: Homelessness affects substance abuse treatment outcomes and costs. Interventions are needed to reduce homelessness among veterans entering substance abuse treatment. (Psychiatric Services 61: 698-706, 2010) C1 [Malte, Carol A.; Baer, John S.; Kivlahan, Daniel R.; Saxon, Andrew J.] VA Puget Sound Hlth Care Syst, VA Ctr Excellence Subst Abuse Treatment & Educ, Seattle, WA 98108 USA. [Buchholz, Jonathan R.] US Dept Vet Affairs, VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Baer, John S.] Univ Washington, Dept Psychol, Seattle, WA 98195 USA. [Kivlahan, Daniel R.; Saxon, Andrew J.] Univ Washington, Dept Psychiat & Behav Sci, Sch Med, Seattle, WA 98195 USA. [Calsyn, Donald A.; Caldeiro, Ryan M.] Grp Hlth Cooperat Puget Sound, Seattle, WA USA. [Nichol, Paul] Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. RP Malte, CA (reprint author), VA Puget Sound Hlth Care Syst, VA Ctr Excellence Subst Abuse Treatment & Educ, 1660 S Columbian Way,MS S-116-ATC, Seattle, WA 98108 USA. EM carol.malte@va.gov FU Health Services Research and Development, U.S. Department of Veterans Affairs [SUI 99-109-1]; Center of Excellence in Substance Abuse Treatment and Education at VA Puget Sound Health Care System, Seattle; Ortho-McNeil Janssen; Titan Pharmaceuticals; U.S. World Meds FX This study was based on work supported by grant SUI 99-109-1 from Health Services Research and Development, U.S. Department of Veterans Affairs, and by the Center of Excellence in Substance Abuse Treatment and Education at VA Puget Sound Health Care System, Seattle.; Dr. Saxon has worked as a consultant to Reckitt Benckiser Pharmaceuticals and received research support from Ortho-McNeil Janssen, Titan Pharmaceuticals, and U.S. World Meds, as well as honoraria from Forest Pharmaceuticals, Alkermes, and Cephalon. The other authors report no competing interests. NR 32 TC 19 Z9 19 U1 0 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 JUL PY 2010 VL 61 IS 7 BP 698 EP 706 PG 9 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 618YV UT WOS:000279393200013 PM 20592005 ER PT J AU Kasckow, J Brown, C Morse, JQ Karpov, I Bensasi, S Thomas, SB Ford, A Reynolds, C AF Kasckow, John Brown, Charlotte Morse, Jennifer Q. Karpov, Irina Bensasi, Salem Thomas, Stephen B. Ford, Angela Reynolds, Charles TI Racial Preferences for Participation in a Depression Prevention Trial Involving Problem-Solving Therapy SO PSYCHIATRIC SERVICES LA English DT Article ID PRIMARY-CARE PATIENTS; AFRICAN-AMERICANS; OLDER AB Objectives: This study compared African Americans' and Caucasians' willingness to participate in an indicated intervention to prevent depression with problem-solving therapy. It also examined participants' problem-solving skills. Hypotheses stated that there would be no racial differences in consent rates and that social problem-solving coping skills would be lower among African Americans than Caucasians. Methods: Proportions of African Americans and Caucasians who consented were compared, as were Social Problem Solving Inventory scores between the groups. Results: Of 2,788 individuals approached, 82 (4%) of 1,970 Caucasians and 46 (6%) of 818 African Americans signed consent, and the difference was not significant (p=.09). Racial differences were observed in neither Social Problem Solving Inventory scores nor in the relationship between problem-solving skills and depressive symptoms. Conclusions: African Americans with depression demonstrated a willingness to participate in an indicated trial of depression prevention. Furthermore, both groups would appear to benefit from the problem-solving process. (Psychiatric Services 61: 722-724, 2010) C1 [Kasckow, John] Pittsburgh Hlth Care Syst, US Dept Vet Affairs, Dept Behav Hlth, Pittsburgh, PA 15206 USA. [Brown, Charlotte; Morse, Jennifer Q.; Karpov, Irina; Bensasi, Salem; Reynolds, Charles] Univ Pittsburgh, Western Psychiat Inst & Clin, Med Ctr, Pittsburgh, PA 15213 USA. [Thomas, Stephen B.; Ford, Angela] Univ Pittsburgh, Grad Sch Publ Hlth, Med Ctr, Pittsburgh, PA 15213 USA. RP Kasckow, J (reprint author), Pittsburgh Hlth Care Syst, US Dept Vet Affairs, Dept Behav Hlth, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM kasckowjw@upmc.edu FU National Center on Minority Health and Health Disparities [P60-MD000107]; National Institute of Mental Health [P30-MH71944, NIMH 6398-01, 2P60-MD000207-07] FX This work was supported primarily by grant P60-MD000107 from the National Center on Minority Health and Health Disparities and by grants P30-MH71944, NIMH 6398-01, and 2P60-MD000207-07 from the National Institute of Mental Health. NR 10 TC 4 Z9 4 U1 0 U2 2 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 JUL PY 2010 VL 61 IS 7 BP 722 EP 724 PG 3 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 618YV UT WOS:000279393200017 PM 20592009 ER PT J AU Ganzini, L Socherman, R Duckart, J Shores, M AF Ganzini, Linda Socherman, Robert Duckart, Jonathan Shores, Molly TI End-of-Life Care for Veterans With Schizophrenia and Cancer SO PSYCHIATRIC SERVICES LA English DT Article ID SERIOUS MENTAL-ILLNESS AB Objective: This study compared the quality of end-of-life care between veterans with and without schizophrenia who died of cancer in the northwestern United States. Methods: In this cross-sectional study, medical records of 60 veterans with schizophrenia and 196 with no major mental illness who died of cancer were compared on hospice enrollment, palliative and life-sustaining interventions, advance directives, and site of death. Results: Among veterans with schizophrenia, 58% had an advance directive, 73% received an opiate before hospice enrollment, 63% had a physician order to forgo cardiopulmonary resuscitation, 55% were hospice enrolled, and 27% died in the hospital. Schizophrenia patients had longer hospice stays (107 +/- 144 versus 63 +/- 96 days, p=.05) and more physician orders for life-sustaining treatment (15% versus 5%, p=.006) compared with veterans without mental illness. Conclusions: On most measures, veterans with schizophrenia who died of cancer received comparable or better end-of-life care than veterans without mental illness. (Psychiatric Services 61: 725-728, 2010) C1 [Ganzini, Linda] Vet Adm Med Ctr, Div Mental Hlth, Portland, OR 97207 USA. [Shores, Molly] VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. RP Ganzini, L (reprint author), Vet Adm Med Ctr, Div Mental Hlth, R&D 66,POB 1034, Portland, OR 97207 USA. EM linda.ganzini@va.gov FU VA Health Services Research and Development FX This study was supported in part by the VA Health Services Research and Development Research Enhancement Award Program, Portland, Oregon. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the VA or the U.S. government. NR 13 TC 10 Z9 10 U1 0 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 JUL PY 2010 VL 61 IS 7 BP 725 EP 728 PG 4 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 618YV UT WOS:000279393200018 PM 20592010 ER PT J AU McDermott, MJ Tull, MT Soenke, M Jakupcak, M Gratz, KL AF McDermott, Michael J. Tull, Matthew T. Soenke, Melissa Jakupcak, Matthew Gratz, Kim L. TI Masculine Gender Role Stress and Posttraumatic Stress Disorder Symptom Severity Among Inpatient Male Crack/Cocaine Users SO PSYCHOLOGY OF MEN & MASCULINITY LA English DT Article DE masculine gender role stress; masculinity; posttraumatic stress disorder; risk factor; vulnerability ID ADMINISTERED PTSD SCALE; PSYCHOMETRIC PROPERTIES; INTERPERSONAL VIOLENCE; THOUGHT SUPPRESSION; ANXIETY SENSITIVITY; RACIAL IDENTITY; ROLE CONFLICT; MEN; METAANALYSIS; PREDICTORS AB This study examined the association between masculine gender role stress (MGRS) and posttraumatic stress disorder (PTSD) symptom severity, above and beyond other factors previously found to be associated with PTSD symptoms (e.g., anxiety sensitivity and thought suppression) among 33 crack/cocaine-dependent patients in residential substance abuse treatment. Participants completed a series of questionnaires and were interviewed to determine current PTSD symptom severity. MGRS accounted for a significant amount of additional variance in PTSD symptom severity above and beyond other identified risk factors for PTSD. Results are discussed in terms of their implications for reducing PTSD risk among men following exposure to a potentially traumatic event. C1 [McDermott, Michael J.; Tull, Matthew T.; Soenke, Melissa; Gratz, Kim L.] Univ Mississippi, Med Ctr, Dept Psychiat & Human Behav, Jackson, MS 39216 USA. [Jakupcak, Matthew] VA Puget Sound Hlth Care Syst, MIRECC, Seattle, WA USA. [Jakupcak, Matthew] Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Tull, MT (reprint author), Univ Mississippi, Med Ctr, Dept Psychiat & Human Behav, 2500 N State St, Jackson, MS 39216 USA. EM mtull@psychiatry.umsmed.edu NR 53 TC 8 Z9 8 U1 5 U2 10 PU EDUCATIONAL PUBLISHING FOUNDATION PI WASHINGTON PA 750 FIRST ST, NE, WASHINGTON, DC 20002-4242 USA SN 1524-9220 J9 PSYCHOL MEN MASCULIN JI Psychol. Men Masculinity PD JUL PY 2010 VL 11 IS 3 BP 225 EP 232 DI 10.1037/a0016671 PG 8 WC Psychology, Social SC Psychology GA 626VG UT WOS:000279994800007 ER PT J AU McCollister, DH Beutz, M McLaughlin, V Rumsfeld, J Masoudi, FA Tripputi, M Yaeger, T Weintraub, P Badesch, DB AF McCollister, Deborah H. Beutz, Michelle McLaughlin, Vallerie Rumsfeld, John Masoudi, Frederick A. Tripputi, Mark Yaeger, Thomas Weintraub, Philippe Badesch, David B. TI Depressive Symptoms in Pulmonary Arterial Hypertension: Prevalence and Association With Functional Status SO PSYCHOSOMATICS LA English DT Article ID CONTINUOUS INTRAVENOUS EPOPROSTENOL; BRAIN NATRIURETIC PEPTIDE; QUALITY-OF-LIFE; PLASMA SEROTONIN; CONTROLLED-TRIAL; HEART-FAILURE; 6-MINUTE WALK; DOUBLE-BLIND; THERAPY; DISEASE AB Background: In patients with left-heart disease, depressive symptoms have a significant impact on functional status and quality of life. The prevalence of depressive symptoms, and their impact on patients with pulmonary arterial hypertension (PAH) is understudied. Objective: The authors investigated the prevalence of depressive symptoms in PAH and their correlation with physical functioning. Method: Consecutive outpatients with PAH ( idiopathic; or associated with scleroderma, congenital heart disease, or anorexiant use) seen in two university PAH clinics were screened. At two outpatient visits, 8 to 16 weeks apart, patients completed the PHQ-8, a well-validated instrument for grading severity of depressive symptoms; they were assessed for cardiac functional class (FC), and performed a 6-minute walk-distance test (6MWD). Results: A group of 100 patients (88% women, 50% with idiopathic PAH) were enrolled. At baseline, 15% of subjects had symptoms suggestive of major depressive disorder; 40% had mild-to-moderate depressive symptoms; and 45% had no-to-minimal depressive symptoms. Conclusion: Depression is common in patients with PAH, with 55% demonstrating depressive symptoms. These results suggest that screening patients with PAH will identify a large proportion of patients who might benefit from depression therapy. (Psychosomatics 2010; 51:339-339.e8) C1 [McCollister, Deborah H.] Univ Colorado Denver, Pulm Hypertens Ctr, Aurora, CO 80045 USA. Natl Jewish Hlth, Denver, CO USA. Univ Michigan, Ann Arbor, MI 48109 USA. Denver VA Hosp, Denver, CO USA. Denver Hlth Med Ctr, Denver, CO USA. RP McCollister, DH (reprint author), Univ Colorado Denver, Pulm Hypertens Ctr, 12401 E 17th Ave,Box L957, Aurora, CO 80045 USA. EM Deb.McCollister@ucdenver.edu FU Actelion, Inc.; University of Colorado Denver; University of Michigan; Actelion/CoTherix; Gilead/Myogen; Encysive; Pfizer; MondoBiotech/mondoGEN; United Therapeutics/Lung Rx; GlaxoSmithKline; Lilly/ICOS; Bayer FX This study was funded by an Investigator-Initiated Proposal by Actelion, Inc., in the form of a grant to the University of Colorado Denver and the University of Michigan. Dr. Badesch has received honoraria for service on steering committees and advisory boards from Actelion/CoTherix, Gilead/Myogen, Encysive, Pfizer, MondoBiotech/mondoGEN, United Therapeutics/Lung Rx, GlaxoSmithKline, Lilly/ICOS, and Bayer. The work was conducted independently, without direction from the sponsor. NR 45 TC 29 Z9 32 U1 1 U2 4 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0033-3182 J9 PSYCHOSOMATICS JI Psychosomatics PD JUL-AUG PY 2010 VL 51 IS 4 BP 339 EP U81 PG 9 WC Psychiatry; Psychology SC Psychiatry; Psychology GA 617YK UT WOS:000279317600010 PM 20587763 ER PT J AU Loftis, JM Turner, EH AF Loftis, Jennifer M. Turner, Erick H. TI Novel Treatment Strategies for Depression in Patients With Hepatitis C SO PSYCHOSOMATICS LA English DT Letter ID INTERFERON-INDUCED DEPRESSION; 5-HYDROXYTRYPTOPHAN; SEROTONIN C1 [Loftis, Jennifer M.; Turner, Erick H.] Oregon Hlth & Sci Univ, Dept Psychiat, Portland VA Med Ctr, Div Mental Hlth & Clin Neurosci, Portland, OR 97201 USA. RP Loftis, JM (reprint author), Oregon Hlth & Sci Univ, Dept Psychiat, Portland VA Med Ctr, Div Mental Hlth & Clin Neurosci, Portland, OR 97201 USA. NR 5 TC 4 Z9 4 U1 0 U2 1 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0033-3182 J9 PSYCHOSOMATICS JI Psychosomatics PD JUL-AUG PY 2010 VL 51 IS 4 BP 357 EP 358 PG 2 WC Psychiatry; Psychology SC Psychiatry; Psychology GA 617YK UT WOS:000279317600016 PM 20587769 ER PT J AU Sawyer, AM Deatrick, JA Kuna, ST Weaver, TE AF Sawyer, Amy M. Deatrick, Janet A. Kuna, Samuel T. Weaver, Terri E. TI Differences in Perceptions of the Diagnosis and Treatment of Obstructive Sleep Apnea and Continuous Positive Airway Pressure Therapy Among Adherers and Nonadherers SO QUALITATIVE HEALTH RESEARCH LA English DT Article DE adherence; compliance; content analysis; decision making; health behavior; mixed methods; sleep disorders; social cognitive theory ID LONG-TERM COMPLIANCE; QUALITATIVE CONTENT-ANALYSIS; CPAP THERAPY; NASAL CPAP; APNOEA/HYPOPNOEA SYNDROME; APNEA/HYPOPNEA SYNDROME; BREATHING DISORDERS; PATIENT COMPLIANCE; SELF-EFFICACY; ADULTS AB Obstructive sleep apnea (OSA) patients' consistent use of continuous positive airway pressure (CPAP) therapy is critical to realizing improved functional outcomes and reducing untoward health risks associated with OSA. We conducted a mixed methods, concurrent, nested study to explore OSA patients' beliefs and perceptions of the diagnosis and CPAP treatment that differentiate adherent from nonadherent patients prior to and after the first week of treatment, when the pattern of CPAP use is established. Guided by social cognitive theory, themes were derived from 30 interviews conducted postdiagnosis and after 1 week of CPAP use. Directed content analysis, followed by categorization of participants as adherent/nonadherent from objectively measured CPAP use, preceded across-case analysis among 15 participants with severe OSA. Beliefs and perceptions that differed between adherers and nonadherers included OSA risk perception, symptom recognition, self-efficacy, outcome expectations, treatment goals, and treatment facilitators/barriers. Our findings suggest opportunities for developing and testing tailored interventions to promote CPAP use. C1 [Sawyer, Amy M.; Deatrick, Janet A.] Univ Penn, Sch Nursing, Ctr Hlth Equ Res, Philadelphia, PA 19104 USA. [Weaver, Terri E.] Univ Penn, Sch Nursing, Biobehav Res Ctr, Philadelphia, PA 19104 USA. [Kuna, Samuel T.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. [Weaver, Terri E.] Univ Penn, Sch Nursing, Biobehav Hlth Sci Div, Philadelphia, PA 19104 USA. [Kuna, Samuel T.] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Sawyer, AM (reprint author), Univ Penn, Sch Nursing, Ctr Hlth Equ Res, Claire M Fagin Hall,307B,418 Curie Blvd, Philadelphia, PA 19104 USA. EM asawyer@nursing.upenn.edu FU NINR NIH HHS [F31 NR009315, F31 NR009315-01, F31NR9315] NR 62 TC 23 Z9 24 U1 1 U2 8 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1049-7323 J9 QUAL HEALTH RES JI Qual. Health Res. PD JUL PY 2010 VL 20 IS 7 BP 873 EP 892 DI 10.1177/1049732310365502 PG 20 WC Information Science & Library Science; Social Sciences, Interdisciplinary; Social Sciences, Biomedical SC Information Science & Library Science; Social Sciences - Other Topics; Biomedical Social Sciences GA 610SV UT WOS:000278757400002 PM 20354236 ER PT J AU Young, AS Niv, N Cohen, AN Kessler, C McNagny, K AF Young, Alexander S. Niv, Noosha Cohen, Amy N. Kessler, Christopher McNagny, Kirk TI The Appropriateness of Routine Medication Treatment for Schizophrenia SO SCHIZOPHRENIA BULLETIN LA English DT Article DE antipsychotics; community mental health; drug side effects; quality measurement; health service research; quality of care; weight management ID INDUCED WEIGHT-GAIN; RESEARCH-TEAM PORT; ANTIPSYCHOTIC MEDICATIONS; TREATMENT RECOMMENDATIONS; ATYPICAL ANTIPSYCHOTICS; TARDIVE-DYSKINESIA; QUALITY-ASSURANCE; CONTROLLED-TRIAL; MENTAL-HEALTH; RATING-SCALE AB Objective: Although national guidelines specify appropriate strategies for the treatment of schizophrenia, this disorder presents challenges to clinicians and health-care organizations. To improve care, it is useful to understand how often patients receive appropriate treatment. Most research evaluating treatment was performed when first-generation antipsychotic medications were the modal treatment. Given that most prescriptions are now for second-generation medications, this study describes current clinical problems and the appropriateness of treatment in routine practice. Method: Between 2002 and 2004, a random sample of patients (n = 398) were interviewed at baseline and 1 year at 3 Department of Veterans Affairs mental health clinics. Symptoms and side effects were assessed. Analyses examined whether prescribing were consistent with guidelines in patients with significant psychosis, depression, parkinsonism, akathisia, tardive dyskinesia, or elevated weight. Results: Few patients met criteria for depression, parkinsonism, or akathisia. A total of 44% of patients had significant psychosis, 11% had tardive dyskinesia, and 46% were overweight. Medication was appropriate in 27% of patients with psychosis, 25% of patients with tardive dyskinesia, and 2% of patients with elevated weight. Management of elevated weight improved modestly over time. Treatment was more likely to improve for patients whose psychiatrists had more than 12 patients with schizophrenia in their caseload. Conclusion: Compared with the 1990s, outpatients are more likely to have significant psychosis. The rate of appropriate treatment of psychosis is unchanged. Weight gain has become a prevalent side effect, yet treatment is rarely changed in response to weight. There is a need for interventions that improve management of psychosis and weight. C1 [Young, Alexander S.; Niv, Noosha; Cohen, Amy N.] Desert Pacific Mental Illness Res Educ & Clin Ctr, Dept Vet Affairs, Los Angeles, CA USA. [Young, Alexander S.; Niv, Noosha; Kessler, Christopher] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90073 USA. [Kessler, Christopher] Greater Los Angeles VA Healthcare Ctr, Los Angeles, CA USA. [McNagny, Kirk] Long Beach Vet Affairs Healthcare, Long Beach, CA USA. RP Young, AS (reprint author), W Los Angeles Vet Affairs Healthcare Ctr, 11301 Wilshire Blvd 210A, Los Angeles, CA 90073 USA. EM ayoung@ucla.edu RI Young, Alexander/A-1523-2009 OI Young, Alexander/0000-0002-9367-9213 FU Department of Veterans Affairs, Veterans Health Administration through the Office of Research and Development Health Services Research and Development Service [RCD 00-033, CPI 99-383, MNT 03-213]; Desert Pacific Mental Illness Research, Education and Clinical Center, Los Angeles, CA; National Institute of Mental Health UCLA-RAND Center for Research on Quality in Managed Care, Los Angeles, CA [MH 068639] FX Department of Veterans Affairs, Veterans Health Administration through the Office of Research and Development Health Services Research and Development Service (RCD 00-033, CPI 99-383, MNT 03-213), and the Desert Pacific Mental Illness Research, Education and Clinical Center, Los Angeles, CA; and by the National Institute of Mental Health UCLA-RAND Center for Research on Quality in Managed Care, Los Angeles, CA (MH 068639). NR 52 TC 10 Z9 10 U1 1 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 JUL PY 2010 VL 36 IS 4 BP 732 EP 739 DI 10.1093/schbul/sbn138 PG 8 WC Psychiatry SC Psychiatry GA 620DO UT WOS:000279479400011 PM 18997159 ER PT J AU Fisher, M Holland, C Subramaniam, K Vinogradov, S AF Fisher, Melissa Holland, Christine Subramaniam, Karuna Vinogradov, Sophia TI Neuroplasticity-Based Cognitive Training in Schizophrenia: An Interim Report on the Effects 6 Months Later SO SCHIZOPHRENIA BULLETIN LA English DT Article DE schizophrenia; cognitive remediation; neuroplasticity; durability ID RANDOMIZED CONTROLLED-TRIAL; QUALITY-OF-LIFE; VOCATIONAL-REHABILITATION; SUPPORTED EMPLOYMENT; ENHANCEMENT THERAPY; REMEDIATION THERAPY; PERFORMANCE; MISMATCH; DEFICITS; FMRI AB Background: New cognitive treatments for schizophrenia are needed that drive persistent gains in cognition and functioning. Using an innovative neuroplasticity-based cognitive training approach, we report our interim findings on the effects on cognition and functional outcome at 6 months after treatment. Methods: Thirty-two clinically stable schizophrenia subjects were randomly assigned to either targeted cognitive training (TCT, N = 22) or a computer games (CGs) control condition (N = 10). Twelve TCT subjects completed 50 hours of auditory based training; 10 TCT subjects completed an additional 50 hours of training targeting visual and cognitive control processes. Subjects were assessed on neurocognition and functional outcome after training and at 6-month follow-up. Results: Both TCT subject groups showed significant durable gains at 6 months on measures of verbal learning/memory and cognitive control. Only TCT subjects who completed 100 hours of training showed durable gains on processing speed and global cognition, with nonsignificant improvement in functional outcome. Improved cognition was significantly associated with improved functional outcome at 6 months for TCT subjects. Conclusions: A total of 50 hours of neuroplasticity-based computerized cognitive training appears sufficient to drive improvements in verbal learning/memory and cognitive control that endure 6 months beyond the intervention, but a higher "dose" and more "broad-spectrum" training may be necessary to drive enduring gains in processing speed and global cognition. Training-induced cognitive improvement is related to enhanced functioning at 6 months. These data suggest that (1) higher and "broader" doses of cognitive training may confer the most benefits for schizophrenia patients; (2) the posttraining period opens a critical window for aggressive adjunctive psychosocial rehabilitation. C1 [Fisher, Melissa; Holland, Christine; Subramaniam, Karuna; Vinogradov, Sophia] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94121 USA. [Fisher, Melissa; Holland, Christine; Subramaniam, Karuna; Vinogradov, Sophia] San Francisco VA Med Ctr, San Francisco, CA 94121 USA. RP Vinogradov, S (reprint author), Univ Calif San Francisco, Dept Psychiat, Mail Code 116C,4150 Clement St, San Francisco, CA 94121 USA. EM Sophia.Vinogradov@ucsf.edu FU National Institute of Mental Health [MH068725-01A1]; National Institutes of Health [1 R42 MH073358-01]; San Francisco Veterans Affairs Medical Center FX National Institute of Mental Health (RO1 grant MH068725-01A1); National Institutes of Health (STTR grant 1 R42 MH073358-01); San Francisco Veterans Affairs Medical Center. The training software used in this study and all technical support were provided to us free of charge by PositScience, Inc. All authors of this study report no conflicts of interest. The National Institute of Mental Health, National Institutes of Health, San Francisco Veterans Affairs Medical Center, and PositScience, Inc. had no further role in study design; collection, analysis, and interpretation of data; writing of the report; and decision to submit the article for publication. NR 46 TC 73 Z9 74 U1 9 U2 33 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD JUL PY 2010 VL 36 IS 4 BP 869 EP 879 DI 10.1093/schbul/sbn170 PG 11 WC Psychiatry SC Psychiatry GA 620DO UT WOS:000279479400024 PM 19269924 ER PT J AU Jimenez-Castro, L Hare, E Medina, R Raventos, H Nicolini, H Mendoza, R Ontiveros, A Jerez, A Munoz, R Dassori, A Escamilla, M AF Jimenez-Castro, Lorena Hare, Elizabeth Medina, Rolando Raventos, Henriette Nicolini, Humberto Mendoza, Ricardo Ontiveros, Alfonso Jerez, Alvaro Munoz, Rodrigo Dassori, Albana Escamilla, Michael TI Substance use disorder comorbidity with schizophrenia in families of Mexican and Central American Ancestry SO SCHIZOPHRENIA RESEARCH LA English DT Article DE Alcohol; Drug abuse; Substance misuse; Dual diagnosis; Schizophrenia; Latino populations ID NATIONAL EPIDEMIOLOGIC SURVEY; IV PSYCHIATRIC-DISORDERS; SEVERE MENTAL-ILLNESS; GENERAL-POPULATION; LIFETIME PREVALENCE; UNITED-STATES; DRUG-ABUSE; PSYCHOTIC DISORDERS; SURVEY REPLICATION; ALCOHOL AB Objectives: The aims of this study were to estimate the frequency and course of substances use disorders in Latino patients with schizophrenia and to ascertain risk factors associated with substance use disorders in this population. Method: We studied 518 subjects with schizophrenia recruited for a genetic study from the Southwest United States, Mexico, and Central America (Costa Rica and Guatemala). Subjects were assessed using structured interviews and a best estimate consensus process. Logistic regression, chi(2), t test, Fisher's exact test, and Yates' correction, as appropriate, were performed to assess the sociodemographic variables associated with dual diagnosis. We defined substance use disorder as either alcohol or substance abuse or dependence. Results: Out of 518 patients with schizophrenia, 121 (23.4%) had substance use disorders. Comorbid substance use disorders were associated with male gender, residence in the United States, immigration of Mexican men to the United States, history of depressive syndrome or episode, and being unemployed. The most frequent substance use disorder was alcohol abuse/dependence, followed by marijuana abuse/dependence, and solvent abuse/dependence. Conclusion: This study provides data suggesting that depressive episode or syndrome, unemployment, male gender, and immigration of Mexican men to the United States were factors associated with substance use disorder comorbidity in schizophrenia. Binary logistic regression showed that country of residence was associated with substance use disorder in schizophrenic patients. The percentage of subjects with comorbid substance use disorders was higher in the Latinos living in the United States compared with subjects living in Central America and Mexico. (C) 2010 Published by Elsevier B.V. C1 [Hare, Elizabeth; Escamilla, Michael] Texas Tech Univ, Hlth Sci Ctr, Paul L Foster Sch Med, Neurosci Ctr Excellence, El Paso, TX 79905 USA. [Jimenez-Castro, Lorena; Hare, Elizabeth; Medina, Rolando; Escamilla, Michael] Texas Tech Univ, Hlth Sci Ctr, Paul L Foster Sch Med, S Texas Psychiat Genet Res Ctr, San Antonio, TX USA. [Jimenez-Castro, Lorena; Raventos, Henriette] Univ Costa Rica, Ctr Invest Biol Mol & Celular, San Jose, Costa Rica. [Medina, Rolando; Dassori, Albana] S Texas Vet Hlth Syst, Dept Psychiat, San Antonio, TX USA. [Nicolini, Humberto] Grp Estudios Med & Familiares Carraci SC, Mexico City, DF, Mexico. [Mendoza, Ricardo] Univ Calif Los Angeles, Los Angeles Med Ctr, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. [Ontiveros, Alfonso] Inst Informac & Invest Salud Mental, Monterrey, Mexico. [Jerez, Alvaro] Ctr Invest Biomed, Guatemala City, Guatemala. [Munoz, Rodrigo] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. [Escamilla, Michael] Texas Tech Univ, Hlth Sci Ctr, Paul L Foster Sch Med, Dept Psychiat, El Paso, TX 79905 USA. RP Escamilla, M (reprint author), Texas Tech Univ, Hlth Sci Ctr, Paul L Foster Sch Med, Neurosci Ctr Excellence, 5001 El Paso Dr, El Paso, TX 79905 USA. EM m.escamilla@ttuhsc.edu OI Nicolini, Humberto/0000-0003-2494-0067; Raventos, Henriette/0000-0001-9423-8308; Jerez Magana, Alvaro Antonio/0000-0002-1208-3769 FU National Institute of Mental Health [MH60881, MH60875, D43 TW06152-01]; National Institute of Drug Abuse; Fogarty Institute FX This research was supported by the following grants from the National Institute of Mental Health: MH60881 and MH60875. Dr Jimenez-Castro was supported by a fellowship of grant D43 TW06152-01 from the National Institute of Mental Health, the National Institute of Drug Abuse and the Fogarty Institute. These institutions had no further role in the study design, in the collection, analysis and interpretation of data, in writing of the report, and in the decision to submit the paper for publication. NR 46 TC 6 Z9 6 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 EI 1573-2509 J9 SCHIZOPHR RES JI Schizophr. Res. PD JUL PY 2010 VL 120 IS 1-3 BP 87 EP 94 DI 10.1016/j.schres.2010.02.1053 PG 8 WC Psychiatry SC Psychiatry GA 636IO UT WOS:000280725500013 PM 20303714 ER PT J AU Wang, Y Wang, JD Wu, HR Zhang, BS Fang, H Ma, QM Liu, H Chen, DC Xiu, MH Hail, CN Kosten, TR Zhang, XY AF Wang, Yu Wang, Jiang Dong Wu, Hao Ran Zhang, Ben Shu Fang, Hui Ma, Qi Min Liu, Hong Chen, Da Chun Xiu, Mei Hong Hail, Colin N. Kosten, Thomas R. Zhang, Xiang Yang TI The Val66Met polymorphism of the brain-derived neurotrophic factor gene is not associated with risk for schizophrenia and tardive dyskinesia in Han Chinese population SO SCHIZOPHRENIA RESEARCH LA English DT Letter ID BDNF VAL66MET C1 [Wang, Yu; Zhang, Ben Shu; Liu, Hong] Tianjin Med Univ, Gen Hosp, Dept Neurol, Tianjin 300052, Peoples R China. [Wang, Jiang Dong; Fang, Hui] Hebei Med Univ, Dept Endocrinol 2, Tangshan Gongren Hosp, Tangshan 06300, Peoples R China. [Wang, Jiang Dong; Fang, Hui] Hebei Med Univ, Dept Endocrinol, Shijiazhuang 050017, Peoples R China. [Wu, Hao Ran; Ma, Qi Min] Rongjun Hosp Hebei Prov, Baoding 071000, Peoples R China. [Chen, Da Chun; Xiu, Mei Hong; Zhang, Xiang Yang] Beijing HuiLongGuan Hosp, Ctr Biol Psychiat, Beijing 100096, Peoples R China. [Hail, Colin N.; Kosten, Thomas R.; Zhang, Xiang Yang] Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. RP Kosten, TR (reprint author), VA Med Ctr, Res Bldg 110,Room 229,2002 Holcombe Blvd, Houston, TX 77030 USA. EM kosten@bcm.edu; xyzhang@bcm.edu NR 11 TC 8 Z9 10 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 JUL PY 2010 VL 120 IS 1-3 BP 240 EP 242 DI 10.1016/j.schres.2010.03.020 PG 3 WC Psychiatry SC Psychiatry GA 636IO UT WOS:000280725500038 PM 20395113 ER PT J AU Segura-Orti, E Johansen, KL AF Segura-Orti, Eva Johansen, Kirsten L. TI Exercise in End-Stage Renal Disease SO SEMINARS IN DIALYSIS LA English DT Article ID QUALITY-OF-LIFE; MAINTENANCE HEMODIALYSIS-PATIENTS; WEIGHT-LOSS; PHYSICAL FUNCTION; DIALYSIS PATIENTS; AEROBIC CAPACITY; CONTROLLED-TRIAL; MUSCLE STRENGTH; KIDNEY-DISEASE; HEALTH-STATUS AB This article will outline the clinical reasoning for exercise counseling in end-stage renal disease (ESRD) patients and give healthcare providers detailed information on the different programs that can be implemented in this population according to patients' specific needs. End-stage renal disease patients often have other health problems that can be improved by participation in regular exercise programs. Research accumulated during the last 30 years on exercise for the ESRD population supports its numerous beneficial effects including those on cardiovascular capacity, sarcopenia, and health-related quality of life. We describe the different types of exercise, aerobic and resistance programs (including their frequency, intensity and progression) that are recommended for the ESRD population, as well as the potential goals of each program. Groups with special needs among the ESRD population are considered, as well as safety, potential adverse events, and adherence to exercise programs. Finally, recommendations for future researches are highlighted. C1 [Segura-Orti, Eva] Univ CEU Cardenal Herrera, Dept Phys Therapy, Valencia, Spain. [Johansen, Kirsten L.] Univ Calif San Francisco, Dept Med, San Francisco, CA USA. [Johansen, Kirsten L.] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. [Johansen, Kirsten L.] San Francisco VA Med Ctr, Nephrol Sect, San Francisco, CA USA. RP Segura-Orti, E (reprint author), Univ CEU Cardenal Herrera, Dept Phys Therapy, Valencia, Spain. EM eva.segura@gmail.com FU CEU-Banco Santander; Universidad CEU-Cardenal Herrera FX E. Segura-Orti is supported by the "5th Edition of research fellowships CEU-Banco Santander" and by the Universidad CEU-Cardenal Herrera. NR 52 TC 14 Z9 17 U1 3 U2 11 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0894-0959 J9 SEMIN DIALYSIS JI Semin. Dial. PD JUL-AUG PY 2010 VL 23 IS 4 BP 422 EP 430 DI 10.1111/j.1525-139X.2010.00766.x PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 635NN UT WOS:000280662500014 PM 20701722 ER PT J AU Larauche, M Gourcerol, G Million, M Adelson, DW Tache, Y AF Larauche, Muriel Gourcerol, Guillaume Million, Mulugeta Adelson, David W. Tache, Yvette TI Repeated psychological stress-induced alterations of visceral sensitivity and colonic motor functions in mice: Influence of surgery and postoperative single housing on visceromotor responses SO STRESS-THE INTERNATIONAL JOURNAL ON THE BIOLOGY OF STRESS LA English DT Article DE Chronic water avoidance stress; colonic motor function; defecation; irritable bowel syndrome; social isolation; visceral pain ID CORTICOTROPIN-RELEASING-FACTOR; IRRITABLE-BOWEL-SYNDROME; WATER-AVOIDANCE STRESS; OPIOID-RECEPTOR AGONISTS; ISOLATED MOUSE COLON; NERVE GROWTH-FACTOR; COLORECTAL DISTENSION; PROTEASE ACTIVITY; NEW-MODEL; PAIN AB Visceral pain modulation by chronic stress in mice has been little studied. Electromyography (EMG) recording of abdominal muscle contractions, as a proxy to the visceromotor response (VMR), requires electrode implantation and post-surgical single housing (SH) which could affect the VMR to stress. To test this hypothesis, male mice had electrode implantation surgery ( S) plus SH, or no surgery and were group housed (NS-GH) or single housed (NS-SH) and exposed to either water avoidance stress ( WAS, 1 h/day) or left undisturbed in their home cages for 10 days. The VMR to phasic ascending colorectal distension (CRD) was assessed before ( basal) and 24 h after 10 days of WAS or no stress using a surgery-free method of intraluminal colonic pressure (ICP) recording (solid-state manometry). WAS heightened significantly the VMR to CRD at 30, 45, and 60 mmHg in S-SH vs. NS-GH, but not compared to NS-SH conscious mice. Compared to basal CRD, WAS increased VMR at 60 mmHg in the S-SH group and decreased it at 30-60 mmHg in NS-GH mice, while having no effect in NS-SH mice. The average defecation during the hour of repeated WAS over 10 days was 1.9 and 2.4 fold greater in S-SH vs. NS-GH and NS-SH mice, respectively. These data indicate that the combination of S-SH required for VMR monitoring with EMG is an important component of repeated WAS-induced post-stress visceral hypersensitivity and defecation in mice. C1 [Larauche, Muriel; Gourcerol, Guillaume; Million, Mulugeta; Adelson, David W.; Tache, Yvette] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. [Larauche, Muriel; Gourcerol, Guillaume; Million, Mulugeta; Adelson, David W.; Tache, Yvette] CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. [Larauche, Muriel; Gourcerol, Guillaume; Million, Mulugeta; Adelson, David W.; Tache, Yvette] Ctr Neurobiol Stress, Los Angeles, CA 90073 USA. [Larauche, Muriel; Gourcerol, Guillaume; Million, Mulugeta; Adelson, David W.; Tache, Yvette] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Larauche, M (reprint author), VA Hlth Care Syst, UCLA Ctr Neurobiol Stress, CURE Bldg 115,Rm 111,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mlarauche@mednet.ucla.edu OI Larauche, Muriel/0000-0003-3320-3675; Adelson, David/0000-0002-4623-6030 FU VA Career Scientist Award; NIHDDK [R01 DK-57238, DK-33061, P50 DK-64539, DK AM 41301, DK-78676, T32 DK07180-33]; French Society of Gastroenterology FX The authors would like to thank Ms Chrysanthy Ha, Dr Agata Mulak, and Dr Yong Sung Kim for their technical help. The research was supported by a VA Career Scientist Award (YT), NIHDDK grants R01 DK-57238 (YT), DK-33061 (YT), P50 DK-64539 (YT), DK AM 41301 (Animal Model Core, YT, MM), DK-78676 (MM), T32 DK07180-33 (ML) and the French Society of Gastroenterology (GG). NR 57 TC 5 Z9 5 U1 1 U2 2 PU INFORMA HEALTHCARE PI LONDON PA TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND SN 1025-3890 J9 STRESS JI Stress PD JUL PY 2010 VL 13 IS 4 BP 344 EP 355 DI 10.3109/10253891003664166 PG 12 WC Behavioral Sciences; Endocrinology & Metabolism; Neurosciences SC Behavioral Sciences; Endocrinology & Metabolism; Neurosciences & Neurology GA 628TW UT WOS:000280146300007 ER PT J AU Shah, SS Todkar, JS Shah, PS Cummings, DE AF Shah, Shashank S. Todkar, Jayashree S. Shah, Poonam S. Cummings, David E. TI Diabetes remission and reduced cardiovascular risk after gastric bypass in Asian Indians with body mass index < 35 kg/m(2) SO SURGERY FOR OBESITY AND RELATED DISEASES LA English DT Article DE Gastric bypass; Metabolic surgery; Bariatric surgery; Diabetes; Mortality; Cardiovascular risk; Ghrelin; Coronary heart disease ID CORONARY-HEART-DISEASE; BARIATRIC SURGERY; BILIOPANCREATIC DIVERSION; METABOLIC SYNDROME; ADIPOSE-TISSUE; MELLITUS; MORTALITY; OBESITY; ANTHROPOMETRY; PARTICIPANTS AB Background: Roux-en-Y gastric bypass (RYGB) benefits patients with type 2 diabetes mellitus (T2DM) and a body mass index (BMI) >35 kg/m(2); however, its effectiveness in patients with T2DM and a BMI <35 kg/m(2) is unclear. Asian Indians have a high risk of T2DM and cardiovascular disease at relatively low BMI levels. We examined the safety and efficacy of RYGB in Asian Indian patients with T2DM and a BMI of 22-35 kg/m(2) in a tertiary care medical center. Methods: A total of 15 consecutive patients with T2DM and a BMI of 22-35 kg/m(2) underwent RYGB. The data were prospectively collected before surgery and at 1, 3, 6, and 9 months postoperatively. Results: Of the 15 patients, 8 were men and 7 were women (age 45.6 +/- 12 years). Their preoperative characteristics were BMI 28.9 +/- 4.0 kg/m(2), body weight 78.7 +/- 12.5 kg, waist circumference 100.2 +/- 6.8 cm, and duration of T2DM 8.7 +/- 5.3 years. At baseline, 80% of subjects required insulin, and 20% controlled their T2DM with oral hypoglycemic medication. The BMI decreased postoperatively by 20%, from 28.9 +/- 4.0 kg/m(2) to 23.0 +/- 3.6 kg/m(2) (P < .001). All antidiabetic medications were discontinued by 1 month after surgery in 80% of the subjects. At 3 months and thereafter, 100% were euglycemic and no longer required diabetes medication. The fasting blood glucose level decreased from 233 +/- 87 mg/dL to 89 +/- 12 mg/dL (P < .001), and the hemoglobin A1c decreased from 10.1% +/- 2.0% to 6.1% +/- 0.6% (P < .001). Their waist circumference, presence of dyslipidemia, and hypertension improved significantly. The predicted 10-year cardiovascular disease risk (calculated using the United Kingdom Prospective Diabetes Study equations) decreased substantially for fatal and nonfatal coronary heart disease and stroke. No mortality, major surgical morbidity, or excessive weight loss occurred. Conclusion: RYGB safely and effectively eliminated T2DM in Asian Indians with a BMI <35 kg/m(2). Larger, longer term studies are needed to confirm this benefit. (Surg Obes Relat Dis 2010;6:332-339.) (C) 2010 American Society for Metabolic and Bariatric Surgery. All rights reserved. C1 [Cummings, David E.] Univ Washington, Sch Med, Dept Med, Diabet & Obes Ctr Excellence, Seattle, WA 98195 USA. [Cummings, David E.] Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. [Shah, Shashank S.; Todkar, Jayashree S.; Shah, Poonam S.] Ruby Hall Clin, Pune, Maharashtra, India. RP Cummings, DE (reprint author), Univ Washington, Sch Med, Dept Med, Diabet & Obes Ctr Excellence, 815 Mercer St,Room S284, Seattle, WA 98195 USA. EM davidec@u.washington.edu FU NIH [DK517498, DK68384, DK66568, DK17047] FX David Cummings is supported by NIH grants DK517498, DK68384, DK66568, and DK17047. NR 31 TC 62 Z9 66 U1 0 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1550-7289 J9 SURG OBES RELAT DIS JI Surg. Obes. Relat. Dis. PD JUL-AUG PY 2010 VL 6 IS 4 BP 332 EP 338 DI 10.1016/j.soard.2009.08.009 PG 7 WC Surgery SC Surgery GA 634WA UT WOS:000280615400001 PM 19846351 ER PT J AU Josbeno, DA Jakicic, JM Hergenroeder, A Eid, GM AF Josbeno, Deborah A. Jakicic, John M. Hergenroeder, Andrea Eid, George M. TI Physical activity and physical function changes in obese individuals after gastric bypass surgery SO SURGERY FOR OBESITY AND RELATED DISEASES LA English DT Article DE Obesity; Bariatric surgery; Gastric bypass; Physical activity; Physical function ID 6-MINUTE WALK TEST; QUALITY-OF-LIFE; LOW-BACK-PAIN; WEIGHT-LOSS; BARIATRIC SURGERY; HEALTH; WOMEN; EXERCISE; INTERVENTION; RELIABILITY AB Background: Little is known about the effects of gastric bypass surgery (GBS) on physical activity and physical function. We examined the physical activity, physical function, psychosocial correlates to physical activity participation, and health-related quality of life of patients before and after GBS. Methods: A total of 20 patients were assessed before and 3 months after GBS. Physical activity was assessed using the 7-day physical activity recall questionnaire and a pedometer worn for 7 days. Physical function was assessed using the 6-minute walk test, Short Physical Performance Battery, and the physical function subscale of the Medical Outcomes Short Form-36 (SF-36). The Physical Activity Self-Efficacy questionnaire, the Physical Activity Barriers and Outcome Expectations questionnaire, the SF-36, and the Numeric Pain Rating Scale were also administered. Results: Physical activity did not significantly increase from before (191.1 +/- 228.23 min/wk) to after (231.7 +/- 230.04 min/wk) GBS (n = 18); however, the average daily steps did significantly increase (from 4621 +/- 3701 to 7370 +/- 4240 steps/d; n = 11). The scores for the 6-minute walk test (393 +/- 62.08 m to 446 +/- 41.39 m; n = 17), Short Physical Performance Battery (11.2 +/- 1.22 to 11.7 +/- .57; n = 18), physical function subscale of the SF-36 (65 +/- 18.5 to 84.1 +/- 19.9), and the total SF-36 (38.2 +/- 23.58 to 89.7 +/- 15.5; n = 17) increased significantly. The Numeric Pain Rating Scale score decreased significantly for low back (3.5 +/- 1.8 to 1.7 +/- 2.63), knee (2.4 +/- 2.51 to 1.0 +/- 1.43), and foot/ankle (2.3 +/- 2.8 to 0.9 +/- 2.05) pain. No significant changes were found in the Physical Activity Self-Efficacy questionnaire or the Physical Activity Barriers and Outcome Expectations questionnaire. Conclusion: GBS improves physical function, health-related quality of life, and self-reported pain and results in a modest improvement in physical activity. These are important clinical benefits of surgical weight loss. Long-term follow-up is needed to quantify the ability to sustain or further improve these important clinical outcomes. (Surg Obes Relat Dis 2010;6:361-366.) (C) 2010 American Society for Metabolic and Bariatric Surgery. All rights reserved. C1 [Josbeno, Deborah A.; Hergenroeder, Andrea] Univ Pittsburgh, Dept Phys Therapy, Pittsburgh, PA 15260 USA. [Jakicic, John M.] Univ Pittsburgh, Dept Hlth & Phys Act, Pittsburgh, PA USA. [Eid, George M.] Univ Pittsburgh, Dept Surg, Pittsburgh, PA USA. [Eid, George M.] Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Josbeno, DA (reprint author), Univ Pittsburgh, Dept Phys Therapy, Pittsburgh, PA 15260 USA. NR 30 TC 34 Z9 35 U1 3 U2 14 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1550-7289 J9 SURG OBES RELAT DIS JI Surg. Obes. Relat. Dis. PD JUL-AUG PY 2010 VL 6 IS 4 BP 361 EP 366 DI 10.1016/j.soard.2008.08.003 PG 6 WC Surgery SC Surgery GA 634WA UT WOS:000280615400007 PM 18996771 ER PT J AU Davies, TF Yin, XM Latif, R AF Davies, Terry F. Yin, Xiaoming Latif, Rauf TI The Genetics of the Thyroid Stimulating Hormone Receptor: History and Relevance SO THYROID LA English DT Article ID HUMAN THYROTROPIN RECEPTOR; X-CHROMOSOME INACTIVATION; GRAVES-DISEASE; TSH RECEPTOR; SUSCEPTIBILITY LOCI; MOLECULAR-CLONING; HASHIMOTOS-THYROIDITIS; FEMALE PREDISPOSITION; ALZHEIMERS-DISEASE; WHICKHAM SURVEY AB Background: The thyroid stimulating hormone receptor (TSHR) is the key regulator of thyrocyte function. The gene for the TSHR on chromosome 14q31 has been implicated as coding for the major autoantigen in the autoimmune hyperthyroidism of Graves' disease (GD) to which T cells and autoantibodies are directed. Summary: The TSHR is a seven-transmembrane domain receptor that undergoes complex posttranslational processing. In this brief review, we look at the genetics of this important autoantigen and its influence on a variety of tissue functions in addition to its role in the induction of GD. Conclusions: There is convincing evidence that the TSH receptor gene confers increased susceptibility for GD, but not Hashimoto's thyroiditis. GD is associated with polymorphisms in the intron 1 gene region. How such noncoding nucleotide changes influence disease susceptibility remains uncertain, but is likely to involve TSHR splicing variants and/or microRNAs arising from this gene region. Whether such influences are confined to the thyroid gland or whether they influence cell function in the many extrathyroidal sites of TSHR expression remains unknown. C1 [Davies, Terry F.; Yin, Xiaoming; Latif, Rauf] Mt Sinai Sch Med, Thyroid Res Unit, James J Peters VA Med Ctr, New York, NY 10029 USA. RP Davies, TF (reprint author), Mt Sinai Sch Med, Thyroid Res Unit, James J Peters VA Med Ctr, Box 1055,1 Gustave L Levy Pl, New York, NY 10029 USA. EM terry.davies@mssm.edu FU NIH [DK069713, DK052464]; VA Merit Award FX Supported in part by NIH grants DK069713 and DK052464, and the VA Merit Award Program. We thank Yaron Tomer, M. D., and David Greenberg, Ph.D., for their ongoing collaboration and support. NR 89 TC 26 Z9 27 U1 0 U2 8 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1050-7256 J9 THYROID JI Thyroid PD JUL PY 2010 VL 20 IS 7 BP 727 EP 736 DI 10.1089/thy.2010.1638 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 620RS UT WOS:000279517600007 PM 20578897 ER PT J AU Brent, GA AF Brent, Gregory A. TI Environmental Exposures and Autoimmune Thyroid Disease SO THYROID LA English DT Article ID ATOMIC-BOMB SURVIVORS; NATIONAL-HEALTH; UNITED-STATES; IODINE; HYPOTHYROIDISM; RADIATION; PREVALENCE; NUTRITION; CHERNOBYL; AUTOANTIBODIES AB Background: Environmental exposures, ranging from perchlorate in rocket fuel to polychlorinated biphenols, have been shown to influence thyroid function. Although most of these agents are associated with reduced thyroid hormone levels or impaired thyroid hormone action, a number of environmental exposures confer an increased risk of autoimmune thyroid disease. Summary: Factors that increase autoimmune thyroid disease risk include radiation exposure, both from nuclear fallout and medical radiation, increased iodine intake, as well as several contaminants in the environment that influence the thyroid. Although similar to 70% of the risk for developing autoimmune thyroid disease is attributable to genetic background, environmental triggers are thought to play a role in the development of autoimmune thyroid disease in susceptible individuals. Conclusions: Understanding the association of environmental agents with thyroid dysfunction can be utilized to reduce the risk to populations. Knowledge of the specific factors that trigger autoimmune thyroid disease and their mode of action, however, may also inform risk reduction in the individual patient. These factors are especially relevant for those at increased risk of autoimmune thyroid disease based on family history. C1 [Brent, Gregory A.] Univ Calif Los Angeles, David Geffen Sch Med, Endocrinol & Diabet Div,Dept Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Brent, Gregory A.] Univ Calif Los Angeles, David Geffen Sch Med, Endocrinol & Diabet Div,Dept Physiol, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Brent, GA (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Endocrinol & Diabet Div,Dept Med, VA Greater Los Angeles Healthcare Syst, 111D,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM gbrent@ucla.edu FU VA Merit Review funds; NIH [RO1 CA89364] FX This work was supported by VA Merit Review funds and NIH RO1 CA89364. NR 48 TC 30 Z9 33 U1 2 U2 9 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1050-7256 J9 THYROID JI Thyroid PD JUL PY 2010 VL 20 IS 7 BP 755 EP 761 DI 10.1089/thy.2010.1636 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 620RS UT WOS:000279517600010 PM 20578899 ER PT J AU Strasser, DC Burridge, AB Falconer, JA Herrin, J Uomoto, J AF Strasser, Dale C. Burridge, Andrea B. Falconer, Judith A. Herrin, Jeph Uomoto, Jay TI Measuring Team Process for Quality Improvement SO TOPICS IN STROKE REHABILITATION LA English DT Article DE patient care teams; process measures; quality of health care; stroke rehabilitation ID STROKE REHABILITATION; VETERANS; OUTCOMES; TRIAL AB Background: Even though team care is pivotal to stroke rehabilitation, we have few tools to measure team process. Process measures of team functioning would benefit stroke rehabilitation outcomes and quality improvement (QI). Objective: To improve measures of team process and evaluate their potential for use in rehabilitation research and QI. Methods: We use item response theory (IRT) to analyze and revise selected scales from the Team Functioning Survey administrated to rehabilitation staff (n=365 at 31 VA hospitals) as part of a national clinical trial (NCT00237757). Revised scales were evaluated for reliability (Cronbach's alpha) and validity (correlations, predictions of patient outcomes). Results: Eight scales (60 items) were selected from the TFS for analyses based on their specificity to rehabilitation and potential utility in process improvement. Factor analyses supported the dropping of 2 scales and the combining of 2 scales. As indicated by the IRT analyses of scale psychometric properties, poor performing scale items were dropped and item response categories modified needed areas for further development were identified. Cronbach's alpha for the resultant best 5 scales was good. Intercorrelations varied among scales but were mostly in the moderate ranges. Two of the scales predicted patient outcomes of mFIM (TM) gain or discharge disposition. Conclusion: The analyses resulted in measures of 5 central components of team functioning: physician support, shared leadership, supervisor team support, teamness, and team effectiveness. IRT enables the scales to be refined and strengthened for use in outcome research and QI. The scales are proposed as another step toward understanding and enhancing team process. C1 [Strasser, Dale C.] Emory Univ, Sch Med, Dept Rehabil Med, Atlanta, GA 30322 USA. [Strasser, Dale C.] Atlanta VA Med Ctr, Atlanta, GA USA. [Falconer, Judith A.] Northwestern Univ, Feinberg Sch Med, Dept Med, Chicago, IL 60611 USA. [Herrin, Jeph] Yale Univ, Yale Sch Med, Div Cardiol, New Haven, CT USA. [Uomoto, Jay] VADoD Liaison, Washington, DC USA. [Uomoto, Jay] US Dept Vet Affairs, TBI, Off Rehabil Serv, Washington, DC USA. RP Strasser, DC (reprint author), Emory Univ, Sch Med, Dept Rehabil Med, Atlanta, GA 30322 USA. RI Backscheider Burridge, Andrea/D-9332-2015 OI Backscheider Burridge, Andrea/0000-0001-7502-0047 FU Veterans Administration Rehabilitation Research and Development Service [B2367R, 03225R] FX Supported by the Veterans Administration Rehabilitation Research and Development Service (Merit Review Grants B2367R, 03225R). NR 23 TC 7 Z9 7 U1 1 U2 11 PU THOMAS LAND PUBLISHERS, INC PI ST LOUIS PA 255 JEFFERSON RD, ST LOUIS, MO 63119 USA SN 1074-9357 J9 TOP STROKE REHABIL JI Top. Stroke Rehabil. PD JUL-AUG PY 2010 VL 17 IS 4 BP 282 EP 293 DI 10.1310/tsr1704-282 PG 12 WC Rehabilitation SC Rehabilitation GA 654FD UT WOS:000282153000007 PM 20826416 ER PT J AU Wyeth, MS Zhang, NH Mody, I Houser, CR AF Wyeth, Megan S. Zhang, Nianhui Mody, Istvan Houser, Carolyn R. TI Selective Reduction of Cholecystokinin-Positive Basket Cell Innervation in a Model of Temporal Lobe Epilepsy SO JOURNAL OF NEUROSCIENCE LA English DT Article ID HIPPOCAMPAL NETWORK OSCILLATIONS; CB1 CANNABINOID RECEPTOR; CA1 PYRAMIDAL CELLS; GABAERGIC INHIBITION; ENDOCANNABINOID SYSTEM; STATUS EPILEPTICUS; MOUSE HIPPOCAMPUS; AXON TERMINALS; GABA RELEASE; IN-VIVO AB Perisomatic inhibition from basket cells plays an important role in regulating pyramidal cell output. Two major subclasses of CA1 basket cells can be identified based on their expression of either cholecystokinin (CCK) or parvalbumin. This study examined their fates in the mouse pilocarpine model of temporal lobe epilepsy. Overall, immunohistochemical labeling of GABAergic boutons in the pyramidal cell layer of CA1 was preserved in the mouse model. However, CCK-labeled boutons in this layer were chronically reduced, whereas parvalbumin-containing boutons were conserved. Immunohistochemistry for cannabinoid receptor 1 (CB(1)), another marker for CCK-containing basket cells, also labeled fewer boutons in pilocarpine-treated mice. Hours after status epilepticus, electron microscopy revealed dark degenerating terminals in the pyramidal cell layer with lingering CCK and CB(1) immunoreactivity. In mice with recurrent seizures, carbachol-induced enhancement of spontaneous IPSCs (sIPSCs) originating from CCK-containing basket cells was accordingly reduced in CA1 pyramidal cells. By suppressing sIPSCs from CCK-expressing basket cells, a CB(1) agonist reverted the stimulatory effects of carbachol in naive mice to levels comparable with those observed in cells from epileptic mice. The agatoxin-sensitive component of CA1 pyramidal cell sIPSCs from parvalbumin-containing interneurons was increased in pilocarpine-treated mice, and miniature IPSCs were reduced, paralleling the decrease in CCK-labeled terminals. Altogether, the findings are consistent with selective reduction in perisomatic CA1 pyramidal cell innervation from CCK-expressing basket cells in mice with spontaneous seizures and a greater reliance on persisting parvalbumin innervation. This differential alteration in inhibition may contribute to the vulnerability of the network to seizure activity. C1 [Houser, Carolyn R.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. [Mody, Istvan] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol & Physiol, Los Angeles, CA 90095 USA. [Mody, Istvan; Houser, Carolyn R.] Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90095 USA. [Houser, Carolyn R.] 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, CHS 73-235,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM houser@mednet.ucla.edu FU National Institutes of Health [NS046524, NS002808, NS035985]; Veterans Affairs Medical Research Funds; University of California FX This work was supported by National Institutes of Health Grants NS046524 (C. R. H.), NS002808 (I. M.), and NS035985 (I. M.), Veterans Affairs Medical Research Funds (C. R. H.), and a University of California, Los Angeles Graduate Research Mentorship Fellowship (M. S. W.). Antibody 9303 raised against cholecystokinin was kindly provided by CURE/Digestive Diseases Research Center, Antibody/Radioimmunoassay Core, National Institutes of Health Grant DK41301. We are grateful to Drs. Ken Mackie and Marco Celio for generously providing antibodies to cannabinoid receptor 1 and parvalbumin, respectively. We thank Dr. Zechun Peng, Christine Huang, and Yliana Cetina for skilled help with tissue preparation and Drs. Vijayalakshmi Santhakumar and Edward Mann for their assistance with electrophysiology. NR 71 TC 43 Z9 45 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 JUN 30 PY 2010 VL 30 IS 26 BP 8993 EP 9006 DI 10.1523/JNEUROSCI.1183-10.2010 PG 14 WC Neurosciences SC Neurosciences & Neurology GA 621LY UT WOS:000279581500031 PM 20592220 ER PT J AU Chan, PS Oetgen, WJ Buchanan, D Mitchell, K Fiocchi, FF Tang, FM Jones, PG Breeding, T Thrutchley, D Rumsfeld, JS Spertus, JA AF Chan, Paul S. Oetgen, William J. Buchanan, Donna Mitchell, Kristi Fiocchi, Fran F. Tang, Fengming Jones, Philip G. Breeding, Tracie Thrutchley, Duane Rumsfeld, John S. Spertus, John A. TI Cardiac Performance Measure Compliance in Outpatients SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE performance measure; compliance; quality of care; outpatient ID ATRIAL-FIBRILLATION; AMERICAN-COLLEGE; QUALITY; CARE; CLASSIFICATION; IMPROVEMENT; REGISTRY; STROKE AB Objectives We examined compliance with performance measures for 14,464 patients enrolled from July 2008 through June 2009 into the American College of Cardiology's PINNACLE (Practice Innovation And Clinical Excellence) program to provide initial insights into the quality of outpatient cardiac care. Background Little is known about the quality of care of outpatients with coronary artery disease (CAD), heart failure, and atrial fibrillation, and whether sex and racial disparities exist in the treatment of outpatients. Methods The PINNACLE program is the first, national, prospective office-based quality improvement program of cardiac patients designed, in part, to capture, report, and improve outpatient performance measure compliance. We examined the proportion of patients whose care was compliant with established American College of Cardiology, American Heart Association, and American Medical Association-Physician Consortium for Performance Improvement (ACC/AHA/PCPI) performance measures for CAD, heart failure, and atrial fibrillation. Results There were 14,464 unique patients enrolled from 27 U. S. practices, accounting for 18,021 clinical visits. Of these, 8,132 (56.4%) had CAD, 5,012 (34.7%) had heart failure, and 2,786 (19.3%) had nonvalvular atrial fibrillation. Data from the PINNACLE program were feasibly collected for 24 of 25 ACC/AHA/PCPI performance measures. Compliance with performance measures ranged from being very low (e. g., 13.3% of CAD patients screened for diabetes mellitus) to very high (e. g., 96.7% of heart failure patients with blood pressure assessments), with moderate (70% to 90%) compliance observed for most performance measures. For 3 performance measures, there were small differences in compliance rates by race or sex. Conclusions For more than 14,000 patients enrolled from 27 practices in the outpatient PINNACLE program, we found that compliance with performance measures was variable, even after accounting for exclusion criteria, suggesting an important opportunity to improve the quality of outpatient care. (J Am Coll Cardiol 2010;56:8-14) (C) 2010 by the American College of Cardiology Foundation C1 [Chan, Paul S.; Buchanan, Donna; Tang, Fengming; Jones, Philip G.; Breeding, Tracie; Thrutchley, Duane; Spertus, John A.] St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO 64111 USA. [Chan, Paul S.; Spertus, John A.] Univ Missouri, Kansas City, MO 64110 USA. [Oetgen, William J.] Georgetown Univ, Sch Med, Washington, DC USA. [Mitchell, Kristi; Fiocchi, Fran F.] Amer Coll Cardiol, Washington, DC USA. [Rumsfeld, John S.] Univ Colorado, Denver Med Ctr, Denver, CO 80202 USA. [Rumsfeld, John S.] Denver VA Med Ctr, Denver, CO USA. RP Chan, PS (reprint author), St Lukes Hosp, Mid Amer Heart Inst, 5th Floor,4401 Wornall Rd, Kansas City, MO 64111 USA. EM pchan@cc-pc.com RI Max, Mad/E-5238-2010 OI Max, Mad/0000-0001-6966-6829 FU Bristol-Myers Squibb/Sanofi Pharmaceuticals; American College of Cardiology; American College of Cardiology Foundation; AMA; NHLBI; Johnson Johnson; Eli Lilly; BMS/Sanofi; Evoheart FX From the *Mid America Heart Institute and dagger University of Missouri, Kansas City, Missouri; Georgetown University School of Medicine and the double dagger American College of Cardiology, Washington, DC; and the parallel to University of Colorado at Denver Medical Center and Denver VA Medical Center, Denver, Colorado. Bristol-Myers Squibb/Sanofi Pharmaceuticals and the American College of Cardiology provide operational funding for the PINNACLE program. Ms. Fiocchi and Mitchell are employees of the American College of Cardiology. Drs. Chan and Spertus and Mr. Jones are affiliated with the Mid America Heart Institute, which is the major analytic center for the PINNACLE program and receives funding from the American College of Cardiology for this role. Dr. Rumsfeld is the Chief Science Officer of the NCDR. Dr. Spertus is supported by a contract from the American College of Cardiology Foundation; receives grant support from AMA, NHLBI, Anger, Johnson & Johnson, Eli Lilly, BMS/Sanofi, and Evoheart; and is a consultant for United-Healthcare, Anger, and St. Jude Medical. NR 16 TC 62 Z9 63 U1 0 U2 6 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 JUN 29 PY 2010 VL 56 IS 1 BP 8 EP 14 DI 10.1016/j.jacc.2010.03.043 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 614AV UT WOS:000279028300002 PM 20620710 ER PT J AU Walling, AM Asch, SM Lorenz, KA Roth, CP Barry, T Kahn, KL Wenger, NS AF Walling, Anne M. Asch, Steven M. Lorenz, Karl A. Roth, Carol P. Barry, Tod Kahn, Katherine L. Wenger, Neil S. TI The Quality of Care Provided to Hospitalized Patients at the End of Life SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 32nd Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 13-16, 2009 CL Miami, FL SP Soc Gen Internal Med ID MEDICAL-CARE; VULNERABLE ELDERS; SUSTAINING TREATMENTS; OLDER PATIENTS; PREFERENCES; DISCUSSIONS; OUTCOMES; COMMUNITY; SURVIVAL; HOSPICE AB Background: Patients in American hospitals receive intensive medical treatments. However, when lifesaving treatments are unsuccessful, patients often die in the hospital with distressing symptoms while receiving burdensome care. Systematic measurement of the quality of care planning and symptom palliation is needed. Methods: Medical records were abstracted using 16 Assessing Care of Vulnerable Elders quality indicators within the domains of end-of-life care and pain management designed to measure the quality of the dying experience for adult decedents (n = 496) hospitalized for at least 3 days between April 2005 and April 2006 at a university medical center recognized for providing intensive care for the seriously ill. Results: Over half of the patients (mean age, 62 years; 47% were women) were admitted to the hospital with end-stage disease, and 28% were 75 years or older. One-third of the patients required extubation from mechanical ventilation prior to death, and 15% died while receiving cardiopulmonary resuscitation. Overall, patients received recommended care for 70% of applicable indicators (range, 25%-100%). Goals of care were addressed in a timely fashion for patients admitted to the intensive care unit approximately half of the time, whereas pain assessments (94%) and treatments for pain (95%) and dyspnea (87%) were performed with fidelity. Follow-up for distressing symptoms was performed less well than initial assessment, and 29% of patients extubated in anticipation of death had documented dyspnea assessments. Conclusion: A practical, medical chart-based assessment identified discrete deficiencies in care planning and symptom palliation that can be targeted to improve care for patients dying in the hospital. C1 [Walling, Anne M.; Kahn, Katherine L.; Wenger, Neil S.] Univ Calif Los Angeles, Div Gen Internal Med & Hlth Serv Res, David Geffen Sch Med, Los Angeles, CA 90024 USA. [Walling, Anne M.; Wenger, Neil S.] Univ Calif Los Angeles, Hlth Syst Eth Ctr, Los Angeles, CA 90024 USA. [Barry, Tod] Univ Calif Los Angeles, Ctr Patient Safety & Qual, Los Angeles, CA 90024 USA. [Asch, Steven M.; Lorenz, Karl A.] Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. [Asch, Steven M.; Roth, Carol P.; Kahn, Katherine L.; Wenger, Neil S.] RAND Corp, RAND Hlth, Santa Monica, CA USA. RP Walling, AM (reprint author), Univ Calif Los Angeles, Div Gen Internal Med, 911 Broxton Plaza, Los Angeles, CA 90024 USA. EM awalling@mednet.ucla.edu RI Baolian W, Baolian W/O-6769-2015 FU BHP HRSA HHS [T32 PE19001]; NIA NIH HHS [L30 AG030993, L30 AG030993-01] NR 43 TC 49 Z9 49 U1 3 U2 10 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60654-0946 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JUN 28 PY 2010 VL 170 IS 12 BP 1057 EP 1063 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 616XO UT WOS:000279245000012 PM 20585072 ER PT J AU Bishop, TF Federman, AD Keyhani, S AF Bishop, Tara F. Federman, Alex D. Keyhani, Salomeh TI Physicians' Views on Defensive Medicine: A National Survey SO ARCHIVES OF INTERNAL MEDICINE LA English DT Letter C1 [Keyhani, Salomeh] Mt Sinai Sch Med, Dept Hlth Policy, New York, NY 10029 USA. [Bishop, Tara F.; Federman, Alex D.; Keyhani, Salomeh] Mt Sinai Sch Med, Div Gen Internal Med, New York, NY 10029 USA. James J Peters Vet Adm Med Ctr, Bronx, NY USA. RP Keyhani, S (reprint author), Mt Sinai Sch Med, Dept Hlth Policy, 1 Gustave L Levy Pl,Box 1077, New York, NY 10029 USA. EM salomeh.keyhani@mssm.edu NR 10 TC 53 Z9 55 U1 1 U2 7 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60654-0946 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JUN 28 PY 2010 VL 170 IS 12 BP 1081 EP 1083 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 616XO UT WOS:000279245000016 PM 20585077 ER PT J AU Miyazaki-Anzai, S Levi, M Kratzer, A Ting, TC Lewis, LB Miyazaki, M AF Miyazaki-Anzai, Shinobu Levi, Moshe Kratzer, Adelheid Ting, Tabitha C. Lewis, Linda B. Miyazaki, Makoto TI Farnesoid X Receptor Activation Prevents the Development of Vascular Calcification in ApoE(-/-) Mice With Chronic Kidney Disease SO CIRCULATION RESEARCH LA English DT Article DE farnesoid X receptor; vascular calcification; chronic kidney disease ID FXR-MEDIATED REGULATION; BILE-ACID; NUCLEAR RECEPTOR; CELL CALCIFICATION; GENE-EXPRESSION; METABOLISM; MECHANISMS; ATHEROSCLEROSIS; INFLAMMATION; DISRUPTION AB Rationale: Vascular calcification is highly associated with cardiovascular morbidity and mortality, especially in patients with chronic kidney disease. The nuclear receptor farnesoid X receptor (FXR) has been implicated in the control of lipid, carbohydrate and bile acid metabolism in several cell types. Although recent studies have shown that FXR is also expressed in vascular smooth muscle cells, its physiological role in vasculature tissue remains obscure. Objective: Here, we have examined the role of FXR in vascular calcification. Methods and Results: The FXR gene, a bile acid nuclear receptor, was highly induced during osteogenic differentiation of bovine calcifying vascular cells (CVCs) and in the aorta of apolipoprotein (Apo) E-/- mice with chronic kidney disease which are common tissue culture and mouse model, respectively, for aortic calcification. FXR activation by a synthetic FXR agonist, 6 alpha-ethyl chenodeoxycholic acid (INT-747) inhibited phosphate induced-mineralization and triglyceride accumulation in CVCs. FXR dominant negative expression augmented mineralization of CVCs and blocked the anticalcific effect of INT-747 whereas VP16FXR that is a constitutively active form reduced mineralization of CVCs. INT-747 treatment also increased phosphorylated c-Jun N-terminal kinase (JNK). SP600125 (specific JNK inhibitor) significantly induced mineralization of CVCs and alkaline phosphatase expression, suggesting that the anticalcific effect of INT-747 is attributable to JNK activation. We also found that INT-747 ameliorates chronic kidney disease induced-vascular calcification in 5/6 nephrectomized ApoE(-/-) mice without affecting the development of atherosclerosis. Conclusions: These observations provide direct evidence that FXR is a key signaling component in regulation of vascular osteogenic differentiation and, thus representing a promising target for the treatment of vascular calcification. (Circ Res. 2010;106:1807-1817.) C1 [Miyazaki, Makoto] Univ Colorado Denver, Div Renal Dis & Hypertens, Dept Med, Denver Vet Affairs Med Ctr, Aurora, CO 80045 USA. [Miyazaki, Makoto] Denver Vet Affairs Med Ctr, Dept Med, Div Endocrinol Diabet & Metab, Denver, CO USA. Univ Colorado, Boulder, CO 80309 USA. RP Miyazaki, M (reprint author), Univ Colorado Denver, Div Renal Dis & Hypertens, Dept Med, Denver Vet Affairs Med Ctr, 12700 E 19th Ave,C281, Aurora, CO 80045 USA. EM Makoto.Miyazaki@ucdenver.edu OI Levi, Moshe/0000-0002-6225-946X FU University of Colorado-Denver School of Medicine, Colorado Clinical Nutrition Research Unit (NIH) [5P30DK048520]; University of Colorado Health Sciences Center Diabetes and Endocrinology Research Center (NIH) [P30DK57516]; NIH [U01 DK076134, R01 AG026529]; Veterans Affairs; Austrian Federal Ministry of Science and Research FX This work was supported by the University of Colorado-Denver School of Medicine, Colorado Clinical Nutrition Research Unit (NIH grant 5P30DK048520); University of Colorado Health Sciences Center Diabetes and Endocrinology Research Center (NIH grant P30DK57516); NIH grants U01 DK076134 and R01 AG026529; and a Veterans Affairs Merit Review grant. A. K. was supported by an Austrian Federal Ministry of Science and Research Mobility fellowship (Genomforschung Austria Project G.O.L.D.II, Genomics of Lipid-associated Disorders II). NR 46 TC 30 Z9 32 U1 0 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7330 J9 CIRC RES JI Circ.Res. PD JUN 25 PY 2010 VL 106 IS 12 BP 1807 EP U55 DI 10.1161/CIRCRESAHA.109.212969 PG 25 WC Cardiac & Cardiovascular Systems; Hematology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Hematology GA 615FC UT WOS:000279117900005 PM 20431060 ER PT J AU Hawn, MT AF Hawn, Mary T. TI Surgical Care Improvement Should Performance Measures Have Performance Measures SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID SITE INFECTIONS; ANTIMICROBIAL-PROPHYLAXIS; ANTIBIOTIC-PROPHYLAXIS; RISK; SURGERY; TRIAL C1 [Hawn, Mary T.] Univ Alabama Birmingham, Dept Surg, Birmingham, AL 35294 USA. [Hawn, Mary T.] Birmingham Vet Affairs Med Ctr, Ctr Surg Med Acute Care Res & Transit, Birmingham, AL USA. RP Hawn, MT (reprint author), Univ Alabama Birmingham, Dept Surg, 1530 3rd Ave S,KB 429, Birmingham, AL 35294 USA. EM mhawn@uab.edu NR 15 TC 23 Z9 23 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 23 PY 2010 VL 303 IS 24 BP 2527 EP 2528 DI 10.1001/jama.2010.854 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 613VM UT WOS:000279010900034 PM 20571022 ER PT J AU Lee, BY Ufberg, PJ Bailey, RR Wiringa, AE Smith, KJ Nowalk, AJ Higgins, C Wateska, AR Muder, RR AF Lee, Bruce Y. Ufberg, Paul J. Bailey, Rachel R. Wiringa, Ann E. Smith, Kenneth J. Nowalk, Andrew J. Higgins, Conor Wateska, Angela R. Muder, Robert R. TI The potential economic value of a Staphylococcus aureus vaccine for neonates SO VACCINE LA English DT Article DE Staphylococcus aureus; Vaccine; Economics ID INTENSIVE-CARE-UNIT; LOW-BIRTH-WEIGHT; NOSOCOMIAL-INFECTIONS; DAPTOMYCIN RESISTANCE; PASSIVE-IMMUNIZATION; SURVEILLANCE; MRSA; EPIDEMIOLOGY; PREVENTION; PROSPECTS AB The continuing morbidity and mortality associated with Staphylococcus aureus (S. aureus) infections, especially methicillin-resistant S. aureus (MRSA) infections, have motivated calls to make S. aureus vaccine development a research priority. We developed a decision analytic computer simulation model to determine the potential economic impact of a S. aureus vaccine for neonates. Our results suggest that a S. aureus vaccine for the neonatal population would be strongly cost-effective (and in many situations dominant) over a wide range of vaccine efficacies (down to 10%) for vaccine costs (<=$500), and S. aureus attack rates (>= 1%). (C) 2010 Elsevier Ltd. All rights reserved. C1 [Lee, Bruce Y.; Ufberg, Paul J.; Bailey, Rachel R.; Wiringa, Ann E.; Smith, Kenneth J.; Higgins, Conor; Wateska, Angela R.] Univ Pittsburgh, Publ Hlth Computat & Operat Res PHICOR, Pittsburgh, PA 15213 USA. [Lee, Bruce Y.; Ufberg, Paul J.; Bailey, Rachel R.; Wiringa, Ann E.; Higgins, Conor; Wateska, Angela R.] Univ Pittsburgh, Dept Biomed Informat, Pittsburgh, PA 15213 USA. [Lee, Bruce Y.; Ufberg, Paul J.; Bailey, Rachel R.; Wiringa, Ann E.; Higgins, Conor; Wateska, Angela R.] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15213 USA. [Ufberg, Paul J.] Univ Pittsburgh, Childrens Hosp Pittsburgh, Div Gastroenterol, Pittsburgh, PA 15213 USA. [Nowalk, Andrew J.] Univ Pittsburgh, Childrens Hosp Pittsburgh, Div Infect Dis, Pittsburgh, PA 15213 USA. [Muder, Robert R.] Univ Pittsburgh, VA Pittsburgh Hlth Syst, Pittsburgh, PA 15213 USA. RP Lee, BY (reprint author), Univ Pittsburgh, Publ Hlth Computat & Operat Res PHICOR, 200 Meyran Ave,Suite 200, Pittsburgh, PA 15213 USA. EM BYL1@pitt.edu OI Nowalk, Andrew/0000-0002-1374-3167; Smith, Kenneth J/0000-0001-8088-566X; Slayton, Rachel/0000-0003-4699-8040 FU Bill and Melinda Gates Foundation; National Institute of General Medical Sciences Models of Infectious Disease Agent Study (MIDAS) [1U54GM088491-0109]; Pennsylvania Department of Health; Vaccine Modeling Initiative (VMI) FX Supported by the National Institute of General Medical Sciences Models of Infectious Disease Agent Study (MIDAS) through grant 1U54GM088491-0109, the Pennsylvania Department of Health, and the Vaccine Modeling Initiative (VMI), funded by the Bill and Melinda Gates Foundation. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 62 TC 8 Z9 8 U1 0 U2 3 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 JUN 23 PY 2010 VL 28 IS 29 BP 4653 EP 4660 DI 10.1016/j.vaccine.2010.04.069 PG 8 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 625AO UT WOS:000279863900018 PM 20472028 ER PT J AU Tormos, JR Taylor, AB Daubner, SC Hart, PJ Fitzpatrick, PF AF Tormos, Jose R. Taylor, Alexander B. Daubner, S. Colette Hart, P. John Fitzpatrick, Paul F. TI Identification of a Hypothetical Protein from Podospora anserina as a Nitroalkane Oxidase SO BIOCHEMISTRY LA English DT Article ID ACYL-COA DEHYDROGENASES; FAD-CONTAINING FORM; FUSARIUM-OXYSPORUM; SUBSTRATE-SPECIFICITY; CRYSTAL-STRUCTURES; HYDRIDE TRANSFER; MECHANISM; OXIDATION; PH; CATALYSIS AB The flavoprotein nitroalkane oxidase (NAO) from Fusarium oxysporum catalyzes the oxidation of primary and secondary nitroalkanes to their respective aldehydes and ketones. Structurally, the enzyme is a member of the acyl-CoA dehydrogenase superfamily. To date no enzymes other than that from F. oxysporum have been annotated as NAOs. To identify additional potential NAOs, the available database was searched for enzymes in which the active site residues Asp402, Ara409, and Ser276 were conserved. Of the several fungal enzymes identified in this fashion, PODANSg2158 from Podospora anserina was selected for expression and characterization. The recombinant enzyme is a flavoprotein with activity on nitroalkanes comparable to the F. oxysporum NAO, although the substrate specificity is somewhat different. Asp399, Arg406, and Ser273 in PODANSg2158 correspond to the active site triad in F. oxysporum NAO. The k(cat)/K(M)-pH profile with nitroethane shows a pK(a) of 5.9 that is assigned to Asp399 as the active site base. Mutation of Asp399 to asparagine decreases the k(cat)/K(M) value for nitroethane over 2 orders of magnitude. The R406K and S373A mutations decrease this kinetic parameter by 64- and 3-fold, respectively. The structure of PODANSg2158 has been determined at a resolution of 2.0 angstrom, confirming its identification as an NAO. C1 [Tormos, Jose R.; Taylor, Alexander B.; Hart, P. John; Fitzpatrick, Paul F.] Univ Texas Hlth Sci Ctr San Antonio, Dept Biochem, San Antonio, TX 78229 USA. [Daubner, S. Colette] St Marys Univ, Dept Biol, San Antonio, TX 78228 USA. [Hart, P. John] S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Dept Vet Affairs, Audie Murphy Div, San Antonio, TX 78229 USA. [Fitzpatrick, Paul F.] Univ Texas San Antonio, Dept Chem, San Antonio, TX 78249 USA. RP Fitzpatrick, PF (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Biochem, San Antonio, TX 78229 USA. EM Fitzpatrick@biochem.uthscsa.edu FU NIH [GM 058698]; Robert A. Welch Foundation [AQ-1399]; National Center for Research Resources at the National Institutes of Health [RR-15301]; U.S. Department of Energy, Office of Basic Energy Sciences [W-31-109-ENG-38] FX This work was supported in part by NIH Grant GM 058698 to P.F.F and Robert A. Welch Foundation Grant AQ-1399 to P.J.H.; This work is based upon research conducted at the Northeastern Collaborative Access Team beamlines of the Advanced Photon Source, supported by award RR-15301 from the National Center for Research Resources at the National Institutes of Health. Use of the Advanced Photon Source is supported by the U.S. Department of Energy, Office of Basic Energy Sciences, under Contract No. W-31-109-ENG-38. We thank Dr. Jonathan P. Schuermann at the Advanced Photon Source for collecting the X-ray diffraction data. Support for the X-ray Crystallography Core Laboratory by the UTHSC-SA Executive Research Committee and the San Antonio Cancer Institute is also gratefully acknowledged. NR 36 TC 6 Z9 6 U1 0 U2 0 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0006-2960 J9 BIOCHEMISTRY-US JI Biochemistry PD JUN 22 PY 2010 VL 49 IS 24 BP 5035 EP 5041 DI 10.1021/bi100610e PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 609VA UT WOS:000278684400012 PM 20481475 ER PT J AU Espitia, CM Zhao, WG Saldarriaga, O Osorio, Y Harrison, LM Cappello, M Travi, BL Melby, PC AF Espitia, Claudia M. Zhao, Weiguo Saldarriaga, Omar Osorio, Yaneth Harrison, Lisa M. Cappello, Michael Travi, Bruno L. Melby, Peter C. TI Duplex real-time reverse transcriptase PCR to determine cytokine mRNA expression in a hamster model of New World cutaneous leishmaniasis SO BMC IMMUNOLOGY LA English DT Article ID FEVER VIRUS-INFECTION; GOLDEN SYRIAN-HAMSTER; MESOCRICETUS-AURATUS; T-CELLS; VISCERAL LEISHMANIASIS; QUANTITATIVE PCR; IMMUNE-RESPONSE; MAJOR INFECTION; GENE-EXPRESSION; DENDRITIC CELLS AB Background: The Syrian hamster, Mesocricetus auratus, has distinct immunological features and is uniquely susceptible to intracellular pathogens. Studies in hamsters are limited by the relative unavailability of tools to conduct immunological studies. To address this limitation we developed duplex real-time reverse transcriptase (RT) PCR assays for the relative quantification of the mRNAs of hamster cytokines, chemokines, and related immune response molecules. Results: Real-time RT-PCR primers and probes were synthesized for analysis of interleukin (IL)-4, IFN-gamma, TNF-alpha, IL-10, IL-12p40, TGF-beta, IL-13, IL-21, chemokine ligand (CCL) 22, CCL17, Chemokine (C-C motif) receptor 4 and FoxP3 expression. Standard curves and validation experiments were performed for each real-time RT-PCR assay, allowing us to use the comparative Ct (2-(Delta Delta Ct)) method to calculate changes in gene expression. Application of the real-time RT PCR assays to a biological model was demonstrated by comparing mRNA expression in skin and lymph node tissues between uninfected and Leishmania panamensis infected hamsters. Conclusions: The duplex real-time RT PCR assays provide a powerful approach for the quantification of cytokine transcription in hamsters, and their application to a model of cutaneous leishmaniasis suggests that a balanced type 1 and type 2 cytokine response contributes to the chronic, nonprogressive course of disease. These new molecular tools will further facilitate investigation into the mechanisms of disease in the hamster, not only for models of leishmaniasis, but also for other viral, bacterial, fungal, and parasitic infections. C1 [Espitia, Claudia M.; Zhao, Weiguo; Saldarriaga, Omar; Osorio, Yaneth; Travi, Bruno L.; Melby, Peter C.] S Texas Vet Hlth Care Syst, Dept Vet Affairs Med Ctr, Res Serv, San Antonio, TX USA. [Espitia, Claudia M.; Zhao, Weiguo; Saldarriaga, Omar; Osorio, Yaneth; Travi, Bruno L.; Melby, Peter C.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. [Harrison, Lisa M.; Cappello, Michael] Yale Univ, Sch Med, Dept Pediat, New Haven, CT 06510 USA. [Melby, Peter C.] Univ Texas Hlth Sci Ctr San Antonio, Dept Microbiol & Immunol, San Antonio, TX 78229 USA. RP Melby, PC (reprint author), S Texas Vet Hlth Care Syst, Dept Vet Affairs Med Ctr, Res Serv, 7400 Merton Minter, San Antonio, TX USA. EM melby@uthscsa.edu FU National Institutes of Health [AI61624, AI058980]; U.S. Department of Veterans Affairs FX This work was supported by the funding from the National Institutes of Health (AI61624) and the U.S. Department of Veterans Affairs to PCM, and NIH grant AI058980 to MC. Special thanks to Lourdes Arteaga and Alheli Rodriguez for technical assistance. NR 47 TC 15 Z9 15 U1 0 U2 5 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1471-2172 J9 BMC IMMUNOL JI BMC Immunol. PD JUN 22 PY 2010 VL 11 AR 31 DI 10.1186/1471-2172-11-31 PG 12 WC Immunology SC Immunology GA 632DV UT WOS:000280401800001 PM 20569429 ER PT J AU Rempel, H Sun, B Calosing, C Pillai, SK Pulliam, L AF Rempel, Hans Sun, Bing Calosing, Cyrus Pillai, Satish K. Pulliam, Lynn TI Interferon-alpha drives monocyte gene expression in chronic unsuppressed HIV-1 infection SO AIDS LA English DT Article DE gene expression; HIV-1; IFN-alpha; lipopolysaccharide; monocyte ID PLASMACYTOID DENDRITIC CELLS; I INTERFERON; HIV-1-INFECTED PATIENTS; MICROBIAL TRANSLOCATION; DISEASE PROGRESSION; IMMUNE ACTIVATION; AIDS PATIENTS; IFN-ALPHA; LIPOPOLYSACCHARIDE; SIALOADHESIN AB Objectives: HIV-1 infection dysregulates the innate immune system and alters leukocyte-gene expression. The objectives were two fold: to characterize the impact of HIV-1 infection on peripheral monocyte gene expression and to identify the predominant factor(s) responsible for altered gene expression. Design and methods: In a cross-sectional study (n = 55), CD14(+) monocytes were isolated from 11 HIV-1 seronegative controls, 22 HIV-1 seropositive individuals with low-viral loads (LVL) and 22 HIV-1 seropositive individuals with high-viral loads (HVL). Monocyte gene expression data were collected for control, LVL and HVL individuals using high-density microarrays. We evaluated three HIV-1 disease-related peripheral factors, interferon (IFN)-alpha, IFN-gamma and lipopolysaccharide (LPS) as candidates causing monocyte dysregulation, by comparing gene expression profiles between study individuals and monocytes treated with these factors in vitro. Plasma from HIV-1 positive individuals was quantified for LPS and soluble CD14. Results: Monocytes from HIV-1-infected individuals with viral loads above 10 000 RNA copies/ml (HVL) displayed an activated phenotype. Characterization of gene expression revealed an ongoing immune response to viral infection including inflammation and chemotaxis. Gene expression analysis of in-vitro-treated HIV-1 seronegative monocytes with IFN-alpha, IFN-gamma or LPS demonstrated that IFN-alpha most accurately recapitulated the HIV-1 HVL profile. No LPS-induced gene expression signature was detected even in HIV-1 individuals with the highest LPS and sCD14 levels. Conclusion: Monocyte gene expression in individuals with HIV-1 viremia is predominantly due to IFN-alpha, whereas individuals with LVL have a nonactivated phenotype. In monocytes, there was no discernible expression profile linked to LPS exposure. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins C1 [Rempel, Hans; Sun, Bing; Calosing, Cyrus; Pulliam, Lynn] San Francisco VA Med Ctr, Dept Lab Med, San Francisco, CA USA. [Pillai, Satish K.; Pulliam, Lynn] San Francisco VA Med Ctr, Dept Med, San Francisco, CA USA. [Pillai, Satish K.; Pulliam, Lynn] Univ Calif San Francisco, Dept Med, San Francisco, CA USA. [Pulliam, Lynn] Univ Calif San Francisco, Dept Lab Med, San Francisco, CA 94143 USA. RP Pulliam, L (reprint author), San Francisco VA Med Ctr, Dept Lab Med, San Francisco, CA USA. EM Lynn.Pulliam@ucsf.edu FU National Institutes of Health (NIMH) [R01MH073478] FX The authors thank Sandy Charles RN, Linda Adams RN and Harry Lampiris MD for recruiting individuals into this study and collecting clinical information. This research was supported by a grant from the National Institutes of Health (NIMH) R01MH073478. NR 37 TC 35 Z9 35 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 EI 1473-5571 J9 AIDS JI Aids PD JUN 19 PY 2010 VL 24 IS 10 BP 1415 EP 1423 DI 10.1097/QAD.0b013e32833ac623 PG 9 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 609DX UT WOS:000278636400003 PM 20495440 ER PT J AU Pai, S Ledoux, WR AF Pai, Shruti Ledoux, William R. TI The compressive mechanical properties of diabetic and non-diabetic plantar soft tissue SO JOURNAL OF BIOMECHANICS LA English DT Article DE Foot; Diabetic; Subcutaneous; Soft tissue; Viscoelastic ID HEEL-PAD; FAT PADS; FOOT; MELLITUS; SOLE; BIOMECHANICS; INDENTATION; STIFFNESS; HISTOLOGY; LOCATION AB Diabetic subjects are at an increased risk of developing plantar ulcers. Knowledge of the physiologic compressive properties of the plantar soft tissue is critical to understanding the possible mechanisms of ulcer formation and improving treatment options. The purpose of this study was to determine the compressive mechanical properties of the plantar soft tissue in both diabetic and non-diabetic specimens from six relevant locations beneath the foot, namely the hallux (big toe), first, third, and fifth metatarsal heads, lateral midfoot, and calcaneus (heel). Cylindrical specimens (1.905 cm diameter) from these locations were excised and separated from the skin and bone from 4 diabetic and 4 non-diabetic age-matched, elderly, fresh-frozen cadaveric feet. Specimens were then subjected to biomechanically realistic strains of similar to 50% in compression using triangle wave tests conducted at five frequencies ranging from 1 to 10 Hz to determine tissue modulus, energy loss, and strain rate dependence. Diabetic vs. non-diabetic results across all specimens, locations, and testing frequencies demonstrated altered mechanical properties with significantly increased modulus (1146.7 vs. 593.0 kPa) but no change in energy loss (68.5 vs. 67.9%). All tissue demonstrated strain rate dependence and tissue beneath the calcaneus was found to have decreased modulus and energy loss compared to other areas. The results of this study could be used to generate material properties for all areas of the plantar soft tissue in diabetic or non-diabetic feet, with implications for foot computational modeling efforts and potentially for pressure alleviating footwear that could reduce plantar ulcer incidence. Published by Elsevier Ltd. C1 [Pai, Shruti; Ledoux, William R.] VA RR&D Ctr Excellence Limb Loss Prevent & Prosth, Seattle, WA 98108 USA. [Pai, Shruti; Ledoux, William R.] Univ Washington, Dept Mech Engn, Seattle, WA 98195 USA. [Ledoux, William R.] Univ Washington, Dept Orthopaed & Sports Med, Seattle, WA 98195 USA. RP Ledoux, WR (reprint author), VA Puget Sound, MS 151,1660 S Columbian Way, Seattle, WA 98108 USA. EM wrledoux@u.washington.edu RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 FU National institutes of Health [1R01 DK75633-03]; Department of Veterans Affairs [A4843C] FX This study was supported by the National institutes of Health grant 1R01 DK75633-03 and the Department of Veterans Affairs, RR&D Service grant A4843C. The authors would also like to thank Jane Shofer, M.S. for the statistical analysis, Michael Fassbind, M.S. for equipment design, and Paul Vawter for assisting with data analysis. NR 39 TC 31 Z9 31 U1 2 U2 16 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0021-9290 J9 J BIOMECH JI J. Biomech. PD JUN 18 PY 2010 VL 43 IS 9 BP 1754 EP 1760 DI 10.1016/j.jbiomech.2010.02.021 PG 7 WC Biophysics; Engineering, Biomedical SC Biophysics; Engineering GA 619ZJ UT WOS:000279468500016 PM 20207359 ER PT J AU Hackler, EA Byun, NE Jones, CK Williams, JM Baheza, R Sengupta, S Grier, MD Avison, M Conn, PJ Gore, JC AF Hackler, E. A. Byun, N. E. Jones, C. K. Williams, J. M. Baheza, R. Sengupta, S. Grier, M. D. Avison, M. Conn, P. J. Gore, J. C. TI SELECTIVE POTENTIATION OF THE METABOTROPIC GLUTAMATE RECEPTOR SUBTYPE 2 BLOCKS PHENCYCLIDINE-INDUCED ACTIVATION HYPERLOCOMOTION AND BRAIN SO NEUROSCIENCE LA English DT Article DE mGluR2; BINA; phMRI; BOLD; antipsychotic; schizophrenia ID POSITIVE ALLOSTERIC MODULATOR; INDUCED LOCOMOTOR-ACTIVITY; PHARMACOLOGICAL MRI; ANIMAL-MODELS; ANTIPSYCHOTIC ACTIVITY; STEREOTYPED BEHAVIOR; GLUCOSE-UTILIZATION; COMPONENT ANALYSIS; NMDA ANTAGONIST; MESSENGER-RNA AB Previous preclinical and clinical studies have demonstrated the efficacy of group II metabotropic glutamate receptor (mGluR) agonists as potential antipsychotics. Recent studies utilizing mGluR2-, mGluR3-, and double knockout mice support that the antipsychotic effects of those compounds are mediated by mGluR2. Indeed, biphenyl indanone-A (BINA), an allosteric potentiator of mGluR2, is effective in experimental models of psychosis, blocking phencyclidine (PCP)-induced hyperlocomotion and prepulse inhibition deficits in mice. In this study, we administered the NMDA receptor antagonist PCP (5.6 mg/kg i.p.) to rats, an established animal model predictive of schizophrenia. Here, we show that BINA (32 mg/kg i.p.) attenuated PCP-induced locomotor activity in rats. Using behaviorally relevant doses of BINA and PCP, we performed pharmacological magnetic resonance imaging (phMRI) to assess the specific brain regions that underlie the psychotomimetic effects of PCP, and examined how BINA modulated the PCP-induced functional changes in vivo. In anesthetized rats, acute administration of PCP produced robust, sustained blood oxygenation level-dependent (BOLD) activation in specific cortical, limbic, thalamic, and striatal regions. Pretreatment with BINA suppressed the amplitude of the BOLD response to PCP in the prefrontal cortex, caudaute-putamen, nucleus accumbens, and mediodorsal thalamus. Our results show key brain structures underlying PCP-induced behaviors in a preclinical model of schizophrenia, and, importantly, its reversal by potentiation of mGluR2 by BINA, revealing specific brain regions functionally involved in its pharmacological action. Finally, our findings bolster the growing body of evidence that mGluR2 is a viable target for the treatment of schizophrenia. (C) 2010 IBRO. Published by Elsevier Ltd. All rights reserved. C1 [Byun, N. E.] Vanderbilt Univ, Inst Imaging Sci, AA Med Ctr N 3101, Nashville, TN 37232 USA. [Hackler, E. A.; Byun, N. E.; Williams, J. M.; Avison, M.; Gore, J. C.] Vanderbilt Univ, Med Ctr, Dept Radiol & Radiol Sci, Nashville, TN 37232 USA. [Jones, C. K.] Tennessee Valley Healthcare Syst, US Dept Vet Affairs, Nashville, TN 37212 USA. [Jones, C. K.; Grier, M. D.; Avison, M.; Conn, P. J.] Vanderbilt Univ, Med Ctr, Dept Pharmacol, Nashville, TN 37232 USA. [Jones, C. K.; Conn, P. J.] Vanderbilt Univ, Med Ctr, Vanderbilt Program Drug Discovery, Nashville, TN 37232 USA. [Sengupta, S.; Gore, J. C.] Vanderbilt Univ, Dept Biomed Engn, Nashville, TN 37232 USA. [Gore, J. C.] Vanderbilt Univ, Dept Phys, Nashville, TN 37232 USA. [Gore, J. C.] Vanderbilt Univ, Med Ctr, Dept Mol Physiol & Biophys, Nashville, TN 37232 USA. RP Byun, NE (reprint author), Vanderbilt Univ, Inst Imaging Sci, AA Med Ctr N 3101, 1161 21st Ave S, Nashville, TN 37232 USA. EM nellie.byun@vanderbilt.edu RI Conn, Peter/D-7848-2012 FU National Institutes of Health; NIBIB; NIMH FX This work was supported by grants from the National Institutes of Health, NIBIB and NIMH. Vanderbilt is a site in the National Institutes of Health-Supported Molecular Libraries Probe Center Network. We would like to thank Jarred True of the Vanderbilt University Institute of Imaging Science for his technical support and assistance. NR 70 TC 33 Z9 33 U1 1 U2 4 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 JUN 16 PY 2010 VL 168 IS 1 BP 209 EP 218 DI 10.1016/j.neuroscience.2010.02.057 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 601ER UT WOS:000278041500020 PM 20350588 ER PT J AU Wear, J McPherson, TB Kolling, WM AF Wear, Jennifer McPherson, Timothy B. Kolling, William M. TI Stability of sodium bicarbonate solutions in polyolefin bags SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Article DE Alkalinizing agents; Concentration; Containers; Dextrose; Diluents; Hydrogen ion concentration; Injections; Polyolefin; Refrigeration; Sodium bicarbonate; Stability; Storage; Temperature; Water for Injection ID OVERDOSE; MANAGEMENT AB Purpose. The stability of sodium bicarbonate solutions in sterile water for injection or 5% dextrose injection stored at 21-24 degrees C or 2-4 degrees C was evaluated. Methods. Sodium bicarbonate injection was obtained in 50-mL vials of 8.4% (1 meq/mL). A total of 50, 100, or 150 meq of sodium bicarbonate was added to each 1-L polyolefin bag of either sterile water for injection or 5% dextrose injection. All solutions were prepared in a laminar-airflow hood using aseptic technique. Bags were punctured once to remove headspace air and once for the addition of each 50 meq of sodium bicarbonate. Six replicates of each test solution were prepared. The solutions were stored at 21-24 degrees C and 2-4 degrees C. Control solutions (50 and 150 meq) were similarly prepared in triplicate. Control solutions were sparged with either nitrogen gas or oxygen gas before storage. Sodium bicarbonate stability was assessed by measuring solution pH. Bicarbonate content was measured utilizing titration. Both pH and bicarbonate concentrations were measured immediately upon preparation and on days 3, 5, and 7 for both test and control solutions. Results. All 95% confidence interval values for sample solution pH remained within 7.0-8.5 for seven days at 2-4 degrees C. Conclusion. Sodium bicarbonate solutions of 50, 100, and 150 meq in sterile water for injection or 5% dextrose injection were stable for up to seven days when refrigerated. The 50-meq solution was stable for up to 48 hours when stored at room temperature, and the 100- and 150-meq solutions were stable for up to 30 hours when stored at room temperature. C1 [McPherson, Timothy B.; Kolling, William M.] So Illinois Univ, Sch Pharm, Edwardsville, IL 62026 USA. [Wear, Jennifer] William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. RP McPherson, TB (reprint author), So Illinois Univ, Sch Pharm, Campus Box 2000, Edwardsville, IL 62026 USA. EM tmcpher@siue.edu NR 16 TC 2 Z9 2 U1 0 U2 0 PU AMER SOC HEALTH-SYSTEM PHARMACISTS PI BETHESDA PA 7272 WISCONSIN AVE, BETHESDA, MD 20814 USA SN 1079-2082 J9 AM J HEALTH-SYST PH JI Am. J. Health-Syst. Pharm. PD JUN 15 PY 2010 VL 67 IS 12 BP 1026 EP 1029 DI 10.2146/ajhp090301 PG 4 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 609VG UT WOS:000278685100017 PM 20516474 ER PT J AU Jones, SF Gaggar, A AF Jones, Shirley Fong Gaggar, Amit TI Is There a Doctor in the House? The Downside of 24/7 Attending Coverage in Academic Intensive Care Units SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Editorial Material ID MORTALITY; PROGRAMS C1 [Jones, Shirley Fong] Scott & White Mem Hosp & Clin, Texas A&M Hlth Sci Ctr, Dept Internal Med, Temple, TX 76508 USA. [Gaggar, Amit] Univ Alabama, Dept Internal Med, Birmingham, AL USA. [Gaggar, Amit] Birmingham VA Med Ctr, Birmingham, AL USA. RP Jones, SF (reprint author), Scott & White Mem Hosp & Clin, Texas A&M Hlth Sci Ctr, Dept Internal Med, Temple, TX 76508 USA. NR 7 TC 12 Z9 12 U1 0 U2 0 PU AMER THORACIC SOC PI NEW YORK PA 61 BROADWAY, FL 4, NEW YORK, NY 10006 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD JUN 15 PY 2010 VL 181 IS 12 BP 1280 EP 1281 DI 10.1164/rccm.201005-0681ED PG 2 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 615UB UT WOS:000279162000002 PM 20558638 ER PT J AU Ziemer, DC Kolm, P Weintraub, WS Vaccarino, V Rhee, MK Twombly, JG Narayan, V Koch, DD Phillips, LS AF Ziemer, David C. Kolm, Paul Weintraub, William S. Vaccarino, Viola Rhee, Mary K. Twombly, Jennifer G. Narayan, Venkat Koch, David D. Phillips, Lawrence S. TI Glucose-Independent, Black-White Differences in Hemoglobin A(1c) Levels SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID DEPENDENT DIABETES-MELLITUS; MEAN BLOOD-GLUCOSE; HEALTH-CARE ACCESS; GLYCEMIC CONTROL; GLYCATED HEMOGLOBIN; ETHNIC DISPARITIES; MICROVASCULAR COMPLICATIONS; GLYCOSYLATED HEMOGLOBIN; BIOLOGICAL VARIATION; RACIAL DISPARITIES AB Background: A previous study of participants with prediabetes found that hemoglobin A(1c) (HbA(1c)) levels differed between black and white participants with no differences in glucose concentration. Objective: To determine whether black-white differences in HbA(1c) level are present in other populations and across the full spectrum of glycemia. Design: Cross-sectional, retrospective. Setting: Outpatient. Participants: 1581 non-Hispanic black and white participants between 18 and 87 years of age without known diabetes in the SIGT (Screening for Impaired Glucose Tolerance) study and 1967 non-Hispanic black and white participants older than 40 years without known diabetes in the NHANES III (Third National Health and Nutrition Examination Survey). Measurements: HbA(1c) levels, anthropometry, and plasma glucose levels during oral glucose tolerance testing. Results: Hemoglobin A(1c) levels were higher in black than in white participants with normal glucose tolerance (0.13 percentage point [P < 0.001] in the SIGT sample and 0.21 percentage point [P < 0.001] in the NHANES III sample), prediabetes (0.26 percentage point [P < 0.001] and 0.30 percentage point [P < 0.001], respectively), or diabetes (0.47 percentage point [P < 0.020] and 0.47 percentage point [P < 0.013], respectively) after adjustment for plasma glucose levels and other characteristics known to correlate with HbA(1c) levels. Limitation: The mechanism for the differences is unknown. Conclusion: Black persons have higher HbA(1c) levels than white persons across the full spectrum of glycemia, and the differences increase as glucose intolerance worsens. These findings could limit the use of HbA(1c) to screen for glucose intolerance, indicate the risk for complications, measure quality of care, and evaluate disparities in health. C1 [Ziemer, David C.] Emory Univ, Sch Med, Div Endocrinol, Atlanta, GA 30303 USA. Med Ctr, US Dept Vet Affairs, Atlanta, GA USA. Christiana Care Hlth Syst, Newark, DE USA. RP Ziemer, DC (reprint author), Emory Univ, Sch Med, Div Endocrinol, 49 Jesse Hill Jr Dr SE, Atlanta, GA 30303 USA. FU National Institutes of Health and National Center for Research Resources [DK07298, DK062668, RR017643, DK066204, RR00039]; U.S. Department of Veterans Affairs Health Services Research and Development Service [SHP 08-144, IIR 07-138] FX By the National Institutes of Health and National Center for Research Resources (awards DK07298, DK062668, RR017643, DK066204, and RR00039) and U.S. Department of Veterans Affairs Health Services Research and Development Service (awards SHP 08-144 and IIR 07-138). NR 51 TC 144 Z9 146 U1 2 U2 8 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 EI 1539-3704 J9 ANN INTERN MED JI Ann. Intern. Med. PD JUN 15 PY 2010 VL 152 IS 12 BP 770 EP + DI 10.7326/0003-4819-152-12-201006150-00004 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 611OP UT WOS:000278827700002 PM 20547905 ER PT J AU Rosell, DR Thompson, JL Slifstein, M Xu, XY Frankle, WG New, AS Goodman, M Weinstein, SR Laruelle, M Abi-Dargham, A Siever, LJ AF Rosell, Daniel R. Thompson, Judy L. Slifstein, Mark Xu, Xiaoyan Frankle, W. Gordon New, Antonia S. Goodman, Marianne Weinstein, Shauna R. Laruelle, Marc Abi-Dargham, Anissa Siever, Larry J. TI Increased Serotonin 2A Receptor Availability in the Orbitofrontal Cortex of Physically Aggressive Personality Disordered Patients SO BIOLOGICAL PSYCHIATRY LA English DT Article DE Aggression; intermittent explosive disorder; orbitofrontal cortex; personality disorder; positron emission tomography; serotonin ID INTERMITTENT EXPLOSIVE DISORDER; POSITRON-EMISSION-TOMOGRAPHY; PLACEBO-CONTROLLED TRIAL; PRIMATE CEREBRAL-CORTEX; IMPULSIVE AGGRESSION; 5-HT2A RECEPTORS; ABNORMAL AGGRESSION; RAT-BRAIN; LEARNED HELPLESSNESS; PREFRONTAL CORTEX AB Background: Impulsive physical aggression is a common and problematic feature of many personality disorders. The serotonergic system is known to be involved in the pathophysiology of aggression, and multiple lines of evidence have implicated the serotonin 2A receptor (5-HT(2A)R). We sought to examine the role of the 5-HT(2A)R in impulsive aggression specifically in the orbitofrontal cortex (OFC), given that our own studies and an extensive literature indicate that serotonergic disturbances in the OFC are linked to aggression. We have previously hypothesized that increased 5-HT(2A)R function in the OFC is a state phenomenon that promotes impulsive aggression. Methods: Serotonin 2A receptor availability was measured with positron emission tomography and the selective 5-HT(2A)R antagonist radioligand [(11)C]MDL100907 in two groups of impulsively aggressive personality disordered patients-14 with current physical aggression, and 15 without current physical aggression-and 25 healthy control subjects. Clinical ratings of various symptom dimensions were also obtained. Results: Orbitofrontal 5-HT(2A)R availability was greater in patients with current physical aggression compared with patients without current physical aggression and healthy control subjects; no differences in OFC 5-HT(2A)R availability were observed between patients without current physical aggression and healthy control subjects. No significant differences in 5-HT(2A)R availability were observed in other brain regions examined. Among both groups of impulsively aggressive personality disordered patients combined, OFC 5-HT(2A)R availability was correlated, specifically, with a state measure of impulsive aggression. Conclusions: These findings are consistent with our previously described model in which impulsive aggression is related to dynamic changes in 5-HT(2A)R function in the OFC. C1 [Rosell, Daniel R.; New, Antonia S.; Goodman, Marianne; Weinstein, Shauna R.; Siever, Larry J.] James J Peters Vet Affairs Med Ctr, Bronx, NY USA. [Rosell, Daniel R.; New, Antonia S.; Goodman, Marianne; Weinstein, Shauna R.; Siever, Larry J.] Mt Sinai Sch Med, New York, NY USA. [Thompson, Judy L.; Slifstein, Mark; Xu, Xiaoyan; Abi-Dargham, Anissa] Columbia Univ, Med Ctr, New York, NY 10027 USA. [Thompson, Judy L.; Slifstein, Mark; Xu, Xiaoyan; Abi-Dargham, Anissa] New York State Psychiat Inst & Hosp, New York, NY 10032 USA. [Frankle, W. Gordon] Univ Pittsburgh, Western Psychiat Inst & Clin, Pittsburgh, PA 15213 USA. [Laruelle, Marc] Univ London Imperial Coll Sci Technol & Med, London, England. RP Siever, LJ (reprint author), James J Peters Dept Vet Affairs, Med Ctr, 130 W Kingsbridge Rd,Room 6A-44, Bronx, NY 10468 USA. EM larry.siever@va.gov OI Frankle, William/0000-0003-0356-4197 FU National Institute of Mental Health [MH063875]; Veterans Affairs Merit Review [7609-028]; Veterans Affairs VISN 3 Mental Illness Research, Education and Clinical Center; Office of Academic Affiliations; Mental Illness Research and Treatment, Department of Veterans Affairs; National Center for Research Resources (NCRR) [MO1-RR-00071]; Intracellular Therapies, Inc.; GlaxoSmithKline, Inc.; Bristol-Meyers Squibb, Inc.; Sepracor Inc. FX This research was supported by Grant MH063875 from the National Institute of Mental Health and by a Veterans Affairs Merit Review Grant (7609-028) to us and by the Veterans Affairs VISN 3 Mental Illness Research, Education and Clinical Center. Writing of this manuscript was supported by the Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, Department of Veterans Affairs. This publication was made possible by Grant MO1-RR-00071 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (Nth). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NCRR or NIH.; Dr. Slifstein reports the following: Grant Support: Intracellular Therapies, Inc.; Consulting: GlaxoSmithKline, Inc., Amgen, Inc. Dr. Frankle reports the following: Consulting: Ono Pharma, USA, Inc.; Sepracor, Inc.; Speaking Fees: Bristol-Meyers Squibb, Inc.; Research Support: GlaxoSmithKline, Inc.; and Sepracor Inc. Dr. Laruelle is a full time employee of GlaxoSmithKline, Inc. Dr. Abi-Dargham reports the following: Grant support: GlaxoSmithKline, Inc.; compensation received from BMS-Otsuka for consulting and speaking engagements. The other authors report no biomedical financial interests or potential conflicts of interest. NR 57 TC 34 Z9 34 U1 1 U2 14 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 JUN 15 PY 2010 VL 67 IS 12 BP 1154 EP 1162 DI 10.1016/j.biopsych.2010.03.013 PG 9 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 616JQ UT WOS:000279205800006 PM 20434136 ER PT J AU Baddley, JW Andes, DR Marr, KA Kontoyiannis, DP Alexander, BD Kauffman, CA Oster, RA Anaissie, EJ Walsh, TJ Schuster, MG Wingard, JR Patterson, TF Ito, JI Williams, OD Chiller, T Pappas, PG AF Baddley, John W. Andes, David R. Marr, Kieren A. Kontoyiannis, Dimitrios P. Alexander, Barbara D. Kauffman, Carol A. Oster, Robert A. Anaissie, Elias J. Walsh, Thomas J. Schuster, Mindy G. Wingard, John R. Patterson, Thomas F. Ito, James I. Williams, O. Dale Chiller, Tom Pappas, Peter G. CA Transplant Associated Infect Surve TI Factors Associated with Mortality in Transplant Patients with Invasive Aspergillosis SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID STEM-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; LIPOSOMAL AMPHOTERICIN-B; PROGNOSTIC-FACTORS; FUNGAL-INFECTIONS; IMMUNOCOMPROMISED PATIENTS; HEMATOLOGIC MALIGNANCIES; ATTRIBUTABLE MORTALITY; PRIMARY THERAPY; EPIDEMIOLOGY AB Background. Invasive aspergillosis (IA) is an important cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) recipients. The purpose of this study was to evaluate factors associated with mortality in transplant patients with IA. Methods. Transplant patients from 23 US centers were enrolled from March 2001 to October 2005 as part of the Transplant Associated Infection Surveillance Network. IA cases were identified prospectively in this cohort through March 2006, and data were collected. Factors associated with 12-week all-cause mortality were determined by logistic regression analysis and Cox proportional hazards regression. Results. Six-hundred forty-two cases of proven or probable IA were evaluated, of which 317 (49.4%) died by the study endpoint. All-cause mortality was greater in HSCT patients (239 [57.5%] of 415) than in SOT patients (78 [34.4%] of 227;). Independent poor prognostic factors P < .001 in HSCT patients were neutropenia, renal insufficiency, hepatic insufficiency, early-onset IA, proven IA, and methylprednisolone use. In contrast, white race was associated with decreased risk of death. Among SOT patients, hepatic insufficiency, malnutrition, and central nervous system disease were poor prognostic indicators, whereas prednisone use was associated with decreased risk of death. Among HSCT or SOT patients who received antifungal therapy, use of an amphotericin B preparation as part of initial therapy was associated with increased risk of death. Conclusions. There are multiple variables associated with survival in transplant patients with IA. Understanding these prognostic factors may assist in the development of treatment algorithms and clinical trials. C1 [Baddley, John W.] Univ Alabama, Dept Med, Div Infect Dis, Birmingham, AL 35294 USA. [Baddley, John W.] Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. [Andes, David R.] Univ Wisconsin, Madison, WI USA. [Marr, Kieren A.] Johns Hopkins Univ, Sch Med, Baltimore, MD USA. [Walsh, Thomas J.] NCI, Bethesda, MD 20892 USA. [Kontoyiannis, Dimitrios P.] Univ Texas MD Anderson Canc Res Ctr, Houston, TX USA. [Patterson, Thomas F.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Patterson, Thomas F.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Alexander, Barbara D.] Duke Univ, Med Ctr, Durham, NC USA. [Kauffman, Carol A.] Univ Michigan, Ann Arbor, MI 48109 USA. [Kauffman, Carol A.] Vet Affairs Hlth Care Syst, Ann Arbor, MI USA. [Anaissie, Elias J.] Univ Arkansas, Dept Med, Div Infect Dis, Little Rock, AR 72204 USA. [Schuster, Mindy G.] Univ Penn, Philadelphia, PA 19104 USA. [Wingard, John R.] Univ Florida, Gainesville, FL USA. [Ito, James I.] City Hope Natl Med Ctr, Duarte, CA 91010 USA. [Chiller, Tom] Ctr Dis Control & Prevent, Div Mycot Dis, Atlanta, GA USA. RP Baddley, JW (reprint author), Univ Alabama, Dept Med, Div Infect Dis, 1900 Univ Blvd,229 Tinsley Harrison Tower, Birmingham, AL 35294 USA. EM jbaddley@uab.edu FU NIAID NIH HHS [K23 AI064613, K23 AI064613-05, K23AI064613, K24 AI072522] NR 28 TC 117 Z9 120 U1 1 U2 9 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 JUN 15 PY 2010 VL 50 IS 12 BP 1559 EP 1567 DI 10.1086/652768 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 598BF UT WOS:000277806200002 PM 20450350 ER PT J AU Lipsky, BA Byren, I Hoey, CT AF Lipsky, Benjamin A. Byren, Ivor Hoey, Christopher T. TI Treatment of Bacterial Prostatitis SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID PELVIC PAIN SYNDROME; DOUBLE-BLIND TRIAL; TISSUE CONCENTRATIONS; SYMPTOM INDEX; ANTIBIOTIC-THERAPY; ESCHERICHIA-COLI; ADENOMA TISSUE; SEMINAL FLUID; MEN; LEVOFLOXACIN AB Prostatitis is characterized by voiding symptoms and genitourinary pain and is sometimes associated with sexual dysfunction. Up to 25% of men receive a diagnosis of prostatitis in their lifetime, but ! 10% have a proven bacterial infection. The causes and treatment of nonbacterial prostatitis are largely unknown, but bacterial prostatitis is caused by infection with uropathogens, especially gram-negative bacilli, although infection is sometimes due to gram-positive and atypical microorganisms. Acute bacterial prostatitis is easily diagnosed (by abrupt urogential and often systemic symptoms, along with bacteriuria) and treated (by systemic antibiotic therapy). Chronic bacterial prostatitis is characterized by prolonged or recurrent symptoms and relapsing bacteriuria; diagnosis traditionally requires comparing urinary specimens obtained before with specimens obtained after prostatic massage. Treating chronic bacterial prostatitis requires prolonged therapy with an antibiotic that penetrates the prostate (ie, one with high lipid solubility, a low degree of ionization, high dissociation constant, low protein binding, and small molecular size). We review recent pharmacological and clinical data on treating bacterial prostatitis. C1 [Lipsky, Benjamin A.] VA Puget Sound Hlth Care Syst, Primary Care Clin S 111 PCC, Gen Internal Med Serv, Seattle, WA 98108 USA. [Hoey, Christopher T.] VA Puget Sound Hlth Care Syst, Serv Pharm, Seattle, WA 98108 USA. [Lipsky, Benjamin A.] Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. [Byren, Ivor] John Radcliffe Hosp, Dept Infect Dis, Oxford OX3 9DU, England. [Byren, Ivor] Univ Oxford, Oxford, England. RP Lipsky, BA (reprint author), VA Puget Sound Hlth Care Syst, Primary Care Clin S 111 PCC, Gen Internal Med Serv, 1660 S Columbian Way, Seattle, WA 98108 USA. EM balipsky@uw.edu OI Lipsky, Benjamin A./0000-0001-9886-5114 FU Merck; Pfizer; Nordic Pharma FX Potential conflicts of interest. B. A. L. has received research funding from Merck and Pfizer and has served as a consultant to Pfizer, Ortho-McNeil, Cubist, and Wyeth-Ayerst. I. B. has received honoraria for serving on advisory boards from Pfizer and has received lecture fees from Pfizer and Nordic Pharma. C. T. H.: no conflicts. NR 102 TC 49 Z9 59 U1 2 U2 8 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 JUN 15 PY 2010 VL 50 IS 12 BP 1641 EP 1652 DI 10.1086/652861 PG 12 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 598BF UT WOS:000277806200015 PM 20459324 ER PT J AU Friedlander, AH AF Friedlander, Arthur H. TI Oral Cavity Staphylococci Are a Potential Source of Prosthetic Joint Infection SO CLINICAL INFECTIOUS DISEASES LA English DT Letter ID MICROFLORA; AGE C1 [Friedlander, Arthur H.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Friedlander, Arthur H.] UCLA Med Ctr, Hosp Dent Serv, Los Angeles, CA USA. [Friedlander, Arthur H.] UCLA Dent Sch, Los Angeles, CA USA. RP Friedlander, AH (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM arthur.friedlander@med.va.gov NR 11 TC 5 Z9 5 U1 0 U2 0 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 JUN 15 PY 2010 VL 50 IS 12 BP 1682 EP 1683 DI 10.1086/653003 PG 2 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 598BF UT WOS:000277806200020 PM 20482262 ER PT J AU Becker, K Poon, C Zeidler, M Wang, TS AF Becker, Kendra Poon, Charles Zeidler, Michelle Wang, Tisha TI An Unusual Cause of Delirium SO JOURNAL OF CLINICAL SLEEP MEDICINE LA English DT Editorial Material DE Central sleep apnea; obstructive sleep apnea; delirium; congestive heart failure; Cheyne-Stokes ID HEART-FAILURE; SLEEP-APNEA AB Sleep disordered breathing (SDB) including obstructive sleep apnea (OSA), central sleep apnea (CSA), and Cheyne-Stokes breathing is common in patients with congestive heart failure (CHF). In a study of 81 males with an ejection fraction (EF) < 45%, 51% of patients had documented SDB with the majority of cases representing CSA.(1) Studies suggest that SDB is an independent risk factor for increased morbidity and mortality in the setting of CHF.(2) Like OSA, CSA frequently presents with nighttime awakenings, nocturnal hypoxia, and daytime somnolence, but only OSA has been reported to present with delirium. We present a patient with clear manifestations of CSA with frank delirium that improved only after BPAP therapy. C1 [Becker, Kendra] VA Greater Los Angeles Healthcare Syst, Sleep Med Dept 111Q, Los Angeles, CA 90073 USA. [Becker, Kendra; Poon, Charles] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. [Becker, Kendra; Poon, Charles] Olive View UCLA Med Ctr, Sylmar, CA 91342 USA. [Zeidler, Michelle; Wang, Tisha] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Becker, K (reprint author), VA Greater Los Angeles Healthcare Syst, Sleep Med Dept 111Q, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM kendrabecker@gmail.com NR 6 TC 3 Z9 3 U1 0 U2 1 PU AMER ACAD SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CTR, STE 920, WESTCHESTER, IL 60154 USA SN 1550-9389 J9 J CLIN SLEEP MED JI J. Clin. Sleep Med. PD JUN 15 PY 2010 VL 6 IS 3 BP 290 EP 291 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 611BU UT WOS:000278786300012 PM 20572424 ER PT J AU Holt, SK Kwon, EM Lin, DW Ostrander, EA Stanford, JL AF Holt, Sarah K. Kwon, Erika M. Lin, Daniel W. Ostrander, Elaine A. Stanford, Janet L. TI Association of Hepsin Gene Variants with Prostate Cancer Risk and Prognosis SO PROSTATE LA English DT Article DE prostate neoplasm; single nucleotide polymorphism; Hepsin; case-control ID SINGLE-NUCLEOTIDE POLYMORPHISMS; LINKAGE DISEQUILIBRIUM; AGGRESSIVENESS LOCI; LAMININ-332; PROGRESSION; SUBSTRATE; SCAN AB BACKGROUND. Hepsin (HPN) is one of the most consistently overexpressed genes in prostate cancer and there is some evidence supporting an association between HPN gene variants and prostate cancer risk. We report results from a population-based case control genetic association study for six tagging single nucleotide polymorphisms (tagSNPs) in the HPN gene. METHODS. Prostate cancer risk was estimated using adjusted unconditional logistic regression in 1,401 incident prostate cancer cases diagnosed in 1993 through 1996 or 2002 through 2005 and 1,351 age-matched controls. Risks of disease recurrence/progression and prostate cancer-specific mortality were estimated using Cox proportional hazards (PH) regression in 437 cases with long-term follow-up. RESULTS. There were 135 recurrence/progression events and 57 cases who died of prostate cancer. Contrary to some earlier studies, we found no evidence of altered risk of developing prostate cancer overall or when clinical measures of tumor aggressiveness were considered for any of the tagSNPs, assessed either individually or by haplotypes. There was no evidence of altered risks of tumor recurrence/progression or prostate cancer death associated with variants in the HPN gene. CONCLUSIONS. Germline genetic variation of HPN does not seem to contribute to risk of prostate cancer or prognosis. Prostate 70: 1012-1019, 2010. (c) 2010 Wiley-Liss, Inc. C1 [Holt, Sarah K.; Lin, Daniel W.; Stanford, Janet L.] Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Seattle, WA 98109 USA. [Kwon, Erika M.; Ostrander, Elaine A.] NHGRI, Canc Genet Branch, NIH, Bethesda, MD 20892 USA. [Kwon, Erika M.] Johns Hopkins Univ, Sch Med, Program Human Genet & Mol Biol, Baltimore, MD USA. [Lin, Daniel W.] Vet Affairs Puget Sound Hlth Care Syst, Dept Urol, Seattle, WA USA. [Lin, Daniel W.] Univ Washington, Dept Urol, Seattle, WA 98195 USA. [Stanford, Janet L.] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. RP Holt, SK (reprint author), Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Mailstop M4-A402,POB 19024, Seattle, WA 98109 USA. EM skholt@fhcrc.org OI Ostrander, Elaine/0000-0001-6075-9738 FU National Cancer Institute [RO1-CA56678, RO1-CA092579, RO1-CA082554, P50-CA097186]; Fred Hutchinson Cancer Research Center; National Human Genome Research Institute FX Grant sponsor: National Cancer Institute; Grant numbers: RO1-CA56678, RO1-CA092579, RO1-CA082554, P50-CA097186; Grant sponsor: Fred Hutchinson Cancer Research Center; Grant sponsor: Intramural Program of the National Human Genome Research Institute. NR 21 TC 15 Z9 15 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-4137 J9 PROSTATE JI Prostate PD JUN 15 PY 2010 VL 70 IS 9 BP 1012 EP 1019 DI 10.1002/pros.21135 PG 8 WC Endocrinology & Metabolism; Urology & Nephrology SC Endocrinology & Metabolism; Urology & Nephrology GA 607IO UT WOS:000278494300009 PM 20166135 ER PT J AU Johansen, KL AF Johansen, Kirsten L. TI Chronic Kidney Disease in Elderly Individuals SO ARCHIVES OF INTERNAL MEDICINE LA English DT Editorial Material ID CARDIOVASCULAR-DISEASE; MORTALITY RISK; AGE; PREVALENCE; OUTCOMES; EGFR; CKD C1 [Johansen, Kirsten L.] San Francisco VA Med Ctr, Nephrol Sect, San Francisco, CA 94121 USA. [Johansen, Kirsten L.] Univ Calif San Francisco, Dept Med, San Francisco, CA USA. RP Johansen, KL (reprint author), San Francisco VA Med Ctr, Nephrol Sect, 4150 Clement St,POB 111J, San Francisco, CA 94121 USA. EM kirsten.johansen@ucsf.edu NR 14 TC 2 Z9 2 U1 0 U2 0 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 JUN 14 PY 2010 VL 170 IS 11 BP 926 EP 927 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 610YA UT WOS:000278775100001 PM 20548002 ER PT J AU O'Hare, AM Hailpern, SM Pavkov, ME Rios-Burrows, N Gupta, I Maynard, C Todd-Stenberg, J Rodriguez, RA Hemmelgarn, BR Saran, R Williams, DE AF O'Hare, Ann M. Hailpern, Susan M. Pavkov, Meda E. Rios-Burrows, Nilka Gupta, Indra Maynard, Charles Todd-Stenberg, Jeff Rodriguez, Rudolph A. Hemmelgarn, Brenda R. Saran, Rajiv Williams, Desmond E. TI Prognostic Implications of the Urinary Albumin to Creatinine Ratio in Veterans of Different Ages With Diabetes SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID CHRONIC KIDNEY-DISEASE; GLOMERULAR-FILTRATION-RATE; ALL-CAUSE MORTALITY; CARDIOVASCULAR MORTALITY; NONDIABETIC INDIVIDUALS; RISK-FACTORS; MICROALBUMINURIA; POPULATION; DEATH; OUTCOMES AB Background: Albuminuria is associated with an increased risk of death independent of level of renal function. Whether this association is similar for adults of all ages is not known. Methods: We examined the association between the albumin to creatinine ratio (ACR) and all-cause mortality after stratification by estimated glomerular filtration rate (eGFR) and age group in 94 934 veterans with diabetes mellitus. Cohort members had at least 1 ACR recorded in the Veterans Affairs Health Care System between October 1, 2002, and September 30, 2003, and were followed up for death through October 15, 2009. Results: From the youngest to the oldest age group, the prevalence of an eGFR less than 60 mL/min/1.73 m(2) ranged from 11% to 41%; microalbuminuria (ACR 30299 mg/g) ranged from 19% to 28%; and macroalbuminuria (ACR >= 300 mg/g) ranged from 3.2% to 3.7%. Of patients with an eGFR less than 60 mL/min/1.73 m(2), 72% of those younger than 65 years, 74% of those 65 to 74 years old, and 59% of those 75 years and older had an eGFR of 45 to 59 mL/min/1.73 m(2). In all age groups, less than 35% of these patients had albuminuria (ie, ACR >= 30 mg/g). In patients 75 years and older, the ACR was independently associated with an increased risk of death at all levels of eGFR after adjusting for potential confounders. In younger age groups, this association was present at higher levels of eGFRs but seemed to be attenuated at lower levels. Conclusion: The ACR is independently associated with mortality at all levels of eGFR in older adults with diabetes and may be particularly helpful for risk stratification in the large group with moderate reductions in eGFR. C1 [O'Hare, Ann M.; Rodriguez, Rudolph A.] Vet Affairs Puget Sound Healthcare Syst, Dept Med, Seattle, WA USA. [O'Hare, Ann M.; Gupta, Indra; Maynard, Charles; Todd-Stenberg, Jeff] Vet Affairs Puget Sound Healthcare Syst, Hlth Serv Res & Dev Ctr Excellence, Seattle, WA USA. [O'Hare, Ann M.; Rodriguez, Rudolph A.] Univ Washington, Dept Med, Seattle, WA USA. [Hailpern, Susan M.; Pavkov, Meda E.; Rios-Burrows, Nilka; Williams, Desmond E.] Ctr Dis Control & Prevent, Div Diabet Translat, Atlanta, GA USA. [Hemmelgarn, Brenda R.] Univ Calgary, Dept Med, Calgary, AB, Canada. [Saran, Rajiv] Univ Michigan, Ann Arbor, MI 48109 USA. RP O'Hare, AM (reprint author), VA Puget Sound Med Ctr, Div Nephrol, Primary & Specialty Med Serv Line, Nephrol & Renal Dialysis Unit, Bldg 100,Room 5B113,1660 S Columbian Way, Seattle, WA 98108 USA. EM ann.ohare@va.gov RI Hemmelgarn, Brenda/I-6894-2012; Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 FU National Institute on Aging; Japanese Society for Footcare; UpToDate; Centers for Disease Control and Prevention; VA Puget Sound Health Care System FX Financial Disclosure: Dr O'Hare receives research support from the National Institute on Aging and has received royalties from UpToDate and speaker fees from the Japanese Society for Footcare in the past year.; Funding/Support: This work was supported by an Interagency Agreement between the Centers for Disease Control and Prevention and the VA Puget Sound Health Care System. NR 29 TC 31 Z9 34 U1 1 U2 1 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 JUN 14 PY 2010 VL 170 IS 11 BP 930 EP 936 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 610YA UT WOS:000278775100005 PM 20548004 ER PT J AU Kerlikowske, K AF Kerlikowske, Karla TI A Call for Evidence of Benefits Outweighing Harms Before Implementing New Technologies SO ARCHIVES OF INTERNAL MEDICINE LA English DT Editorial Material ID COMPUTER-AIDED DETECTION; SCREENING MAMMOGRAPHY; BREAST-CANCER; PERFORMANCE C1 [Kerlikowske, Karla] Univ Calif San Francisco, Gen Internal Med Sect, Dept Vet Affairs, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. [Kerlikowske, Karla] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94121 USA. [Kerlikowske, Karla] Univ Calif San Francisco, Dept Med, San Francisco, CA 94121 USA. RP Kerlikowske, K (reprint author), Univ Calif San Francisco, Gen Internal Med Sect, Dept Vet Affairs, San Francisco Vet Affairs Med Ctr, 111A1,4150 Clement St, San Francisco, CA 94121 USA. EM karla.kerlikowske@ucsf.edu FU NCI NIH HHS [P50 CA58207, U01CA63740] NR 14 TC 4 Z9 5 U1 0 U2 0 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 JUN 14 PY 2010 VL 170 IS 11 BP 990 EP 991 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 610YA UT WOS:000278775100015 PM 20548014 ER PT J AU Greenstein, RJ Su, LY Brown, ST AF Greenstein, Robert J. Su, Liya Brown, Sheldon T. TI The Thioamides Methimazole and Thiourea Inhibit Growth of M. avium Subspecies paratuberculosis in Culture SO PLOS ONE LA English DT Article ID CROHNS-DISEASE; MYCOBACTERIUM-LEPRAE; ANTITHYROID DRUGS; GRAVES-DISEASE; HASHIMOTOS-THYROIDITIS; LEPROSY; MECHANISM; TUBERCULOSIS; HYPERTHYROIDISM; MULTIPLICATION AB Background: Thyrotoxicosis is conceptualized as an "autoimmune'' disease with no accepted infectious etiology. There are increasingly compelling data that another "autoimmune'' affliction, Crohn disease, may be caused by Mycobacterium avium subspecies paratuberculosis (MAP). Like M. tb, MAP is systemic. We hypothesized that some cases of thyrotoxicosis may be initiated by a MAP infection. Because other thioamides treat tuberculosis, leprosy and M. avium complex, we hypothesized that a mode of action of some thioamide anti-thyrotoxicosis medications may include MAP growth inhibition. Methods: The effect of the thioamides, thiourea, methimazole and 6-propo-2-thiouracil (6-PTU) were studied in radiometric Bactec (R) culture, on ten strains of three mycobacterial species (six of MAP, two of M. avium and two of M. tb. complex). Data are presented as "cumulative growth index,'' (cGI) or "percent decrease in cumulative GI'' (%-Delta cGI). Principal Findings: Methimazole was the most effective thioamide at inhibiting MAP growth. At 128 mu g/ml: MAP UCF-4; 65%-Delta cGI & MAP ATCC 19698; 90%-Delta cGI. Thiourea inhibited MAP "Ben'' maximally; 70%-Delta cGI. Neither methimazole nor thiourea inhibited M. avium or M. tb. at the doses tested. 6-PTU has no inhibition on any strain studied, although a structurally analogous control, 5-PTU, was the most inhibitory thioamide tested. Significance: We show inhibition of MAP growth by the thioamides, thiourea and methimazole in culture. These data are compatible with the hypothesis that these thioamides may have anti-prokaryotic in addition to their well-established eukaryotic actions in thyrotoxic individuals. C1 [Greenstein, Robert J.] James J Peters VA Med Ctr, Dept Surg, Bronx, NY USA. [Greenstein, Robert J.; Su, Liya] James J Peters VA Med Ctr, Lab Mol Surg Res, Bronx, NY USA. [Brown, Sheldon T.] James J Peters VA Med Ctr, Dept Med, Bronx, NY USA. [Brown, Sheldon T.] Mt Sinai Sch Med, New York, NY USA. RP Greenstein, RJ (reprint author), James J Peters VA Med Ctr, Dept Surg, Bronx, NY USA. EM BGAxis@aol.com FU Bronx Veterans Medical Research Foundation, Inc. at the James J. Peters VAMC Bronx NY FX The authors thank Becton-Dickinson for providing the Bactec (R) vials. Becton-Dickinson had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No other extramural funds were obtained. This material is the result of work supported with resources and the use of facilities at the James J. Peters VAMC Bronx NY. Other than the JJP VAMC Bronx Research and Development Committee reviewing, and approving, our submitted research protocol the James J. Peters VAMC Bronx NY had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This study was supported by the Bronx Veterans Medical Research Foundation, Inc. at the James J. Peters VAMC Bronx NY. The Bronx Veterans Medical Research Foundation, Inc. had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 39 TC 4 Z9 4 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 JUN 14 PY 2010 VL 5 IS 6 AR e11099 DI 10.1371/journal.pone.0011099 PG 8 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 610NX UT WOS:000278741100013 PM 20559419 ER PT J AU Zraika, S Aston-Mourney, K Marek, P Hull, RL Green, PS Udayasankar, J Subramanian, SL Raleigh, DP Kahn, SE AF Zraika, Sakeneh Aston-Mourney, Kathryn Marek, Peter Hull, Rebecca L. Green, Pattie S. Udayasankar, Jayalakshmi Subramanian, Shoba L. Raleigh, Daniel P. Kahn, Steven E. TI Neprilysin Impedes Islet Amyloid Formation by Inhibition of Fibril Formation Rather Than Peptide Degradation SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID INSULIN-DEGRADING ENZYME; NEUTRAL ENDOPEPTIDASE; DIABETES-MELLITUS; POLYPEPTIDE IAPP; IN-VITRO; TRANSGENIC MICE; MOUSE ISLETS; A-BETA; CELL; SECRETION AB Deposition of islet amyloid polypeptide (IAPP) as islet amyloid in type 2 diabetes contributes to loss of beta-cell function and mass, yet the mechanism for its occurrence is unclear. Neprilysin is a metallopeptidase known to degrade amyloid in Alzheimer disease. We previously demonstrated neprilysin to be present in pancreatic islets and now sought to determine whether it plays a role in degrading islet amyloid. We used an in vitro model where cultured human IAPP (hIAPP) transgenic mouse islets develop amyloid and thereby have increased beta-cell apoptosis. Islet neprilysin activity was inhibited or up-regulated using a specific inhibitor or adenovirus encoding neprilysin, respectively. Following neprilysin inhibition, islet amyloid deposition and beta-cell apoptosis increased by 54 and 75%, respectively, whereas when neprilysin was up-regulated islet amyloid deposition and beta-cell apoptosis both decreased by 79%. To determine if neprilysin modulated amyloid deposition by cleaving hIAPP, analysis of hIAPP incubated with neprilysin was performed by mass spectrometry, which failed to demonstrate neprilysin-induced cleavage. Rather, neprilysin may act by reducing hIAPP fibrillogenesis, which we showed to be the case by fluorescence-based thioflavin T binding studies and electron microscopy. In summary, neprilysin decreases islet amyloid deposition by inhibiting hIAPP fibril formation, rather than degrading hIAPP. These findings suggest that targeting the role of neprilysin in IAPP fibril assembly, in addition to IAPP cleavage by other peptidases, may provide a novel approach to reduce and/or prevent islet amyloid deposition in type 2 diabetes. C1 [Zraika, Sakeneh; Aston-Mourney, Kathryn; Hull, Rebecca L.; Green, Pattie S.; Udayasankar, Jayalakshmi; Subramanian, Shoba L.; Kahn, Steven E.] Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Seattle, WA 98108 USA. [Zraika, Sakeneh; Aston-Mourney, Kathryn; Hull, Rebecca L.; Green, Pattie S.; Udayasankar, Jayalakshmi; Subramanian, Shoba L.; Kahn, Steven E.] Univ Washington, Seattle, WA 98108 USA. [Marek, Peter; Raleigh, Daniel P.] SUNY Stony Brook, Dept Chem, Stony Brook, NY 11794 USA. RP Zraika, S (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Dept Med, 1660 S Columbian Way 151, Seattle, WA 98108 USA. EM zraikas@u.washington.edu OI Aston-Mourney, Kathryn/0000-0003-1412-6715; Hull, Rebecca/0000-0001-9690-4087 FU National Institutes of Health [DK-080945, DK-074404, GM-078114]; Dept. of Veterans Affairs, Virginia; NIH [DK-017047] FX This work was supported, in whole or in part, by National Institutes of Health Grants DK-080945 (to S. Z.), DK-074404 (to R. L. H.), and GM-078114 (to D. P. R.). This work was also supported by the Dept. of Veterans Affairs, Virginia Affairs Puget Sound Health Care System, Seattle, WA. Mass spectrometry work was performed at the University of Washington's Diabetes Endocrinology Research Center Mass Spectrometry Core, which is supported by NIH Grant DK-017047. NR 44 TC 17 Z9 17 U1 1 U2 6 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 JUN 11 PY 2010 VL 285 IS 24 BP 18177 EP 18183 DI 10.1074/jbc.M109.082032 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 606UN UT WOS:000278453900008 PM 20400513 ER PT J AU Xu, C Liu, Y Wang, P Fan, WH Rue, TC Upton, MP Houck, JR Lohavanichbutr, P Doody, DR Futran, ND Zhao, LP Schwartz, SM Chen, C Mendez, E AF Xu, Chang Liu, Yan Wang, Pei Fan, Wenhong Rue, Tessa C. Upton, Melissa P. Houck, John R. Lohavanichbutr, Pawadee Doody, David R. Futran, Neal D. Zhao, Lue Ping Schwartz, Stephen M. Chen, Chu Mendez, Eduardo TI Integrative analysis of DNA copy number and gene expression in metastatic oral squamous cell carcinoma identifies genes associated with poor survival SO MOLECULAR CANCER LA English DT Article ID LYMPH-NODE METASTASIS; CLINICOPATHOLOGICAL FEATURES; ANALYSIS REVEALS; LUNG-CANCER; BREAST; HEAD; PROFILES; GENOME; HETEROZYGOSITY; TUMORS AB Background: Lymphotropism in oral squamous cell carcinoma (OSCC) is one of the most important prognostic factors of 5-year survival. In an effort to identify genes that may be responsible for the initiation of OSCC lymphotropism, we examined DNA copy number gains and losses and corresponding gene expression changes from tumor cells in metastatic lymph nodes of patients with OSCC. Results: We performed integrative analysis of DNA copy number alterations (CNA) and corresponding mRNA expression from OSCC cells isolated from metastatic lymph nodes of 20 patients using Affymetrix 250 K Nsp I SNP and U133 Plus 2.0 arrays, respectively. Overall, genome CNA accounted for expression changes in 31% of the transcripts studied. Genome region 11q13.2-11q13.3 shows the highest correlation between DNA CNA and expression. With a false discovery rate < 1%, 530 transcripts (461 genes) demonstrated a correlation between CNA and expression. Among these, we found two subsets that were significantly associated with OSCC (n = 122) when compared to controls, and with survival (n = 27), as tested using an independent dataset with genome-wide expression profiles for 148 primary OSCC and 45 normal oral mucosa. We fit Cox models to calculate a principal component analysis-derived risk-score for these two gene sets ('122-' or '27-transcript PC'). The models combining the 122- or 27-transcript PC with stage outperformed the model using stage alone in terms of the Area Under the Curve (AUC = 0.82 or 0.86 vs. 0.72, with p = 0.044 or 0.011, respectively). Conclusions: Genes exhibiting CNA-correlated expression may have biological impact on carcinogenesis and cancer progression in OSCC. Determination of copy number-associated transcripts associated with clinical outcomes in tumor cells with an aggressive phenotype (i.e., cells metastasized to the lymph nodes) can help prioritize candidate transcripts from high-throughput data for further studies. C1 [Xu, Chang; Futran, Neal D.; Chen, Chu; Mendez, Eduardo] Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. [Liu, Yan; Fan, Wenhong; Zhao, Lue Ping] Fred Hutchinson Canc Res Ctr, Program Biostat & Biomath, Div Publ Hlth Sci, Seattle, WA 98109 USA. [Wang, Pei] Fred Hutchinson Canc Res Ctr, Program Canc Prevent & Biostat, Div Publ Hlth Sci, Seattle, WA 98109 USA. [Rue, Tessa C.; Zhao, Lue Ping] Univ Washington, Dept Biostat, Seattle, WA 98195 USA. [Upton, Melissa P.] Univ Washington, Dept Pathol, Seattle, WA 98195 USA. [Houck, John R.; Lohavanichbutr, Pawadee; Doody, David R.; Schwartz, Stephen M.; Chen, Chu; Mendez, Eduardo] Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Program Epidemiol, Seattle, WA 98109 USA. [Schwartz, Stephen M.; Chen, Chu] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. [Mendez, Eduardo] Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98109 USA. [Mendez, Eduardo] VA Puget Sound Hlth Care Syst, Surg & Perioperat Care Serv, Seattle, WA 98108 USA. RP Mendez, E (reprint author), Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. EM edmendez@u.washington.edu FU National Center for Research Resources, National Institutes of Health (NIH) [5KL2RR025015-03]; Robert Wood Johnson Foundation; Howard Hughes Medical Institute; National Cancer Institute, NIH [R01CA095419]; Institute of Translational Health Sciences, University of Washington, National Center for Research Resources, NIH [UL1RR025014]; Department of Otolaryngology - Head and Neck Surgery, University of Washington FX This work was supported in part by grants 5KL2RR025015-03 from National Center for Research Resources, National Institutes of Health (NIH); Amos Medical Faculty Development Program Award from The Robert Wood Johnson Foundation; Early Physician-Scientist Career Development Award from the Howard Hughes Medical Institute; R01CA095419 from the National Cancer Institute, NIH; Small Grants Translational Research Projects Award from the Institute of Translational Health Sciences, University of Washington supported by grant UL1RR025014 from the National Center for Research Resources, NIH; center funds from the Department of Otolaryngology - Head and Neck Surgery, University of Washington; and by resources from and use of facilities at the VA Puget Sound Health Care System, Fred Hutchinson Cancer Research Center, University of Washington Medical Center and Harborview Medical Center, Seattle, Washington. NR 37 TC 28 Z9 28 U1 1 U2 5 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1476-4598 J9 MOL CANCER JI Mol. Cancer PD JUN 11 PY 2010 VL 9 AR 143 DI 10.1186/1476-4598-9-143 PG 12 WC Biochemistry & Molecular Biology; Oncology SC Biochemistry & Molecular Biology; Oncology GA 617LA UT WOS:000279281000001 PM 20537188 ER PT J AU Gyurkocza, B Storb, R Storer, BE Chauncey, TR Lange, T Shizuru, JA Langston, AA Pulsipher, MA Bredeson, CN Maziarz, RT Bruno, B Petersen, FB Maris, MB Agura, E Yeager, A Bethge, W Sahebi, F Appelbaum, FR Maloney, DG Sandmaier, BM AF Gyurkocza, Boglarka Storb, Rainer Storer, Barry E. Chauncey, Thomas R. Lange, Thoralf Shizuru, Judith A. Langston, Amelia A. Pulsipher, Michael A. Bredeson, Christopher N. Maziarz, Richard T. Bruno, Benedetto Petersen, Finn B. Maris, Michael B. Agura, Edward Yeager, Andrew Bethge, Wolfgang Sahebi, Firoozeh Appelbaum, Frederick R. Maloney, David G. Sandmaier, Brenda M. TI Nonmyeloablative Allogeneic Hematopoietic Cell Transplantation in Patients With Acute Myeloid Leukemia SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID TOTAL-BODY IRRADIATION; ACUTE MYELOGENOUS LEUKEMIA; SOUTHWEST-ONCOLOGY-GROUP; VERSUS-HOST-DISEASE; BONE-MARROW GRAFTS; MYELODYSPLASTIC SYNDROME; UNRELATED DONORS; OLDER PATIENTS; POSTGRAFTING IMMUNOSUPPRESSION; HEMATOLOGIC MALIGNANCIES AB Purpose Allogeneic hematopoietic cell transplantation (HCT) after high-dose conditioning regimens imposes prohibitively high risks of morbidity and mortality for patients with high-risk acute myeloid leukemia (AML) who are older or have comorbid conditions. Here, we examined outcomes after nonmyeloablative allogeneic HCT in such patients. Patients and Methods Two hundred seventy-four patients (median age, 60 years) with de novo or secondary AML underwent allogeneic HCT from related (n = 118) or unrelated donors (n = 156) after conditioning with 2 Gy of total-body irradiation (TBI) with or without fludarabine. A calcineurin inhibitor and mycophenolate mofetil were used for postgrafting immunosuppression. Results With a median follow-up of 38 months in surviving patients, the estimated overall survival at 5 years was 33%. The estimated 5-year relapse/progression and nonrelapse mortality rates were 42% and 26%, respectively. The cumulative incidences of grades 2, 3, and 4 acute graft-versus-host disease (GVHD) were 38%, 9%, and 5%, respectively. The cumulative incidence of chronic GVHD at 5 years was 44%. Patients in first and second complete remission had better survival rates than patients with more advanced disease (37% and 34% v 18%, respectively). Patients with HLA-matched related or unrelated donors had similar survivals. Unfavorable cytogenetic risk status was associated with increased relapse and subsequent mortality. Chronic GVHD was associated with lower relapse risk. Conclusion Allogeneic HCT from related or unrelated donors after conditioning with low-dose TBI and fludarabine, relying almost exclusively on graft-versus-leukemia effects, can result in long-term remissions in older or medically infirm patients with AML. C1 [Sandmaier, Brenda M.] Fred Hutchinson Canc Res Ctr, Seattle, WA 98109 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Stanford Univ, Stanford, CA 94305 USA. City Hope Kaiser Permanente Med Grp, Duarte, CA USA. Emory Univ, Atlanta, GA 30322 USA. Univ Utah, Latter Day St Hosp, Salt Lake City, UT 84143 USA. Med Coll Wisconsin, Milwaukee, WI 53226 USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Rocky Mt Canc Ctr, Denver, CO USA. Baylor Univ, Dallas, TX USA. Univ Arizona, Tucson, AZ USA. Univ Leipzig, Leipzig, Germany. Univ Tubingen, Tubingen, Germany. Univ Turin, Turin, Italy. RP Sandmaier, BM (reprint author), Fred Hutchinson Canc Res Ctr, 1100 Fairview Ave N,Mail Stop D1-100,POB 19024, Seattle, WA 98109 USA. EM bsandmai@fhcrc.org OI Gyurkocza, Boglarka/0000-0002-2933-2119 FU National Institutes of Health, Bethesda, MD [CA78902, HL36444, CA18029, CA15704, CA106177] FX Supported by Grants No. CA78902, HL36444, CA18029, CA15704, and CA106177 from the National Institutes of Health, Bethesda, MD. NR 45 TC 114 Z9 114 U1 0 U2 2 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD JUN 10 PY 2010 VL 28 IS 17 BP 2859 EP 2867 DI 10.1200/JCO.2009.27.1460 PG 9 WC Oncology SC Oncology GA 608AA UT WOS:000278548000009 PM 20439626 ER PT J AU Kastman, EK Willette, AA Coe, CL Bendlin, BB Kosmatka, KJ McLaren, DG Xu, GF Canu, E Field, AS Alexander, AL Voytko, ML Beasley, TM Colman, RJ Weindruch, RH Johnson, SC AF Kastman, Erik K. Willette, Auriel A. Coe, Christopher L. Bendlin, Barbara B. Kosmatka, Kris J. McLaren, Donald G. Xu, Guofan Canu, Elisa Field, Aaron S. Alexander, Andrew L. Voytko, Mary Lou Beasley, T. Mark Colman, Ricki J. Weindruch, Richard H. Johnson, Sterling C. TI A Calorie-Restricted Diet Decreases Brain Iron Accumulation and Preserves Motor Performance in Old Rhesus Monkeys SO JOURNAL OF NEUROSCIENCE LA English DT Article ID VOXEL-BASED MORPHOMETRY; TRANSVERSE RELAXATION RATES; PARKINSONS-DISEASE; ALZHEIMERS-DISEASE; SUBSTANTIA-NIGRA; NONHUMAN-PRIMATES; OXIDATIVE DAMAGE; HEME OXYGENASE-1; SKELETAL-MUSCLE; RANDOM-FIELD AB Caloric restriction (CR) reduces the pathological effects of aging and extends the lifespan in many species, including nonhuman primates, although the effect on the brain is less well characterized. We used two common indicators of aging, motor performance speed and brain iron deposition measured in vivo using MRI, to determine the potential effect of CR on elderly rhesus macaques eating restricted (n = 24; 13 males, 11 females) and standard diets (n = 17; 8 males, 9 females). Both the CR and control monkeys showed age-related increases in iron concentrations in globus pallidus (GP) and substantia nigra (SN), although the CR group had significantly less iron deposition in the GP, SN, red nucleus, and temporal cortex. A diet X age interaction revealed that CR modified age-related brain changes, evidenced as attenuation in the rate of iron accumulation in basal ganglia and parietal, temporal, and perirhinal cortex. Additionally, control monkeys had significantly slower fine motor performance on the Movement Assessment Panel, which was negatively correlated with iron accumulation in left SN and parietal lobe, although CR animals did not show this relationship. Our observations suggest that the CR-induced benefit of reduced iron deposition and preserved motor function may indicate neural protection similar to effects described previously in aging rodent and primate species. C1 [Kastman, Erik K.; Bendlin, Barbara B.; Kosmatka, Kris J.; McLaren, Donald G.; Xu, Guofan; Canu, Elisa; Weindruch, Richard H.; Johnson, Sterling C.] William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. [Kastman, Erik K.; Willette, Auriel A.; Bendlin, Barbara B.; Kosmatka, Kris J.; McLaren, Donald G.; Xu, Guofan; Canu, Elisa; Weindruch, Richard H.; Johnson, Sterling C.] Univ Wisconsin, Sch Med & Publ Hlth, Wisconsin Alzheimers Dis Res Ctr, Madison, WI 53705 USA. [Willette, Auriel A.; Coe, Christopher L.] Univ Wisconsin, Dept Psychol, Harlow Primate Lab, Madison, WI 53715 USA. [Willette, Auriel A.; Coe, Christopher L.; Alexander, Andrew L.; Johnson, Sterling C.] Univ Wisconsin, Waisman Imaging Ctr, Madison, WI 53705 USA. [McLaren, Donald G.] Univ Wisconsin, Neurosci Training Program, Madison, WI 53706 USA. [Field, Aaron S.] Univ Wisconsin, Dept Radiol, Madison, WI 53792 USA. [Voytko, Mary Lou] Wake Forest Univ, Bowman Gray Sch Med, Dept Neurobiol & Anat, Winston Salem, NC 27157 USA. [Voytko, Mary Lou] Wake Forest Univ, Bowman Gray Sch Med, Interdisciplinary Neurosci Program, Winston Salem, NC 27157 USA. [Beasley, T. Mark; Colman, Ricki J.] Univ Alabama, Dept Biostat, Birmingham, AL 35294 USA. [Weindruch, Richard H.; Johnson, Sterling C.] Wisconsin Natl Primate Res Ctr, Madison, WI 53792 USA. RP Johnson, SC (reprint author), D4225 Vet Adm Hosp, Ctr Geriatr Res Educ & Clin, 2500 Overlook Terrace, Madison, WI 53705 USA. EM scj@medicine.wisc.edu RI McLaren, Donald/G-9906-2011; Kastman, Erik/N-6645-2016; Canu, Elisa/K-1423-2016 OI Kastman, Erik/0000-0001-7221-9042; Bendlin, Barbara/0000-0002-0580-9875; Canu, Elisa/0000-0001-5804-3378 FU National Institutes of Health [P01 AG11915, P51 RR000167]; Institute of Aging [AG000213]; Research Facilities Improvement Program [RR15459-01, RR020141-01] FX This work was supported by funding from the National Institutes of Health to the WNPRC (Grants P01 AG11915 and P51 RR000167) and Institute of Aging Grant AG000213. This research was conducted in part at a facility constructed with support from Research Facilities Improvement Program (Grants RR15459-01 and RR020141-01). The project also benefited from resources and facilities at the William S. Middleton Memorial Veterans Hospital. We gratefully acknowledge the excellent technical assistance provided by R. Fisher; S. Baum; J. Smith; J. Adriansjach; C. Armstrong; the Waisman Center; and the Animal Care, Veterinary and Pathology Staff of the WNPRC. We thank Dr. Craig Atwood for critical comments on the manuscript. NR 80 TC 28 Z9 28 U1 1 U2 4 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 JUN 9 PY 2010 VL 30 IS 23 BP 7940 EP 7947 DI 10.1523/JNEUROSCI.0835-10.2010 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 608LY UT WOS:000278586900020 PM 20534842 ER PT J AU Forrest, GN Kopack, AM Perencevich, EN AF Forrest, Graeme N. Kopack, Angela M. Perencevich, Eli N. TI Statins in Candidemia: clinical outcomes from a matched cohort study SO BMC INFECTIOUS DISEASES LA English DT Article ID POPULATION-BASED COHORT; FLUCONAZOLE THERAPY; SEVERE SEPSIS; MORTALITY; HOSPITALIZATION; CANDIDAEMIA; INFECTIONS; PROTECTION; CYTOKINES; ALBICANS AB Background: HMG CoA reductase inhibitors (statins) in patients with bacteremic sepsis have shown significant survival benefits in several studies. There is no data on the effect of statins in candidemic patients, however in-vitro models suggest that statins interfere with ergesterol formation in the wall of yeasts. Methods: This retrospective matched-cohort study from 1/2003 to 12/2006 evaluated the effects of statins on patients with candidemia within intensive care units. Statin-users had candidemia as a cause of their systemic inflammatory response and were on statins throughout their antifungal therapy, while non-statin users were matched based on age +/-5 years and co-morbid factors. Primary analysis was 30-day survival or discharge using bivariable comparisons. Multivariable comparisons were completed using conditional logistic regression. All variables with a p-value less than 0.10 in the bivariable comparisons were considered for inclusion in the conditional logistic model. Results: There were 15 statin-users and 30 non-statin users that met inclusion criteria, all with similar demographics and co-morbid conditions except the statin group had more coronary artery disease (P < 0.01) and peripheral vascular disease (P = 0.03) and lower median APCAHE II scores (14.6 vs 17, p = 0.03). There were no differences in duration of candidemia, antifungal therapy or Candida species between the groups. Statins were associated with lower mortality on bivariable (OR 0.09, 95% Cl 0.11-0.75, p = 0.03) and multivariable (OR 0.22, 95% Cl 0.02-2.4, p = 0.21) analyses compared to controls; although, in the latter the protective effect lacked statistical signficance. Conclusion: In our small, single-center matched-cohort study, statins may provide a survival benefit in candidemia, however further studies are warranted to validate and further explore this association. C1 [Forrest, Graeme N.] Oregon Hlth & Sci Univ, Div Infect Dis, Portland, OR 97239 USA. [Forrest, Graeme N.] Portland VA Med Ctr, Portland, OR 97239 USA. [Kopack, Angela M.] Infect Dis Associates, Ellicott City, MD 21201 USA. [Perencevich, Eli N.] Univ Iowa, Carver Coll Med, Iowa City VA Med Ctr, Iowa City, IA 52242 USA. RP Forrest, GN (reprint author), Oregon Hlth & Sci Univ, Div Infect Dis, 3701 SW US Vet Hosp Rd,P3-ID, Portland, OR 97239 USA. EM forrestg@ohsu.edu NR 30 TC 14 Z9 16 U1 0 U2 0 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1471-2334 J9 BMC INFECT DIS JI BMC Infect. Dis. PD JUN 4 PY 2010 VL 10 AR 152 DI 10.1186/1471-2334-10-152 PG 8 WC Infectious Diseases SC Infectious Diseases GA 625LK UT WOS:000279896600002 PM 20525374 ER PT J AU Follett, KA Weaver, FM Stern, M Hur, K Harris, CL Luo, P Marks, WJ Rothlind, J Sagher, O Moy, C Pahwa, R Burchiel, K Hogarth, P Lai, EC Duda, JE Holloway, K Samii, A Horn, S Bronstein, JM Stoner, G Starr, PA Simpson, R Baltuch, G De Salles, A Huang, GD Reda, DJ AF Follett, Kenneth A. Weaver, Frances M. Stern, Matthew Hur, Kwan Harris, Crystal L. Luo, Ping Marks, William J., Jr. Rothlind, Johannes Sagher, Oren Moy, Claudia Pahwa, Rajesh Burchiel, Kim Hogarth, Penelope Lai, Eugene C. Duda, John E. Holloway, Kathryn Samii, Ali Horn, Stacy Bronstein, Jeff M. Stoner, Gatana Starr, Philip A. Simpson, Richard Baltuch, Gordon De Salles, Antonio Huang, Grant D. Reda, Domenic J. CA CSP 468 Study Grp TI Pallidal versus Subthalamic Deep-Brain Stimulation for Parkinson's Disease SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID QUALITY-OF-LIFE; GLOBUS-PALLIDUS; FOLLOW-UP; MOTOR FLUCTUATIONS; NUCLEUS; TRIAL; VALIDATION; EFFICACY AB BACKGROUND Deep-brain stimulation is the surgical procedure of choice for patients with advanced Parkinson's disease. The globus pallidus interna and the subthalamic nucleus are accepted targets for this procedure. We compared 24-month outcomes for patients who had undergone bilateral stimulation of the globus pallidus interna (pallidal stimulation) or subthalamic nucleus (subthalamic stimulation). METHODS At seven Veterans Affairs and six university hospitals, we randomly assigned 299 patients with idiopathic Parkinson's disease to undergo either pallidal stimulation (152 patients) or subthalamic stimulation (147 patients). The primary outcome was the change in motor function, as blindly assessed on the Unified Parkinson's Disease Rating Scale, part III (UPDRS-III), while patients were receiving stimulation but not receiving antiparkinsonian medication. Secondary outcomes included self-reported function, quality of life, neurocognitive function, and adverse events. RESULTS Mean changes in the primary outcome did not differ significantly between the two study groups (P=0.50). There was also no significant difference in self-reported function. Patients undergoing subthalamic stimulation required a lower dose of dopaminergic agents than did those undergoing pallidal stimulation (P=0.02). One component of processing speed (visuomotor) declined more after subthalamic stimulation than after pallidal stimulation (P=0.03). The level of depression worsened after subthalamic stimulation and improved after pallidal stimulation (P=0.02). Serious adverse events occurred in 51% of patients undergoing pallidal stimulation and in 56% of those undergoing subthalamic stimulation, with no significant between-group differences at 24 months. CONCLUSIONS Patients with Parkinson's disease had similar improvement in motor function after either pallidal or subthalamic stimulation. Nonmotor factors may reasonably be included in the selection of surgical target for deep-brain stimulation. (ClinicalTrials.gov numbers, NCT00056563 and NCT01076452.) C1 [Weaver, Frances M.] Hines Vet Affairs Hosp, Ctr Management Complex Chron Care, Hines, IL 60141 USA. [Follett, Kenneth A.] Iowa City Vet Affairs Med Ctr, Iowa City, IA USA. [Stoner, Gatana] Univ Iowa Hlth Care, Iowa City, IA USA. [Follett, Kenneth A.] Univ Nebraska Med Ctr, Omaha, NE USA. [Hur, Kwan; Luo, Ping; Reda, Domenic J.] Hines Vet Affairs Hosp, Cooperat Studies Coordinating Ctr, Hines, IL 60141 USA. [Weaver, Frances M.] Loyola Univ, Stritch Sch Med, Maywood, IL 60153 USA. [Stern, Matthew; Horn, Stacy; Baltuch, Gordon] Univ Penn Hlth Syst, Philadelphia, PA USA. [Stern, Matthew; Duda, John E.; Baltuch, Gordon] Philadelphia VA Med Ctr, Philadelphia, PA USA. [Harris, Crystal L.] VA Cooperat Studies Program, Clin Res Pharm, Albuquerque, NM USA. [Marks, William J., Jr.; Rothlind, Johannes; Starr, Philip A.] San Francisco VA Med Ctr, San Francisco, CA USA. [Marks, William J., Jr.; Rothlind, Johannes; Starr, Philip A.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Sagher, Oren] Univ Michigan, Med Ctr, Ann Arbor, MI USA. [Moy, Claudia] NINDS, Rockville, MD USA. [Pahwa, Rajesh] Univ Kansas, Med Ctr, Kansas City, MO USA. [Burchiel, Kim] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Burchiel, Kim; Hogarth, Penelope] Portland VA Med Ctr, Portland, OR USA. [Lai, Eugene C.; Simpson, Richard] Michael E DeBakey VA Med Ctr, Houston, TX USA. [Lai, Eugene C.; Simpson, Richard] Baylor Coll Med, Houston, TX 77030 USA. [Hur, Kwan] Richmond VA Med Ctr, Richmond, VA USA. [Samii, Ali] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Bronstein, Jeff M.; De Salles, Antonio] Univ Calif Los Angeles, W Los Angeles VA Med Ctr, Los Angeles, CA USA. [Bronstein, Jeff M.; De Salles, Antonio] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Huang, Grant D.] US Dept Vet Affairs, Cooperat Studies Program, Cent Off, Washington, DC USA. RP Weaver, FM (reprint author), Hines Vet Affairs Hosp, Ctr Management Complex Chron Care, 5000 S 5th Ave,151H, Hines, IL 60141 USA. EM frances.weaver@va.gov FU Department of Veterans Affairs Office of Research and Development; National Institute of Neurological Disorders and Stroke; Medtronic; Novartis; Teva; Schering-Plough; Boehringer Ingelheim; Vernalis; Ipsen; Ceregene; Sofamor Danek; Schering-Plough Research Institute; Samueli Institute; Ipsen Pharmaceuticals; Teva Pharmaceuticals; Boston Scientific; SurgiVision FX Supported by the Cooperative Studies Program of the Department of Veterans Affairs Office of Research and Development, the National Institute of Neurological Disorders and Stroke, and Medtronic.; Dr. Stern reports receiving consulting fees from Novartis, Teva, Schering-Plough, Boehringer Ingelheim, Vernalis, and Ipsen and lecture fees from Novartis and having an equity interest in Adamis; Dr. Harris, having an equity interest in Johnson & Johnson; Dr. Marks, receiving consulting and lecture fees from Medtronic and grant support from Boehringer Ingelheim and Ceregene; Dr. Pahwa, receiving consulting and lecture fees from Medtronic; Dr. Burchiel, having an equity interest in Medtronic and receiving grant support from Medtronic and Sofamor Danek; Dr. Hogarth, receiving grant support from Schering-Plough Research Institute; Dr. Lai, receiving grant support from Medtronic; Dr. Duda, receiving consulting fees from Boehringer Ingelheim and grant support from the Samueli Institute; Dr. Holloway, receiving consulting fees and grant support from Medtronic; Dr. Samii, receiving lecture fees from Ipsen Pharmaceuticals, Boehringer Ingelheim, and Teva Pharmaceuticals; Dr. Starr, receiving consulting fees from Medtronic and Boston Scientific and grant support from SurgiVision; Dr. Simpson, receiving consulting and lecture fees from Medtronic; and Dr. De Salles, receiving fellowship support from Medtronic. No other potential conflict of interest relevant to this article was reported. NR 25 TC 415 Z9 425 U1 8 U2 55 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 JUN 3 PY 2010 VL 362 IS 22 BP 2077 EP 2091 DI 10.1056/NEJMoa0907083 PG 15 WC Medicine, General & Internal SC General & Internal Medicine GA 603XU UT WOS:000278242200007 PM 20519680 ER PT J AU Bueno, H Ross, JS Wang, Y Chen, J Vidan, MT Normand, SLT Curtis, JP Drye, EE Lichtman, JH Keenan, PS Kosiborod, M Krumholz, HM AF Bueno, Hector Ross, Joseph S. Wang, Yun Chen, Jersey Vidan, Maria T. Normand, Sharon-Lise T. Curtis, Jeptha P. Drye, Elizabeth E. Lichtman, Judith H. Keenan, Patricia S. Kosiborod, Mikhail Krumholz, Harlan M. TI Trends in Length of Stay and Short-term Outcomes Among Medicare Patients Hospitalized for Heart Failure, 1993-2006 SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID READMISSION RATES; TEMPORAL TRENDS; MORTALITY; SURVIVAL; CARE; PERFORMANCE; MODEL AB Context Whether decreases in the length of stay during the past decade for patients with heart failure (HF) may be associated with changes in outcomes is unknown. Objective To describe the temporal changes in length of stay, discharge disposition, and short-term outcomes among older patients hospitalized for HF. Design, Setting, and Participants An observational study of 6 955 461 Medicare fee-for-service hospitalizations for HF between 1993 and 2006, with a 30-day follow-up. Main Outcome Measures Length of hospital stay, in-patient and 30-day mortality, and 30-day readmission rates. Results Between 1993 and 2006, mean length of stay decreased from 8.81 days (95% confidence interval [CI], 8.79-8.83 days) to 6.33 days (95% CI, 6.32-6.34 days). In-hospital mortality decreased from 8.5% (95% CI, 8.4%-8.6%) in 1993 to 4.3% (95% CI, 4.2%-4.4%) in 2006, whereas 30-day mortality decreased from 12.8% (95% CI, 12.8%-12.9%) to 10.7% (95% CI, 10.7%-10.8%). Discharges to home or under home care service decreased from 74.0% to 66.9% and discharges to skilled nursing facilities increased from 13.0% to 19.9%. Thirty-day readmission rates increased from 17.2% (95% CI, 17.1%-17.3%) to 20.1% (95% CI, 20.0%-20.2%; all P<.001). Consistent with the unadjusted analyses, the 2005-2006 risk-adjusted 30-day mortality risk ratio was 0.92 (95% CI, 0.91-0.93) compared with 1993-1994, and the 30-day readmission risk ratio was 1.11 (95% CI, 1.10-1.11). Conclusion For patients admitted with HF during the past 14 years, reductions in length of stay and in-hospital mortality, less marked reductions in 30-day mortality, and changes in discharge disposition accompanied by increases in 30-day readmission rates were observed. JAMA. 2010; 303(21): 2141-2147 C1 [Bueno, Hector] Hosp Gen Univ Gregorio Maranon, Dept Cardiol, Madrid, Spain. [Vidan, Maria T.] Hosp Gen Univ Gregorio Maranon, Serv Geriatr Med, Madrid, Spain. [Ross, Joseph S.] Mt Sinai Sch Med, Dept Geriatr & Palliat Med, New York, NY USA. [Ross, Joseph S.] James J Peters VA Med Ctr, HSR&D Res Enhancement Award Program, Bronx, NY USA. [Ross, Joseph S.] James J Peters VA Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. [Wang, Yun; Chen, Jersey; Curtis, Jeptha P.; Drye, Elizabeth E.; Krumholz, Harlan M.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Sch Publ Hlth, New Haven, CT 06510 USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Sch Publ Hlth, Robert Wood Johnson Clin Scholars Program, New Haven, CT 06510 USA. [Lichtman, Judith H.] Yale Univ, Sch Med, Sch Publ Hlth, Sect Chron Dis Epidemiol, New Haven, CT 06510 USA. [Keenan, Patricia S.; Krumholz, Harlan M.] Yale Univ, Sch Med, Sch Publ Hlth, Sect Hlth Policy & Adm, New Haven, CT 06510 USA. [Normand, Sharon-Lise T.] Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA. [Normand, Sharon-Lise T.] Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. [Kosiborod, Mikhail] Univ Missouri, St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO USA. [Kosiborod, Mikhail] Univ Missouri, Dept Med, Kansas City, MO USA. RP Krumholz, HM (reprint author), Yale Univ, Sch Med, Dept Internal Med, Sch Publ Hlth, 1 Church St,Ste 200, New Haven, CT 06510 USA. EM harlan.krumholz@yale.edu RI BUENO, HECTOR/I-3910-2015 OI BUENO, HECTOR/0000-0003-0277-7596 FU Centers for Medicare & Medicaid Services, US Department of Health and Human Services [HHSM-500-2005-CO001C]; Centers for Disease Control and Prevention [K01 DP000085-05]; Fondo de Investigacion Sanitaria del Instituto de Salud Carlos III, Spain [BA08/90010, BA08/90012]; National Institute on Aging [K08 AG032886]; American Federation for Aging Research; American Heart Association; Almirall; Bayer; Bristol-Myers Squibb; Sanofi-Aventis; Astra-Zeneca; Pfizer; Centers for Medicare & Medicaid Services FX The analyses upon which this publication is based were performed under contract HHSM-500-2005-CO001C, entitled "Utilization and Quality Control Quality Improvement Organization for the State (commonwealth) of Colorado," which was funded by the Centers for Medicare & Medicaid Services, an agency of the US Department of Health and Human Services. This work was also funded by grant K01 DP000085-05 from the Centers for Disease Control and Prevention. Drs Bueno and Vidan were supported in part by grants BA08/90010 and BA08/90012, respectively, from the Fondo de Investigacion Sanitaria del Instituto de Salud Carlos III, Spain, while at the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, where they participated in the development of this study. Dr Ross is supported by grant K08 AG032886 from the National Institute on Aging and by the American Federation for Aging Research through the Paul B. Beeson Career Development Award Program. Dr Kosiborod is supported by the American Heart Association Career Development Award in Implementation Research.; Dr Bueno reported having received consulting fees from Almirall, Bayer, Bristol-Myers Squibb, and Sanofi-Aventis, and research grants from Astra-Zeneca, Bristol-Myers Squibb, and Pfizer. Drs Wang, Chen, Normand, Curtis, Drye, Keenan, and Krumholz reported that they develop and maintain performance measures under contract with the Centers for Medicare & Medicaid Services. Dr Kosiborod reported serving on the advisory board of Sanofi-Aventis and receiving speaking honoraria from the Vascular Biology Working Group and DiaVed Inc. Dr Krumholz reported chairing a scientific advisory board for United Healthcare. Drs Ross, Vidan, and Lichtman did not report any disclosures. NR 27 TC 259 Z9 264 U1 0 U2 10 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 2 PY 2010 VL 303 IS 21 BP 2141 EP 2147 DI 10.1001/jama.2010.748 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 603BE UT WOS:000278182100022 PM 20516414 ER PT J AU Marso, SP Amin, AP House, JA Kennedy, KF Spertus, JA Rao, SV Cohen, DJ Messenger, JC Rumsfeld, JS AF Marso, Steven P. Amin, Amit P. House, John A. Kennedy, Kevin F. Spertus, John A. Rao, Sunil V. Cohen, David J. Messenger, John C. Rumsfeld, John S. CA Natl Cardiovasc Data Registry TI Association Between Use of Bleeding Avoidance Strategies and Risk of Periprocedural Bleeding Among Patients Undergoing Percutaneous Coronary Intervention SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; GLYCOPROTEIN IIB/IIIA INHIBITION; EARLY INVASIVE MANAGEMENT; VASCULAR CLOSURE DEVICES; PROPENSITY SCORE; CARDIAC-CATHETERIZATION; ECONOMIC-EVALUATION; REPLACE-2 TRIAL; ACUITY TRIAL; BIVALIRUDIN AB Context Bleeding complications with percutaneous coronary intervention (PCI) are associated with adverse patient outcomes. The association between the use of bleeding avoidance strategies and post-PCI bleeding as a function of a patient's preprocedural risk of bleeding is unknown. Objective To describe the use of 2 bleeding avoidance strategies, vascular closure devices and bivalirudin, and associated post-PCI bleeding rates in a nationally representative PCI population. Design, Setting, and Patients Analysis of data from 1 522 935 patients undergoing PCI procedures performed at 955 US hospitals participating in the National Cardiovascular Data Registry (NCDR) CathPCI Registry from January 1, 2004, through September 30, 2008. Main Outcome Measure Periprocedural bleeding. Results Bleeding occurred in 30 654 patients (2%). Manual compression, vascular closure devices, bivalirudin, or vascular closure devices plus bivalirudin were used in 35%, 24%, 23%, and 18% of patients, respectively. Bleeding events were reported in 2.8% of patients who received manual compression, compared with 2.1%, 1.6%, and 0.9% of patients receiving vascular closure devices, bivalirudin, and both strategies, respectively (P<.001). Bleeding rates differed by preprocedural risk assessed with the NCDR bleeding risk model (low risk, 0.72%; intermediate risk, 1.73%; high risk, 4.69%). In high-risk patients, use of both strategies was associated with lower bleeding rates (manual compression, 6.1%; vascular closure devices, 4.6%; bivalirudin, 3.8%; vascular closure devices plus bivalirudin, 2.3%; P<.001). This association persisted following adjustment using a propensity-matched and site-controlled model. Use of both strategies was used least often in high-risk patients (14.4% vs 21.0% in low-risk patients, P<.001). Conclusions In a large national PCI registry, vascular closure devices and bivalirudin were associated with significantly lower bleeding rates, particularly among patients at greatest risk for bleeding. However, these strategies were less often used among higher-risk patients. JAMA. 2010; 303(21): 2156-2164 C1 [Marso, Steven P.; Amin, Amit P.; House, John A.; Kennedy, Kevin F.; Spertus, John A.; Cohen, David J.] Univ Missouri, St Lukes Mid Amer Heart Inst, Kansas City, MO 64111 USA. [Rao, Sunil V.] Duke Clin Res Inst, Durham, NC USA. [Messenger, John C.; Rumsfeld, John S.] Univ Colorado, Denver, CO 80202 USA. [Messenger, John C.; Rumsfeld, John S.] Denver VA Med Ctr, Denver, CO USA. RP Marso, SP (reprint author), Univ Missouri, St Lukes Mid Amer Heart Inst, 4401 Wornall Rd, Kansas City, MO 64111 USA. EM smarso@saint-lukes.org FU American Diabetes Association; Amylin Pharmaceuticals; Boston Scientific; Medicines Company; Volcano Corporation; Terumo Corporation; National Institutes of Health; American College of Cardiology Foundation; American Heart Association; Amgen; Lilly; Bristol-Myers Squibb/Sanofi-Aventis; EvaHeart; Cordis Corporation; Atherotech; Roche Diagnostics; Momenta Pharmaceuticals; Portola Pharmaceuticals; Schering-Plough; Eli Lilly; Daichi Sankyo; Pfizer; Medtronic; Sanofi-Aventis; Society for Cardiac Angiography and Interventions FX Dr Marso reported receiving research support from the American Diabetes Association, Amylin Pharmaceuticals, Boston Scientific, The Medicines Company, Volcano Corporation, and Terumo Corporation and serving as a consultant for Abbott Vascular, NovoNordisk, Volcano Corporation, and The Medicines Company. Mr House reported receiving consulting fees from Volcano Corporation. Dr Spertus reported receiving research funding from the National Institutes of Health, American College of Cardiology Foundation, American Heart Association, Amgen, Lilly, Bristol-Myers Squibb/Sanofi-Aventis, EvaHeart, and Cordis Corporation; receiving in-kind research support from Atherotech and Roche Diagnostics; serving as a consultant for United Healthcare, St Jude Medical, and Amgen; serving as a copyright holder of the Seattle Angina Questionnaire, the Kansas City Cardiomyopathy Questionnaire, and the Peripheral Artery Questionnaire; having equity ownership in Health Outcomes Sciences; and holding a patent on the PRISM technology, which executes multivariable models at the point of clinical care. Dr Rao reported receiving research support from Momenta Pharmaceuticals, Portola Pharmaceuticals, and Cordis Corporation and serving as a consultant for Bristol-Myers Squibb, Sanofi-Aventis, The Medicines Company, AstraZeneca, and Terumo Corporation. Dr Cohen reported receiving research support from The Medicines Company, Schering-Plough, Eli Lilly, and Daichi Sankyo; serving as a consultant for Schering-Plough and Eli Lilly; and receiving speaking honoraria from The Medicines Company, Eli Lilly, and St Jude Medical. Dr Messenger reported receiving research support from Pfizer, Medtronic, and Sanofi-Aventis. Dr Rumsfeld reported receiving salary support for the position of chief science officer for the NCDR. No other authors reported financial disclosures.; The views expressed in this article represent those of the authors and do not necessarily represent the American College of Cardiology Foundation or the Society for Cardiac Angiography and Interventions, which cosponsor the National Cardiovascular Data Registry. NR 49 TC 160 Z9 164 U1 2 U2 10 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 2 PY 2010 VL 303 IS 21 BP 2156 EP 2164 DI 10.1001/jama.2010.708 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 603BE UT WOS:000278182100024 PM 20516416 ER PT J AU Gore, JL Litwin, MS Lai, J Yano, EM Madison, R Setodji, C Adams, JL Saigal, CS AF Gore, John L. Litwin, Mark S. Lai, Julie Yano, Elizabeth M. Madison, Rodger Setodji, Claude Adams, John L. Saigal, Christopher S. CA Urologic Dis Amer Project TI Use of Radical Cystectomy for Patients With Invasive Bladder Cancer SO JOURNAL OF THE NATIONAL CANCER INSTITUTE LA English DT Article ID HEALTH-SERVICES RESEARCH; INSTRUMENTAL VARIABLES; UTILIZATION PROJECT; OUTCOMES RESEARCH; CARE UTILIZATION; MORTALITY; SURVIVAL; REGIONALIZATION; ACCESS; BREAST AB Evidence-based guidelines recommend radical cystectomy for patients with muscle-invasive bladder cancer. However, many patients receive alternate therapies, such as chemotherapy or radiation. We examined factors that are associated with the use of radical cystectomy for invasive bladder cancer and compared the survival outcomes of patients with invasive bladder cancer by the treatment they received. From linked Surveillance, Epidemiology, and End Results-Medicare data, we identified a cohort of 3262 Medicare beneficiaries aged 66 years or older at diagnosis with stage II muscle-invasive bladder cancer from January 1, 1992, through December 31, 2002. We examined the use of radical cystectomy with multilevel multivariable models and survival after diagnosis with the use of instrumental variable analyses. All statistical tests were two-sided. A total of 21% of the study subjects underwent radical cystectomy. Older age at diagnosis and higher comorbidity were associated with decreased odds of receiving cystectomy (for those >= 80 vs 66-69 years old, odds ratio [OR] = 0.10, 95% confidence interval [CI] = 0.07 to 0.14; for Charlson comorbidity index of 3 vs 0-1, OR = 0.25, 95% CI = 0.14 to 0.45). Long travel distance to an available surgeon was associated with decreased odds of receiving cystectomy (for > 50 vs 0-4 miles travel distance to an available surgeon, OR = 0.60, 95% CI = 0.37 to 0.98). Overall survival was better for those who underwent cystectomy compared with those who underwent alternative treatments (for chemotherapy and/or radiation vs cystectomy, hazard ratio of death = 1.5, 95% CI = 1.3 to 1.8; for surveillance vs cystectomy, hazard ratio of death = 1.9, 95% CI = 1.6 to 2.3; 5-year adjusted survival: 42.2% [95% CI = 39.1% to 45.4%] for cystectomy; 20.7% [95% CI = 18.7% to 22.8%] for chemotherapy and/or radiation; 14.5% [95% CI = 13.0% to 16.2%] for surveillance). Guideline-recommended care with radical cystectomy is underused for patients with muscle-invasive bladder cancer. Many bladder cancer patients whose survival outcomes might benefit with surgery are receiving alternative less salubrious treatments. C1 [Gore, John L.] Univ Washington, Dept Urol, Sch Med, Seattle, WA 98195 USA. [Gore, John L.; Litwin, Mark S.; Saigal, Christopher S.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Urol, Los Angeles, CA 90095 USA. [Gore, John L.; Litwin, Mark S.; Lai, Julie; Madison, Rodger; Setodji, Claude; Adams, John L.; Saigal, Christopher S.] RAND Corp, Santa Monica, CA USA. [Yano, Elizabeth M.] VA Greater Los Angeles HSR&D Ctr Excellence, Los Angeles, CA USA. RP Gore, JL (reprint author), Univ Washington, Dept Urol, Sch Med, 1959 NE Pacific St,Box 356510, Seattle, WA 98195 USA. EM jlgore@u.washington.edu OI Gore, John/0000-0002-2847-5062 FU California Department of Public Health [103885]; National Cancer Institute [N01-PC-35136, N01-PC-35139, N02-PC-15105]; Centers for Disease Control and Prevention [U55/CCR921930-02]; UCLA Robert Wood Johnson Clinical Scholars Program; National Institute of Diabetes and Digestive and Kidney Diseases [N01-DK-7-0003] FX Collection of the California cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program under contract N01-PC-35136 awarded to the Northern California Cancer Center, contract N01-PC-35139 awarded to the University of Southern California, and contract N02-PC-15105 awarded to the Public Health Institute; Centers for Disease Control and Prevention's National Program of Cancer Registries, under agreement #U55/CCR921930-02 awarded to the Public Health Institute. This work was supported by the UCLA Robert Wood Johnson Clinical Scholars Program and the National Institute of Diabetes and Digestive and Kidney Diseases N01-DK-7-0003 (Principal investigator: M.S.L.). NR 52 TC 89 Z9 93 U1 1 U2 3 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 JUN 2 PY 2010 VL 102 IS 11 BP 802 EP 811 DI 10.1093/jnci/djq121 PG 10 WC Oncology SC Oncology GA 606QA UT WOS:000278440900009 PM 20400716 ER PT J AU Sheridan, JT Fine, E Pribbenow, CM Handelsman, J Carnes, M AF Sheridan, Jennifer T. Fine, Eve Pribbenow, Christine Maidl Handelsman, Jo Carnes, Molly TI Searching for Excellence & Diversity: Increasing the Hiring of Women Faculty at One Academic Medical Center SO ACADEMIC MEDICINE LA English DT Article ID DECISION-MAKING; GENDER; GLASS; LEADERSHIP; FEMALE; HEALTH; IMPACT; MODEL AB One opportunity to realize the diversity goals of academic health centers comes at the time of hiring new faculty. To improve the effectiveness of search committees in increasing the gender diversity of faculty hires, the authors created and implemented a training workshop for faculty search committees designed to improve the hiring process and increase the diversity of faculty hires at the University of Wisconsin-Madison. They describe the workshops, which they presented in the School of Medicine and Public Health between 2004 and 2007, and they compare the subsequent hiring of women faculty in participating and nonparticipating departments and the self-reported experience of new faculty within the hiring process. Attendance at the workshop correlates with improved hiring of women faculty and with a better hiring experience for faculty recruits, especially women. The authors articulate successful elements of workshop implementation for other medical schools seeking to increase gender diversity on their faculties. Acad Med. 2010;85:999-1007. C1 [Sheridan, Jennifer T.; Fine, Eve; Pribbenow, Christine Maidl; Handelsman, Jo; Carnes, Molly] Univ Wisconsin, WISELI, Madison, WI 53706 USA. [Pribbenow, Christine Maidl] Univ Wisconsin, Wisconsin Ctr Educ Res, Madison, WI 53706 USA. [Handelsman, Jo] Yale Univ, Howard Hughes Med Inst, New Haven, CT 06511 USA. [Carnes, Molly] Univ Wisconsin, Ctr Womens Hlth Res, Madison, WI 53706 USA. [Carnes, Molly] William S Middleton Mem Vet Adm Med Ctr, Women Vet Hlth Program, Madison, WI USA. RP Sheridan, JT (reprint author), Univ Wisconsin, WISELI, 2107 Mech Engn Bldg,1513 Univ Ave, Madison, WI 53706 USA. EM sheridan@engr.wisc.edu FU National Science Foundation (NSF) [0123666, 0619979] FX This research was funded with support from the National Science Foundation (NSF #0123666 and #0619979). NR 68 TC 12 Z9 12 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD JUN PY 2010 VL 85 IS 6 BP 999 EP 1007 DI 10.1097/ACM.0b013e3181dbf75a PG 9 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 618SZ UT WOS:000279377300021 PM 20505400 ER PT J AU Bogart, LM Howerton, D Lange, J Setodji, CM Becker, K Klein, DJ Asch, SM AF Bogart, Laura M. Howerton, Devery Lange, James Setodji, Claude Messan Becker, Kirsten Klein, David J. Asch, Steven M. TI Provider-related Barriers to Rapid HIV Testing in US Urban Non-profit Community Clinics, Community-based Organizations (CBOs) and Hospitals SO AIDS AND BEHAVIOR LA English DT Article DE Rapid HIV testing; Provider barriers; Hospitals; Community clinics; Community-based organizations ID UNITED-STATES; OF-CARE; RANDOMIZED-TRIAL; EXPERIENCE; ROUTINE; LABOR; METAANALYSIS; FLUID; IMPLEMENTATION; PREVENTION AB We examined provider-reported barriers to rapid HIV testing in U.S. urban non-profit community clinics, community-based organizations (CBOs), and hospitals. 12 primary metropolitan statistical areas (PMSAs; three per region) were sampled randomly, with sampling weights proportional to AIDS case reports. Across PMSAs, all 671 hospitals and a random sample of 738 clinics/CBOs were telephoned for a survey on rapid HIV test availability. Of the 671 hospitals, 172 hospitals were randomly selected for barriers questions, for which 158 laboratory and 136 department staff were eligible and interviewed in 2005. Of the 738 clinics/CBOs, 276 were randomly selected for barriers questions, 206 were reached, and 118 were eligible and interviewed in 2005-2006. In multivariate models, barriers regarding translation of administrative/quality assurance policies into practice were significantly associated with rapid HIV testing availability. For greater rapid testing diffusion, policies are needed to reduce administrative barriers and provide quality assurance training to non-laboratory staff. C1 [Bogart, Laura M.; Setodji, Claude Messan; Becker, Kirsten; Klein, David J.; Asch, Steven M.] RAND Corp, Santa Monica, CA 90407 USA. [Howerton, Devery; Lange, James] Ctr Dis Control & Prevent, Lab Practice Evaluat & Genom Branch, Atlanta, GA USA. [Asch, Steven M.] VA Greater Los Angeles Healthcare Network, Los Angeles, CA USA. [Asch, Steven M.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Bogart, LM (reprint author), RAND Corp, 1776 Main St,POB 2138, Santa Monica, CA 90407 USA. EM lbogart@rand.org FU PHS HHS [U65/CCU924523-01] NR 61 TC 11 Z9 11 U1 2 U2 4 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1090-7165 J9 AIDS BEHAV JI AIDS Behav. PD JUN PY 2010 VL 14 IS 3 BP 697 EP 707 DI 10.1007/s10461-008-9456-3 PG 11 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA 592VU UT WOS:000277410500023 PM 18770022 ER PT J AU Baillargeon, J Giordano, TP Harzke, AJ Spaulding, AC Wu, ZH Grady, JJ Baillargeon, G Paar, DP AF Baillargeon, Jacques Giordano, Thomas P. Harzke, Amy Jo Spaulding, Anne C. Wu, Z. Helen Grady, James J. Baillargeon, Gwen Paar, David P. TI Predictors of Reincarceration and Disease Progression Among Released HIV-Infected Inmates SO AIDS PATIENT CARE AND STDS LA English DT Article ID US CORRECTIONAL FACILITIES; ANTIRETROVIRAL THERAPY; PSYCHIATRIC-DISORDERS; HEALTH-SERVICES; PRISON RELEASE; CARE; COMMUNITY; INCARCERATION; ADHERENCE; WOMEN AB We conducted a retrospective cohort study to determine the 3-year reincarceration rate of all HIV-infected inmates (n = 1917) released from the Texas prison system between January 2004 and March 2006. We also analyzed postrelease changes in HIV clinical status in the subgroup of inmates who were subsequently reincarcerated and had either CD4 lymphocyte counts (n = 119) or plasma HIV RNA levels (n = 122) recorded in their electronic medical record at both release and reincarceration. Multivariable analyses were performed to assess predictors of reincarceration and clinical changes in HIV status. Only 20% of all HIV-infected inmates were reincarcerated within 3 years of release. Female inmates (hazard ratio [HR] 0.63; 95% confidence interval [CI], 0.47, 0.84) and inmates taking antiretroviral therapy at the time of release (HR 0.31; 95% CI, 0.25, 0.39) were at decreased risk of reincarceration. African Americans (HR 1.58; 95% CI, 1.22, 2.05), inmates with a major psychiatric disorder (HR 1.82; 95% CI, 1.41, 2.34), and inmates released on parole (HR 2.86; 95% CI, 2.31, 3.55) were at increased risk of reincarceration. A subgroup of reincarcerated inmates had a mean decrease in CD4 cell count of 79.4 lymphocytes per microliter (p<0.0003) and a mean increase in viral load of 1.5 log(10) copies per milliliter (p<0.0001) in the period between release and reincarceration. Our findings, although substantially limited by selection bias, highlight the importance of developing discharge planning programs to improve linkage to community-based HIV care and reduce recidivism among released HIV-infected inmates. C1 [Baillargeon, Jacques; Harzke, Amy Jo; Grady, James J.; Paar, David P.] Univ Texas Med Branch, Dept Prevent Med & Community Hlth, Galveston, TX 77555 USA. [Baillargeon, Jacques; Harzke, Amy Jo; Baillargeon, Gwen] Univ Texas Med Branch, Community Hlth Serv, Galveston, TX 77555 USA. [Giordano, Thomas P.] Baylor Coll Med, Dept Med, Houston, TX 77030 USA. [Giordano, Thomas P.] Michael E DeBakey VA Med Ctr Hlth Serv, Res & Dev Ctr Excellence, Houston, TX USA. [Spaulding, Anne C.] Emory Univ, Dept Med, Atlanta, GA 30322 USA. [Wu, Z. Helen] Univ Texas Med Branch, Dept Obstet & Gynecol, Galveston, TX 77555 USA. [Paar, David P.] Univ Texas Med Branch, Dept Med, Galveston, TX 77555 USA. RP Baillargeon, J (reprint author), Univ Texas Med Branch, Dept Prevent Med & Community Hlth, 301 Univ Blvd,Mail Route 1007, Galveston, TX 77555 USA. EM jbaillar@utmb.edu FU National Institute on Drug Abuse [R03-DA023870-02]; National Institutes of Health [K01-DA-21814] FX This study was supported by a grant from the National Institute on Drug Abuse # R03-DA023870-02. Dr. Wu's participation was also supported by National Institutes of Health grant K01-DA-21814. The authors thank Mr. Leonard Pechacek for assistance in editing the manuscript and Ms. DeeAnn Novakosky for data management assistance. The research described herein was coordinated in part by the Texas Department of Criminal Justice (TDCJ) research agreement # 542-MR07. The contents of this manuscript reflect the views of the authors and not necessarily those of the TDCJ or the Department of Veterans Affairs. NR 36 TC 21 Z9 21 U1 1 U2 7 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1087-2914 J9 AIDS PATIENT CARE ST JI Aids Patient Care STDS PD JUN PY 2010 VL 24 IS 6 BP 389 EP 394 DI 10.1089/apc.2009.0303 PG 6 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 614CN UT WOS:000279032800008 PM 20565323 ER PT J AU Froehlich, JC Federoff, D Rasmussen, DD AF Froehlich, J. C. Federoff, D. Rasmussen, D. D. TI PRAZOSIN, AN A(1)-ADRENERGIC RECEPTOR ANTAGONIST, MAINTAINS CONTINUED SUPPRESSION OF ALCOHOL DRINKING DURING PROLONGED ADMINISTRATION SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 33rd Annual Meeting of the Research-Society-on-Alcoholism CY JUN 26-30, 2010 CL San Antonio, TX SP Res Soc Alcoholism C1 [Froehlich, J. C.; Federoff, D.] Indiana Univ Sch Med, Indianapolis, IN 46202 USA. [Rasmussen, D. D.] Univ Washington, Seattle, WA 98195 USA. [Rasmussen, D. D.] VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUN PY 2010 VL 34 IS 6 SU 2 BP 19A EP 19A PG 1 WC Substance Abuse SC Substance Abuse GA 601ZJ UT WOS:000278107200034 ER PT J AU Rasmussen, DD Kincaid, CL AF Rasmussen, D. D. Kincaid, C. L. TI PROTRACTED ABSTINENCE FOLLOWING CHRONIC ETHANOL: INCREASED LOCUS COERULEUS TYROSINE HYDROXYLASE GENE EXPRESSION IS REVERSED BY MELATONIN TREATMENT IN RATS SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 33rd Annual Meeting of the Research-Society-on-Alcoholism CY JUN 26-30, 2010 CL San Antonio, TX SP Res Soc Alcoholism C1 Univ Washington, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, VISN Mental Illness Res Educ & Clin Ctr 20, Seattle, WA 98108 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUN PY 2010 VL 34 IS 6 SU 2 BP 19A EP 19A PG 1 WC Substance Abuse SC Substance Abuse GA 601ZJ UT WOS:000278107200035 ER PT J AU Durazzo, TC Gazdzinski, S Mon, A Wang, J Meyerhoff, DJ AF Durazzo, T. C. Gazdzinski, S. Mon, A. Wang, J. Meyerhoff, D. J. TI N-ACETYLASPARTATE LEVELS IN THE BRAIN REWARD SYSTEM DIFFERENTIATE SMOKING AND NON-SMOKING ALCOHOL DEPENDENT INDIVIDUALS DURING EARLY ABSTINENCE SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 33rd Annual Meeting of the Research-Society-on-Alcoholism CY JUN 26-30, 2010 CL San Antonio, TX SP Res Soc Alcoholism C1 [Durazzo, T. C.; Gazdzinski, S.; Mon, A.; Wang, J.; Meyerhoff, D. J.] Univ Calif San Francisco, San Francisco VA Med Ctr, Ctr Imaging Neurodegenerat Dis, San Francisco, CA 94143 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUN PY 2010 VL 34 IS 6 SU 2 BP 24A EP 24A PG 1 WC Substance Abuse SC Substance Abuse GA 601ZJ UT WOS:000278107200054 ER PT J AU Walter, NAR Denmark, DL Buck, KJ AF Walter, N. A. R. Denmark, D. L. Buck, K. J. TI FINE-MAPPING MULTIPLE TRANS-REGULATION EVENTS ON MOUSE DISTAL CHROMOSOME 1 POTENTIALLY INVOLVED IN ETHANOL SENSITIVITY AND WITHDRAWAL SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 33rd Annual Meeting of the Research-Society-on-Alcoholism CY JUN 26-30, 2010 CL San Antonio, TX SP Res Soc Alcoholism C1 Oregon Hlth & Sci Univ, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR 97239 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUN PY 2010 VL 34 IS 6 SU 2 BP 131A EP 131A PG 1 WC Substance Abuse SC Substance Abuse GA 601ZJ UT WOS:000278107200485 ER PT J AU Batki, SL Dimmock, JA Meszaros, ZS Ploutz-Snyder, R Cavallerano, M Leontieva, L Carey, KB Maisto, SA Canfield, K AF Batki, S. L. Dimmock, J. A. Meszaros, Z. S. Ploutz-Snyder, R. Cavallerano, M. Leontieva, L. Carey, K. B. Maisto, S. A. Canfield, K. TI EXTENDED-RELEASE NALTREXONE FOR ALCOHOL DEPENDENCE IN PATIENTS WITH SERIOUS MENTAL ILLNESS SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 33rd Annual Meeting of the Research-Society-on-Alcoholism CY JUN 26-30, 2010 CL San Antonio, TX SP Res Soc Alcoholism C1 San Francisco VA Med Ctr, UCSF Dept Psychiat, San Francisco, CA 94121 USA. SUNY Upstate Med Univ, Syracuse, NY 13210 USA. Syracuse Univ, Syracuse, NY 13210 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUN PY 2010 VL 34 IS 6 SU 2 BP 176A EP 176A PG 1 WC Substance Abuse SC Substance Abuse GA 601ZJ UT WOS:000278107200661 ER PT J AU Myrick, H Li, X Randall, P Henderson, S Anton, R AF Myrick, H. Li, X. Randall, P. Henderson, S. Anton, R. TI THE EFFECT OF VARENICLINE ON CUE-INDUCED BRAIN ACTIVATION AND DRINKING PARAMETERS IN ALCOHOLICS SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 33rd Annual Meeting of the Research-Society-on-Alcoholism CY JUN 26-30, 2010 CL San Antonio, TX SP Res Soc Alcoholism C1 [Myrick, H.; Li, X.; Randall, P.; Henderson, S.; Anton, R.] Med Univ S Carolina, Alcohol Res Ctr, Dept Psychiat, Ralph H Johnson VAMC, Charleston, SC 29425 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUN PY 2010 VL 34 IS 6 SU 2 BP 177A EP 177A PG 1 WC Substance Abuse SC Substance Abuse GA 601ZJ UT WOS:000278107200668 ER PT J AU Lapham, GT Rubinsky, AD Hawkins, EJ Kivlahan, DR Bradley, KA AF Lapham, G. T. Rubinsky, A. D. Hawkins, E. J. Kivlahan, D. R. Bradley, K. A. TI TRAJECTORIES OF ALCOHOL SCREENING SCORES OVER TIME SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 33rd Annual Meeting of the Research-Society-on-Alcoholism CY JUN 26-30, 2010 CL San Antonio, TX SP Res Soc Alcoholism C1 [Lapham, G. T.; Rubinsky, A. D.; Hawkins, E. J.; Kivlahan, D. R.; Bradley, K. A.] VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98101 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUN PY 2010 VL 34 IS 6 SU 2 BP 180A EP 180A PG 1 WC Substance Abuse SC Substance Abuse GA 601ZJ UT WOS:000278107200678 ER PT J AU Myrick, H AF Myrick, H. TI NEUROIMAGING PREDICTORS OF RESPONSE TO ARIPIPRAZOLE AND VARENICLINE SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 33rd Annual Meeting of the Research-Society-on-Alcoholism CY JUN 26-30, 2010 CL San Antonio, TX SP Res Soc Alcoholism C1 [Myrick, H.] Med Univ S Carolina, Alcohol Res Ctr, Charleston, SC 29425 USA. [Myrick, H.] Ralph H Johnson VAMC, Mental Hlth Serv Line, Charleston, SC 29425 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 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUN PY 2010 VL 34 IS 6 SU 2 SI SI BP 264A EP 264A PG 1 WC Substance Abuse SC Substance Abuse GA 777RF UT WOS:000291641500079 ER PT J AU Littman, AJ Jacobson, IG Powell, T Boyko, EJ Smith, TC AF Littman, A. J. Jacobson, I. G. Powell, T. Boyko, E. J. Smith, T. C. CA Millennium Cohort TI WEIGHT CHANGE FOLLOWING SEPARATION FROM THE MILITARY SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract CT 43rd Annual Meeting of the Society-for-Epidemiologic-Research CY JUN 23-26, 2010 CL Anaheim, CA SP Soc Epidemiol Res C1 [Littman, A. J.; Jacobson, I. G.; Powell, T.; Boyko, E. J.; Smith, T. C.; Millennium Cohort] VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 2010 VL 171 SU 11 BP S77 EP S77 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 603QO UT WOS:000278223300306 ER PT J AU Ioannou, GN AF Ioannou, George N. TI Cholelithiasis, Cholecystectomy, and Liver Disease SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID SERUM ALANINE AMINOTRANSFERASE; UNITED-STATES POPULATION; NONALCOHOLIC STEATOHEPATITIS; DIETARY-CHOLESTEROL; GALLSTONE DISEASE; PREVALENCE; CIRRHOSIS; HOMEOSTASIS; FIBROSIS; MICE AB OBJECTIVES: Cholelithiasis and fatty liver disease share some important risk factors, such as central obesity, insulin resistance, and diabetes. We sought to determine whether persons with cholelithiasis or a history of cholecystectomy were more likely to have elevated serum liver enzymes or to develop cirrhosis. METHODS: We used cohort data from the first National Health and Nutrition Examination Survey (NHANES), to determine whether persons with a self-reported history of cholecystectomy at baseline (n = 466) had a higher incidence of hospitalization or death due to cirrhosis than persons without a history of cholecystectomy (n = 8,691) during up to 21 years of follow-up. We also used cross-sectional data from the third NHANES conducted between the years 1988 and 1994 to determine whether persons with cholelithiasis (n = 833) or previous cholecystectomy (n = 709), as determined by ultrasonography, were more likely to have elevated serum alanine aminotransferase (ALT) or gamma-glutamyl transferase (GGT) than persons without cholecystectomy or cholelithiasis (n = 8,027). RESULTS: Persons with previous cholecystectomy were two times more likely to be hospitalized for or die of cirrhosis (adjusted hazard ratio 2.1, 95% confidence interval (CI) 1.1-4.0) and were more likely to have elevated serum ALT (adjusted odds ratio 1.8, 95 % CI 1.3-2.5) or GGT (adjusted odds ratio 1.7, 95 % CI 1.1-2.6) than persons without cholecystectomy. We did not identify an independent association between cholelithiasis and serum ALT or GGT levels. CONCLUSIONS: Cholecystectomy is a predictor of the development cirrhosis and is associated with elevated serum liver enzymes. Cholelithiasis is not independently associated with serum liver enzyme levels; whether cholelithiasis is associated with the development of cirrhosis remains to be determined. C1 [Ioannou, George N.] Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Gastroenterol, Seattle, WA 98108 USA. [Ioannou, George N.] Univ Washington, Seattle, WA 98108 USA. [Ioannou, George N.] 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 FU Veterans Affairs Research Enhancement Award Program (REAP) FX This project was supported by a Veterans Affairs Research Enhancement Award Program (REAP). NR 27 TC 15 Z9 15 U1 1 U2 5 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD JUN PY 2010 VL 105 IS 6 BP 1364 EP 1373 DI 10.1038/ajg.2009.737 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 607OU UT WOS:000278515700026 PM 20068558 ER PT J AU Marcum, ZA Handler, SM Wright, R Hanlon, JT AF Marcum, Zachary A. Handler, Steven M. Wright, Rollin Hanlon, Joseph T. TI Interventions to Improve Suboptimal Prescribing in Nursing Homes: A Narrative Review SO AMERICAN JOURNAL OF GERIATRIC PHARMACOTHERAPY LA English DT Review DE drug utilization; prescribing; nursing home; long-term care; geriatrics ID RANDOMIZED CONTROLLED-TRIAL; TERM-CARE FACILITIES; CLINICAL DECISION-SUPPORT; MULTIFACETED INTERVENTION; EDUCATIONAL-PROGRAM; ELDERLY-PEOPLE; DRUG-THERAPY; ORDER ENTRY; RESIDENTS; GUIDELINES AB Background: Appropriate medication prescribing for nursing home residents remains a challenge. Objective: The purpose of this study was to conduct a narrative review of the published literature describing randomized controlled trials that used interventions to improve suboptimal prescribing in nursing homes. Methods: The PubMed, International Pharmaceutical Abstracts, and EMBASE databases were searched for articles published in the English language between January 1975 and December 2009, using the terms drug utilization, pharmaceutical services, aged, long-term care, nursing homes, prescribing, geriatrics, and randomized controlled trial. A manual search of the reference lists of identified articles and the authors' files, book chapters, and recent review articles was also conducted. Abstracts and posters from meetings were not included in the search. Studies were included if they: (1) had a randomized controlled design; (2) had a process measure outcome for quality of prescribing or a distal outcome measure for medication-related adverse patient events; and (3) involved nursing home residents. Results: Eighteen studies met the inclusion criteria for this review. Seven of those studies described educational approaches using various interventions (eg, outreach visits) and measured suboptimal prescribing in different manners (eg, adherence to guidelines). Two studies described computerized decision-support systems to measure the intervention's impact on adverse drug events (ADEs) and appropriate drug orders. Five studies described clinical pharmacist activities, most commonly involving a medication review, and used various measures of suboptimal prescribing, including a measure of medication appropriateness and the total number of medications prescribed. Two studies each described multidisciplinary and multifaceted approaches that included heterogeneous interventions and measures of prescribing. Most (15/18; 83.3%) of these studies reported statistically significant improvements in >= 1 aspect of suboptimal prescribing. Only 3 of the studies reported significant improvements in distal health outcomes, and only 3 measured ADEs or adverse drug reactions. Conclusions: Mixed results were reported for a variety of approaches used to improve suboptimal prescribing. However, the heterogeneity of the study interventions and the various measures of suboptimal prescribing used in these studies does not allow for an authoritative conclusion based on the currently available literature. (Am J Geriatr Pharmacother. 2010;8:183-200) (C) 2010 Excerpta Medica Inc. C1 [Marcum, Zachary A.; Handler, Steven M.; Wright, Rollin; Hanlon, Joseph T.] Univ Pittsburgh, Sch Med, Dept Geriatr Med, Pittsburgh, PA 15213 USA. [Handler, Steven M.] Univ Pittsburgh, Sch Med, Dept Biomed Informat, Pittsburgh, PA 15213 USA. [Hanlon, Joseph T.] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15213 USA. [Hanlon, Joseph T.] Univ Pittsburgh, Sch Pharm, Dept Pharm & Therapeut, Pittsburgh, PA 15213 USA. [Handler, Steven M.; Hanlon, Joseph T.] Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Handler, Steven M.; Hanlon, Joseph T.] Vet Affairs Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA. RP Marcum, ZA (reprint author), Univ Pittsburgh, Sch Med, Dept Med, Div Geriatr Med, Kaufman Med Bldg,Suite 500,3471 5th Ave, Pittsburgh, PA 15213 USA. EM zam12@pitt.edu OI Handler, Steven/0000-0002-3940-3224 FU National Institute of Aging [R01AG027017, P30AG024827, T32AG021885, K07AG033174, R01AG034056]; National Institute of Mental Health [R34 MH082682]; National Institute of Nursing [R01 NR010135]; Agency for Healthcare [R01 HS017695]; Veterans Affairs Health Services [IIR-06-062]; National Institutes of Health [K12 RR023267] FX This study was supported by National Institute of Aging grants (R01AG027017, P30AG024827, T32AG021885, K07AG033174, and R01AG034056), a National Institute of Mental Health grant (R34 MH082682), a National Institute of Nursing Research grant (R01 NR010135), an Agency for Healthcare Research and Quality grant (R01 HS017695), a Veterans Affairs Health Services Research grant (IIR-06-062), and a National Institutes of Health Roadmap Multidisciplinary Clinical Research Career Development Award Grant (K12 RR023267). The authors have indicated that they have no other conflicts of interest regarding the content of this article. NR 40 TC 30 Z9 33 U1 4 U2 11 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 1543-5946 J9 AM J GERIATR PHARMAC JI Am. J. Geriatr. Pharmacother. PD JUN PY 2010 VL 8 IS 3 BP 183 EP 200 DI 10.1016/j.amjopharm.2010.05.004 PG 18 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 621KU UT WOS:000279578200001 PM 20624609 ER PT J AU Rodriguez, KL Hanlon, JT Perera, S Jaffe, EJ Sevick, MA AF Rodriguez, Keri L. Hanlon, Joseph T. Perera, Subashan Jaffe, Emily J. Sevick, Mary Ann TI A Cross-Sectional Analysis of the Prevalence of Undertreatment of Nonpain Symptoms and Factors Associated With Undertreatment in Older Nursing Home Hospice/Palliative Care Patients SO AMERICAN JOURNAL OF GERIATRIC PHARMACOTHERAPY LA English DT Article DE long-term care; nursing homes; palliative care; hospice care; aged ID PALLIATIVE-CARE; TERMINALLY-ILL; HOSPICE CARE; LIFE; PAIN; MANAGEMENT; NETHERLANDS; NATIONWIDE; DISEASES; DEATH AB Background: Approximately 25% of all US deaths occur in the long-term care setting, and this figure is projected to rise to 40% by the year 2040. Currently, there is limited information on nonpain symptoms and their appropriate treatment in this setting at the end of life. Objective: This study evaluated the prevalence of undertreatment of nonpain symptoms and factors associated with undertreatment in older nursing home hospice/palliative care patients. Methods: This study used a cross-sectional sample of older (>= 65 years) hospice/palliative care patients to represent all patients from the 2004 National Nursing Home Survey (NNHS) funded by the Centers for Disease Control and Prevention. Nonpain symptoms were determined from facility staff, who used the medical records to answer questions about the residents. Data on medication use were derived from medication administration records. Under-treatment was defined as the omission of a necessary medication for a specific nonpain symptom and was evaluated as a dichotomous variable (yes = the nonpain symptom was not treated with a medication; no = the nonpain symptom was treated with a medication). Cross-sectional bivariate analyses were conducted using chi(2) and regression coefficient tests to determine factors potentially associated with undertreatment of nonpain symptoms. Results: The cross-sectional sample included 303 older nursing home hospice/palliative care patients from among the 33,413 (weighted) patients from the 2004 NNHS. Overall, most of the patients were white (91.4% [277/303]) and female (71.9% [218/303]), and nearly half were aged >= 85 years (47.9% [145/303]). One or more nonpain symptoms occurred in 82 patients (22.0% weighted). The most common nonpain symptoms (weighted percentages) were constipation/fecal impaction in 35 patients (8.8%), cough in 34 patients (9.2%), nausea/vomiting in 26 patients (7.2%), fever in 11 patients (3.1%), and diarrhea in 9 patients (1.9%). Medication undertreatment of any of the above symptoms was seen in 47 of 82 patients (60.0% weighted), ranging from a low of 26.4% for constipation/fecal impaction to a high of 88.0% for nausea/vomiting. Undertreated patients had significantly more problems with bed mobility (n [weighted %], 43 [92.3%] vs 21 [67.2%]; P = 0.013), mood (21 [44.7%] vs 7 [19.7%]; P = 0.017), and pressure ulcers (12 [25.7%] vs 2 [6.1%]; P = 0.023) than did treated patients. The undertreated group also had a significantly greater number of secondary diagnoses (weighted mean [SD], 6.5 [0.7] vs 5.2 [0.5]; P = 0.004) but had a shorter length of stay in hospice/palliative care (120.5 [20.1] vs 219.4 [51.8] days; P < 0.001) or in the nursing home (552.0 [96.5] vs 1285.4 [268.3] days; P = 0.001). Conclusions: The prevalence of nonpain symptoms was low (22.0% weighted) in older nursing home hospice/palliative care patients. However, medication undertreatment of nonpain symptoms was seen in more than half of these patients. Future quality-improvement initiatives for nursing home hospice/palliative care patients arc needed beyond the management of pain symptoms. (Am J Geriatr Pharmacother. 2010;8:225-232) (C) 2010 Excerpta Medica Inc. C1 [Rodriguez, Keri L.; Hanlon, Joseph T.; Sevick, Mary Ann] Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15206 USA. [Perera, Subashan] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Pittsburgh, PA 15261 USA. [Rodriguez, Keri L.; Hanlon, Joseph T.; Sevick, Mary Ann] Vet Affairs Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA 15206 USA. [Sevick, Mary Ann] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Behav & Community Hlth Sci, Pittsburgh, PA 15261 USA. [Jaffe, Emily J.] Univ Pittsburgh, Sect Palliat Care & Med Eth, Pittsburgh, PA 15261 USA. [Rodriguez, Keri L.; Sevick, Mary Ann] Univ Pittsburgh, Sch Med, Dept Med, Div Gen Internal Med, Pittsburgh, PA 15261 USA. [Hanlon, Joseph T.] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15261 USA. [Hanlon, Joseph T.] Univ Pittsburgh, Sch Pharm, Dept Pharm & Therapeut, Pittsburgh, PA 15261 USA. [Hanlon, Joseph T.; Perera, Subashan] Univ Pittsburgh, Sch Med, Dept Med, Div Geriatr Med, Pittsburgh, PA 15261 USA. RP Rodriguez, KL (reprint author), Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, 7180 Highland Dr,Bldg 2,Room 4083E 151C-H, Pittsburgh, PA 15206 USA. EM keri.rodriguez@va.gov RI Perera, Subashan/D-7603-2014 FU National Institute of Aging [R01 AG027017, P30 AG024827, T32 AG021885, K07 AG033174, R01 AG034056]; National Institute of Mental Health [R34 MH082682]; National Institute of Nursing [R01 NR010135]; Agency for Healthcare [R01 HS017695]; VA Health Services [IIR-06-062] FX There was no funding for this study. Dr. Hanlon was supported by the following: National Institute of Aging grants (R01 AG027017, P30 AG024827, T32 AG021885, K07 AG033174, and R01 AG034056), a National Institute of Mental Health grant (R34 MH082682), a National Institute of Nursing Research grant (R01 NR010135), an Agency for Healthcare Research and Quality grant (R01 HS017695), and a VA Health Services Research grant (IIR-06-062). The authors have indicated that they have no other conflicts of interest regarding the content of this article. NR 32 TC 15 Z9 15 U1 0 U2 8 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 1543-5946 J9 AM J GERIATR PHARMAC JI Am. J. Geriatr. Pharmacother. PD JUN PY 2010 VL 8 IS 3 BP 225 EP 232 DI 10.1016/j.amjopharm.2010.05.002 PG 8 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 621KU UT WOS:000279578200004 PM 20624612 ER PT J AU Young, BA AF Young, Bessie Ann TI The Interaction of Race, Poverty, and CKD SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Editorial Material ID STAGE RENAL-DISEASE; CHRONIC KIDNEY-DISEASE; NEIGHBORHOOD SOCIOECONOMIC-STATUS; ATHEROSCLEROSIS RISK; UNITED-STATES; EXPLANATORY FACTORS; HEALTH DISPARITIES; RACIAL-DIFFERENCES; AFRICAN-AMERICANS; EXCESS RISK C1 Univ Washington, VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA 98101 USA. RP Young, BA (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Metropolitan Pk W,1100 Olive Way,Ste 1400, Seattle, WA 98101 USA. EM youngb@u.washington.edu FU NIDDK NIH HHS [R01 DK079745, R01 DK079745-01, R01 DK079745-03] NR 42 TC 8 Z9 9 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 0272-6386 EI 1523-6838 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD JUN PY 2010 VL 55 IS 6 BP 977 EP 980 DI 10.1053/j.ajkd.2010.04.008 PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 601CU UT WOS:000278036400003 PM 20497834 ER PT J AU Post, JB AF Post, James B. TI Thrombocytopenia Associated With Use of a Biocompatible Hemodialysis Membrane: A Case Report SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE Hemodialysis; thrombocytopenia; thrombosis ID PLATELET-ACTIVATING FACTOR; COMPLEMENT ACTIVATION; DIALYZER AB Biocompatibility of a dialyzer membrane has been defined largely by the degree to which it activates complement. Modifications of the cellulose membrane and the development of synthetic membranes have minimized the activation of complement and its associated complications. However, less is known about the blood-dialyzer membrane interactions that may occur in membranes made of the same synthetic polymer. A patient is described who developed dialysis-associated thrombocytopenia using a Fresenius Medical Care Optiflux polysulfone membrane (F-160) that significantly improved when switched to the polysulfone Asahi REXEED 25S membrane (AR-25S). A comparison of postdialysis D-dimer level suggests that the F-160 membrane activated the coagulation pathway to a greater extent than the AR-25S. Subtle differences between the internal surfaces of the membranes that are manufacturer specific may be responsible for exposing this patient's unique predisposition to thrombosis and thrombocytopenia. Despite the advances in membrane biocompatibility, differences may exist among membranes made of the same synthetic polymer. Am J Kidney Dis 55:e25-e28. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is a US Government Work. There are no restrictions on its use. C1 [Post, James B.] James J Peters VA Med Ctr, Bronx, NY 10468 USA. [Post, James B.] Mt Sinai Sch Med, Dept Med, New York, NY USA. RP Post, JB (reprint author), James J Peters VA Med Ctr, 4C-12 Outpatient Renal Practice,130 W Kingsbridge, Bronx, NY 10468 USA. EM james.post@va.gov FU Veterans Administration Rehabilitation Research and Development [B5050W] FX Support: This study was supported by Veterans Administration Rehabilitation Research and Development Career Development Award CDA2-#B5050W. NR 15 TC 12 Z9 13 U1 1 U2 5 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 JUN PY 2010 VL 55 IS 6 BP E25 EP E28 DI 10.1053/j.ajkd.2009.10.059 PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 601CU UT WOS:000278036400028 PM 20110145 ER PT J AU Ko, CW Dominitz, JA Green, P Kreuter, W Baldwin, LM AF Ko, Cynthia W. Dominitz, Jason A. Green, Pam Kreuter, William Baldwin, Laura-Mae TI Specialty Differences in Polyp Detection, Removal, and Biopsy during Colonoscopy SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE Colonic polyp; Colonoscopy; Colorectal neoplasms ID MEDICARE CLAIMS DATA; COLORECTAL-CANCER; FAMILY PHYSICIAN; SENSITIVITY; RISK AB BACKGROUND: Colonoscopy is a technically complex procedure commonly performed to detect and remove colorectal pathology. This study examined the influence of provider characteristics on polyp detection, polyp removal, and diagnostic biopsy rates. METHODS: We conducted a retrospective cross-sectional study using a 20% sample of 2003 Medicare claims. Primary outcome measures were use of diagnostic biopsy, polyp detection, and polyp removal. We used generalized estimating equations to identify independent predictors of the outcomes, adjusting for patient and provider characteristics. RESULTS: Among 328,167 outpatient colonoscopies, polyp detection and removal rates were significantly lower for nongastroenterologists than gastroenterologists, with adjusted relative risk for polyp detection between 0.80 (95% confidence interval [CI], 0.77-0.83) for general surgeons and 0.93 (95% CI, 0.89-0.98) for internists. Compared with gastroenterologists, diagnostic biopsy was significantly less likely for general (relative risk [RR] 0.69; 95% CI, 0.65-0.74) or colorectal surgeons (RR 0.58; 95% CI, 0.52-0.65). The likelihood of polyp detection and removal was higher for physicians in the middle 2 quartiles of annual colonoscopy volume, but similar for physicians in the highest and lowest volume quartiles. Polyp detection and removal were significantly less likely for examinations in ambulatory surgery centers or offices than hospital outpatient settings, while diagnostic biopsy was significantly less likely in office settings. CONCLUSIONS: Physician specialty, annual colonoscopy volume, and site of service are significant predictors of polyp detection, polyp removal, and diagnostic biopsy. These findings may have important implications for the effectiveness of colonoscopy. (C) 2010 Elsevier Inc. All rights reserved. . The American Journal of Medicine (2010) 123, 528-535 C1 [Ko, Cynthia W.] Univ Washington, Div Gastroenterol, Dept Med, Seattle, WA 98195 USA. [Dominitz, Jason A.] Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. [Green, Pam; Baldwin, Laura-Mae] Univ Washington, Dept Family Med, Seattle, WA 98195 USA. [Kreuter, William] Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Ko, CW (reprint author), Univ Washington, Div Gastroenterol, Dept Med, Box 356424, Seattle, WA 98195 USA. EM cwko@u.washington.edu OI Dominitz, Jason/0000-0002-8070-7086 FU American College of Gastroenterology; American Society for Gastrointestinal Endoscopy; VA Puget Sound Health Care System, Seattle, Washington FX Funding: This work was funded by the American College of Gastroenterology. Dr. Dominitz was supported by the American Society for Gastrointestinal Endoscopy Endoscopic Research Career Development Award. This material is the result of work supported in part by resources from the VA Puget Sound Health Care System, Seattle, Washington. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or the Department of Veterans Affairs. NR 27 TC 25 Z9 25 U1 2 U2 3 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 JUN PY 2010 VL 123 IS 6 BP 528 EP 535 DI 10.1016/j.amjmed.2010.01.016 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 607DX UT WOS:000278480100014 PM 20569759 ER PT J AU Scremin, OU Figoni, SF Norman, K Scremin, AME Kunkel, CF Opava-Rutter, D Schmitter, ED Bert, A Mandelkern, M AF Scremin, Oscar U. Figoni, Stephen F. Norman, Keith Scremin, A. M. Erika Kunkel, Charles F. Opava-Rutter, Dorene Schmitter, Eric D. Bert, Alberto Mandelkern, Mark TI Preamputation Evaluation of Lower-Limb Skeletal Muscle Perfusion with H-2 O-15 Positron Emission Tomography SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Article DE Amputation; Positron Emission Tomography; Ischemia; Peripheral Vascular Diseases ID CEREBRAL-BLOOD-FLOW; ARTERIAL INPUT FUNCTION; LOWER-EXTREMITY; GLUCOSE-UPTAKE; HEART-DISEASE; PET; HUMANS; SKIN; (H2O)-O-15; EXERCISE AB Objective: To establish whether muscle blood flow (MBF) measurements with O-15-water positron emission tomography could reliably identify patients with critical limb ischemia and detect and quantify a distal deficit in skeletal MBF in these cases. Design: O-15-water positron emission tomography scans were performed at rest or during unloaded ankle plantar and dorsiflexion exercise of the diseased leg in 17 subjects with leg ischemia or on a randomly selected leg of 18 age-matched healthy control subjects. TcPO2 was evaluated with Novametrix monitors and perfusion of skin topically heated to 44 degrees C and adjacent nonheated areas with a Moor Instruments laser Doppler imaging scanner. Results: The enhancement of MBF induced by exercise was significantly lower in ischemic than in normal legs, and the sensitivity and specificity of this phenomenon were similar to those of laser Doppler imaging or TcPO2 in identifying ischemia subjects. In addition, the exercise MBF deficit was predominant at the distal-leg levels, indicating the ability of the technique to help determine the correct level of amputation. Conclusions: Skeletal MBF of legs with severe ischemia can be detected accurately with O-15-water positron emission tomography and could add valuable information about viability of skeletal muscle in the residual limb when deciding the level of an amputation. C1 [Scremin, Oscar U.; Figoni, Stephen F.; Scremin, A. M. Erika; Kunkel, Charles F.; Opava-Rutter, Dorene] VA Greater Los Angeles Healthcare Syst, Dept Phys Med & Rehabil, Los Angeles, CA 90073 USA. [Scremin, Oscar U.; Norman, Keith] VA Greater Los Angeles Healthcare Syst, Dept Res, Los Angeles, CA 90073 USA. [Mandelkern, Mark] VA Greater Los Angeles Healthcare Syst, Dept Nucl Med, Los Angeles, CA 90073 USA. [Scremin, Oscar U.] Univ Calif Los Angeles, Dept Physiol, Los Angeles, CA 90024 USA. [Scremin, A. M. Erika; Kunkel, Charles F.; Bert, Alberto] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. [Schmitter, Eric D.] Univ Calif Los Angeles, Dept Surg, David Geffen Sch Med, Los Angeles, CA 90024 USA. [Mandelkern, Mark] Univ Calif Irvine, Dept Phys, Irvine, CA 92717 USA. RP Scremin, OU (reprint author), VA Greater Los Angeles Healthcare Syst, Dept Phys Med & Rehabil, 11301 Wilshire Blvd,Bldg 115,Room 319, Los Angeles, CA 90073 USA. OI Bert, Alberto/0000-0001-8391-7508 FU VA Rehabilitation Research and Development Awards [A2196PA, A2860R]; Senior Research Career Scientist Award [B2541SA] FX Supported by VA Rehabilitation Research and Development Awards A2196PA and A2860R and a Senior Research Career Scientist Award (B2541SA; to O.U.S). Part of this work was presented as a poster in the American Academy of Physical Medicine and Rehabilitation 67th Annual Assembly and Technical Exhibition in Honolulu, HI, November 9-12, 2006. Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. NR 39 TC 8 Z9 8 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 JUN PY 2010 VL 89 IS 6 BP 473 EP 486 DI 10.1097/PHM.0b013e3181d89b08 PG 14 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 605GY UT WOS:000278337100005 PM 20357647 ER PT J AU Brose, SW Weber, DJ Salatin, BA Grindle, GG Wang, H Vazquez, JJ Cooper, RA AF Brose, Steven W. Weber, Douglas J. Salatin, Ben A. Grindle, Garret G. Wang, Hongwu Vazquez, Juan J. Cooper, Rory A. TI The Role of Assistive Robotics in the Lives of Persons with Disability SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Review DE Robotics; Rehabilitation; Assistive Devices; Disabled Persons ID NONHOLONOMIC MOBILE ROBOT; ENERGY-EXPENDITURE; POWER WHEELCHAIR; SENSORY FEEDBACK; PROSTHETIC ARM; REHABILITATION; SYSTEM; TETRAPLEGIA; PERSPECTIVE; INTERFACES AB Robotic assistive devices are used increasingly to improve the independence and quality of life of persons with disabilities. Devices as varied as robotic feeders, smart-powered wheelchairs, independent mobile robots, and socially assistive robots are becoming more clinically relevant. There is a growing importance for the rehabilitation professional to be aware of available systems and ongoing research efforts. The aim of this article is to describe the advances in assistive robotics that are relevant to professionals serving persons with disabilities. This review breaks down relevant advances into categories of Assistive Robotic Systems, User Interfaces and Control Systems, Sensory and Feedback Systems, and User Perspectives. An understanding of the direction that assistive robotics is taking is important for the clinician and researcher alike; this review is intended to address this need. C1 [Salatin, Ben A.; Grindle, Garret G.; Wang, Hongwu; Vazquez, Juan J.; Cooper, Rory A.] VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Ctr Excellence, Pittsburgh, PA 15206 USA. [Brose, Steven W.; Weber, Douglas J.; Cooper, Rory A.] Univ Pittsburgh, Dept Phys Med & Rehabil, Med Ctr, Pittsburgh, PA 15260 USA. [Salatin, Ben A.; Grindle, Garret G.; Wang, Hongwu; Vazquez, Juan J.; Cooper, Rory A.] Univ Pittsburgh, Dept Rehabil Sci & Technol, Sch Hlth & Rehabil Sci, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Ctr Excellence, 7180 Highland Dr,Bldg 4,2nd Floor E,151R-1, Pittsburgh, PA 15206 USA. RI Weber, Douglas/E-7554-2011; Wang, Hongwu/J-6133-2013 OI Wang, Hongwu/0000-0002-6567-9144 FU National Science Foundation Quality of Life Technology Engineering Research Center [EEC-0540865]; VA Center of Excellence for Wheelchairs and Associated Rehabilitation [B6789C]; National Science Foundation Integrative Graduate Education and Research Traineeship [DGE0333420]; Paralyzed Veterans of America FX Supported by the National Science Foundation Quality of Life Technology Engineering Research Center (grant no. EEC-0540865), VA Center of Excellence for Wheelchairs and Associated Rehabilitation (grant no. B6789C), the National Science Foundation Integrative Graduate Education and Research Traineeship, Interdisciplinary Research Training in Assistive Technology (grant no. DGE0333420), and the Paralyzed Veterans of America. Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. NR 92 TC 35 Z9 37 U1 2 U2 10 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0894-9115 EI 1537-7385 J9 AM J PHYS MED REHAB JI Am. J. Phys. Med. Rehabil. PD JUN PY 2010 VL 89 IS 6 BP 509 EP 521 DI 10.1097/PHM.0b013e3181cf569b PG 13 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 605GY UT WOS:000278337100009 PM 20134305 ER PT J AU Said, HM Mee, L Sekar, VT Ashokkumar, B Pandol, SJ AF Said, Hamid M. Mee, Lisa Sekar, V. Thillai Ashokkumar, Balasubramaniem Pandol, Stephen J. TI Mechanism and regulation of folate uptake by pancreatic acinar cells: effect of chronic alcohol consumption SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE RFC; PCFT; transporter; pancreas; chronic alcohol use ID FUNCTIONAL-CHARACTERIZATION; ETHANOL-CONSUMPTION; MAMMALIAN-CELLS; RATS; DEFICIENCY; SECRETION; IDENTIFICATION; TRANSPORTER; METABOLISM; PROMOTER AB Said HM, Mee L, Sekar VT, Ashokkumar B, Pandol SJ. Mechanism and regulation of folate uptake by pancreatic acinar cells: effect of chronic alcohol consumption. Am J Physiol Gastrointest Liver Physiol 298: G985-G993, 2010. First published April 1, 2010; doi:10.1152/ajpgi.00068.2010.-Folate plays an essential role in one-carbon metabolism, and a relationship exists between methyl group metabolism and pancreatic exocrine function. Little, however, is known about the mechanism(s) and regulation of folate uptake by pancreatic acinar cells and the effect of chronic alcohol use on the process. We addressed these issues using the rat-derived pancreatic acinar cell line AR42J and freshly isolated primary rat pancreatic acinar cells as models. We found [(3)H] folic acid uptake to be 1) temperature and pH dependent with a higher uptake at acidic than at neutral/alkaline pH; 2) saturable as a function of substrate concentration at both buffer pH 7.4 and 6.0; 3) inhibited by folate structural analogs and by anion transport inhibitors at both buffer pH 7.4 and 6.0; 4) trans-stimulated by unlabeled folate; 5) adaptively regulated by the prevailing extracellular folate level, and 6) inhibited by modulators of the cAMP/PKA-mediated pathway. Both the reduced folate carrier (RFC) and the proton-coupled folate transporter (PCFT) were found to be expressed in AR42J and in primary pancreatic acinar cells, as well as in native human pancreas with expression of RFC being higher than PCFT. Chronic alcohol feeding of rats (4 wk; 36% of calories from ethanol) led to a significant decrease in folate uptake by freshly isolated primary pancreatic acinar cells compared with cells from pair-fed controls; this effect was associated with a parallel decrease in the level of expression of RFC and PCFT. These studies reveal that folate uptake by pancreatic acinar cells is via a regulated carrier-mediated process which may involve RFC and PCFT. In addition, chronic alcohol feeding leads to a marked inhibition in folate uptake by pancreatic acinar cells, an effect that is associated with reduction in level of expression of RFC and PCFT. C1 [Said, Hamid M.] Vet Adm Med Ctr, Dept Med Res, Long Beach, CA 90822 USA. [Said, Hamid M.; Mee, Lisa; Sekar, V. Thillai; Ashokkumar, Balasubramaniem] Univ Calif Irvine, Dept Med, Irvine, CA 92717 USA. [Said, Hamid M.; Mee, Lisa; Sekar, V. Thillai; Ashokkumar, Balasubramaniem] Univ Calif Irvine, Dept Physiol Biophys, Irvine, CA USA. [Pandol, Stephen J.] Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. [Pandol, Stephen J.] Univ Calif Los Angeles, Los Angeles, CA USA. RP Said, HM (reprint author), VA Med Ctr 151, Long Beach, CA 90822 USA. EM hmsaid@uci.edu FU National Institutes of Health [AA018071, DK56061]; Southern California Research Center for Alcoholic Liver and Pancreatic Diseases [P50-AA11999]; Department of Veterans Affairs FX This study was supported by grants from the National Institutes of Health (AA018071 and DK56061 to H. M. Said; and the Southern California Research Center for Alcoholic Liver and Pancreatic Diseases P50-AA11999) and the Department of Veterans Affairs. NR 30 TC 15 Z9 15 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD JUN PY 2010 VL 298 IS 6 BP G985 EP G993 DI 10.1152/ajpgi.00068.2010 PG 9 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 598CE UT WOS:000277809200021 PM 20360131 ER PT J AU Lorentz, CU Alston, EN Belcik, T Lindner, JR Giraud, GD Habecker, BA AF Lorentz, Christina U. Alston, Eric N. Belcik, Todd Lindner, Jonathan R. Giraud, George D. Habecker, Beth A. TI Heterogeneous ventricular sympathetic innervation, altered beta-adrenergic receptor expression, and rhythm instability in mice lacking the p75 neurotrophin receptor SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE sympathetic innervation; nerve growth factor; semaphorin 3a; ventricular arrhythmias ID NERVE GROWTH-FACTOR; SUDDEN CARDIAC DEATH; SUPERIOR CERVICAL-GANGLIA; TYROSINE-HYDROXYLASE; MYOCARDIAL-INFARCTION; CHOLINERGIC NEURONS; CIRCADIAN VARIATION; TARGET INNERVATION; SEMAPHORIN-III; HEART-FAILURE AB Lorentz CU, Alston EN, Belcik T, Lindner JR, Giraud GD, Habecker BA. Heterogeneous ventricular sympathetic innervation, altered beta-adrenergic receptor expression, and rhythm instability in mice lacking the p75 neurotrophin receptor. Am J Physiol Heart Circ Physiol 298: H1652-H1660, 2010. First published February 26, 2010; doi:10.1152/ajpheart.01128.2009.-Sympathetic nerves stimulate cardiac function through the release of norepinephrine and the activation of cardiac beta(1)-adrenergic receptors. The sympathetic innervation of the heart is sculpted during development by chemoattractive factors including nerve growth factor (NGF) and the chemorepulsive factor semaphorin 3a. NGF acts through the TrkA receptor and the p75 neurotrophin receptor (p75(NTR)) in sympathetic neurons. NGF stimulates sympathetic axon extension into the heart through TrkA, but p75(NTR) modulates multiple coreceptors that can either stimulate or inhibit axon outgrowth. In mice lacking p75(NTR), the sympathetic innervation density in target tissues ranges from denervation to hyperinnervation. Recent studies have revealed significant changes in the sympathetic innervation density of p75(NTR)-deficient (p75(NTR-/-)) atria between early postnatal development and adulthood. We examined the innervation of adult p75(NTR-/-) ventricles and discovered that the sub-endocardium of the p75(NTR-/-) left ventricle was essentially devoid of sympathetic nerve fibers, whereas the innervation density of the subepicardium was normal. This phenotype is similar to that seen in mice overexpressing semaphorin 3a, and we found that sympathetic axons lacking p75(NTR) are more sensitive to semaphorin 3a in vitro than control neurons. The lack of subendocardial innervation was associated with decreased dP/dt, altered cardiac beta(1)-adrenergic receptor expression and sensitivity, and a significant increase in spontaneous ventricular arrhythmias. The lack of p75(NTR) also resulted in increased tyrosine hydroxylase content in cardiac sympathetic neurons and elevated norepinephrine in the right ventricle, where innervation density was normal. C1 [Lorentz, Christina U.; Alston, Eric N.; Habecker, Beth A.] Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97239 USA. [Belcik, Todd; Lindner, Jonathan R.; Giraud, George D.] Oregon Hlth & Sci Univ, Div Cardiovasc Med, Portland, OR 97239 USA. [Giraud, George D.] Portland VA Med Ctr, Dept Hosp & Specialty Med, Portland, OR USA. RP Habecker, BA (reprint author), Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM habecker@ohsu.edu FU American Heart Association [0715669Z, 09PRE2110052, 0555553Z]; National Heart, Lung, and Blood Institute [HL-093056] FX This work was supported by American Heart Association Grants 0715669Z and 09PRE2110052 (to C. U. Lorentz) and 0555553Z (to B. A. Habecker) and National Heart, Lung, and Blood Institute Grant HL-093056 (to B. A. Habecker). NR 63 TC 23 Z9 24 U1 0 U2 2 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 JUN PY 2010 VL 298 IS 6 BP H1652 EP H1660 DI 10.1152/ajpheart.01128.2009 PG 9 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 598UB UT WOS:000277863100005 PM 20190098 ER PT J AU Pettinati, HM Oslin, DW Kampman, KM Dundon, WD Xie, H Gallis, TL Dackis, CA O'Brien, CP AF Pettinati, Helen M. Oslin, David W. Kampman, Kyle M. Dundon, William D. Xie, Hu Gallis, Thea L. Dackis, Charles A. O'Brien, Charles P. TI A Double-Blind, Placebo-Controlled Trial Combining Sertraline and Naltrexone for Treating Co-Occurring Depression and Alcohol Dependence SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID MAJOR DEPRESSION; USE DISORDERS; COMORBIDITY; DRINKING; DRINKERS; OUTCOMES; ABUSE AB Objective: Empirical evidence has only weakly supported antidepressant treatment for patients with co-occurring depression and alcohol dependence. While some studies have demonstrated that antidepressants reduce depressive symptoms in individuals with depression and alcohol dependence, most studies have not found antidepressant treatment helpful in reducing excessive drinking in these patients. The authors provide results from a double-blind, placebo-controlled trial that evaluated the efficacy of combining approved medications for depression (sertraline) and alcohol dependence (naltrexone) in treating patients with both disorders. Method: A total of 170 depressed alcohol-dependent patients were randomly assigned to receive 14 weeks of treatment with sertraline (200 mg/day [N=40]), naltrexone (100 mg/day [N=49]), the combination of sertraline plus naltrexone (N=42), or double placebo (N=39) while receiving weekly cognitive-behavioral therapy. Results: The sertraline plus naltrexone combination produced a higher alcohol abstinence rate (53.7%) and demonstrated a longer delay before relapse to heavy drinking (median delay=98 days) than the naltrexone (abstinence rate: 21.3%; delay=29 days), sertraline (abstinence rate: 27.5%; delay=23 days), and placebo (abstinence rate: 23.1%; delay=26 days) groups. The number of patients in the medication combination group not depressed by the end of treatment (83.3%) approached significance when compared with patients in the other treatment groups. The serious adverse event rate was 25.9%, with fewer reported with the medication combination (11.9%) than the other treatments. Conclusion: More depressed alcohol-dependent patients receiving the sertraline plus naltrexone combination achieved abstinence from alcohol, had delayed relapse to heavy drinking, reported fewer serious adverse events, and tended to not be depressed by the end of treatment. (Am J Psychiatry 2010;167:668-675) C1 Univ Penn, Ctr Studies Addict, Dept Psychiat, Sch Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Pettinati, HM (reprint author), Univ Penn, Treatment Res Ctr, 3900 Chestnut St, Philadelphia, PA 19104 USA. EM pettinati_h@mail.trc.upenn.edu FU National Institute on Alcohol Abuse and Alcoholism [R01-AA09544-10]; Pfizer Inc. U.S. Pharmaceuticals Group FX Supported by the National Institute on Alcohol Abuse and Alcoholism grant R01-AA09544-10 (principal investigator, Dr. Pettinati) and Pfizer Inc. U.S. Pharmaceuticals Group, who donated sertraline and matching placebo. These agencies had no role in the design, conduct, or reporting of this study. NR 31 TC 83 Z9 84 U1 4 U2 12 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X EI 1535-7228 J9 AM J PSYCHIAT JI Am. J. Psychiat. PD JUN PY 2010 VL 167 IS 6 BP 668 EP 675 PG 8 WC Psychiatry SC Psychiatry GA 604HG UT WOS:000278269500011 PM 20231324 ER PT J AU Keyhani, S Wang, S Hebert, P Carpenter, D Anderson, G AF Keyhani, Salomeh Wang, Steven Hebert, Paul Carpenter, Daniel Anderson, Gerard TI US Pharmaceutical Innovation in an International Context SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID DRUG BENEFIT; MEDICINES; PRICE; EXPENDITURE; INDUSTRY AB Objectives. We explored whether the United States, which does not regulate pharmaceutical prices, is responsible for the development of a disproportionate share of the new molecular entities (NMEs; a drug that does not contain an active moiety previously approved by the Food and Drug Administration) produced worldwide. Methods. We collected data on NMEs approved between 1992 and 2004 and assigned each NME to an inventor country. We examined the relation between the proportion of total NMEs developed in each country and the proportion of total prescription drug spending and gross domestic product (GDP) of each country represented. Results. The United States accounted for 42% of prescription drug spending and 40% of the total GDP among innovator countries and was responsible for the development of 43.7% of the NMEs. The United Kingdom, Switzerland, and a few other countries innovated proportionally more than their contribution to GDP or prescription drug spending, whereas Japan, South Korea, and a few other countries innovated less. Conclusions. Higher prescription drug spending in the United States does not disproportionately privilege domestic innovation, and many countries with drug price regulation were significant contributors to pharmaceutical innovation. (Am J Public Health. 2010;100:1075-1080. doi:10.2105/AJPH.2009.178491) C1 [Keyhani, Salomeh] Mt Sinai Sch Med, Dept Hlth Policy, New York, NY 10128 USA. [Keyhani, Salomeh] James J Peters VA Med Ctr, New York, NY USA. [Wang, Steven] Yale Univ, Sch Med, Dept Radiol, New Haven, CT 06510 USA. [Hebert, Paul] VA Puget Sound Hlth Care Syst, Hlth Serv Res & Devel, Seattle, WA USA. [Hebert, Paul] Univ Washington, Sch Publ Hlth & Community Med, Dept Hlth Serv, Seattle, WA 98195 USA. [Carpenter, Daniel] Harvard Univ, Fac Arts & Sci, Dept Govt, Cambridge, MA 02138 USA. [Anderson, Gerard] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA. RP Keyhani, S (reprint author), Mt Sinai Sch Med, Dept Hlth Policy, 1 Gustave L Levy Pl,Box 1077, New York, NY 10128 USA. EM salomeh.keyhani@mountsinai.org FU VA HSRD FX This project was not supported by any direct funds. S. Keyhani is funded by a VA HSRD Career Development Award. NR 27 TC 8 Z9 8 U1 2 U2 13 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 JUN PY 2010 VL 100 IS 6 BP 1075 EP 1080 DI 10.2105/AJPH.2009.178491 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 596YT UT WOS:000277722500029 PM 20403883 ER PT J AU Kougias, P AF Kougias, Panos TI Endoscopically unmanageable bleeding from duodenal ulcers: a job for the vascular surgeon or the interventional radiologist? Response SO AMERICAN JOURNAL OF SURGERY LA English DT Letter ID ARTERIAL EMBOLIZATION; GASTROINTESTINAL HEMORRHAGE; EMBOLOTHERAPY C1 [Kougias, Panos] Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg, Houston, TX 77030 USA. [Kougias, Panos] Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Kougias, P (reprint author), Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg, Houston, TX 77030 USA. NR 9 TC 0 Z9 0 U1 0 U2 1 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD JUN PY 2010 VL 199 IS 6 BP 865 EP 866 DI 10.1016/j.amjsurg.2009.05.015 PG 2 WC Surgery SC Surgery GA 623ZH UT WOS:000279785400027 ER PT J AU Bakaeen, FG Chow, M Ghadir, M Albo, D Berger, DH Chu, D AF Bakaeen, Faisal G. Chow, Michael Ghadir, Mued Albo, Daniel Berger, David H. Chu, Danny TI Ruptured Colonic Intramural Hematoma with Massive Hemorrhage after Aortic Valve Replacement SO AMERICAN SURGEON LA English DT Letter ID ANTICOAGULANT-THERAPY C1 [Bakaeen, Faisal G.] Michael E DeBakey VA Med Ctr, Dept Cardiothorac Surg, Houston, TX 77030 USA. [Chu, Danny] Baylor Coll Med, Michael E DeBakey Dept Surg, Div Cardiothorac Surg, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Albo, Daniel; Berger, David H.] Baylor Coll Med, Michael E DeBakey Dept Surg, Div Gen Surg, Houston, TX 77030 USA. RP Bakaeen, FG (reprint author), Michael E DeBakey VA Med Ctr, Dept Cardiothorac Surg, OCL 112 2002 Holcombe Blvd, Houston, TX 77030 USA. EM fbakaeen@bcm.edu NR 4 TC 1 Z9 1 U1 0 U2 0 PU SOUTHEASTERN SURGICAL CONGRESS PI ATLANTA PA 141 WEST WIEUCA RD, STE B100, ATLANTA, GA 30342 USA SN 0003-1348 J9 AM SURGEON JI Am. Surg. PD JUN PY 2010 VL 76 IS 6 BP 647 EP 648 PG 2 WC Surgery SC Surgery GA 602YG UT WOS:000278174400018 PM 20583525 ER PT J AU Merchant, RM Abella, BS Abotsi, EJ Smith, TM Long, JA Trudeau, ME Leary, M Groeneveld, PW Becker, LB Asch, DA AF Merchant, Raina M. Abella, Benjamin S. Abotsi, Edem J. Smith, Thomas M. Long, Judith A. Trudeau, Martha E. Leary, Marion Groeneveld, Peter W. Becker, Lance B. Asch, David A. TI Cell Phone Cardiopulmonary Resuscitation: Audio Instructions When Needed by Lay Rescuers: A Randomized, Controlled Trial SO ANNALS OF EMERGENCY MEDICINE LA English DT Article ID HOSPITAL CARDIAC-ARREST; QUALITY AB Study objective: Given the ubiquitous presence of cellular telephones, we seek to evaluate the extent to which prerecorded audio cardiopulmonary resuscitation (CPR) instructions delivered by a cell telephone will improve the quality of CPR provided by untrained and trained lay rescuers Methods: We randomly assigned both previously CPR trained and untrained volunteers to perform CPR on a manikin for 3 minutes with or without audio assistance from a cell telephone programmed to provide CPR instructions. We measured CPR quality metrics-pauses (ie, no flow time), compression rate (minute), depth (millimeters), and hand placement (percentage correct) across the 4 groups defined by being either CPR trained or untrained and receiving or not receiving cell telephone CPR instructions. Results: There was no difference in CPR measures for participants who had or had not received previous CPR training. Participants using the cell telephone aid performed better compression rate (100/minute [95% confidence interval (Cl) 97 to 103/minute] versus 44/minute [95% Cl 38 to 50/minute]), compression depth (41 mm [95% Cl 38 to 44 mm] versus 31 mm [95% Cl 28 to 34 mm]), hand placement (97% [95% Cl 94% to 100%] versus 75% [95% Cl 68% to 83%] correct), and fewer pauses (74 seconds [95% Cl 72 to 76 seconds] versus 89 seconds [95% Cl 80 to 98 seconds]) compared with participants without the cell telephone aid. Conclusion: A simple audio program that can be made available for cell telephones increases the quality of bystander CPR in a manikin simulation. [Ann Emerg Med 2010,55-538-543.] C1 [Merchant, Raina M.] Univ Penn, Sch Med, Robert Wood Johnson Fdn, Clin Scholars Program, Philadelphia, PA 19104 USA. [Merchant, Raina M.; Abella, Benjamin S.; Abotsi, Edem J.; Smith, Thomas M.; Leary, Marion; Becker, Lance B.] Univ Penn, Sch Med, Ctr Resuscitat Sci, Philadelphia, PA 19104 USA. [Merchant, Raina M.; Abella, Benjamin S.; Abotsi, Edem J.; Smith, Thomas M.; Leary, Marion; Becker, Lance B.] Univ Penn, Sch Med, Dept Emergency Med, Philadelphia, PA 19104 USA. [Long, Judith A.; Trudeau, Martha E.; Groeneveld, Peter W.; Asch, David A.] Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RP Merchant, RM (reprint author), Univ Penn, Sch Med, Robert Wood Johnson Fdn, Clin Scholars Program, 13th Floor Blockley Hall,423 Guardian St, Philadelphia, PA 19104 USA. EM raina.merchant@uphs.upenn.edu RI Abella, Benjamin/G-3579-2010 OI Asch, David/0000-0002-7970-286X; Abella, Benjamin/0000-0003-2521-0891 FU Philadelphia Veterans Affairs Medical Center; Robert Wood Johnson Foundation at University of Pennsylvania FX By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This research was supported by funding from the Philadelphia Veterans Affairs Medical Center for Health Equity Research and Promotion pilot grant and the Robert Wood Johnson Foundation Clinical Scholars program at the University of Pennsylvania. The contents do not reflect the views of the Department of Veterans Affairs or the United States Government NR 10 TC 27 Z9 28 U1 0 U2 5 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 JUN PY 2010 VL 55 IS 6 BP 538 EP 543 DI 10.1016/j.annemergmed.2010.01.020 PG 6 WC Emergency Medicine SC Emergency Medicine GA 609RC UT WOS:000278673800010 PM 20202719 ER PT J AU Poon, LH Kang, GA Lee, AJ AF Poon, Linda H. Kang, Gail A. Lee, Audrey J. TI Role of Tetrabenazine for Huntington's Disease-Associated Chorea SO ANNALS OF PHARMACOTHERAPY LA English DT Article DE chorea; Huntington's disease; tetrabenazine ID HYPERKINETIC MOVEMENT-DISORDERS; NEUROLEPTIC MALIGNANT SYNDROME; BASAL GANGLIA; THERAPY; BRAIN; DEPRESSION; MANAGEMENT; SYMPTOMS; DRUGS; SCALE AB OBJECTIVE: To review the pharmacology, pharmacokinetics, efficacy, and safety of tetrabenazine for the treatment of Huntington's disease (HD) associated chorea. DATA SOURCES: Primary literature and review articles were obtained through a PubMed search (1959 November 2009) using the terms tetrabenazine, HD, chorea, and hyperkinetic movement disorders. A bibliographic search was performed on selected articles. STUDY SELECTION AND DATA EXTRACTION: All English-language articles identified from the data sources were reviewed. Studies including greater than 10 patients and a direct comparative study with primarily HD-associated chorea were included in the review. DATA SYNTHESIS: Tetrabenazine is the first drug approved by the Food and Drug Administration (FDA) for the management of HD-associated chorea. Tetrabenazine binds reversibly to the type 2 vesicular monoamine transporters and has been shown to inhibit monoamine uptake in presynaptic vesicles, resulting in monoamine depletion. The duration of the antichorea effect of tetrabenazine has been reported to be approximately 5.5 hours. Tetrabenazine is extensively metabolized hepatically by the CYP2D6 enzyme to its primary active metabolite, alpha-dihydrotetrabenazine. The half-life of alpha-dihydrotetrabenazine is 4-8 hours. Clinical trials demonstrated that tetrabenazine reduces chorea, on average, by 5 units based upon the chorea score from the Unified Huntington's Disease Rating Scale. The most common adverse effects reported include sedation, drowsiness, parkinsonism, and depression. Rarely, corrected QT interval prolongation, orthostatic hypotension, and hyperprolactinemia have been reported. Tetrabenazine also has a black box warning for increasing the risk of depression and suicidality. CONCLUSIONS: Tetrabenazine can provide significant benefit in the treatment of chorea associated with HD. Given the potential adverse effects of tetrabenazine, health-care providers need to screen patients carefully prior to initiating treatment with this medication. In the future, additional long-term and comparative studies would be useful for further clarification of the role of tetrabenazine in the treatment of HD-associated chorea. C1 [Poon, Linda H.] San Francisco VA Med Ctr, Pharm Serv 119, San Francisco, CA 94121 USA. [Kang, Gail A.] Univ Calif San Francisco, Memory & Aging Ctr, San Francisco, CA 94143 USA. [Poon, Linda H.; Lee, Audrey J.] Univ Pacific, Thomas J Long Sch Pharm, Stockton, CA 95211 USA. RP Poon, LH (reprint author), San Francisco VA Med Ctr, Pharm Serv 119, 4150 Clement St, San Francisco, CA 94121 USA. EM Linda.poon@va.gov NR 53 TC 17 Z9 19 U1 3 U2 15 PU HARVEY WHITNEY BOOKS CO PI CINCINNATI PA PO BOX 42696, CINCINNATI, OH 45242 USA SN 1060-0280 J9 ANN PHARMACOTHER JI Ann. Pharmacother. PD JUN PY 2010 VL 44 IS 6 BP 1080 EP 1089 DI 10.1345/aph.1M582 PG 10 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 603DQ UT WOS:000278189100015 PM 20442355 ER PT J AU Hsia, TY McQuinn, TC Mukherjee, R Deardorff, RL Squires, JE Stroud, RE Crawford, FA Bradley, SM Reeves, ST Spinale, FG AF Hsia, Tain-Yen McQuinn, Tim C. Mukherjee, Rupak Deardorff, Rachael L. Squires, Jerry E. Stroud, Robert E. Crawford, Fred A. Bradley, Scott M. Reeves, Scott T. Spinale, Francis G. TI Effects of Aprotinin or Tranexamic Acid on Proteolytic/Cytokine Profiles in Infants After Cardiac Surgery SO ANNALS OF THORACIC SURGERY LA English DT Article; Proceedings Paper CT 56th Annual Meeting of the Southern-Thoracic-Surgical-Association CY NOV 04-07, 2009 CL Marco Isl, FL SP So Thorac Surg Assoc ID EPSILON-AMINOCAPROIC ACID; SYSTEMIC INFLAMMATORY RESPONSE; CARDIOPULMONARY BYPASS; MATRIX METALLOPROTEINASES; RENAL DYSFUNCTION; COLLAGENASE-2 MMP-8; PEDIATRIC-PATIENTS; TISSUE INHIBITORS; CHILDREN; ACTIVATION AB Background. After cardiopulmonary bypass (CPB), elaboration of cytokines, and subsequent induction of interstitial proteases, such as matrix metalloproteinases (MMPs), can result in a complex postoperative course. The serine protease inhibitor, aprotinin, which has been used in congenital heart surgery putatively for modulating fibrinolysis is now unavailable, necessitating the use of lysine analogues such as tranexamic acid (TXA). The present study tested the hypothesis that distinctly different plasma profiles of signaling molecules and proteases would be differentially affected after the administration of aprotinin or TXA in the context of congenital cardiac surgery and CPB. Methods. Thirty-seven patients (age, 4.8 +/- 0.3 months) undergoing corrective surgery for ventricular septal defect and tetralogy of Fallot received either aprotinin (n = 22) or TXA (n = 15). Using a high throughput multiplex suspension immunoassay, plasma was serially quantified for cytokines and MMPs: before aprotinin or TXA (baseline), after separation from CPB, and 4, 12, 24, and 48 hours post-CPB. Results. Tumor necrosis factor-alpha increased initially after CPB in both the aprotinin and TXA groups, but at 24 and 48 hours post-CPB was approximately 50% lower in the aprotinin group (p < 0.05). The IL-10 levels were threefold higher in the TXA group compared with the aprotinin group immediately post-CBP (p < 0.05). Plasma levels of MMP types associated with inflammation, MMP-8, and MMP-9, were twofold higher in the late post-CPB period in the TXA group when compared with the aprotinin group. Conclusions. After ventricular septal defect or tetralogy of Fallot repair in children, cytokine induction occurs, which is temporally related to the emergence of a specific MMP profile. Moreover, these unique findings demonstrated differential effects between the serine protease inhibitor aprotinin and the lysine analogue TXA with respect to cytokine and MMP induction in the early postoperative period. The different cytokine-proteolytic profile between these antifibrinolytics may in turn influence biologic processes in the postoperative period. (Ann Thorac Surg 2010; 89: 1843-52) (C) 2010 by The Society of Thoracic Surgeons C1 [Spinale, Francis G.] Med Univ S Carolina, Div Cardiothorac Surg, Strom Thurmond Res Ctr, Dept Pathol & Lab Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Anesthesia Perioperat Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Univ Washington, Dept Pediat, Seattle, WA 98195 USA. RP Spinale, FG (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, Strom Thurmond Res Ctr, Dept Pathol & Lab Med, 114 Doughty St,Ste 625, Charleston, SC 29425 USA. EM wilburnm@musc.edu FU NHLBI NIH HHS [R01 HL057952, HL059165-09, R01 HL059165, HL057952-08, R01 HL059165-12, R01 HL057952-12] NR 35 TC 10 Z9 10 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0003-4975 J9 ANN THORAC SURG JI Ann. Thorac. Surg. PD JUN PY 2010 VL 89 IS 6 BP 1843 EP 1852 DI 10.1016/j.athoracsur.2010.02.069 PG 10 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 599ST UT WOS:000277934200019 PM 20494037 ER PT J AU Matthews, PB Azadani, AN Jhun, CS Ge, L Guy, TS Guccione, JM Tseng, EE AF Matthews, Peter B. Azadani, Ali N. Jhun, Choon-Sik Ge, Liang Guy, T. Sloane Guccione, Julius M. Tseng, Elaine E. TI Comparison of Porcine Pulmonary and Aortic Root Material Properties SO ANNALS OF THORACIC SURGERY LA English DT Article ID ROSS PROCEDURE; AUTOGRAFT DILATATION; OPERATION; VALVE; MECHANICS; PRESSURE; DYNAMICS; IMPACT; FLOW AB Background. The pulmonary autograft remodels when subjected to systemic pressure and subsequent dilation can lead to reoperation. Inherent material property differences between pulmonary and aortic roots may influence remodeling but are currently unknown. The objective of this study was to determine stiffness across a wide range of strain and compare nonlinear material properties of corresponding regions of native aortic and pulmonary roots. Methods. Tissue samples from porcine aortic and pulmonary roots-sinuses and supravalvular artery distal to the sinotubular junction-were subjected to displacement-controlled equibiaxial stretch testing. Stress-strain data recorded were used to derive strain energy functions for each region. Stiffness from low to high strains at 0.15, 0.3, and 0.5 strain were determined for comparisons. Results. Aortic and pulmonary roots exhibited qualitatively similar material properties; both had greater non-linearity in the sinus than supravalvular artery. The pulmonary artery was significantly more compliant than the ascending aorta both circumferentially and longitudinally throughout the strain range (p < 0.03), except at high strain circumferentially (p = 0.06). However, no differences in stiffness were seen circumferentially or longitudinally between pulmonary and aortic sinuses (p >= 0.3) until high strain, when the pulmonary sinuses were significantly stiffer (p < 0.05) in both directions. Conclusions. Differences in stiffness between porcine aortic and pulmonary roots are regionally specific, supravalvular artery versus sinus. These regional differences may impact the mode of remodeling to influence late autograft dilation. (Ann Thorac Surg 2010; 89: 1981-9) (C) 2010 by The Society of Thoracic Surgeons C1 [Tseng, Elaine E.] Univ Calif San Francisco, Med Ctr, Dept Surg, Div Cardiothorac Surg, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Tseng, EE (reprint author), Univ Calif San Francisco, Med Ctr, Dept Surg, Div Cardiothorac Surg, 500 Parnassus Ave,Ste W405,Box 0118, San Francisco, CA 94143 USA. EM elaine.tseng@ucsfmedctr.org NR 31 TC 18 Z9 18 U1 0 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0003-4975 J9 ANN THORAC SURG JI Ann. Thorac. Surg. PD JUN PY 2010 VL 89 IS 6 BP 1981 EP 1989 DI 10.1016/j.athoracsur.2010.03.002 PG 10 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 599ST UT WOS:000277934200038 PM 20494060 ER PT J AU Yaffe, K Vittinghoff, E Lindquist, K Barnes, D Covinsky, KE Neylan, T Kluse, M Marmar, C AF Yaffe, Kristine Vittinghoff, Eric Lindquist, Karla Barnes, Deborah Covinsky, Kenneth E. Neylan, Thomas Kluse, Molly Marmar, Charles TI Posttraumatic Stress Disorder and Risk of Dementia Among US Veterans SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article ID HOLOCAUST SURVIVORS; ALZHEIMERS-DISEASE; COGNITIVE DECLINE; PTSD SYMPTOMS; HIPPOCAMPAL; BRAIN; IRAQ; CORTISOL; OUTCOMES; VIETNAM AB Context: Posttraumatic stress disorder (PTSD) is highly prevalent among US veterans because of combat and may impair cognition. Objective: To determine whether PTSD is associated with the risk of developing dementia among older US veterans receiving treatment in the Department of Veterans Affairs medical centers. Design: A stratified, retrospective cohort study conducted using the Department of Veterans Affairs National Patient Care Database. Setting: Department of Veterans Affairs medical centers in the United States. Participants: A total of 181 093 veterans 55 years or older without dementia from fiscal years 1997 through 2000 (53 155 veterans with and 127 938 veterans without PTSD). Main Outcome Measures: During the follow-up period between October 1, 2000, and December 31, 2007, 31 107 (17.2%) veterans were ascertained to have newly diagnosed dementia according to International Classification of Diseases, Ninth Revision, Clinical Modification codes. Results: The mean baseline age of the veterans was 68.8 years, and 174 806 (96.5%) were men. Veterans with PTSD had a 7-year cumulative incident dementia rate of 10.6%, whereas those without had a rate of 6.6% (P<.001). With age as the time scale, Cox proportional hazards models indicated that patients with PTSD were more than twice as likely to develop incident dementia compared with those without PTSD (hazard ratio, 2.31; 95% confidence interval, 2.24-2.39). After multivariable adjustment, patients with PTSD were still more likely to develop dementia (hazard ratio, 1.77; 95% confidence interval, 1.70-1.85). Results were similar when we excluded those with a history of head injury, substance abuse, or clinical depression. Conclusions: In a predominantly male veteran cohort, those diagnosed as having PTSD were at a nearly 2-fold-higher risk of developing dementia compared with those without PTSD. Mechanisms linking these important disorders need to be identified with the hope of finding ways to reduce the increased risk of dementia associated with PTSD. C1 [Yaffe, Kristine; Covinsky, Kenneth E.; Neylan, Thomas; Marmar, Charles] San Francisco VA Med Ctr, San Francisco, CA 94121 USA. [Yaffe, Kristine; Barnes, Deborah; Neylan, Thomas; Kluse, Molly; Marmar, Charles] Univ Calif San Francisco, Sch Med, Dept Psychiat, San Francisco, CA 94143 USA. [Yaffe, Kristine] Univ Calif San Francisco, Sch Med, Dept Neurol, San Francisco, CA 94143 USA. [Yaffe, Kristine; Vittinghoff, Eric] Univ Calif San Francisco, Sch Med, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. [Lindquist, Karla; Covinsky, Kenneth E.] Univ Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA. RP Yaffe, K (reprint author), San Francisco VA Med Ctr, 4150 Clement St,Box 181, San Francisco, CA 94121 USA. EM kristine.yaffe@ucsf.edu FU US Department of Defense [W81XWH-05-2-0094]; National Institute on Aging [AG031155] FX This study was funded by US Department of Defense grant W81XWH-05-2-0094 (principal investigator: Dr Yaffe). Dr Yaffe was supported in part by the National Institute on Aging (grant AG031155) and an anonymous foundation. NR 38 TC 132 Z9 134 U1 5 U2 19 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 JUN PY 2010 VL 67 IS 6 BP 608 EP 613 PG 6 WC Psychiatry SC Psychiatry GA 605CD UT WOS:000278324000009 PM 20530010 ER PT J AU Sano, M AF Sano, Mary TI Tarenflurbil Mechanisms and Myths SO ARCHIVES OF NEUROLOGY LA English DT Editorial Material ID GAMMA-SECRETASE INHIBITOR; ALZHEIMER-DISEASE; AMYLOID-BETA; SAFETY; TRIAL; FLURBIPROFEN C1 James J Peters Vet Affairs Med Ctr, Alzheimer Dis Res Ctr, Dept Psychiat, Mt Sinai Sch Med, Bronx, NY 10468 USA. RP Sano, M (reprint author), James J Peters Vet Affairs Med Ctr, Alzheimer Dis Res Ctr, Dept Psychiat, Mt Sinai Sch Med, 130 Kingsbridge Rd,Code 150,Room 1F01, Bronx, NY 10468 USA. EM mary.sano@mssm.edu FU NIA NIH HHS [2P50 AG005138-26, P50 AG005138-21A1, P50 AG005138] NR 9 TC 4 Z9 4 U1 0 U2 4 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 JUN PY 2010 VL 67 IS 6 BP 750 EP 752 PG 3 WC Clinical Neurology SC Neurosciences & Neurology GA 607OJ UT WOS:000278513400015 PM 20558395 ER PT J AU Korenstein, D Keyhani, S Ross, JS AF Korenstein, Deborah Keyhani, Salomeh Ross, Joseph S. TI Physician Attitudes Toward Industry A View Across the Specialties SO ARCHIVES OF SURGERY LA English DT Article ID MEDICAL-STUDENTS EXPOSURE; CONFLICTS-OF-INTEREST; PHARMACEUTICAL-INDUSTRY; EDUCATIONAL INTERVENTION; NATIONAL-SURVEY; RESIDENTS; GIFTS; REPRESENTATIVES; PAYMENTS; PROPOSAL AB Objectives: To explore attitudes of physicians from all specialties toward gifts from and interactions with the pharmaceutical and medical device industries. Design: Anonymous, cross-sectional survey distributed and collected between June 1 and September 1, 2008. Setting: Hospitals in the Mount Sinai School of Medicine consortium in the New York, New York, metropolitan area. Participants: Faculty and trainee physicians from all clinical departments. Main Outcome Measures: Attitudes toward industry interactions and gifts and their appropriateness measured on 4-point Likert scales. Results: A total of 590 physicians and medical students completed the survey (response rate, 67.0%); 351 (59.5%) were male, 230 (39.0%) were attending physicians, and 131 (23.7%) of 553 (excluding medical students) were from surgical specialties. Attitudes toward industry and gifts were generally positive: 72.2% found sponsored lunches appropriate, whereas 25.4% considered large gifts appropriate. Surgeons, trainees, and those unfamiliar with institutional policies on industry interactions held more positive attitudes than others and were more likely to deem some gifts appropriate, including industry funding of residency programs and, among surgeons, receiving meals, travel expenses, and payments for attending lectures. Nonattending physicians held more positive attitudes toward receiving meals in clinical settings, textbooks, and samples. Conclusions: Physicians continue to hold positive attitudes toward marketing-oriented activities of the pharmaceutical and device industries. Changes in medical culture and physician education focused on surgeons and trainees may align physician attitudes with current policy trends. C1 [Korenstein, Deborah] Mt Sinai Sch Med, Dept Med, New York, NY 10029 USA. [Keyhani, Salomeh] Mt Sinai Sch Med, Dept Hlth Policy, New York, NY 10029 USA. [Ross, Joseph S.] Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY 10029 USA. [Keyhani, Salomeh; Ross, Joseph S.] James J Peters Vet Affairs Med Ctr, Hlth Serv Res & Dev Res Enhancement Award Program, Bronx, NY USA. [Keyhani, Salomeh; Ross, Joseph S.] James J Peters Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. RP Korenstein, D (reprint author), Mt Sinai Sch Med, Dept Med, 1 Gustave Levy Pl,Campus Box 1087, New York, NY 10029 USA. EM deborah.korenstein@mssm.edu FU Attorney General Prescriber Education; National Institute on Aging [K08 AG032886]; American Federation of Aging Research FX Data collection for this work was partially supported by the Attorney General Prescriber Education Grant Program administered by the state of Oregon. Dr Ross is supported by the National Institute on Aging grant K08 AG032886 and by the American Federation of Aging Research through the Paul B. Beeson Career Development Award Program. NR 29 TC 25 Z9 25 U1 2 U2 3 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 JUN PY 2010 VL 145 IS 6 BP 570 EP 577 PG 8 WC Surgery SC Surgery GA 610XY UT WOS:000278774800013 PM 20566978 ER PT J AU Tsang, HWH Leung, AY Chung, RCK Bell, M Cheung, WM AF Tsang, Hector W. H. Leung, Ada Y. Chung, Raymond C. K. Bell, Morris Cheung, Wai-Ming TI Review on vocational predictors: a systematic review of predictors of vocational outcomes among individuals with schizophrenia: an update since 1998 SO AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY LA English DT Review DE employment outcome; frequency; meta-analysis; rehabilitation; schizophrenia ID SEVERE MENTAL-ILLNESS; NEUROCOGNITIVE ENHANCEMENT THERAPY; RANDOMIZED CONTROLLED-TRIAL; COGNITIVE-BEHAVIORAL THERAPY; OF-THE-LITERATURE; SUPPORTED EMPLOYMENT; PSYCHIATRIC DISABILITIES; WORK THERAPY; FOLLOW-UP; CLINICAL PREDICTORS AB Objective: Predictors of employment outcomes of individuals with schizophrenia have continued to be studied over the past decade with implications for the development of vocational interventions to help the mentally ill get and keep jobs. Methods: A total of 62 relevant studies since 1998 were systematically reviewed by means of meta-analysis and frequency counts. Frequency count allowed all 62 studies to be included, whereas the meta-analysis excluded studies with inadequate information but made it possible to estimate the magnitude of effects. Results: Both methods resulted in similar findings. In contrast to an earlier review, cognitive functioning received overwhelming support as a significant predictor. Other significant predictors included education, negative symptoms, social support and skills, age, work history (previous history of successful employment), and rehabilitation service to restore community functioning and well-being by occupational therapists, psychiatrists, psychologists, social workers and other mental health professionals. Positive symptoms, substance abuse, gender and hospitalization history were found to be non-significant predictors. The frequency count did not support marital status as a significant predictor but the meta-analysis did. Conclusions: This review highlights increasing sophistication in understanding the links between individual characteristics and functional impairments. It also suggests that more research is needed into other potentially important predictors that may be changeable and relate to recovery. These include attitudes and beliefs about disability payments and psychological processes such as self-stigmatization, negative beliefs, and social skills deficits for which intervention may be possible. C1 [Tsang, Hector W. H.; Leung, Ada Y.; Chung, Raymond C. K.] Hong Kong Polytech Univ, Dept Rehabil Sci, Neuropsychiat Rehabil Lab, Hong Kong, Hong Kong, Peoples R China. [Cheung, Wai-Ming] Univ Hong Kong, Fac Educ, Hong Kong, Hong Kong, Peoples R China. [Bell, Morris] US Dept Vet Affairs, Rehabil Res & Dev Serv, New Haven, CT USA. [Bell, Morris] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA. RP Tsang, HWH (reprint author), Hong Kong Polytech Univ, Dept Rehabil Sci, Neuropsychiat Rehabil Lab, Hong Kong, Hong Kong, Peoples R China. EM rshtsang@inet.polyu.edu.hk NR 84 TC 85 Z9 85 U1 8 U2 35 PU INFORMA HEALTHCARE PI NEW YORK PA 52 VANDERBILT AVE, NEW YORK, NY 10017 USA SN 0004-8674 J9 AUST NZ J PSYCHIAT JI Aust. N. Z. J. Psych. PD JUN PY 2010 VL 44 IS 6 BP 495 EP 504 PG 10 WC Psychiatry SC Psychiatry GA 612MK UT WOS:000278902600001 PM 20482409 ER PT J AU Nappi, CM Nappi, CM Drummond, SPA Thorp, SR McQuaid, JR AF Nappi, Carla M. Nappi, Carla M. Drummond, Sean P. A. Thorp, Steven R. McQuaid, John R. TI Effectiveness of Imagery Rehearsal Therapy for the Treatment of Combat-Related Nightmares in Veterans SO BEHAVIOR THERAPY LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER; SEXUAL ASSAULT SURVIVORS; SLEEP DISTURBANCES; FOLLOW-UP; PTSD; TRIAL; SAMPLE AB Imagery Rehearsal Therapy (IRT) has been shown to be efficacious in reducing nightmares, but the treatment has not been well-studied in veterans. The effectiveness of IRT was assessed from a chart review of veterans seeking outpatient treatment for chronic, trauma-related nightmares. Of those offered IRT, veterans who completed a full course of treatment for PTSD in the past year were more likely to initiate treatment. However, completion of IRT was not related to previous treatment, demographic variables, or nightmare severity reported at the first treatment session. Treatment completers reported significant reductions in nightmare frequency and intensity, severity of insomnia, and subjective daytime PTSD symptoms. Insomnia and PTSD symptoms, on average, were below clinical cutoffs following treatment, and 23% of patients showed a complete treatment response (<= 1 nightmare/week). Findings suggest IRT may be an effective short-term treatment for nighttime and daytime PTSD symptoms among veterans who complete a full course of treatment. C1 [Drummond, Sean P. A.] Univ Calif San Diego, Lab Sleep & Behav Neurosci, San Diego, CA 92161 USA. [Nappi, Carla M.; Nappi, Carla M.; Drummond, Sean P. A.; Thorp, Steven R.] Vet Affairs San Diego Healthcare Syst, San Diego, CA 92161 USA. [McQuaid, John R.] San Francisco VA Med Ctr, San Francisco, CA USA. RP Drummond, SPA (reprint author), Univ Calif San Diego, Lab Sleep & Behav Neurosci, 3350 La Jolla Village Dr,MC 151B,Bldg 13,3rd Floo, San Diego, CA 92161 USA. EM drummond@ucsd.edu NR 26 TC 22 Z9 22 U1 3 U2 13 PU ASSOC ADV BEHAVIOR THERAPY PI NEW YORK PA 305 7TH AVE #16A, NEW YORK, NY 10001-6008 USA SN 0005-7894 J9 BEHAV THER JI Behav. Therapy PD JUN PY 2010 VL 41 IS 2 BP 237 EP 244 PG 8 WC Psychology, Clinical SC Psychology GA 594PI UT WOS:000277549200008 PM 20412888 ER PT J AU Schwab, P Lipton, S Kerr, GS AF Schwab, Pascale Lipton, Sarah Kerr, Gail S. TI Rheumatologic sequelae and challenges in organ transplantation SO BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY LA English DT Article DE transplant; gout; osteoporosis; avascular necrosis; graft-versus-host disease; calcineurin inhibitor pain syndrome ID VERSUS-HOST-DISEASE; STEM-CELL TRANSPLANTATION; CARPAL-TUNNEL-SYNDROME; CHRONIC-RENAL-FAILURE; DISTAL LIMB SYNDROME; BONE LOSS; LIVER-TRANSPLANTATION; KIDNEY-TRANSPLANT; CARDIAC TRANSPLANTATION; LUNG TRANSPLANTATION AB Despite the increasing success of transplantation, graft recipients experience a high burden of musculoskeletal symptoms that may hinder quality of life. Post-transplant musculoskeletal problems may result from sequelae of the organ dysfunction that indicated the transplant or from the subsequent anti-rejection therapy. Rheumatology consultants need to be familiar with the spectrum of musculoskeletal syndromes presenting in these unique patients and their appropriate treatment in the context of complex drug regimens and immunosuppression. Published by Elsevier Ltd. C1 [Schwab, Pascale] Oregon Hlth & Sci Univ, Portland Vet Affairs Med Ctr, Div Arthrit & Rheumat Dis, Portland, OR 97239 USA. [Lipton, Sarah] Portland VA Med Ctr, Dept Hosp & Specialty Med, Portland, OR 97239 USA. [Kerr, Gail S.] Georgetown Univ, Vet Affairs Med Ctr, Rheumatol Sect, Washington, DC 20422 USA. [Kerr, Gail S.] Howard Univ Hosp, Washington, DC 20422 USA. RP Schwab, P (reprint author), Oregon Hlth & Sci Univ, Portland Vet Affairs Med Ctr, Div Arthrit & Rheumat Dis, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM schwabp@ohsu.edu; sarah.lipton@va.gov; Gail.kerr@va.gov NR 95 TC 0 Z9 1 U1 1 U2 6 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1521-6942 J9 BEST PRACT RES CL RH JI Best Pract. Res. Clin. Rheumatol. PD JUN PY 2010 VL 24 IS 3 BP 329 EP 340 DI 10.1016/j.berh.2009.12.011 PG 12 WC Rheumatology SC Rheumatology GA 618QM UT WOS:000279370800004 PM 20534367 ER EF