FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Spettell, CM Wall, TC Allison, J Calhoun, J Kobylinski, R Fargason, R Kiefe, CI AF Spettell, CM Wall, TC Allison, J Calhoun, J Kobylinski, R Fargason, R Kiefe, CI TI Identifying physician-recognized depression from administrative data: Consequences for quality measurement SO HEALTH SERVICES RESEARCH LA English DT Article DE depression; HEDIS; quality of care; predictive value ID COOPERATIVE CARDIOVASCULAR PROJECT; ACUTE MYOCARDIAL-INFARCTION; PRIMARY-CARE; MEDICARE PATIENTS; MAJOR DEPRESSION; ACHIEVABLE BENCHMARKS; CHRONIC PAIN; OF-CARE; MANAGEMENT; ANTIDEPRESSANTS AB Background. Multiple factors limit identification of patients with depression from administrative data. However, administrative data drives many quality measurement systems, including the Health Plan Employer Data and Information Set (HEDIS(R)). Methods. We investigated two algorithms for identification of physician-recognized depression. The study sample was drawn from primary care physician member panels of a large managed care organization. All members were continuously enrolled between January I and December 31, 1997. Algorithm I required at least two criteria in any combination: (1) an outpatient diagnosis of depression or (2) a pharmacy claim for an antidepressant. Algorithm 2 included the same criteria as algorithm 1, but required a diagnosis of depression for all patients. With algorithm 1, we identified the medical records of a stratified, random subset of patients with and without depression (n = 465). We also identified patients of primary care physicians with a minimum of 10 depressed members by algorithm 1 (n = 32,819) and algorithm 2 (n = 6,837). Results. The sensitivity, specificity, and positive predictive values were: Algorithm 1: 95 percent, 65 percent, 49 percent; Algorithm 2: 52 percent, 88 percent, 60 percent. Compared to algorithm 1, profiles from algorithm 2 revealed higher rates of follow-up visits (43 percent, 55 percent) and appropriate antidepressant dosage acutely (82 percent, 90 percent) and chronically (83 percent, 91 percent) (p < 0.05 for all). Conclusions. Both algorithms had high false positive rates. Denominator construction (algorithm I versus 2) contributed significantly to variability in measured quality. Our findings raise concern about interpreting depression quality reports based upon administrative data. C1 USQA, Aetna Inc, Blue Bell, PA 19422 USA. Univ Alabama, Ctr Outcomes & Effect Res & Educ, Birmingham, AL USA. Univ Alabama, Div Gen Internal Med, Birmingham, AL USA. Univ Alabama, Div Prevent Med, Birmingham, AL USA. Univ Alabama, Dept Psychiat, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Spettell, CM (reprint author), USQA, Aetna Inc, 980 Jolly Rd,Mailstop U38A, Blue Bell, PA 19422 USA. OI Allison, Jeroan/0000-0003-4472-2112 FU AHRQ HHS [HS09446, HS1112403, U18 HS009446] NR 71 TC 45 Z9 45 U1 3 U2 7 PU BLACKWELL PUBL LTD PI OXFORD PA 108 COWLEY RD, OXFORD OX4 1JF, OXON, ENGLAND SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD AUG PY 2003 VL 38 IS 4 BP 1081 EP 1102 DI 10.1111/1475-6773.00164 PG 22 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 714ZL UT WOS:000184945500007 PM 12968818 ER PT J AU Rosen, HR Prieto, M Casanovas-Taltavull, T Cuervas-Mons, V Guckelberger, O Muiesan, P Strong, RW Bechstein, WO O'Grady, J Zaman, A Chan, B Berenguer, J Williams, R Heaton, N Neuhaus, P AF Rosen, HR Prieto, M Casanovas-Taltavull, T Cuervas-Mons, V Guckelberger, O Muiesan, P Strong, RW Bechstein, WO O'Grady, J Zaman, A Chan, B Berenguer, J Williams, R Heaton, N Neuhaus, P TI Validation and refinement of survival models for liver retransplantation SO HEPATOLOGY LA English DT Article; Proceedings Paper CT 53rd Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY NOV 01-05, 2002 CL BOSTON, MA SP Amer Assoc Study Liver Dis ID HEPATIC RETRANSPLANTATION; RESOURCE UTILIZATION; PREDICT SURVIVAL; GRAFT CIRRHOSIS; TRANSPLANTATION; DISEASE; MELD; MORTALITY; EVOLUTION; FAILURE AB Orthotopic liver retransplantation (re-OLT) is highly controversial. The objectives of this study were to determine the validity of a recently developed United Network for Organ Sharing (UNOS) multivariate model using an independent cohort of patients undergoing re-OLT outside the United States, to determine whether incorporation of other variables that were incomplete in the UNOS registry would provide additional prognostic information, to develop new models combining data sets from both cohorts, and to evaluate the validity of the model for end-stage liver disease (MELD) in patients undergoing re-OLT. Two hundred eighty-one adult patients undergoing re-OLT (between 1986 and 1999) at 6 foreign transplant centers comprised the validation cohort. We found good agreement between actual survival and predicted survival in the validation cohort; 1-year patient survival rates in the low-, intermediate-, and high-risk groups (as assigned by the original UNOS model) were 72%, 68%, and 36%, respectively (P < .0001). In the patients for whom the international normalized ratio (INR) of prothrombin time was available, MELD correlated with outcome following re-OLT; the median MELD scores for patients surviving at least 90 days compared with those dying within 90 days were 20.75 versus 25.9, respectively (P = .004). Utilizing both patient cohorts (n = 979), a new model, based on recipient age, total serum bilirubin, creatinine, and interval to re-OLT, was constructed (whole model chi(2) = 105, P < .0001). Using the c-statistic with 30-day, 90-day, 1-year, and 3-year mortality as the end points, the area under the receiver operating characteristic (ROC) curves for 4 different models were compared. In conclusion, prospective validation and use of these models as adjuncts to clinical decision making in the management of patients being considered for re-OLT are warranted. C1 Portland VA Med Ctr, Div Gastroenterol Hepatol, Portland, OR 97207 USA. Oregon Hlth & Sci Univ, Biostat Clin Informat Anal & Decis Support Ctr, Portland, OR USA. Hosp La Fe, E-46009 Valencia, Spain. Ciudad Sanitaria & Univ Bellvitge, Unidad Trasplante Hepat, Barcelona, Spain. Univ Autonoma Madrid, Hosp Puerta Hierro, E-28049 Madrid, Spain. Free Univ Berlin, Klinikum Rudolf Virchow, D-1000 Berlin, Germany. Kings Coll London, London WC2R 2LS, England. Royal Brisbane Hosp, Brisbane, Qld 4029, Australia. UCL, London, England. RP Rosen, HR (reprint author), Portland VA Med Ctr, Div Gastroenterol Hepatol, 3710 SW US Vet Hosp,P3-GI, Portland, OR 97207 USA. EM hugo.rosen@medva.gov OI Muiesan, Paolo/0000-0002-7389-6691; Cuervas-Mons Martinez, Valentin/0000-0003-3086-9463 NR 28 TC 77 Z9 83 U1 0 U2 5 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD AUG PY 2003 VL 38 IS 2 BP 460 EP 469 DI 10.1053/jhep.2003.50328 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 707VV UT WOS:000184531300022 PM 12883491 ER PT J AU Spiegel, BMR Targownik, L Dulai, GS Karsan, H Gralnek, IM AF Spiegel, BMR Targownik, L Dulai, GS Karsan, H Gralnek, IM TI Cost effectiveness of preventing variceal hemorrhage - Reply SO HEPATOLOGY LA English DT Letter C1 Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. RP Spiegel, BMR (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD AUG PY 2003 VL 38 IS 2 BP 535 EP 535 DI 10.1053/jhep.2003.50324 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 707VV UT WOS:000184531300036 ER PT J AU Maldonado, A Game, BA Song, LX Huang, Y AF Maldonado, A Game, BA Song, LX Huang, Y TI Up-regulation of matrix metalloproteinase-1 expression in U937 cells by low-density lipoprotein-containing immune complexes requires the activator protein-1 and the Ets motifs in the distal and the proximal promoter regions SO IMMUNOLOGY LA English DT Article; Proceedings Paper CT 75th Annual Scientific Session of the American-Heart-Association CY NOV 17-20, 2002 CL CHICAGO, ILLINOIS SP Amer Heart Assoc ID BREAST-CANCER CELLS; OXIDIZED LDL; ATHEROSCLEROTIC PLAQUES; CIRCUMFERENTIAL STRESS; HUMAN MACROPHAGES; GENE-EXPRESSION; COLLAGENASE; RECEPTOR; TRANSCRIPTION; MECHANISMS AB We reported previously that low-density lipoprotein (LDL)-containing immune complexes (LDL-IC) stimulated matrix metalloproteinase-1 (MMP-1) expression in U937 histiocytes through Fc gamma receptor (FcgammaR)-mediated extracellular signal-regulated kinase pathway. The present study has explored the transcriptional mechanisms involved in the stimulation. Deletion analysis showed that LDL-IC stimulated MMP-1 promoter activity in cells transfected with the Construct 1 that contained a 4,334-bp MMP-1 promoter fragment, but had no effect in cells transfected with other constructs that had shorter MMP-1 promoter (2685-bp or less), suggesting that cis-acting elements located between -4334 and -2685 are required for the promoter stimulation. The mutation study further indicated that the activator protein-1 (AP-1) (-3471) or Ets (-3836) motifs in this distal region were essential for the LDL-IC-stimulated MMP-1 expression. Moreover, although above deletion analysis showed that LDL-IC did not stimulate MMP-1 promoter activity in cells transfected with constructs that contained the proximal AP-1 (-72) and Ets (-88) in the promoter fragments that are 2685-bp or less, the mutations of the -72 AP-1 or the -88 Ets motif in the construct 1 abolished the stimulation of MMP-1 expression by LDL-IC, suggesting that a long promoter sequence is required for the -72 AP-1 and -88 Ets motifs to be involved in the stimulation. Finally, electrophoretic mobility shift assay showed that LDL-IC stimulated the activities of transcription factors AP-1 and Ets. In conclusion, the present study shows that both the distal and proximal AP-1 and Ets motifs are required for LDL-IC-stimulated MMP-1 expression in U937 histiocytes. C1 Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29403 USA. Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Charleston, SC 29403 USA. RP Huang, Y (reprint author), Ralph H Johnson Vet Affairs Med Ctr, 114 Doughty St, Charleston, SC 29403 USA. NR 27 TC 7 Z9 10 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0019-2805 J9 IMMUNOLOGY JI Immunology PD AUG PY 2003 VL 109 IS 4 BP 572 EP 579 DI 10.1046/j.1365-2567.2003.01694.x PG 8 WC Immunology SC Immunology GA 710PM UT WOS:000184688700014 PM 12871225 ER PT J AU Halpern, SD Asch, DA AF Halpern, SD Asch, DA TI Commentary: Improving response rates to mailed surveys: what do we learn from randomized controlled trials? SO INTERNATIONAL JOURNAL OF EPIDEMIOLOGY LA English DT Editorial Material ID PHYSICIAN RESPONSE; QUESTIONNAIRES; INCENTIVES; SIZE C1 Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Bioeth, Philadelphia, PA 19104 USA. Univ Penn, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. Univ Penn, Div Gen Internal Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity & Promot, Philadelphia, PA USA. RP Asch, DA (reprint author), Univ Penn, Leonard Davis Inst Hlth Econ, 3641 Locust Walk, Philadelphia, PA 19104 USA. OI Asch, David/0000-0002-7970-286X NR 13 TC 16 Z9 17 U1 0 U2 2 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0300-5771 J9 INT J EPIDEMIOL JI Int. J. Epidemiol. PD AUG PY 2003 VL 32 IS 4 BP 637 EP 638 DI 10.1093/ije/dyg184 PG 2 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 712ED UT WOS:000184783500033 PM 12913043 ER PT J AU Conigliaro, J Gordon, AJ McGinnis, KA Rabeneck, L Justice, AC AF Conigliaro, J Gordon, AJ McGinnis, KA Rabeneck, L Justice, AC CA Veterans Aging Cohort 3 Site Study TI How harmful is hazardous alcohol use and abuse in HIV infection: Do health care providers know who is at risk? SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE alcohol; AUDIT; binge drinking; HIV; AIDS; CD4 cell count; HIV-1 load; aspartate transaminase ID PROBLEM DRINKING; DISORDERS; QUESTIONS; ADHERENCE; VETERANS; DRINKERS; AUDIT AB We conducted a prospective cohort study to describe the association between alcohol use, HIV disease progression, and drug toxicity and to determine health care provider awareness of excessive alcohol use by recruiting 881 HIV-infected veterans (median age, 49 years; 99% male; 54% African American) from 3 VA HIV clinics. Twenty percent of patients were hazardous drinkers by the Alcohol Use Disorders Identification Test, 33% were binge drinkers, 32% had a chart ICD-9 alcohol diagnosis, and 12.5% and 66.7%, respectively, were described by their health care providers, as currently and ever drinking "too much." Hazardous/binge drinkers more often had detectable viral loads (P < 0.001). Patients with alcohol diagnoses more often had elevated alanine transaminase or aspartate transaminase levels (P < 0.02), anemia (P < 0.001), and elevated mean corpuscular volume (P < 0.001). Health care providers missed hazardous drinking in patients with undetectable viral loads (P = 0.01), patients without hepatitis C (P = 0.09), and patients with normal aspartate transaminase levels (P = 0.07) and missed alcohol diagnoses in patients without hepatitis and those with CD4 cell counts of >200/mL. We conclude that in HIV-positive veterans, hazardous drinking and alcohol diagnoses were common and associated with HIV disease progression and/or hepatic comorbidity and anemia. Health care providers more often missed alcohol problems in patients with less severe HIV infection and those without evidence of liver disease. Health care providers should routinely screen and counsel patients regarding alcohol problems as part of standard of care to minimize disease progression and bone marrow and hepatic toxicity. C1 Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Toronto, Sunnybrook & Womens Coll, Hlth Sci Ctr, Toronto, ON, Canada. RP Justice, AC (reprint author), Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C,130-VACS, Pittsburgh, PA 15240 USA. FU NIA NIH HHS [AG00826-03]; NIAAA NIH HHS [U01 AA 13566-02] NR 17 TC 78 Z9 79 U1 1 U2 4 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 2003 VL 33 IS 4 BP 521 EP 525 PG 5 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 703LA UT WOS:000184279800014 PM 12869842 ER PT J AU Chen, LX Eberhardt, R Enzenauer, RJ Horwitz, HM Luk, AJ Melnicoff, I Pepmuellar, PH Queen, KT Ramanujam, B Straka, PC Svara, C Travers, R Wallace, D Watanabe, W Weiss, T Schumacher, HR AF Chen, LX Eberhardt, R Enzenauer, RJ Horwitz, HM Luk, AJ Melnicoff, I Pepmuellar, PH Queen, KT Ramanujam, B Straka, PC Svara, C Travers, R Wallace, D Watanabe, W Weiss, T Schumacher, HR TI A look at rheumatology in China (2002) SO JCR-JOURNAL OF CLINICAL RHEUMATOLOGY LA English DT Editorial Material AB This report describes a visit by an international group interested in Rheumatology to the Rheumatology centers And traditional Chinese medicine units in the People's Republic of China. Differing disease patterns and treatment approaches offer opportunities for studies and collaborations. We can also learn from the traditional Chinese approach with individualization of therapy and attention to health maintenance. C1 Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Presbyterian Med Ctr, Philadelphia, PA 19104 USA. Sheboygan Clin, Sheboygan, WI USA. Univ Tennessee, Coll Med, Ooltewah, TN USA. Miriam Hosp, Providence, RI 02906 USA. Brown Univ, Providence, RI 02912 USA. Univ Washington, Seattle, WA 98195 USA. VA Med Ctr, Seattle, WA USA. N Suburban Rheumatol Ltd, Des Plaines, IL USA. Lutheran Gen Advocate Hosp, Des Plaines, IL USA. St Louis Univ, St Louis, MO 63103 USA. Mt Med Associates, Waynesville, NC USA. Solo Practice, Santa Cruz, CA USA. Ctr DeReumatol DYK SA, Quito, Ecuador. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. Raleigh Rheumatol Consultants, Raleigh, NC USA. Western Hosp, Melbourne, Vic, Australia. Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. Akita Univ, Sch Med, Akita 010, Japan. Arthrit Consultants Inc, St Louis, MO USA. RP Schumacher, HR (reprint author), Philadelphia VA Med Ctr, Univ & Woodland Ave, Philadelphia, PA 19104 USA. NR 0 TC 2 Z9 2 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1076-1608 J9 JCR-J CLIN RHEUMATOL JI JCR-J. Clin. Rheumatol. PD AUG PY 2003 VL 9 IS 4 BP 228 EP 238 DI 10.1097/01.rhu.0000082156.86721.d8 PG 11 WC Rheumatology SC Rheumatology GA 758QC UT WOS:000187660800004 PM 17041463 ER PT J AU Sawalha, AH Lutz, BD Chaudhary, NA Kern, W Harley, JB Greenfield, RA AF Sawalha, AH Lutz, BD Chaudhary, NA Kern, W Harley, JB Greenfield, RA TI Panniculitis - A presenting manifestation of disseminated histoplasmosis in a patient with rheumatoid arthritis SO JCR-JOURNAL OF CLINICAL RHEUMATOLOGY LA English DT Article DE panniculitis; histoplasmosis; rheumatoid arthritis; infliximab ID IMMUNOSUPPRESSIVE THERAPY; INFLIXIMAB AB We report a case of histoplasma panniculitis in a patient with rheumatoid arthritis treated with multiple immunosuppressive agents including infliximab. The patient presented with erythematous, plaques involving the right upper anterior abdominal wall, the right flank and later extension to involve the left flank and the left axilla. The histopathologic examination of these lesions was consistent with lobular panniculitis and the cultures of these lesions and blood grew Histoplasma capsulatum. The clinical and histopathologic picture of histoplasma panniculitis and rheumatoid arthritis-associated panniculitis can be very similar, but the treatment is clearly different. Our case emphasizes the importance of considering rare manifestations of opportunistic infections in an era of widespread use of immunosuppressive medications in the field of rheumatology. C1 Univ Oklahoma, Hlth Sci Ctr, Dept Med, Oklahoma City, OK 73104 USA. Univ Oklahoma, Hlth Sci Ctr, Dept Pathol, Oklahoma City, OK 73104 USA. US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. Oklahoma Med Res Fdn, Arthrit & Immunol Program, Oklahoma City, OK 73104 USA. RP Sawalha, AH (reprint author), Univ Oklahoma, Hlth Sci Ctr, Dept Med, 825 NE 13th St,OMRF,Mail Stop 24, Oklahoma City, OK 73104 USA. NR 14 TC 8 Z9 9 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1076-1608 J9 JCR-J CLIN RHEUMATOL JI JCR-J. Clin. Rheumatol. PD AUG PY 2003 VL 9 IS 4 BP 259 EP 262 DI 10.1097/01.rhu.0000083606.71931.79 PG 4 WC Rheumatology SC Rheumatology GA 758QC UT WOS:000187660800008 PM 17041467 ER PT J AU Abboud, SL Ghosh-Choudhury, N Liu, C Shen, V Woodruff, K AF Abboud, SL Ghosh-Choudhury, N Liu, C Shen, V Woodruff, K TI Osteoblast-specific targeting of soluble colony-stimulating factor-1 increases cortical bone thickness in mice SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Article; Proceedings Paper CT 22nd Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 22-26, 2000 CL TORONTO, CANADA SP Amer Soc Bone & Mineral Res DE macrophage colony-stimulating factor; osteoclasts; osteoblasts; transgenic mice; bone remodeling ID AGED MALE RATS; OP/OP MICE; OSTEOCLAST FORMATION; MOLECULAR-CLONING; CANCELLOUS BONE; STROMAL CELLS; GROWTH-FACTOR; LONG-TERM; M-CSF; EXPRESSION AB The soluble and membrane-bound forms of CSF-1 are synthesized by osteoblasts and stromal cells in the bone microenvironment. Transgenic mice, generated to selectively express sCSF-1 in bone, showed increased cortical thickness in the femoral diaphysis caused by new bone formation along the endosteal surface. The ability of sCSF-1 to enhance bone cell activity in vivo is potentially relevant for increasing cortical bone in a variety of disorders. Introduction: The soluble form of colony-stimulating factor-1 (sCSF-1) and the membrane-bound form of CSF-1 (mCSF-1) have been shown to support osteoclastogenesis in vitro; however, the effect of each peptide on bone remodeling in vivo is unclear. To determine the effect of sCSF-1, selectively expressed in bone, the skeletal phenotype of transgenic mice harboring the human sCSF-1 cDNA under the control of the osteocalcin promoter was assessed. Methods: At 5 and 14 weeks, mice were analyzed for CSF-1 protein levels, weighed, and X-rayed, and femurs were removed for peripheral quantitative computed tomography, histology, and histomorphometry. Results: High levels of human sCSF-1 were detected in bone extracts and, to a lesser extent, in plasma. Adult transgenic mice showed normal body weight and increased circulating monocytic cells. At 5 weeks, the femoral diaphysis was similar in CSF-1T and wt/wt littermates. However, by 14 weeks, the femoral diaphysis in CSF-1T mice showed increased cortical thickness and bone mineral density. In contrast to the diaphysis, the femoral metaphysis of CSF-1T mice showed normal cancellous bone comparable with wt/wt littermates at each time point. Histological sections demonstrated increased woven bone along the endosteal surface of the diaphysis and intracortical remodeling. Fluorochrome-labeling analysis confirmed endocortical bone formation in CSF-1T, with a 3.1-fold increase in the percentage of double-labeled surfaces and a 3.6-fold increase in the bone formation rate compared with wt/wt mice. Although remodeling resulted in a slightly porous cortex, sCSF-1 preferentially stimulated endocortical bone formation, leading to increased cortical thickness. Conclusions: These findings indicate that sCSF-1 is a key determinant of bone cell activity in the corticoendosteal envelope. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. Skeletech Inc, Bothell, WA USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Abboud, SL (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. FU NIAMS NIH HHS [AR42306, R01 AR042306] NR 44 TC 10 Z9 10 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD AUG PY 2003 VL 18 IS 8 BP 1386 EP 1394 DI 10.1359/jbmr.2003.18.8.1386 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 704CU UT WOS:000184320800002 PM 12929928 ER PT J AU Lopez, I Rodriguez, M Felsenfeld, AJ Estepa, JC Aguilera-Tejero, E AF Lopez, I Rodriguez, M Felsenfeld, AJ Estepa, JC Aguilera-Tejero, E TI Direct suppressive effect of acute metabolic and respiratory alkalosis on parathyroid hormone secretion in the dog SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Article DE calcium; metabolic alkalosis; parathyroid hormone; pH; respiratory alkalosis ID IONIZED CALCIUM-CONCENTRATION; CHRONIC HYPERCALCEMIA; ALKALINE TIDE; HYPOCALCEMIA; BICARBONATE; ACIDOSIS; BONE; INVITRO; SEPSIS; SODIUM AB Acute alkalosis may directly affect PTH secretion. The effect of acute metabolic and respiratory alkalosis was studied in 20 dogs. PTH values were lower in the metabolic (5.6 +/- 0.8 pg/ml) and respiratory (1.8 +/- 0.6 pg/ml) alkalosis groups than in the control group (27 +/- 5 pg/ml). Acute alkalosis is an independent factor that decreases PTH values during normocalcemia and delays the PTH response to hypocalcemia. Introduction: We recently showed that acute metabolic and respiratory acidosis stimulated PTH secretion. This study was designed to evaluate whether acute metabolic and respiratory alkalosis suppressed parathyroid hormone (PTH) secretion. Materials and Methods: Three groups of 10 dogs were studied: control, acute metabolic alkalosis, and acute respiratory alkalosis. Metabolic alkalosis was induced with an infusion of sodium bicarbonate and respiratory alkalosis by hyperventilation. Calcium chloride was infused to prevent alkalosis-induced hypocalcemia during the first 60 minutes. During the next 30 minutes, disodium EDTA was infused to induce hypocalcemia and to evaluate the PTH response to hypocalcemia. Because the infusion of sodium bicarbonate resulted in hypernatremia, the effect of hypernatremia was studied in an additional group that received hypertonic saline. Results: After 60 minutes of a normocalcemic clamp, PTH values were less (p < 0.05) in the metabolic (5.6 +/- 0.8 pg/ml) and respiratory (1.8 0.6 pg/ml) alkalosis groups than in the control group (27 5 pg/ml); the respective blood pH values were 7.61 +/- 0.01, 7.59 +/- 0.02, and 7.39 +/- 0.02. The maximal PTH response to hypocalcemia was similar among the three groups. However, the maximal PTH response was observed after a decrease in ionized calcium of 0.20 mM in the control group but not until a decrease of 0.40 mM in the metabolic and respiratory alkalosis groups. In contrast to the metabolic alkalosis group, hypernatremia (157 +/- 2 mEq/liter) in the hypertonic saline group was associated with an increased PTH value (46 4 pg/ml). Finally, the half-life of intact PTH was not different among the control and two alkalosis groups. Conclusions: Acute metabolic and respiratory alkalosis markedly decreased PTH values during normocalcemia and delayed the PTH response to hypocalcemia. Whether acute metabolic and respiratory alkalosis affect PTH and calcium metabolism in such settings as the postprandial alkaline tide (metabolic alkalosis) and acute sepsis (respiratory alkalosis) deserves to be evaluated in future studies. C1 Univ Rabanales, Dept Med & Cirugia, Cordoba 14014, Spain. Univ Cordoba, Hosp Univ Reina Sofia, Dept Nefrol, Cordoba, Spain. Univ Cordoba, Hosp Reina Sofia, Unidad Invest, Cordoba, Spain. Univ Calif Los Angeles, Los Angeles, CA USA. W Los Angeles VA Med Ctr, Dept Med, Los Angeles, CA USA. Univ Cordoba, Dept Med & Ciurgia Anim, Cordoba, Spain. RP Aguilera-Tejero, E (reprint author), Univ Rabanales, Dept Med & Cirugia, Ctra Madrid Cadiz Km 396,Animal Campus, Cordoba 14014, Spain. RI Rodriguez, teresa/H-5452-2011 NR 29 TC 16 Z9 16 U1 0 U2 5 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD AUG PY 2003 VL 18 IS 8 BP 1478 EP 1485 DI 10.1359/jbmr.2003.18.8.1478 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 704CU UT WOS:000184320800011 PM 12929937 ER PT J AU Havranek, EP Krumholz, HM Dudley, RA Adams, K Gregory, D Lampert, S Lindenfeld, J Massie, BM Pina, I Restaino, S Rich, MW Konstam, MA AF Havranek, EP Krumholz, HM Dudley, RA Adams, K Gregory, D Lampert, S Lindenfeld, J Massie, BM Pina, I Restaino, S Rich, MW Konstam, MA TI Aligning quality and payment for heart failure care: Defining the challenges SO JOURNAL OF CARDIAC FAILURE LA English DT Article DE heart failure management; reimbursement; quality of care AB Hospitals may not support programs that improve the quality of care delivered to heart failure patients because these programs lower readmission rates and empty beds, and therefore further diminish already-declining revenues. A conflict between the highest quality of care and financial solvency does not serve the interests of patients, physicians, hospitals, or payers. In principle, resolution of this conflict is simple: reimbursement systems should reward higher quality care. In practice, resolving the conflict is not simple. A recent roundtable discussion sponsored by the Heart Failure Society of America identified 4 major challenges to the design and implementation of reimbursement schemes that promote higher quality care for heart failure: defining quality, accounting for differences in disease severity, crafting novel payment mechanisms, and overcoming professional parochialism. This article describes each of these challenges in turn. C1 Denver Hlth Med Ctr, Dept Med, Div Cardiol, Denver, CO 80204 USA. Univ Colorado, HSC, Denver, CO 80202 USA. Yale Univ, Sch Med, Sect Cardiovasc Med,Sect Hlth Policy & Adm, Dept Internal Med,Dept Epidemiol & Publ Hlth, New Haven, CT USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, Sch Med, Inst Hlth Policy Studies, San Francisco, CA 94143 USA. Univ N Carolina, Div Cardiol, Dept Med, Dept Radiol, Chapel Hill, NC USA. Tufts New England Med Ctr, Boston, MA USA. Harvard Vanguard Med Assoc, Boston, MA USA. Univ Colorado, HSC, Dept Med, Div Cardiol, Denver, CO 80202 USA. Univ Calif San Francisco, Div Cardiol, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. Case Western Reserve Univ, Sch Med, Dept Med, Div Cardiol, Cleveland, OH 44106 USA. Columbia Univ, Coll Phys & Surg, Dept Med, New York, NY USA. Univ Washington, Sch Med, Div Cardiovasc, Dept Med, St Louis, MO USA. Tufts New England Med Ctr, Div Cardiol, Dept Med, Boston, MA USA. Tufts Univ, Sch Med, Boston, MA 02111 USA. RP Havranek, EP (reprint author), Denver Hlth Med Ctr, Dept Med, Div Cardiol, 0960,777 Bannock St, Denver, CO 80204 USA. NR 9 TC 6 Z9 6 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 2003 VL 9 IS 4 BP 251 EP 254 DI 10.1054/jcaf.2003.30 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 715HP UT WOS:000184966000001 PM 13680543 ER PT J AU Anderson, JL Krause-Steinrauf, H Goldman, S Clemson, BS Domanski, MJ Hager, WD Murray, DR Mann, DL Massie, BM McNamara, DM Oren, R Rogers, WJ AF Anderson, JL Krause-Steinrauf, H Goldman, S Clemson, BS Domanski, MJ Hager, WD Murray, DR Mann, DL Massie, BM McNamara, DM Oren, R Rogers, WJ CA Beta Blocker Evaluation Survival T TI Failure of benefit and early hazard of bucindolol for Class IV heart failure SO JOURNAL OF CARDIAC FAILURE LA English DT Article DE beta-blocker; bucindolol; heart failure; survival ID IDIOPATHIC DILATED CARDIOMYOPATHY; ADRENERGIC-RECEPTOR BLOCKADE; INTRINSIC SYMPATHOMIMETIC ACTIVITY; CONGESTIVE CARDIOMYOPATHY; RANDOMIZED TRIAL; SURVIVAL TRIAL; BETA-BLOCKADE; DOUBLE-BLIND; MERIT-HF; METOPROLOL AB Objectives: The risks and benefits of beta-blockade with bucindolol were assessed in heart failure (HF) patients with Class IV symptoms within the Beta-blocker Evaluation of Survival Trial (BEST). Background: beta-blockade is accepted therapy for mild to moderate HF, but its safety and efficacy in advanced HF have not been established. Methods: BEST recruited 2708 HF patients; of these, 226 with Class IV symptoms (n = 114 randomized to bucindolol, n = 112 to placebo) formed the basis of this study. All-cause death, HF hospitalization, and drug discontinuations occurring early during therapy (less than or equal to6 months) and overall during follow-up were assessed. Compared with Class III, Class IV patients were older and had higher plasma norepinephrine levels, prevalence of coronary disease, S3 gallops, and lower ejection fractions, but characteristics of the 2 Class IV treatment groups were similar. Results: During a mean of 1.6 years, 49% Class IV patients died, and 54% were hospitalized for HE Bucindolol increased the combined endpoint of death or HE hospitalization within the first 6 months (hazard ratio [HR] = 1.7, 95% confidence interval [CI] = 1.1-2.7) and did not result in benefit overall (HR = 1.2, 95% CI = 0.9-1.6). HF hospitalization alone within 6 months was increased by bucindolol (HR = 1.7), and an early adverse trend for death was seen (HR = 1.6) with no benefit overall (HR = 1.1). Bucindolol was discontinued more frequently than placebo for worsening HF (11% versus 4%) and hypotension (3% versus 0%). Conclusions: Class IV HF patients in BEST were at high risk. Bucindolol did not reduce death or HF hospitalization and was associated with early hazard. C1 Univ Utah, Latter Day St Hosp, Sch Med, Div Cardiol, Salt Lake City, UT 84143 USA. NHLBI, Bethesda, MD 20892 USA. Vet Adm Med Ctr, Tucson, AZ 85723 USA. Heart Care Midwest, Peoria, IL USA. Univ Connecticut, Farmington, CT USA. Vet Adm Med Ctr, San Antonio, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Vet Adm Med Ctr, San Francisco, CA 94121 USA. Univ Pittsburgh, Pittsburgh, PA USA. Univ Iowa, Iowa City, IA USA. Univ Alabama, Tuscaloosa, AL 35487 USA. RP Anderson, JL (reprint author), Univ Utah, Latter Day St Hosp, Sch Med, Div Cardiol, 8th Ave & C St, Salt Lake City, UT 84143 USA. OI Mann, Douglas /0000-0002-2516-0145 NR 29 TC 16 Z9 17 U1 1 U2 4 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 2003 VL 9 IS 4 BP 266 EP 277 DI 10.1054/jcaf.2003.42 PG 12 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 715HP UT WOS:000184966000005 PM 13680547 ER PT J AU Bush, RL Lin, PH Lumsden, AB AF Bush, RL Lin, PH Lumsden, AB TI Endovascular management of abdominal aortic aneurysms SO JOURNAL OF CARDIOVASCULAR SURGERY LA English DT Article DE aortic aneurysm, abdominal, therapy; stents; blood vessel prosthesis implantation ID STENT GRAFT; CLINICAL-TRIAL; REPAIR; ENDOLEAK; DEVICE; EXPERIENCE; CONVERSION; DIAGNOSIS; MIGRATION; RUPTURE AB An estimated 1.5 Million people in the United States have abdominal aortic aneurysms (AAAs) with more than 200 000 American diagnosed each year. The natural history of AAAs is to expand and rupture, accounting for an estimated 15 000 deaths per year. Thus, the major impetus for AAA repair is for prophylaxis against aneurysm-related death. The standard open surgical repair of AAAs is a well-established and durable procedure. However, as with all other major abdominal surgical operations, associated significant morbidity and mortality exist, along with prolonged recovery and various late complications. Furthermore, both mortality and morbidity increase significantly with advanced patient age and associated co-morbid disease states. Endovascular AAA repair using covered stent-grafts offers a significantly less invasive alternative to conventional open-surgical repair. A considerable reduction in hospital stay has been demonstrated, with early return to preoperative levels of activity. Patients previously considered unsuitable for open repair can often receive treatment for aneurysms with endovascular techniques. Current estimates are that more than 1/2 all infrarenal AAAs will be repaired using endovascular approach in the future. Despite the minimally-invasiveness of this new treatment, there are unanswered questions as to the durability and efficacy of devices, which results in concerns about their ability to successfully protect the patient from subsequent rupture. Three devices are commercially available and have been extensively used for implantation in the United States with a 4(th) device recently receiving approval from the Food and Drug Administration (FDA). In this review article, endovascular management of AAAs with these devices is described, as are the design and deployment techniques of the currently available endografts. C1 Baylor Coll Med, Michael E DeBakey Dept Surg, Div Vasc Surg & Endovasc Therapy, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. RP Bush, RL (reprint author), Baylor Coll Med, Michael E DeBakey Dept Surg, Div Vasc Surg & Endovasc Therapy, Houston VAMC,2002 Holcomb Blvd 112, Houston, TX 77030 USA. NR 29 TC 5 Z9 5 U1 0 U2 3 PU EDIZIONI MINERVA MEDICA PI TURIN PA CORSO BRAMANTE 83-85 INT JOURNALS DEPT., 10126 TURIN, ITALY SN 0021-9509 J9 J CARDIOVASC SURG JI J. Cardiovasc. Surg. PD AUG PY 2003 VL 44 IS 4 BP 527 EP 534 PG 8 WC Cardiac & Cardiovascular Systems; Surgery; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Surgery GA 722TE UT WOS:000185392100005 PM 14627225 ER PT J AU Holschneider, DP Maarek, JMI Yang, J Harimoto, J Scremin, OU AF Holschneider, DP Maarek, JMI Yang, J Harimoto, J Scremin, OU TI Functional brain mapping in freely moving rats during treadmill walking SO JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM LA English DT Article DE brain mapping; cerebral blood flow; infusion pumps; autoradiography; cerebral cortex; motor activity ID CEREBRAL BLOOD-FLOW; MOTOR CORTEX; C-14 IODOANTIPYRINE; METABOLIC-ACTIVITY; FORELIMB MOVEMENT; VISUAL-SYSTEM; DIFFUSE LIGHT; STIMULATION; ORGANIZATION; EXERCISE AB A dilemma in functional neuroimaging is that immobilization of the subject, necessary to avoid movement artifact, extinguishes all but the simplest behaviors. Recently, we developed an implantable microbolus infusion pump (MIP) that allows bolus injection of radiotracers by remote activation in freely moving, nontethered animals. The MIP is examined as a tool for brain mapping in rats during a locomotor task. Cerebral blood flow-related tissue radioactivity (CBF-TR) was measured using [C-14]-iodoantipyrine with an indicator-fractionation method, followed by autoradiography. Rats exposed to walking on a treadmill, compared to quiescent controls, showed increases in CBF-TR in motor circuits (primary motor cortex, dorsolateral striatum, ventrolateral thalamus, midline cerebellum, copula pyramis, paramedian lobule), in primary somatosensory cortex mapping the forelimbs, hindlimbs and trunk, as well as in secondary visual cortex. These results support the use of implantable pumps as adjunct tools for functional neuroimaging of behaviors that cannot be elicited in restrained or tethered animals. C1 Univ So Calif, Keck Sch Med, Dept Cell & Neurobiol, Los Angeles, CA 90089 USA. Univ So Calif, Keck Sch Med, Dept Neurol, Los Angeles, CA USA. Univ So Calif, Keck Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA USA. Univ So Calif, Sch Engn, Dept Biomed Engn, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Physiol, Los Angeles, CA USA. RP Holschneider, DP (reprint author), Univ So Calif, Keck Sch Med, Dept Cell & Neurobiol, 1333 San Pablo St,BMT 401,MC 9112, Los Angeles, CA 90089 USA. FU NIBIB NIH HHS [R01 EB000300, R01 EB-00300-03] NR 44 TC 39 Z9 39 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0271-678X J9 J CEREBR BLOOD F MET JI J. Cereb. Blood Flow Metab. PD AUG PY 2003 VL 23 IS 8 BP 925 EP 932 DI 10.1097/01.WCB.0000072797.66873.6A PG 8 WC Endocrinology & Metabolism; Hematology; Neurosciences SC Endocrinology & Metabolism; Hematology; Neurosciences & Neurology GA 709BJ UT WOS:000184604600005 PM 12902836 ER PT J AU Saab, S Wang, V AF Saab, S Wang, V TI Recurrent hepatitis C following liver transplant - Diagnosis, natural history, and therapeutic options SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Review DE hepatitis C; liver transplantation ID PEGINTERFERON ALPHA-2A PEGASYS(R); RANDOMIZED MULTICENTER TRIAL; INTERFERON PLUS RIBAVIRIN; VIRUS-INFECTION; MYCOPHENOLATE-MOFETIL; PEGYLATED-INTERFERON; REJECTION EPISODES; VIRAL-HEPATITIS; GRAFT-SURVIVAL; DONOR AGE AB Hepatitis C virus (HCV) related cirrhosis is the most common indication for orthotopic liver transplantation (OLT). Updated data suggest Worse long-term outcomes for those transplanted with HCV than those transplanted for other indications. Re-infection With HCV post-OLT is universal, therefore diagnosis of recurrence should be based on histological findings in the setting of persistent viremia. Variables associated with worse outcome of recurrent disease include early recurrence, degree of immunosuppression, and donor age. Antiviral therapy has been used in the prevention and treatment of recurrent disease, and can be initiated prior to transplantation, prophylactically after transplantation, and during recurrence. Preliminary studies of pre-transplantation treatment demonstrate virological responses, but tolerance is common. Higher efficacy has been associated with combination therapy for recur-rent disease. Adverse effects limit its widespread use. C1 Univ Calif Los Angeles, Med Ctr, Div Dig Dis 44 138 CHS MC 168417, Dept Med, Los Angeles, CA 90095 USA. Dumont UCLA Transplant Ctr, Dept Surg, Los Angeles, CA USA. W Los Angeles VA Med Ctr, Los Angeles, CA USA. RP Saab, S (reprint author), Univ Calif Los Angeles, Med Ctr, Div Dig Dis 44 138 CHS MC 168417, Dept Med, 10833 Le Conte Ave, Los Angeles, CA 90095 USA. NR 93 TC 13 Z9 16 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD AUG PY 2003 VL 37 IS 2 BP 155 EP 163 DI 10.1097/00004836-200308000-00013 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 702PW UT WOS:000184233100012 PM 12869888 ER PT J AU Porteous, NB Grooters, AM Redding, SW Thompson, EH Rinaldi, MG De Hoog, GS Sutton, DA AF Porteous, NB Grooters, AM Redding, SW Thompson, EH Rinaldi, MG De Hoog, GS Sutton, DA TI Identification of Exophiala mesophila isolated from treated dental unit waterlines SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID DEMATIACEOUS FUNGI; MOLECULAR DIVERSITY; ATLANTIC SALMON; BLACK YEASTS; DERMATITIDIS; PHEOHYPHOMYCOSIS; INFECTION; HERPOTRICHIELLACEAE; JEANSELMEI; FUNGEMIA AB Members of the genus Exophiala are often difficult to identify to the species level because of their variable morphological appearances. This paper describes the methods used to identify Exophiala mesophila and provides salient differential features for distinguishing other mesophilic members of the genus. C1 Univ Texas, Hlth Sci Ctr, Dept Community Dent, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Gen Dent, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Fungus Testing Lab, Dept Pathol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. Centraalbur Schimmelcultures, Utrecht, Netherlands. Louisiana State Univ, Sch Vet Med, Baton Rouge, LA USA. RP Porteous, NB (reprint author), Univ Texas, Hlth Sci Ctr, Dept Community Dent, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 40 TC 21 Z9 22 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 AUG PY 2003 VL 41 IS 8 BP 3885 EP 3889 DI 10.1128/JCM.41.8.3885-3889.2003 PG 5 WC Microbiology SC Microbiology GA 711MW UT WOS:000184746500071 PM 12904410 ER PT J AU Oslin, DW Ten Have, TR Streim, JE Datto, CJ Weintraub, D DiFilippo, S Katz, IR AF Oslin, DW Ten Have, TR Streim, JE Datto, CJ Weintraub, D DiFilippo, S Katz, IR TI Probing the safety of medications in the frail elderly: Evidence from a randomized clinical trial of sertraline and venlafaxine in depressed nursing home residents SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID ADVERSE DRUG EVENTS; PHARMACOLOGICAL TREATMENT; ALZHEIMERS-DISEASE; MAJOR DEPRESSION; RATING-SCALE; EARLY-ONSET; ANTIDEPRESSANTS; NORTRIPTYLINE; EFFICACY; DEMENTIA AB Background. In nursing home residents and other frail elderly patients, old age and potential drug-drug and drug-disease interactions may affect the relative safety and efficacy of medications. The purpose of this study was to examine the efficacy and tolerability of venlafaxine and sertraline for the treatment of depression among nursing home residents. Method. The study was a 10-week randomized, double-blind, controlled trial of venlafaxine (doses up to 150 mg/day) versus sertraline (doses up to 100 mg/day) among 52 elderly nursing home residents with a DSM-IV depressive disorder and, at most, moderate dementia. The primary measure of outcome was the Hamilton Rating Scale for Depression (HAM-D). Adverse events were monitored and recorded systematically during the trial. Results: Twelve subjects were discontinued due to serious adverse events (SAE), 5 were discontinued due to other significant side effects, and 2 withdrew consent. Tolerability estimated by the time to termination was lower for venlafaxine than sertraline for serious adverse events (log rank statistic = 5.28, p = .022), for serious adverse events or side effects (log rank statistic = 8.08, p = .005), or for serious adverse events, side effects, or withdrawal of consent (log rank statistic = 10.04, p = .002). Mean (SD) HAM-D scores at baseline were 20.2 (3.4) for sertraline and 20.3 (3.7) for venlafaxine; intent-to-treat endpoint HAM-D scores were 12.2 (5.1) and 15.7 (6.2) (F = 3.45; p = .069). There were no differences in categorical responses for the intent-to-treat sample or completers. Conclusion: In this frail elderly population, venlafaxine was less well tolerated and, possibly, less safe than sertraline without evidence for an increase in efficacy. This unexpected finding demonstrates the need for systematic research on the safety of drugs in the frail elderly. C1 Univ Penn, Dept Psychiat, Sect Geriatr Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. Univ Penn, Dept Psychiat, Ctr Stydy Addict, Philadelphia, PA 19104 USA. Univ Penn, Dept Epidemiol & Biostat, Philadelphia, PA 19104 USA. RP Katz, IR (reprint author), Univ Penn, Dept Psychiat, Sect Geriatr Psychiat, 3535 Market St,Rm 3055, Philadelphia, PA 19104 USA. FU NIMH NIH HHS [R37MH52147-09, P30MH66270, P30MH52129] NR 52 TC 68 Z9 69 U1 2 U2 8 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 AUG PY 2003 VL 64 IS 8 BP 875 EP 882 PG 8 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 714NM UT WOS:000184920400004 PM 12927001 ER PT J AU Long, JA Polsky, D Asch, DA AF Long, JA Polsky, D Asch, DA TI Receipt of health services by low-income veterans SO JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED LA English DT Article ID UNITED-STATES; CARE COVERAGE; OLDER-ADULTS; RISK-FACTORS; MORTALITY; INSURANCE; ACCESS; HOSPITALIZATION; DISPARITIES; PLUS C1 Philadelphia Vet Affairs Ctr Hlth Equ Res & Promo, Philadelphia, PA USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Long, JA (reprint author), Philadelphia Vet Affairs Ctr Hlth Equ Res & Promo, Philadelphia, PA USA. NR 30 TC 0 Z9 0 U1 1 U2 3 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1049-2089 J9 J HEALTH CARE POOR U JI J. Health Care Poor Underserved PD AUG PY 2003 VL 14 IS 3 BP 305 EP 317 DI 10.1177/1049208903255439 PG 13 WC Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 706XL UT WOS:000184480300001 PM 12955911 ER PT J AU Linseman, DA Cornejo, BJ Le, SS Meintzer, MK Laessig, TA Bouchard, RJ Heidenreich, KA AF Linseman, DA Cornejo, BJ Le, SS Meintzer, MK Laessig, TA Bouchard, RJ Heidenreich, KA TI A myocyte enhancer factor 2D (MEF2D) kinase activated during neuronal apoptosis is a novel target inhibited by lithium (vol 85, pg 1488, 2002) SO JOURNAL OF NEUROCHEMISTRY LA English DT Correction C1 Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Linseman, DA (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. NR 1 TC 0 Z9 0 U1 0 U2 1 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2003 VL 86 IS 4 BP 1055 EP 1055 DI 10.1046/j.1471-4159.2003.01999.x PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 706JW UT WOS:000184451400027 ER PT J AU Sanford, LD Tang, XD Xiao, JH Ross, RJ Morrison, AR AF Sanford, LD Tang, XD Xiao, JH Ross, RJ Morrison, AR TI GABAergic regulation of REM sleep in reticularis pontis oralis and caudalis in rats SO JOURNAL OF NEUROPHYSIOLOGY LA English DT Article ID EYE-MOVEMENT SLEEP; GIGANTOCELLULAR TEGMENTAL FIELD; GABA-A ANTAGONIST; PARADOXICAL SLEEP; MICROINJECTIONS; INDUCTION; CAT; BICUCULLINE; LESIONS; HYPOTHALAMUS AB The nucleus reticularis pontis oralis (RPO) and nucleus reticularis pontis caudalis (RPC) are implicated in the generation of rapid eye movement sleep (REM). Work in cats has indicated that GABA in RPO plays a role in the regulation of REM. We assessed REM after local microinjections into RPO and RPC of the gamma-aminobutyric acid-A (GABA(A)) agonist, muscimol (MUS), and the GABA(A) antagonist, bicuculline (BIC). Rats (90-day-old male Sprague-Dawley) were implanted with electrodes for recording electroencephalographs (EEG) and electromyographs (EMG). Guide cannulae were aimed into RPO (n = 9) and RPC (n = 8) for microinjecting MUS (200, 1,000.0 muM) and BIC (0.056, 0.333, 1.0, 1,000.0, and 10,000.0 muM). Animals received bilateral microinjections of saline, MUS, and BIC (0.2 mul microinjected at 0.1 mul/min) into each region followed by 6-h sleep recordings. In RPO, MUS (1,000.0 muM) suppressed REM and BIC (1,000.0 muM) enhanced REM. In RPC, MUS (200, 1,000.0 muM) suppressed REM, but BIC (1,000.0 muM and less) did not significantly affect REM. Higher concentrations of BIC (10,000.0 muM) injected into RPO (n = 9) and RPC (n = 4) produced wakefulness and escape behavior. The results indicate that GABA in RPO/RPC is involved in the regulation of REM and suggest site-specific differences in this regulation. C1 Eastern Virginia Med Sch, Sleep Res Lab, Dept Anat & Pathol, Norfolk, VA 23501 USA. Univ Penn, Lab Study Brain Sleep, Dept Biol Anim, Philadelphia, PA 19104 USA. Univ Penn, Sch Vet Med, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Sanford, LD (reprint author), Eastern Virginia Med Sch, Sleep Res Lab, Dept Anat & Pathol, POB 1980, Norfolk, VA 23501 USA. FU NINDS NIH HHS [NS-36694] NR 39 TC 61 Z9 62 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-3077 J9 J NEUROPHYSIOL JI J. Neurophysiol. PD AUG PY 2003 VL 90 IS 2 BP 938 EP 945 DI 10.1152/jn.00993.2002 PG 8 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 708KE UT WOS:000184565300042 PM 12672782 ER PT J AU Simon, JA Hudes, ES Perez-Perez, GI AF Simon, JA Hudes, ES Perez-Perez, GI TI Relation of serum ascorbic acid to Helicobacter pylori serology in US adults: The Third National Health and Nutrition Examination Survey SO JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION LA English DT Article DE ascorbic acid; Helicobacter pylori; vitamin C ID VITAMIN-C; GASTRIC-CANCER; UNITED-STATES; INFECTION; JUICE; RISK; CAGA; DETERMINANTS; ERADICATION; CARCINOMA AB Purpose: To examine the relation between serum ascorbic acid and Helicobacter pylori serology from a probability sample of US adults. Subjects and Methods: Data from 6,746 adults (ages 20 to 90 years) enrolled in the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994 were analyzed. Multiple logistic regression models were examined taking into account sample weights and the complex survey design of NHANES III, and controlling for the effects of potential confounders. Because race appeared to modify the association between serum ascorbic acid and seropositivity to H. pylori, we conducted the analyses stratified by race. Results: A total of 2,189 adults (32%) had a positive serology for H. pylori, and, of these, 1,175 (54%) were positive for the CagA antigen. Among whites, a 0.50 mg/dL increase in serum ascorbic acid level was associated with decreased seroprevalence of H. pylori (Odds Ratio (OR) = 0.89, 95% confidence interval (CI) CI 0.82-0.96, p < 0.01). In analyses that controlled for seroprevalence of H. pylori, a 0.50 mg/dL increase in serum ascorbic acid level among whites was independently associated with a decreased seroprevalence of the pathogenic cagA-positive strain of H. pylori (OR = 0.31, 95% CI 0.12-0.79, p < 0.05). Serum ascorbic acid levels were not significantly associated with H. pylori serology among non-whites (all p > 0.05). Conclusions: Higher serum levels of ascorbic acid were associated with a decreased seroprevalence of H. pylori and of the pathogenic cagA-positive strain of H. pylori among whites. If these associations are related causally and are not the result of residual confounding by factors such as socioeconomic status, ascorbic acid may affect the risk of H. pylori infection and in turn, the risk for peptic ulcer disease and gastric cancer among white Americans. C1 San Francisco VA Med Ctr, Med Serv, Gen Internal Med Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. NYU, Sch Med, Dept Med, New York, NY USA. NYU, Sch Med, Dept Microbiol, New York, NY USA. RP Simon, JA (reprint author), San Francisco VA Med Ctr, Med Serv, Gen Internal Med Sect, 4150 Clement St, San Francisco, CA 94121 USA. FU NHLBI NIH HHS [HL 53479] NR 41 TC 16 Z9 16 U1 0 U2 0 PU AMER COLL NUTRITION PI NEW YORK PA C/O HOSP. JOINT DIS. 301 E. 17TH ST., NEW YORK, NY 10003 USA SN 0731-5724 J9 J AM COLL NUTR JI J. Am. Coll. Nutr. PD AUG PY 2003 VL 22 IS 4 BP 283 EP 289 PG 7 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 707RR UT WOS:000184524100005 PM 12897042 ER PT J AU Hubchak, SC Runyan, CE Kreisberg, JI Schnaper, HW AF Hubchak, SC Runyan, CE Kreisberg, JI Schnaper, HW TI Cytoskeletal rearrangement and signal transduction in TGF-beta 1-stimulated mesangial cell collagen accumulation SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID GROWTH-FACTOR-BETA; FOCAL ADHESION PROTEINS; TGF-BETA; EXTRACELLULAR-MATRIX; TRANSFORMING GROWTH-FACTOR-BETA-1; EXPERIMENTAL GLOMERULONEPHRITIS; TRANSCRIPTIONAL ACTIVATION; EPITHELIAL-CELLS; CYTOCHALASIN-D; SMAD PROTEINS AB TGF-beta1 has been implicated in glomerular extracellular matrix accumulation, although the precise cellular mechanism(s) by which this occurs is not fully understood. The authors have previously shown that the Smad signaling pathway is present and functional in human glomerular mesangial cells and plays a role in activating type I collagen gene expression. It also was determined that TGF-beta1 activates ERK mitogen-activated protein kinase in mesangial cells to enhance Smad activation and collagen expression. Here, it was shown that TGF-beta1 rapidly induces cytoskeletal rearrangement in human mesangial cells, stimulating smooth muscle alpha-actin detection in stress fibers and promoting focal adhesion complex assembly and redistribution. Disrupting the actin cytoskeleton with cytochalasin D (Cyto D) selectively decreased basal and TGF-beta1-induced cell-layer collagen I and IV accumulation. The balance of matrix metalloproteinases (MMP) and inhibitors was altered by Cyto D or TGF-beta1 alone, increasing MMP activity, increasing MMP-1 expression, and decreasing tissue inhibitor of matrix metalloproteinase-2 expression. Cyto D also decreased basal and TGF-beta1-stimulated alpha1(1) collagen mRNA but did not inhibit TGF-beta-stimulated alpha1(IV) mRNA expression. A similar decrease in alpha1(I) mRNA expression caused by the actin polymerization inhibitor latrunculin B was partially blocked by the addition of jasplakinolide, which promotes actin assembly. The Rho-family GTPase inhibitor C. difficile toxin B or the Rho-associated kinase inhibitor Y-27632 also blocked TGF-beta1-stimulated alpha1(I) mRNA expression. Cytoskeletal disruption reduced Smad2 phosphorylation but had little effect on mRNA stability, TGF-beta receptor number, or receptor affinity. Thus, TGF-beta1-mediated collagen I accumulation is associated with cytoskeletal rearrangement and Rho-GTPase signaling. C1 Northwestern Univ, Sch Med, Dept Pediat, Chicago, IL 60611 USA. Childrens Mem Inst Educ & Res, Chicago, IL USA. Univ Texas, Ctr Hlth Sci, Dept Surg, San Antonio, TX USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX USA. RP Hubchak, SC (reprint author), Northwestern Univ, Sch Med, Dept Pediat, W-140 Pediat,303 E Chicago Ave,Ward 12-112, Chicago, IL 60611 USA. FU NIDDK NIH HHS [DK49362, R01 DK049362] NR 48 TC 44 Z9 47 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD AUG PY 2003 VL 14 IS 8 BP 1969 EP 1980 DI 10.1097/01.ASN.0000076079.02452.92 PG 12 WC Urology & Nephrology SC Urology & Nephrology GA 704QZ UT WOS:000184352600002 PM 12874450 ER PT J AU Lin, PH Bush, RL Lumsden, AB AF Lin, PH Bush, RL Lumsden, AB TI Proximal aortic stent-graft displacement with type I endoleak due to Heimlich maneuver SO JOURNAL OF VASCULAR SURGERY LA English DT Editorial Material ID THROMBOSIS; ANEURYSM; COMPLICATIONS; REPAIR AB The Heimlich maneuver has saved countless lives by relieving foreign body obstruction from the respiratory tract. Complications related to this life-saving technique, particularly involving the abdominal aorta, are extremely rare. We report the case of a patient who underwent successful endovascular abdominal aortic aneurysm (AAA) repair, with AAA reduction at postoperative surveillance. Endograft displacement after performance of the Heimlich maneuver resulted in a proximal type I endoleak. This case underscores both the potential for aortic trauma from the Heimlich maneuver and the risk for clinical failure as a result of abdominal compression after successful endovascular AAA repair. C1 Baylor Coll Med, Houston VAMC, Michael E DrBakey Dept Surg, Div Vasc Surg & Endovasc Therapy, Houston, TX 77030 USA. RP Lin, PH (reprint author), Baylor Coll Med, Houston VAMC, Michael E DrBakey Dept Surg, Div Vasc Surg & Endovasc Therapy, 2002 Holcomb Blvd, Houston, TX 77030 USA. NR 16 TC 5 Z9 5 U1 0 U2 1 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD AUG PY 2003 VL 38 IS 2 BP 380 EP 382 DI 10.1016/S0741-5214(03)00294-5 PG 3 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 705RR UT WOS:000184409000026 PM 12891124 ER PT J AU DeBiasi, RL Clarke, P Meintzer, S Jotte, R Kleinschmidt-Demasters, BK Johnson, GL Tyler, KL AF DeBiasi, RL Clarke, P Meintzer, S Jotte, R Kleinschmidt-Demasters, BK Johnson, GL Tyler, KL TI Reovirus-induced alteration in expression of apoptosis and DNA repair genes with potential roles in viral pathogenesis SO JOURNAL OF VIROLOGY LA English DT Article ID NF-KAPPA-B; CASPASE RECRUITMENT DOMAIN; HEAT-SHOCK-PROTEIN-70 INHIBITS APOPTOSIS; SPINAL MUSCULAR-ATROPHY; CELL-CYCLE PROGRESSION; CENTRAL-NERVOUS-SYSTEM; ENDOPLASMIC-RETICULUM; TRANSCRIPTION FACTOR; VIRUS-INFECTION; HOST-CELL AB Reoviruses are a leading model for understanding cellular mechanisms of virus-induced apoptosis. Reoviruses induce apoptosis in multiple cell lines in vitro, and apoptosis plays a key role in virus-induced tissue injury of the heart and brain in vivo. The activation of transcription factors NF-kappaB and c-Jun are key events in reovirus-induced apoptosis, indicating that new gene expression is critical to this process. We used high-density oligonucleotide microarrays to analyze cellular transcriptional alterations in HEK293 cells after infection with reovirus strain T3A (i.e., apoptosis inducing) compared to infection with reovirus strain T1L (i.e., minimally apoptosis inducing) and uninfected cells. These strains also differ dramatically in their potential to induce apoptotic injury in hearts of infected mice in vivo-T3A is myocarditic, whereas T1L is not. Using high-throughput microarray analysis of over 12,000 genes, we identified differential expression of a defined subset of genes involved in apoptosis and DNA repair after reovirus infection. This provides the first comparative analysis of altered gene expression after infection with viruses of differing apoptotic phenotypes and provides insight into pathogenic mechanisms of virus-induced disease. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol B182, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pediat, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Hematol & Oncol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pathol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Microbiol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Immunol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Program Mol Signal Transduct, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. RP Tyler, KL (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol B182, 4200 E 9th Ave, Denver, CO 80262 USA. EM Ken.Tyler@uchsc.edu OI Tyler, Kenneth/0000-0003-3294-5888 NR 98 TC 28 Z9 33 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD AUG PY 2003 VL 77 IS 16 BP 8934 EP 8947 DI 10.1128/JVI.77.16.8934-8947.2003 PG 14 WC Virology SC Virology GA 706PU UT WOS:000184462800033 PM 12885910 ER PT J AU Senthil, D Choudhury, GG Mclaurin, C Kasinath, BS AF Senthil, D Choudhury, GG Mclaurin, C Kasinath, BS TI Vascular endothelial growth factor induces protein synthesis in renal epithelial cells: A potential role in diabetic nephropathy SO KIDNEY INTERNATIONAL LA English DT Article DE renal hypertrophy; growth factors; protein translation ID PERMEABILITY FACTOR; RETINAL NEOVASCULARIZATION; SIGNALING PATHWAYS; MAMMALIAN TARGET; MESANGIAL CELLS; MESSENGER-RNA; FACTOR VEGF; FACTOR-BETA; KINASE-B; PHAS-I AB Background. Vascular endothelial growth factor (VEGF) is an important determinant of ocular complications of diabetes. Its potential role in diabetic renal disease has not been extensively studied. Methods. We employed mice with streptozotocin-induced type 1 diabetes and db/db mice with type 2 diabetes to study the regulation of renal VEGF. Studies of VEGF regulation of protein synthesis were performed using proximal tubular epithelial (MCT) cells in culture. Results. A nearly three-fold increase of VEGF165 expression in the renal cortex was seen, coinciding with renal hypertrophy in mice with either type 1 or type 2 diabetes. VEGF increased de novo protein synthesis and induced significant hypertrophy in MCT cells. VEGF stimulation of protein synthesis was dependent on tyrosine phosphorylation of the type 2 VEGF receptor and phosphatidylinositol 3-kinase (PI 3-kinase) activity. Activity of Akt was increased two- to three-fold by VEGF. Expression of dominant-negative Akt showed that Akt activation was also needed for VEGF-induced protein synthesis and cell hypertrophy. As PI 3-kinase-Akt axis regulates initial events in protein translation, these events were examined in the context of VEGF regulation of protein synthesis. VEGF stimulated eukaryotic initiation factor 4E-binding protein (4E-BP1) phosphorylation, which was dependent on activation of PI 3-kinase and Akt. Stable transfection with 4E-BP1 Thr(37,46) -Ala(37,46) mutant abolished the VEGF-induced de novo protein synthesis and cell hypertrophy. Conclusion. VEGF augments protein synthesis and induces hypertrophy in MCT cells in a PI 3-kinase- and Akt-dependent manner. Phosphorylation of Thr(37,46) in 4E-BP1 is required for VEGF-induced protein synthesis and hypertrophy in MCT cells. These data suggest a role for VEGF in the pathogenesis of diabetic renal disease. C1 S Texas Vet Hlth Care Syst, San Antonio, TX USA. GRECC, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Div Nephrol, Dept Med, San Antonio, TX 78229 USA. RP Kasinath, BS (reprint author), Univ Texas, Hlth Sci Ctr, Div Nephrol, Dept Med, Mail Code 7882,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NIDDK NIH HHS [DK55815] NR 48 TC 59 Z9 76 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD AUG PY 2003 VL 64 IS 2 BP 468 EP 479 DI 10.1046/j.1523-1755.2003.00135.x PG 12 WC Urology & Nephrology SC Urology & Nephrology GA 697WP UT WOS:000183966500009 PM 12846742 ER PT J AU Seliger, SL Gillen, DL Longstreth, WT Kestenbaum, B Stehman-Breen, CO AF Seliger, SL Gillen, DL Longstreth, WT Kestenbaum, B Stehman-Breen, CO TI Elevated risk of stroke among patients with end-stage renal disease SO KIDNEY INTERNATIONAL LA English DT Article DE end-stage renal disease; cerebrovascular accident; epidemiology ID MAINTENANCE HEMODIALYSIS; DIALYSIS PATIENTS; BLOOD-PRESSURE; ATHEROSCLEROSIS; FAILURE; ADULTS; CALCIFICATION; PREDICTORS; POPULATION; ARTERIES AB Background. Although end-stage renal disease (ESRD) has been associated with accelerated vascular disease of the cerebral circulation, there are no prior studies that have estimated the risk of hemorrhagic and ischemic stroke among the United States dialysis population relative to the general population. Methods. We performed a population-based cohort study to compare rates of hospitalized ischemic and hemorrhagic stroke among incident dialysis patients in the United States Renal System database and non-ESRD subjects from the general population identified in the National Hospital Discharge Survey. Results. After adjustment for age, gender, and race, estimated rates of hospitalized stroke were markedly higher for dialysis patients compared to the general population. The age-adjusted relative risk (RR) of stroke among dialysis patients compared to the general population was 6.1 [95% Confidence Interval (95% CI) 5.1, 7.1] for Caucasian males, 4.4 (95% CI 3.3, 5.5) for African American males, 9.7 (95%CI 8.2, 11.2) for Caucasians females and 6.2 (95%CI 4.8, 7.6) for African American females. When considered as separate outcomes, hospitalization rates for hemorrhagic and ischemic stroke were both markedly elevated for subjects treated with dialysis (ischemic, RR = 4.3 to 10.1; hemorrhagic, RR = 4.1 to 6.7). Conclusion. Incident dialysis patients are at markedly higher risk for hospitalized stroke when compared to the general population. Although prior public health initiatives have focused primarily on cardiac disease among patients treated with dialysis, our data suggest that new initiatives are needed to control the high risk of stroke in this population. C1 Univ Washington, Div Nephrol, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Publ Hlth & Community Med, Dept Biostat, Div Nephrol, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Div Nephrol, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Div Nephrol, Seattle, WA 98195 USA. RP Stehman-Breen, CO (reprint author), Univ Washington, Div Nephrol, Vet Affairs Puget Sound Hlth Care Syst, Mailstop 111A,1650 S Columbian Way, Seattle, WA 98108 USA. FU NIDDK NIH HHS [DK07721-6] NR 34 TC 199 Z9 212 U1 0 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD AUG PY 2003 VL 64 IS 2 BP 603 EP 609 DI 10.1046/j.1523-1755.2003.00101.x PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 697WP UT WOS:000183966500023 PM 12846756 ER PT J AU Leaf, DA AF Leaf, DA TI The effect of physical exercise on reverse cholesterol transport SO METABOLISM-CLINICAL AND EXPERIMENTAL LA English DT Article ID HIGH-DENSITY-LIPOPROTEIN; APOLIPOPROTEIN-A-I; ESTER TRANSFER PROTEIN; PHOSPHOLIPID TRANSFER PROTEIN; CORONARY-ARTERY DISEASE; PLASMA HDL-CHOLESTEROL; MIDDLE-AGED MEN; HEPATIC LIPASE; MYOCARDIAL-INFARCTION; PROLONGED EXERCISE AB High-density lipoproteins (HDL) are recognized for their role in coronary artery disease (CAD) risk reduction. Plasma HDL plays a pivotal role in the reverse cholesterol transport (RCT) process. Physical exercise is well recognized as a modality that affects HDL metabolism. The purpose of this discussion is to describe the effects of physical exercise on RCT. (C) 2003 Elsevier Inc. All rights reserved. C1 Greater Los Angeles VA Healthcare Syst, Div Gen Internal Med, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RP Leaf, DA (reprint author), Greater Los Angeles VA Healthcare Syst, Div Gen Internal Med, Dept Med, 111G,Wilshire & Sawtelle Blvd, Los Angeles, CA 90073 USA. NR 95 TC 27 Z9 28 U1 0 U2 2 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0026-0495 J9 METABOLISM JI Metab.-Clin. Exp. PD AUG PY 2003 VL 52 IS 8 BP 950 EP 957 DI 10.1016/S0026-0495(03)00147-1 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 716EF UT WOS:000185015300002 PM 12898457 ER PT J AU Murray, SS Duarte, MEL Brochmann, EJ AF Murray, SS Duarte, MEL Brochmann, EJ TI The effects of dietary restriction on humeral and mandibular bone in SENCAR, C57BL/6, and DBA/2 mice SO METABOLISM-CLINICAL AND EXPERIMENTAL LA English DT Article; Proceedings Paper CT 24th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 20-24, 2002 CL SAN ANTONIO, TEXAS SP American-Soc-Bone-Mineral-Res ID MONKEYS MACACA-MULATTA; RHESUS-MONKEYS; CALORIE RESTRICTION; TUMOR PROMOTION; CALCIUM-REPLETE; INBRED STRAINS; INDUCED OBESE; B6C3F1 MICE; DNA DAMAGE; HIGH-FAT AB Dietary restriction (DR) increases the life span and retards the development of age-related disorders. However, the low body mass that accompanies DR is associated with risk factors for fracture that may outweigh the beneficial effects of DR on cellular aging that are mediated, in part, by limiting free radical generation and oxidative damage. We tested the effects of DR in murine models that differ in free radical generation capacity (SENCAR > C57 > DBA). Male mice of each strain were killed at 10 weeks of age (t(0); time zero) or randomized to an ad libitum-fed (AL-fed) or 30% DR feeding regimen for 6 months. The food consumption of AL-fed mice was measured daily. DR mice received 70% of the amount of food consumed by their respective AL-fed mice the previous day. The DR diet was normalized with respect to calcium (Ca), phosphorus (P), and micronutrients. Lean body mass (LBM), bone mineral density (BMD), and bone mineral content (BMC) in the humerus and mandible were determined by PIXImus densitometry. The length and midshaft width of the humerus were determined by direct measurement. There were highly strain- and diet/time-dependent effects on LBM, humerus length, mandibular and humeral BMD, and humeral BMC. The interaction between diet/time and strain was more significant in the humerus than the mandible. All 30% DR mice had lower humeral BMDs and BMCs than their respective AL-fed controls. However, 30% DR C57 and DBA (but not SENCAR) mice had higher humeral BMD and BMC than their respective to controls. There was a linear relationship between LBM and humeral BMD and BMC in both AL-fed and 30% DR mice, suggesting that the lower BMD and BMC in 30% DR mice, relative to AL-fed controls, reflects a physiologic adaptation to lower biomechanical loading. Mandibular BMC in 30% DR C57 (but not DBA or SENCAR) mice was lower than that observed in their AL-fed controls. Mandibular BMD and BMC increased versus t(0) values in 30% DR mice of all strains. (C) 2003 Elsevier Inc. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, GRECC 11E, Sepulveda Ambulatory Care Ctr & Nursing Home, Sepulveda, CA 91343 USA. Fed Univ Rio De Janeiro, Dept Histol & Embryol, Rio De Janeiro, Brazil. Fed Univ Rio De Janeiro, PABCAM HUCFF, Rio De Janeiro, Brazil. RP Murray, SS (reprint author), VA Greater Los Angeles Healthcare Syst, GRECC 11E, Sepulveda Ambulatory Care Ctr & Nursing Home, 16111 Plummer St, Sepulveda, CA 91343 USA. NR 36 TC 5 Z9 5 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0026-0495 J9 METABOLISM JI Metab.-Clin. Exp. PD AUG PY 2003 VL 52 IS 8 BP 970 EP 977 DI 10.1016/S002600495(03)00164-1 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 716EF UT WOS:000185015300005 PM 12898460 ER PT J AU Matsunaga, J Barocchi, MA Croda, J Young, TA Sanchez, Y Siqueira, I Bolin, CA Reis, MG Riley, LW Haake, DA Albert, KI AF Matsunaga, J Barocchi, MA Croda, J Young, TA Sanchez, Y Siqueira, I Bolin, CA Reis, MG Riley, LW Haake, DA Albert, KI TI Pathogenic Leptospira species express surface-exposed proteins belonging to the bacterial immunoglobulin superfamily SO MOLECULAR MICROBIOLOGY LA English DT Article ID INTERROGANS SEROVAR COPENHAGENI; MESSENGER-RNA STABILITY; OUTER-MEMBRANE PROTEIN; MAMMALIAN INFECTION; MOLECULAR ANALYSIS; SEQUENCE-ANALYSIS; BINDING PROTEIN; CELLS; LIPOPROTEIN; CLONING AB Proteins with bacterial immunoglobulin-like (Big) domains, such as the Yersinia pseudotuberculosis invasin and Escherichia coli intimin, are surface-expressed proteins that mediate host mammalian cell invasion or attachment. Here, we report the identification and characterization of a new family of Big domain proteins, referred to as Lig (leptospiral Ig-like) proteins, in pathogenic Leptospira. Screening of L. interrogans and L. kirschneri expression libraries with sera from leptospirosis patients identified 13 lambda phage clones that encode tandem repeats of the 90 amino acid Big domain. Two fig genes, designated ligA and ligB, and one pseudogene, ligC, were identified. The ligA and ligB genes encode amino-terminal lipoprotein signal peptides followed by 10 or 11 Big domain repeats and, in the case of ligB, a unique carboxy-terminal non-repeat domain. The organization of ligC is similar to that of ligB but contains mutations that disrupt the reading frame. The fig sequences are present in pathogenic but not saprophytic Leptospira species. LigA and LigB are expressed by a variety of virulent leptospiral strains. Loss of Lig protein and RNA transcript expression is correlated with the observed loss of virulence during culture attenuation of pathogenic strains. High-pressure freeze substitution followed by immunocytochemical electron microscopy confirmed that the Lig proteins were localized to the bacterial surface. Immunoblot studies with patient sera found that the Lig proteins are a major antigen recognized during the acute host infection. These observations demonstrate that the Lig proteins are a newly identified surface protein of pathogenic Leptospira, which by analogy to other bacterial immunoglobulin superfamily virulence factors, may play a role in host cell attachment and invasion during leptospiral pathogenesis. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Berkeley, Sch Publ Hlth, Div Infect Dis & Immun, Berkeley, CA 94720 USA. Brazilian Minist Hlth, Oswaldo Cruz Fdn, Goncalo Moniz Res Ctr, Salvador, BA, Brazil. Michigan State Univ, Coll Vet Med, E Lansing, MI 48824 USA. Cornell Univ, Weill Med Coll, Div Internal Med & Infect Dis, New York, NY USA. RP Haake, DA (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RI Ko, Albert/P-2343-2015 OI Ko, Albert/0000-0001-9023-2339 FU FIC NIH HHS [D43 TW000905, D43 TW000919, TW-00905, TW-00919]; NIAID NIH HHS [R21 AI034431, AI-01605, AI-34431, R01 AI034431, R29 AI034431] NR 56 TC 151 Z9 158 U1 0 U2 5 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0950-382X J9 MOL MICROBIOL JI Mol. Microbiol. PD AUG PY 2003 VL 49 IS 4 BP 929 EP 945 DI 10.1046/j.1365-2958.2003.03619.x PG 17 WC Biochemistry & Molecular Biology; Microbiology SC Biochemistry & Molecular Biology; Microbiology GA 714WJ UT WOS:000184936200007 PM 12890019 ER PT J AU Richtand, NM Welge, JA Levant, B Logue, AD Hayes, S Pritchard, LM Geracioti, TD Coolen, LM Berger, SP AF Richtand, NM Welge, JA Levant, B Logue, AD Hayes, S Pritchard, LM Geracioti, TD Coolen, LM Berger, SP TI Altered behavioral response to dopamine D(3) receptor agonists 7-OH-DPAT and PD 128907 following repetitive amphetamine administration SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE dopamine D3 receptor; behavioral sensitization; amphetamine; 7-OH-DPAT; PD 128907; locomotion ID VENTRAL TEGMENTAL AREA; HUMAN COCAINE FATALITIES; NUCLEUS-ACCUMBENS; RAT-BRAIN; LOCOMOTOR-ACTIVITY; MESSENGER-RNA; AUTORECEPTOR SUBSENSITIVITY; EXTRACELLULAR DOPAMINE; INDIVIDUAL-DIFFERENCES; ENVIRONMENTAL STIMULI AB Behavioral sensitization, the progressive and enduring enhancement of certain behaviors following repetitive drug use, is mediated in part by dopaminergic pathways. Increased locomotor response to drug treatment, a sensitizable behavior, is modulated by an opposing balance of dopamine receptor subtypes, with D1/D2 dopamine receptor stimulation increasing and D3 dopamine receptor activation inhibiting amphetamine-induced locomotion. We hypothesize that tolerance of D3 receptor locomotor inhibition contributes to behavioral sensitization. In order to test the hypothesis that expression of behavioral sensitization results in part from release of D3 receptor-mediated inhibition, thereby resulting in decreased response to D3 receptor agonists, we examined the effect of repetitive amphetamine administration on the behavioral response to the D3 receptor preferring agonists 7-OH-DPAT and PD 128907. D3-selective effects have recently been described for both drugs at a low dose. At 1 week following completion of a repetitive treatment regimen, amphetamine-pretreated rats displayed a decreased response to D3-selective doses of both 7-OH-DPAT and PD 128907, when compared to animals receiving saline pretreatment. Moreover, in addition to the quantitative alteration in response, there was a change in the inter-relation between response to amphetamine and D3 agonist. A highly significant inverse relation between locomotor inhibitory response to PD 128907 and the locomotor-stimulant response to amphetamine was observed prior to amphetamine treatment. In contrast, 10 days following repetitive amphetamine treatment, the relation between response to PD 128907 and amphetamine was not detected. The observed behavioral alteration could not be accounted for by changes in D3 receptor binding in ventral striatum. These findings suggest a persistent release of D3 receptor-mediated inhibitory influence contributes to the expression of behavioral sensitization to amphetamine. C1 Univ Cincinnati, Coll Med, Dept Psychiat, Cincinnati, OH 45267 USA. Cincinnati Vet Affairs Med Ctr, Dept Psychiat 5116A, Cincinnati, OH 45220 USA. Univ Cincinnati, Coll Med, Ctr Biostat Serv, Cincinnati, OH 45267 USA. Univ Kansas, Med Ctr, Dept Pharmacol Toxicol & Therapeut, Kansas City, KS 66160 USA. Univ Cincinnati, Coll Med, Dept Cell Biol Neurobiol & Anat, Cincinnati, OH 45267 USA. Portland VA Med Ctr, Mental Hlth & Neurosci Div, Portland, OR 97201 USA. RP Richtand, NM (reprint author), Univ Cincinnati, Coll Med, Dept Psychiat, 231 Albert Sabin Way,Ml0559, Cincinnati, OH 45267 USA. EM neil.richtand@uc.edu NR 81 TC 24 Z9 24 U1 0 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 2003 VL 28 IS 8 BP 1422 EP 1432 DI 10.1038/sj.npp.1300182 PG 11 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 704DD UT WOS:000184321700004 PM 12700693 ER PT J AU Oslin, DW Berrettini, W Kranzler, HR Pettinati, H Gelernter, J Volpicelli, JR O'Brien, CP AF Oslin, DW Berrettini, W Kranzler, HR Pettinati, H Gelernter, J Volpicelli, JR O'Brien, CP TI A functional polymorphism of the mu-opioid receptor gene is associated with naltrexone response in alcohol-dependent patients SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE alcoholism; naltrexone; genetics; treatment; pharmacology ID ADDICTION SEVERITY INDEX; PLACEBO-CONTROLLED TRIAL; SUBSTANCE DEPENDENCE; RELAPSE PREVENTION; BETA-ENDORPHIN; ABUSE; OPRM1; THERAPY; RISK; SENSITIVITY AB This study examined the association between two specific polymorphisms of the gene encoding the m-opioid receptor and treatment outcomes in alcohol-dependent patients who were prescribed naltrexone or placebo. A total of 82 patients (71 of European descent) who were randomized to naltrexone and 59 who were randomized to placebo (all of European descent) in one of three randomized, placebo-controlled clinical trials of naltrexone were genotyped at the A(+118)G (Asn40Asp) and C+17T (Ala6Val) SNPs in the gene encoding the m-opioid receptor (OPRM1). The association between genotype and drinking outcomes was measured over 12 weeks of treatment. In subjects of European descent, individuals with one or two copies of the Asp40 allele treated with naltrexone had significantly lower rates of relapse (p = 0.044) and a longer time to return to heavy drinking (p = 0.040) than those homozygous for the Asn40 allele. There were no differences in overall abstinence rates (p = 0.611), nor were there differences in relapse rates or abstinence rates between the two genotype groups among those assigned to placebo. These preliminary results are consistent with prior literature demonstrating that the opioid system is involved in the reinforcing properties of alcohol and that allelic variation at OPRM1 is associated with differential response to a m-receptor antagonist. If replicated, these results would help to identify alcohol-dependent individuals who may be most likely to respond to treatment with naltrexone. C1 Univ Penn, Dept Psychiat, Ctr Study Addict, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, MIRECC, Philadelphia, PA USA. Univ Penn, Dept Psychiat, Sect Geriatr Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychiat, Ctr Neurobiol & Behav, Philadelphia, PA 19104 USA. Univ Connecticut, Sch Med, Dept Psychiat, Alcohol Res Ctr, Storrs, CT 06269 USA. VA Connecticut Healthcare Syst, Psychiat Serv, New Haven, CT USA. Yale Univ, Sch Med, Dept Psychiat, New Haven, CT 06520 USA. RP Oslin, DW (reprint author), Univ Penn, Dept Psychiat, Ctr Study Addict, 3535 Market St,Room 3002, Philadelphia, PA 19104 USA. FU NCRR NIH HHS [RR 06192]; NIAAA NIH HHS [AA 03510, AA 07517, AA 11062, AA 11330, AA 13736]; NIDA NIH HHS [DA 001586, DA 11385, DA 14008]; NIMH NIH HHS [MH 01599] NR 50 TC 383 Z9 398 U1 3 U2 15 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 2003 VL 28 IS 8 BP 1546 EP 1552 DI 10.1038/sj.npp.1300219 PG 7 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 704DD UT WOS:000184321700019 PM 12813472 ER PT J AU Saxon, AJ Baer, JS Davis, TM Sloan, KL Malte, CA Fitzgibbons, K Kivlahan, DR AF Saxon, AJ Baer, JS Davis, TM Sloan, KL Malte, CA Fitzgibbons, K Kivlahan, DR TI Smoking cessation treatment among dually diagnosed individuals: Preliminary evaluation of different pharmacotherapies SO NICOTINE & TOBACCO RESEARCH LA English DT Article ID NICOTINE DEPENDENCE TREATMENT; SUSTAINED-RELEASE BUPROPION; PSYCHIATRIC-DISORDERS; REPLACEMENT THERAPY; INTERVENTION TRIAL; CIGARETTE-SMOKING; UNITED-STATES; DRUG-ABUSE; ALCOHOL; TOBACCO AB This descriptive, observational pilot study evaluated a smoking cessation intervention using open-label bupropion and nicotine replacement within an addiction treatment center for patients with high rates of comorbid psychiatric diagnoses. Participants were 115 veterans receiving substance abuse treatment at a Veterans Administration outpatient program who voluntarily sought smoking cessation treatment. Three fourths of participants had a psychiatric diagnosis in addition to substance dependence (i.e., dual diagnosis). The intervention consisted of a weekly smoking cessation therapy group and pharmacotherapy as determined by participant and clinician preference (none, nicotine replacement only, bupropion only, or combined nicotine and bupropion). A total of 47 participants (40.9%) completed four group smoking cessation sessions, and 17 (14.8%) completed eight sessions. Of these participants, 27 (23.5%) had breath carbon monoxide (CO) levels <9ppm (indicating short-term abstinence) at session 4, and nine (7.8%) had CO levels <9 ppm at session 8. Participants who received nicotine replacement alone or with bupropion attended more sessions than did subjects who did not receive nicotine replacement. Participants receiving combined medications had greater reductions in CO levels at session 4 than did the other participants. There was no evidence of increased use of other substances during smoking cessation treatment. These findings indicate that many dually diagnosed individuals are willing to attempt smoking cessation with appropriate pharmacotherapy and achieve reductions in CO measures, but only minimal success was observed with respect to cessation. Additional research is needed to assess medication effects in randomized trials, to explore effects of more intensive treatments, and to assess possible harm reduction from smoking interventions within this population. C1 Univ Washington, Ctr Excellence Subst Abuse Treatment & Educ, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Psychol, Seattle, WA 98195 USA. RP Saxon, AJ (reprint author), VA Med Ctr, S-116-ATC,1660 S Columbian Way, Seattle, WA 98108 USA. NR 38 TC 16 Z9 18 U1 1 U2 2 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1462-2203 J9 NICOTINE TOB RES JI Nicotine Tob. Res. PD AUG PY 2003 VL 5 IS 4 BP 589 EP 596 DI 10.1080/1462220031000118702 PG 8 WC Substance Abuse; Public, Environmental & Occupational Health SC Substance Abuse; Public, Environmental & Occupational Health GA 718LM UT WOS:000185147700017 PM 12959797 ER PT J AU Pian, D Ferrucci, S Anderson, SF Wu, C AF Pian, D Ferrucci, S Anderson, SF Wu, C TI Paramacular coloboma SO OPTOMETRY AND VISION SCIENCE LA English DT Article DE albinitic nevus; coloboma; congenital; embryology; macula; paramacular coloboma; torpedo maculopathy ID RETINAL-PIGMENT EPITHELIUM; EYE DEVELOPMENT; HUMAN FOVEA; MACULOPATHY AB Background. Paramacular coloboma (plural: colobomata) is a solitary oval football or torpedo-shaped chorioretinal lesion located temporal to the fovea in one or both eyes. Previous case reports have speculated varying etiology, but few have justified its pathognomonic shape and location. We believe it to be congenital in nature and caused by incomplete differentiation of the arcuate bundles along the horizontal raphe in development of the macular architecture. Associated ocular findings may include blepharophimosis, situs inversus, or other anomalous retinal vascular patterns. Case Reports. Three cases of asymptomatic unilateral paramacular colobomata are presented. In each case, a single oval chorioretinal lesion temporal to the macula was found during routine examination. Visual acuity and Humphrey threshold visual field testing were normal with no other associated congenital, systemic, or ocular abnormalities. Because the lesion is nonprogressive, these patients can be followed on an annual basis. Conclusion. Due to their anatomical origin, paramacular colobomata are always located temporal to the macula and have an oval football-shaped appearance. Visual acuity and visual field testing are usually normal, although highly observant patients may be aware of a mild scotoma. Differential diagnosis is important because the clinical appearance can be similar to acquired conditions, most notably age-related macular degeneration and presumed ocular histoplasmosis syndrome. C1 Sepulveda VA Ambulatory Care Ctr, VA Greater Los Angeles Healthcare Syst, Sepulveda, CA 91343 USA. Santa Barbara Community Based Outpatient Clin, VA Greater Los Angeles Healthcare Syst, Santa Barbara, CA USA. Nursing Home, Sepulveda, CA USA. So Calif Coll Optometry, Fullerton, CA USA. Baltimore VA Med Ctr, VA Maryland Healthcare Syst, Baltimore, MD USA. SUNY Coll Optometry, New York, NY 10010 USA. Kaiser Permanente, Thousand Oaks, CA USA. RP Ferrucci, S (reprint author), Sepulveda VA Ambulatory Care Ctr, VA Greater Los Angeles Healthcare Syst, 16111 Plummer St,112E, Sepulveda, CA 91343 USA. NR 40 TC 13 Z9 14 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-5488 J9 OPTOMETRY VISION SCI JI Optom. Vis. Sci. PD AUG PY 2003 VL 80 IS 8 BP 556 EP 563 DI 10.1097/00006324-200308000-00008 PG 8 WC Ophthalmology SC Ophthalmology GA 714CA UT WOS:000184893700003 PM 12917574 ER PT J AU Gubbels, SP Barkhuizen, A Hwang, PH AF Gubbels, SP Barkhuizen, A Hwang, PH TI Head and neck manifestations of Wegener's granulomatosis SO OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA LA English DT Article ID ANTINEUTROPHIL CYTOPLASMIC ANTIBODY; QUALITY-OF-LIFE; SUBGLOTTIC STENOSIS; CYCLOPHOSPHAMIDE THERAPY; OTOLOGIC MANIFESTATIONS; SYSTEMIC VASCULITIS; DISEASE-ACTIVITY; EAR; METHOTREXATE; INVOLVEMENT AB Although Wegener's granulomatosis classically affects the kidneys, lungs, and respiratory tract, head and neck manifestations are common. A broad range of head and neck manifestations has been reported in this patient population. The otolaryngologist plays an important role in the diagnosis and management of Wegener's granulomatosis. This article reviews the multiple head and neck manifestations that have been reported in patients with Wegener's granulomatosis. The diagnostic work up and therapeutic approach to the patient with Wegener's granulomatosis, both medical and surgical, are also discussed. C1 Oregon Hlth & Sci Univ, Dept Otolaryngol Head & Neck Surg, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Med Arthrit & Rheumat Dis, Portland, OR 97239 USA. Portland VA Med Ctr, Rheumatol Sect, Portland, OR 97239 USA. RP Hwang, PH (reprint author), Oregon Hlth & Sci Univ, Dept Otolaryngol Head & Neck Surg, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. NR 88 TC 34 Z9 43 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0030-6665 J9 OTOLARYNG CLIN N AM JI Otolaryngol. Clin. N. Am. PD AUG PY 2003 VL 36 IS 4 BP 685 EP + DI 10.1016/S0030-665(03)00023-9 PG 22 WC Otorhinolaryngology SC Otorhinolaryngology GA 702DH UT WOS:000184209600010 PM 14567060 ER PT J AU Molinari, V Karel, M Jones, S Zeiss, A Cooley, SG Wray, L Brown, E Gallagher-Thompson, D AF Molinari, V Karel, M Jones, S Zeiss, A Cooley, SG Wray, L Brown, E Gallagher-Thompson, D TI Recommendations about the knowledge and skills required of psychologists working with older adults SO PROFESSIONAL PSYCHOLOGY-RESEARCH AND PRACTICE LA English DT Article ID MENTAL-HEALTH AB This article is an initial attempt to furnish recommendations for the skills and knowledge psychologists need to work competently with older adults. We use two levels of competence across seven broad areas that are most relevant for professional practice. The first competence level is that required of general psychologists who provide some professional services to older adults; the second level is that needed by more specialized experts in the field for practice and training. This article is not fashioned as a "how to" document and is not intended to disenfranchise anyone. Recommendations are proposed that delineate the types of competence needed for specific geropsychology activities that are relevant to a variety of settings providing mental health services to older adults. C1 Vet Affairs Boston Healthcare Syst, Boston, MA USA. Houston Vet Affairs Med Ctr, Houston, TX USA. Perry Point Vet Affairs Med Ctr, Perry Point, MD USA. Vet Affairs Palo Alto Hlth Care Syst, Psychol Serv, Palo Alto, CA USA. Dept Vet Affairs, Geriatr & Extended Care Strateg Healthcare Grp, Washington, DC USA. Vet Affairs Western New York Healthcare Syst, Buffalo, NY USA. Stanford Univ, Sch Med, Stanford, CA 94305 USA. RP Molinari, V (reprint author), Univ S Florida, Dept Aging & Mental Hlth, MHC 1440, Louis de la Parte Florida Mental Hlth Inst, 13301 Bruce B Downs Blvd, Tampa, FL 33612 USA. NR 26 TC 15 Z9 15 U1 0 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 2003 VL 34 IS 4 BP 435 EP 443 DI 10.1037/0735-7028.34.4.435 PG 9 WC Psychology, Multidisciplinary SC Psychology GA 705NR UT WOS:000184401600013 ER PT J AU Craft, S Asthana, S Cook, DG Baker, LD Cherrier, M Purganan, K Wait, C Petrova, A Latendresse, S Watson, GS Newcomer, JW Schellenberg, GD Krohn, AJ AF Craft, S Asthana, S Cook, DG Baker, LD Cherrier, M Purganan, K Wait, C Petrova, A Latendresse, S Watson, GS Newcomer, JW Schellenberg, GD Krohn, AJ TI Insulin dose-response effects on memory and plasma amyloid precursor protein in Alzheimer's disease: interactions with apolipoprotein E genotype SO PSYCHONEUROENDOCRINOLOGY LA English DT Article DE MESH terms; amyloid beta-protein precursor; insulin resistance; apolipoproteins e; energy metabolism; diabetes ID MILD SENILE DEMENTIA; DEGRADING ENZYME; EXTRACELLULAR LEVELS; CEREBROSPINAL-FLUID; DIABETES-MELLITUS; BETA-PROTEIN; ZUCKER RATS; GLUCOSE; RECEPTOR; HYPERINSULINEMIA AB In previous studies, adults with Alzheimer's disease (AD) showed memory enhancement when plasma insulin levels were raised to 85 muU/ml, whereas normal adults' memory was unchanged. Degree of memory enhancement was also related to apolipoprotein E (apoE) genotype status for AD patients. Response differences between normal and AD groups could reflect dose-response differences for insulin. To examine this question, 22 adults with AD and 15 normal adults received five doses of insulin on separate days in counterbalanced order, resulting in five plasma insulin levels (10, 25 35, 85 and 135 muU/ml), while plasma glucose levels of similar to100 mg/dl were maintained. Cognitive performance and plasma APP levels were measured after 120 min of infusion. Relative to baseline, AD patients who were not apoE-epsilon4 homozygotes had improved memory at higher insulin levels of 35 and 85 muU/ml, whereas normal adults and AD patients who were epsilon4 homozygotes showed improved memory at insulin levels of 25 muU/ml. Normal adults' memory was also improved at insulin levels of 85 muU/ml. Plasma APP was lowered for adults with AD without the epsilon4 allele at higher levels (85 muU/ml) than for normal adults and epsilon4 homozygotes, who showed decreased APP at the 35 muU/ml level. AD patients with a single epsilon4 allele showed a different pattern of insulin effects on APP than did other subjects. In general, few effects of insulin were seen at the highest dose for any subject group. These results support a role for insulin in normal memory and APP modulation that follows a curvilinear response pattern, and suggest that AD patients who are not epsilon4 homozygotes have reduced sensitivity to insulin that may interfere with such modulation. (C) 2003 Elsevier Science Ltd. All rights reserved. C1 Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Psychiat, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Behav Sci, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Pharmacol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA 98195 USA. Washington Univ, Dept Psychiat, St Louis, MO 63105 USA. RP Craft, S (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIA NIH HHS [AG-05136, AG-10880] NR 36 TC 152 Z9 159 U1 2 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4530 J9 PSYCHONEUROENDOCRINO JI Psychoneuroendocrinology PD AUG PY 2003 VL 28 IS 6 BP 809 EP 822 DI 10.1016/S0306-4530(02)00087-2 PG 14 WC Endocrinology & Metabolism; Neurosciences; Psychiatry SC Endocrinology & Metabolism; Neurosciences & Neurology; Psychiatry GA 695TY UT WOS:000183847500007 PM 12812866 ER PT J AU Reddy, R Keshavan, M Yao, JK AF Reddy, R Keshavan, M Yao, JK TI Reduced plasma antioxidants in first-episode patients with schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE plasma antioxidants; albumin; uric acid; bilirubin; gender; psychosis; cigarette smoking; neuroleptic-naive ID FUNCTIONAL LIFE-SPAN; ACUTE-PHASE PROTEINS; OXIDATIVE DAMAGE; SERUM-ALBUMIN; URIC-ACID; CAPACITY; SEVERITY; SCALE AB Recent findings suggest that free radical-mediated pathological processes may underlie membrane deficits that have been observed in schizophrenia. We have previously demonstrated that both total antioxidant status (TAS) and individual antioxidants were significantly reduced in plasma of chronic schizophrenic patients, on and off haloperidol. To test whether reductions in plasma antioxidants are independent of treatment or illness progression, levels of plasma antioxidants were evaluated in 43 patients at first-episode of psychosis, 31 patients meeting DSM-IV criteria for schizophrenia or schizoaffective disorder (reconfirmed after 6 months) and 12 patients with primary mood (bipolar or depressive (BP/D)) disorder, at neuroleptic-naive baseline as well as 40 age- and sex-matched normal controls (NC). The major plasma antioxidants albumin, uric acid and bilirubin were all significantly lower in the first-episode schizophrenic, but not in the BP/D patients, than in normal controls. Factors that can affect these antioxidants-age, gender, diet and smoking-were examined. Body mass index (BMI) was significantly lower in patients, but was not correlated with plasma albumin and bilirubin; there was a trend for a correlation with uric acid in schizophrenic patients. Lower antioxidant levels were independent of smoking status of patients. The present data suggest that a defect in the antioxidant defense system (AODS), which may lead to oxidative damage, occurs early in the course of illness and is independent of treatment effect. (C) 2003 Elsevier Science B.V. All rights reserved. C1 VA Pittsburgh Healthcare Syst, Neurochem & Psychopharmacol Lab, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Med Ctr, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Pharm, Dept Pharmaceut Sci, Pittsburgh, PA 15213 USA. RP Yao, JK (reprint author), VA Pittsburgh Healthcare Syst, Neurochem & Psychopharmacol Lab, Bldg 13,7180 Highland Dr, Pittsburgh, PA 15206 USA. FU NIMH NIH HHS [MH45203, MH58141] NR 33 TC 101 Z9 107 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 1 PY 2003 VL 62 IS 3 BP 205 EP 212 DI 10.1016/S0920-9964(02)00407-3 PG 8 WC Psychiatry SC Psychiatry GA 699ML UT WOS:000184060500002 PM 12837516 ER PT J AU Messamore, E Hoffman, WF Janowsky, A AF Messamore, E Hoffman, WF Janowsky, A TI The niacin skin flush abnormality in schizophrenia: a quantitative dose - response study SO SCHIZOPHRENIA RESEARCH LA English DT Article DE schizophrenia; niacin; laser Doppler flowmetry; prostaglandins; skin flush ID LASER-DOPPLER FLOWMETRY; CUTANEOUS BLOOD-FLOW; NICOTINIC-ACID; PROSTAGLANDIN ACTIVITY; INFLAMMATION; SPECTROSCOPY; RELEASE; HUMANS AB Niacin dilates cutaneous blood vessels, resulting in a pronounced skin flush in most people. The flush response to niacin is attenuated in schizophrenia, but the quantification and physiological mechanism of this abnormality have not been described in detail. It is not clear whether the mechanism involves changes in the pharmacological sensitivity to niacin, or whether there is a reduced ability of the vasculature to dilate adequately in subjects with schizophrenia. We address this question in the present study by characterizing the dose-response relationship between topically applied alpha-methylnicotinate (AMN) and cutaneous blood flow changes, which were quantified by laser Doppler flowmetry. The dose-response curve was shifted to the right in subjects with schizophrenia. The EC50 value of AMN was significantly increased in the schizophrenia group (mean: 1.66 mM; 95% confidence interval: 1.04-2.65 mM) as compared to the control group (mean: 0.38 mM; 95% confidence interval: 0.263-0.547 mM). The blood flow responses to higher ANM doses were lower in the schizophrenics; however, there was no statistically significant difference in the extrapolated maximal blood flow response value (F-max) between the two groups. The results suggest that the skin flush abnormality in schizophrenia primarily reflects reduced pharmacological sensitivity to niacin rather than an inadequate cutaneous vasodilatory response to the stimulus. Since vasodilatation in response to niacin requires the release of prostaglandins, the data from this study suggest that schizophrenia is associated with abnormalities in enzymes, receptors, or signal transduction mechanisms that affect the synthesis, release, or response to vasodilatory prostaglandins. Published by Elsevier Science B.V. C1 Portland VA Med Ctr, Behav Hlth & Clin Neurosci Div, Portland, OR 97201 USA. Portland VA Med Ctr, Res Serv, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Psychiat, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97201 USA. RP Messamore, E (reprint author), Portland VA Med Ctr, Behav Hlth & Clin Neurosci Div, P35C,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. FU NIMH NIH HHS [R01 MH43586] NR 28 TC 48 Z9 49 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 1 PY 2003 VL 62 IS 3 BP 251 EP 258 DI 10.1016/S0920-9964(02)00311-0 PG 8 WC Psychiatry SC Psychiatry GA 699ML UT WOS:000184060500008 PM 12837522 ER PT J AU Jakupcak, M Salters, K Gratz, KL Roemer, L AF Jakupcak, M Salters, K Gratz, KL Roemer, L TI Masculinity and emotionality: An investigation of men's primary and secondary emotional responding SO SEX ROLES LA English DT Article DE masculinity; affect intensity; fear of emotions ID AFFECT INTENSITY MEASURE; GENDER-ROLE STRESS; NEGATIVE AFFECT; CHILD CONVERSATIONS; MEASUREMENT MODEL; SEX-DIFFERENCES; APPRAISAL; EXPRESSION; STEREOTYPES; FREQUENCY AB In this study, we investigated the role of masculinity in men's affect intensity and men's fear of emotions. Men's masculine ideology and self-reported masculine gender role stress were assessed as cognitive and experiential factors of adherence to traditional masculine gender norms. Masculine ideology was negatively related to men's global affect intensity. However, on a 3-factor model of affect intensity, only negative reactivity was significantly related to masculine ideology. Both masculine ideology and masculine gender role stress were positively related to men's fear of emotions. Results are discussed in the context of theories of gender differences in emotion. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, Seattle, WA 98108 USA. Univ Massachusetts, Boston, MA 02125 USA. RP Jakupcak, M (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, 1660 S Columbian Way 116 MHC, Seattle, WA 98108 USA. NR 52 TC 27 Z9 28 U1 0 U2 6 PU KLUWER ACADEMIC/PLENUM PUBL PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0360-0025 J9 SEX ROLES JI Sex Roles PD AUG PY 2003 VL 49 IS 3-4 BP 111 EP 120 DI 10.1023/A:1024452728902 PG 10 WC Psychology, Developmental; Psychology, Social; Women's Studies SC Psychology; Women's Studies GA 692EH UT WOS:000183647500002 ER PT J AU Maggard, MA O'Connell, JB Liu, JH Etzioni, DA Ko, CY AF Maggard, MA O'Connell, JB Liu, JH Etzioni, DA Ko, CY TI Sample size calculations in surgery: Are they done correctly? SO SURGERY LA English DT Article; Proceedings Paper CT 64th Annual Meeting of the Society-of-University-Surgeons CY FEB 12-15, 2003 CL HOUSTON, TEXAS SP Soc Univ Surg ID RANDOMIZED CONTROLLED TRIALS; STATISTICAL POWER; CLINICAL-TRIALS; QUALITY AB Background. Randomized controlled trials (RCTs) are considered the gold standard for evidence-based clinical research, but Prior work has suggested that there may be poor reporting of sample sizes in the surgical literature. Sample size calculations are essential for planning a study to minimize both type I and type II errors. We hypothesized that sample size calculations may not be performed consistently in surgery studies and, therefore, many studies may be "undetpowered." To address this issue, we reviewed RCTs published in the surgical literature to determine how often sample size calculations were reported and to analyze each study's ability to detect varying degrees of differences in outcomes. Methods. A comprehensive MEDLINE search identified RCTs published in Annals of Surgery, Archives of Surgery, and Surgery between 1999 and 2002. Each study was evaluated by two independent reviewers. Sample size calculations were performed to determine whether they had 80% power to detect differences between treatment groups of 50% (large) and 20% (small), with one-sided test, alpha = 0.05. For the underpowered studies, the degree to which sample size would need to be increased was determined. Results. One hundred twenty-seven RCT articles were identified; of these, 48 (38%) reported sample size calculations. Eighty-six (68%) studies reported positive treatment effect, whereas 41 (32%)found negative results. Sixty-three (50%) of the studies were appropriately powered to detect a 50% effect change, whereas 24 (19%) had the power to detect a 20% difference. Of the studies that were underpowered, more than half needed to increase sample size by more than 10-fold. Conclusions. The reporting of sample size calculations was not provided in more than 60% of recently published surgical RCTs. Moreover, only half of studies had sample sizes appropriate to detect large, differences between treatment groups. C1 Univ Calif Los Angeles, Sch Med, Dept Surg, Los Angeles, CA 90095 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Maggard, MA (reprint author), Univ Calif Los Angeles, Sch Med, Dept Surg, 10833 Conte Ave,CHS,Rm 72-215, Los Angeles, CA 90095 USA. NR 12 TC 31 Z9 32 U1 0 U2 4 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0039-6060 J9 SURGERY JI Surgery PD AUG PY 2003 VL 134 IS 2 BP 275 EP 279 DI 10.1067/msy.2003.235 PG 5 WC Surgery SC Surgery GA 719BZ UT WOS:000185184900024 PM 12947329 ER PT J AU Fihn, SD Gadisseur, AAP Pasterkamp, E van der Meer, FJM Breukink-Engbers, WGM Geven-Boere, LM van Meegen, E de Vries-Goldschmeding, H Antheunissn-Anneveld, I van't Hoff, R Harderman, D Smink, M Rosendaal, FR AF Fihn, SD Gadisseur, AAP Pasterkamp, E van der Meer, FJM Breukink-Engbers, WGM Geven-Boere, LM van Meegen, E de Vries-Goldschmeding, H Antheunissn-Anneveld, I van't Hoff, R Harderman, D Smink, M Rosendaal, FR TI Comparison of control and stability of oral anticoagulant therapy using acenocoumarol versus. phenprocoumon SO THROMBOSIS AND HAEMOSTASIS LA English DT Article DE anticoagulation; international normalised ratio; phenprocoumon; acenocoumarol ID RISK-FACTORS; WARFARIN ANTICOAGULATION; BLEEDING COMPLICATIONS; VITAMIN-K; REVERSAL; PHYTONADIONE; OUTPATIENTS; INFARCTION; QUALITY AB Variability in the control of oral anticoagulant therapy has been associated with a heightened risk of complications. We compared, control of anticoagulation between two commonly used coumarins, phenprocournon and acenocoumarol, and among anticoagulation clinics. All qualifying patients were managed at six regional anticoagulation clinics in the Netherlands. This retrospective cohort study compiled data during a three-year period from a computerised dosing and management system. Anticoagulation control was expressed as the percent of time within the therapeutic range and stability expressed as the time-weighted variance in the international normalised ratio (INR). Data were available for 22,178 patients of whom 72% were treated with acenocoumarol. INRs of patients who received phenprocoumon were within the therapeutic range 50% of the time compared with 43% for acenocoumarol (OR 1.32,95% Cl 1.24-1.41). Moreover, patients on phenprocoumon required 15% fewer monitoring visits and had more stable INR values. These observations were consistent for all six clinics. There were also sizable differences between the clinics with respect to control and stability of anticoagulation that were stable from year-to-year and were unrelated to the drug used. With its longer half-life of three to five days, phenprocoumon produces more stable anticoagulation than acenocoumarol and should generally be the drug of choice when these are the available choices. The differences observed among clinics suggest that certain clinics employ policies and practices resulting in better control of anti coagulation. C1 Vet Affairs Puget Sound Hlth Care Syst, NW Hlth Serv Res Ctr Excellence, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. Leiden Univ, Med Ctr, Dept Clin Epidemiol & Hemostasis, NL-2300 RA Leiden, Netherlands. Leiden Univ, Med Ctr, Thrombosis Ctr, NL-2300 RA Leiden, Netherlands. Oostgelderland Anticoagulat Clin, Lichtenvoorde, Netherlands. Leeuwarden Anticoagulat Clin, Leeuwarden, Netherlands. Anticoagulat Clin Hague, The Hague, Netherlands. Dutch Red Cross, Utrecht Div, Thrombosis Ctr, Utrecht, Netherlands. Schiedam Anticoagulat Clin, Schiedam, Netherlands. Anticoagulat Clin Midden Brabant, Brabant, Netherlands. Anticoagulat Serv Alkmaar, Alkmaar, Netherlands. RP Fihn, SD (reprint author), VA Puget Sound Hlth Care Syst, NW VA Hlth Serv Res & Dev Ctr Excellence, 152,1660 S Columbian Way, Seattle, WA 98108 USA. NR 29 TC 56 Z9 57 U1 0 U2 0 PU SCHATTAUER GMBH-VERLAG MEDIZIN NATURWISSENSCHAFTEN PI STUTTGART PA HOLDERLINSTRASSE 3, D-70174 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 2003 VL 90 IS 2 BP 260 EP 266 DI 10.1160/TH02-10-0179 PG 7 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 712AV UT WOS:000184774000012 PM 12888873 ER PT J AU Medeiros, BC Kogel, KE Kane, MA AF Medeiros, BC Kogel, KE Kane, MA TI Transfusion-related acute lung injury (TRALI) following platelet transfusion in a patient receiving high-dose Interleukin-2 for treatment of metastatic renal cell carcinoma SO TRANSFUSION AND APHERESIS SCIENCE LA English DT Article DE Interleukin-2; platelet; renal cell carcinoma; transfusion-related acute lung injury (TRALI) AB Transfusion-related acute lung injury (TRALI) is an uncommon life-threatening complication of hemotherapy. It is hypothesized to be the result of two independent insults: the first related to the clinical status of the patient and the second to the infusion of biologic response modifiers within blood components. We present a case of TRALI in a patient who received high-dose Interleukin-2 (IL-2) as treatment for metastatic renal cell carcinoma, where IL-2 is speculated to have been the first insult and transfusion of platelet concentrate the second. This is the first reported case of TRALI complicating treatment with high-dose immunotherapy. (C) 2003 Elsevier Ltd. All rights reserved. C1 Univ Colorado, Hlth Sci Ctr, Dept Med Oncol Hematol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Sch Med Oncol, Denver, CO 80220 USA. RP Medeiros, BC (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Med Oncol Hematol, 4200 E 9th Ave, Denver, CO 80262 USA. NR 11 TC 18 Z9 18 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 1473-0502 J9 TRANSFUS APHER SCI JI Transfus. Apher. Sci. PD AUG PY 2003 VL 29 IS 1 BP 25 EP 27 DI 10.1016/S1473-0502(03)00094-6 PG 3 WC Hematology SC Hematology GA 711YP UT WOS:000184768900007 PM 12877889 ER PT J AU Zorrilla, EP Tache, Y Koob, GF AF Zorrilla, EP Tache, Y Koob, GF TI Nibbling at CRF receptor control of feeding and gastrocolonic motility SO TRENDS IN PHARMACOLOGICAL SCIENCES LA English DT Review ID CORTICOTROPIN-RELEASING-FACTOR; HUMAN UROCORTIN-II; ANXIETY-LIKE BEHAVIOR; COMPETITIVE ANTAGONISTS; PHARMACOLOGICAL CHARACTERIZATION; RAT-BRAIN; GASTROINTESTINAL-TRACT; NONPEPTIDE ANTAGONIST; PERIPHERAL UROCORTIN; TYPE-1 RECEPTOR AB Inadequate pharmacological tools, until recently, hindered the understanding of the roles of corticotropin-releasing factor (CRF) receptor subtypes in appetite regulation and gastrocolonic motor function. Now, novel ligands that are selective for CRF1 or CRF2 receptors are helping to uncover the specific functions of CRF receptor subtypes. Central or peripheral CRF2 receptor activation suppresses feeding independently of CRF1 receptors. In the rat, central administration of CRF2 receptor agonists promotes satiation without eliciting the malaise, behavioral arousal or anxiogenesis associated with CRF, receptor agonists. Conversely, central administration of CRF1 receptor agonists elicits short-onset anorexia independently of CRF2 receptor activation. With respect to gastrointestinal motor function, stress inhibits gastric motility through CRF2 receptor-dependent central autonomic and peripheral myenteric systems. By contrast, stress stimulates colonic motility via CRF, receptor-dependent sacral parasympathetic and colonic myenteric mechanisms. These findings have important physiological implications and suggest targeted approaches for the pharmacotherapy of obesity and stress-related functional gastrointestinal and eating disorders. C1 Scripps Res Inst, Dept Neuropharmacol, La Jolla, CA 92037 USA. Univ Calif Los Angeles, Sch Med, Inst Brain Res, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, CURE, Digest Dis Res Ctr, Dept Med,Div Digest Dis, Los Angeles, CA 90073 USA. RP Zorrilla, EP (reprint author), Scripps Res Inst, Dept Neuropharmacol, 10550 N Torrey Pines Rd, La Jolla, CA 92037 USA. RI koob, george/P-8791-2016 FU NIDDK NIH HHS [DK26741, DK57238, DK33061] NR 60 TC 92 Z9 94 U1 0 U2 2 PU ELSEVIER SCIENCE LONDON PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0165-6147 J9 TRENDS PHARMACOL SCI JI Trends Pharmacol. Sci. PD AUG PY 2003 VL 24 IS 8 BP 421 EP 427 DI 10.1016/S0165-6147(03)00177-9 PG 7 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 714TP UT WOS:000184929800008 PM 12915052 ER PT J AU Smith, RP Devine, P Jones, H DeNittis, A Whittington, R Metz, JM AF Smith, RP Devine, P Jones, H DeNittis, A Whittington, R Metz, JM TI Internet use by patients with prostate cancer undergoing radiotherapy SO UROLOGY LA English DT Article ID HEALTH INFORMATION; ONCOLOGY; QUALITY AB Objectives. To analyze the amount of Internet use, type of Internet use, and factors that predict Internet use by patients with prostate cancer. Methods. A questionnaire evaluating the use of the Internet was given to 295 patients undergoing radiotherapy for prostate cancer in three different settings: an academic center (AC), a Veterans Affairs center (VA), and a community hospital. The study included 171 AC patients (58%), 104 VA patients (35%), and 20 community hospital patients (7%). Results. The response rate to the questionnaire was greater than 99%. Overall, 128 (43%) of 295 patients had a home computer. This differed among the institutions, with 64% of AC patients and only 5% of VA patients having a home computer (P < 0.0001). Overall, 94 (32%) of 295 patients used the Internet to access cancer information, with 48% of AC patients and 8% of VA patients using the Internet (P < 0.0001). Seventeen percent of black patients (n = 113) had a home computer compared with 62% of white patients (n = 175; P < 0.0001). Equal access to computers did not influence Internet use because, among those patients who had access to computers, black patients used the Internet less than did white patients (32% versus 61%, P < 0.0001). Men 65 years of age or younger were more likely to use the Internet (45%) than those older than 65 years (28%; P = 0.004). Patients used many sites to access different types of information. Conclusions. A significant number of patients with prostate cancer access the Internet to obtain cancer information. Urologists and radiation oncologists should be familiar with this important resource to help patients access appropriate material. C1 Univ Penn, Sch Med, Dept Radiat Oncol, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Dept Radiat Oncol, Philadelphia, PA USA. W Jersey Canc Ctr, Voorhees, NJ USA. RP Smith, RP (reprint author), Hosp Univ Penn, Dept Radiat Oncol, 3400 Spruce St,2 Donner, Philadelphia, PA 19104 USA. NR 19 TC 45 Z9 45 U1 0 U2 0 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 AUG PY 2003 VL 62 IS 2 BP 273 EP 277 DI 10.1016/S0090-4295(03)00251-6 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 708FU UT WOS:000184557200016 PM 12893334 ER PT J AU Armstrong, K Weber, B FitzGerald, G Hershey, JC Pauly, MV Lemaire, J Subramanian, K Asch, DA AF Armstrong, K Weber, B FitzGerald, G Hershey, JC Pauly, MV Lemaire, J Subramanian, K Asch, DA TI Life insurance and breast cancer risk assessment: Adverse selection, genetic testing decisions, and discrimination SO AMERICAN JOURNAL OF MEDICAL GENETICS PART A LA English DT Article DE insurance selection bias; genetic screening; BRCA1 ID OVARIAN-CANCER; MUTATION; IDENTIFICATION; INFORMATION; WOMEN; BRCA1 AB Life insurance industry access to genetic information is controversial. Consumer groups argue that access will increase discrimination in life insurance premiums and discourage individuals from undergoing genetic testing that may provide health benefits. Conversely, life insurers argue that without access to risk information available to individuals, they face substantial financial risk from adverse selection. Given this controversy, we conducted a retrospective cohort study to evaluate the impact of breast cancer risk information on life insurance purchasing, the impact of concerns about life insurance discrimination on use of BRCA1/2 testing, and the incidence of life insurance discrimination following participation in breast cancer risk assessment and BRCA1/2 testing. Study participants were 636 women who participated in genetic counseling and/or genetic testing at a University based clinic offering breast cancer risk assessment, genetic counseling, and BRCA1/2 testing between January 1995 and May 2000. Twenty-seven women (4%) had increased and six (1%) had decreased their life insurance since participation in breast cancer risk assessment. The decision to increase life insurance coverage was associated with predicted breast cancer risk (adjusted OR 1.03 for each 1% absolute increase in risk, 95% CI 1.01-1.10) and being found to carry a mutation in BRCA1/2 (OR 5.10, 95% CI 1.90-13.66). Concern about life insurance discrimination was inversely associated with the decision to undergo BRCA1/2 testing (RR 0.67, 95% Cl 0.52-0.85). No respondent reported having life insurance denied or canceled. In this cohort of women, these results indicate that information about increased breast cancer risk is associated with increase in life insurance purchasing, raising the possibility of adverse selection. Although fear of insurance discrimination is associated with the decision not to undergo BRCA1/2 testing, there was no evidence of actual insurance discrimination from BRCA1/2 testing. (C) 2003 Wiley-Liss, Inc. C1 Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Canc, Abramson Family Canc Res Inst, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Philadelphia, PA 19104 USA. Temple Univ, Philadelphia, PA 19122 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. RP Armstrong, K (reprint author), 1233 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. OI Asch, David/0000-0002-7970-286X FU NCI NIH HHS [CA57601, R01-CA82393] NR 24 TC 39 Z9 42 U1 2 U2 11 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0148-7299 J9 AM J MED GENET A JI Am. J. Med. Genet. A PD JUL 30 PY 2003 VL 120A IS 3 BP 359 EP 364 DI 10.1002/ajmg.a.20025 PG 6 WC Genetics & Heredity SC Genetics & Heredity GA 698AE UT WOS:000183974800009 PM 12838555 ER PT J AU Feldman, RB Rhew, DC Wong, JY Charles, RA Goetz, MB AF Feldman, RB Rhew, DC Wong, JY Charles, RA Goetz, MB TI Azithromycin monotherapy for patients hospitalized with community-acquired pneumonia - A 3(1)/(2)-year experience from a veterans affairs hospital SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID RESISTANT STREPTOCOCCUS-PNEUMONIAE; MACROLIDE RESISTANCE; ANTIMICROBIAL RESISTANCE; ELDERLY PATIENTS; THERAPY; ERYTHROMYCIN; EPIDEMIOLOGY; MANAGEMENT; CLARITHROMYCIN; SUSCEPTIBILITY AB Background: Current American Thoracic Society (ATS) community-acquired pneumonia treatment guidelines recommend azithromycin monotherapy for a limited subset of hospitalized patients. We evaluated the effectiveness of azithromycin monotherapy in a more generalized population of patients hospitalized with mild-to-moderate community-acquired pneumonia. Methods: We reviewed medical records from a Veterans Affairs facility for patients admitted with community-acquired pneumonia between December 1, 1997, and June 30, 2001, comparing those receiving azithromycin monotherapy, other ATS-recommended antibiotics, and non-ATS-recommended antibiotics. We excluded patients with immunosuppression, metastatic cancer, or hospital-acquired pneumonia. Outcome measures included times to stability, meeting criteria for change to oral therapy, and eligibility for discharge; length of stay; intensive care unit transfer; and mortality. Outcomes were adjusted for pneumonia severity, skilled nursing facility status, and processes of care. Results: A total of 442 patients were eligible for the study (221 in the azithromycin monotherapy group, 129 in the ATS group, and 92 in the non-ATS group). Times to clinical stability and to fulfilling early switch criteria were not statistically significantly different among the 3 groups. Mean time to fulfilling early discharge criteria was 2.48 days for patients receiving azithromycin monotherapy vs 2.84 days for those receiving ATS antibiotics (P=.008) and 2.58 days for those receiving non-ATS antibiotics (P=.64). Overall mean length of stay was shorter in the azithromycin monotherapy group (4.35 days) vs the ATS (5.73 days) (P=.002) and non-ATS (6.21 days) (P<.001) groups. Mortality, intensive care unit transfer, and readmission rates were similar across the groups. Conclusion: Azithromycin monotherapy is equally as efficacious as other ATS-recommended regimens for treating hospitalized patients with mild-to-moderate community-acquired pneumonia. C1 Zynx Hlth Inc, Cedars Sinai Hlth Syst, Dept Hlth Serv Res, Beverly Hills, CA 90212 USA. VA Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. RP Rhew, DC (reprint author), Zynx Hlth Inc, Cedars Sinai Hlth Syst, Dept Hlth Serv Res, 9100 Wilshire Blvd,Suite 655E, Beverly Hills, CA 90212 USA. OI Goetz, Matthew/0000-0003-4542-992X NR 39 TC 19 Z9 19 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JUL 28 PY 2003 VL 163 IS 14 BP 1718 EP 1726 DI 10.1001/archinte.163.14.1718 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 704YQ UT WOS:000184369900012 PM 12885688 ER PT J AU Natarajan, S Liao, YL Cao, GC Lipsitz, SR McGee, DL AF Natarajan, S Liao, YL Cao, GC Lipsitz, SR McGee, DL TI Sex differences in risk for coronary heart disease mortality associated with diabetes and established coronary heart disease SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID IMPAIRED FASTING GLUCOSE; MYOCARDIAL-INFARCTION; CARDIOVASCULAR-DISEASE; US ADULTS; WOMEN; MELLITUS; IMPACT; PREVALENCE; SURVIVAL; INSULIN AB Background: The sex-specific independent effect of diabetes mellitus and established coronary heart disease (CHD) on subsequent CHD mortality is not known. Methods: This is an analysis of pooled data (n = 5243) from the Framingham Heart Study and the Framingham Offspring Study with follow-up of 20 years. At baseline (1971-1975), 134 men and 95 women had diabetes, while 222 men and 129 women had CHD. Risk for CHD death was analyzed by proportional hazards models, adjusting for age, hypertension, serum cholesterol levels, smoking, and body mass index. The comparative effect of established CHD vs diabetes on the risk of CHD mortality was tested by testing the difference in log hazards. Results: The adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for death from CHD were 2.1 (95% CI, 1.3-3.3) in men with diabetes only, and 4.2 (95% CI, 3.2-5.6) in men with CHD only compared with men without diabetes or CHD. The HR for CHD death was 3.8 (95% CI, 2.2-6.6) in women with diabetes, and 1.9 (95% CI, 1.1-3.4) in women with CHD. The difference between the CHD and the diabetes log hazards was +0.73 (95% Cl, 0.72-0.75) in men and -0.65 (95% Cl, -0.68 to -0.63) in women. Conclusions: In men, established CHD signifies a higher risk for CHD mortality than diabetes. This is reversed in women, with diabetes being associated with greater risk for CHD mortality. Current treatment recommendations for women with diabetes may need to be more aggressive to match CHD mortality risk. C1 Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Med Univ S Carolina, Ctr Hlth Care Res, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biometry & Epidemiol, Charleston, SC 29425 USA. Florida State Univ, Dept Stat, Tallahassee, FL 32306 USA. RP Natarajan, S (reprint author), 423 E 23rd St,Room 11101-S, New York, NY 10010 USA. FU NHLBI NIH HHS [HL52329, HL67460, HL68900]; NIDDK NIH HHS [DK52329] NR 38 TC 95 Z9 96 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JUL 28 PY 2003 VL 163 IS 14 BP 1735 EP 1740 DI 10.1001/archinte.163.14.1735 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 704YQ UT WOS:000184369900014 PM 12885690 ER PT J AU Ioannidis, JPA Contopoulos-Ioannidis, DG Rosenberg, PS Goedert, JJ De Rossi, A Espanol, T Frenkel, L Mayaux, MJ Newell, ML Pahwa, SG Rousseau, C Scarlatti, G Sei, S Sen, L O'Brien, TR AF Ioannidis, JPA Contopoulos-Ioannidis, DG Rosenberg, PS Goedert, JJ De Rossi, A Espanol, T Frenkel, L Mayaux, MJ Newell, ML Pahwa, SG Rousseau, C Scarlatti, G Sei, S Sen, L O'Brien, TR CA HIV Host Genetics Int Meta Anal TI Effects of CCR5-Delta 32 and CCR2-64I alleles on disease progression of perinatally HIV-1-infected children: an international meta-analysis SO AIDS LA English DT Article DE CCR5-Delta 32; CCR2-64I; death; disease progression; HIV-1; perinatal transmission ID INDIVIDUAL-PATIENT DATA; PEDIATRIC HIV-1 INFECTION; CHEMOKINE GENE VARIANT; CORECEPTOR USAGE; VIRAL PHENOTYPE; CCR5; TRANSMISSION; POLYMORPHISMS; RISK; PATHOGENESIS AB Objective: Among perinatally infected children, the effects of certain alleles of the CCR5 and CCR2 genes on the rate of disease progression remain unclear. We addressed the effects of CCR5-Delta32 and CCR2-641 in an international meta-analysis. Methods: Genotype data were contributed from 10 studies with 1317 HIV-1-infected children (7263 person-years of follow-up). Time-to-event analyses were performed stratified by study and racial group. Endpoints included progression to clinical AIDS, death, and death after the diagnosis of clinical AIDS. The time-dependence of the genetic effects was specifically investigated. Results: There was large heterogeneity in the observed rates of disease progression between different cohorts. For progression to clinical AIDS, both CCR5-Delta32 and CCR2-641 showed overall non-significant trends for protection [hazard ratios 0.84, 95% confidence interval (0) 0.58-1.23; and 0.87, 95% CI 0.67-1.14, respectively]. However, analyses of survival showed statistically significant time-dependence. No deaths occurred among CCR5-Delta32 carriers in the first 3 years of life, whereas there was no protective effect (hazard ratio 0.95; 95% CI 0.43-2.10) in later years (P = 0.01 for the time-dependent model). For CCR2-641, the hazard ratio for death was 0.69 (95% CI 0.39-1.21) in the first 6 years of life and 2.56 (95% CI 1.26-5.20) in subsequent years (P < 0.01 for the time-dependent model). CCR5-Delta32 and CCR2-641 offered no clear protection after clinical AIDS had developed. Conclusion: The CCR5-Delta32 and CCR2-641 alelles are associated with a decreased risk of death among perinatally infected children, but only for the first years of life. (C) 2003 Lippincott Williams Wilkins. C1 Univ Ioannina, Dept Hyg & Epidemiol, Sch Med, Clin & Mol Epidemiol Unit, GR-45110 Ioannina, Greece. Univ Ioannina, Dept Pediat, Sch Med, GR-45110 Ioannina, Greece. Fdn Res & Technol Hellas, Inst Biomed Res, Ioannina, Greece. Tufts Univ, New England Med Ctr, Dept Med, Boston, MA 02111 USA. George Washington Univ, Sch Med & Hlth Sci, Dept Pediat, Washington, DC 20052 USA. NCI, Div Canc Epidemiol & Genet, NIH, Rockville, MD USA. Univ Padua, AIDS Reference Ctr, Oncol Sect, Dept Oncol & Surg Sci, I-35100 Padua, Italy. Hosp Gen Valle Hebron, Immunol Unit, Barcelona, Spain. Univ Washington, Sch Med, Childrens Hosp & Reg Med Ctr, Div Pediat Infect Dis,Dept Pediat, Seattle, WA 98195 USA. INSERM, Paris, France. UCL, Inst Child Hlth, Ctr Paediat Epidemiol, London WC1E 6BT, England. NYU, Sch Med, N Shore Univ Hosp, Div Immunol,Dept Pediat, Manhasset, NY USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. DIBIT San Raffaele Sci Inst, Viral Evolut & Transmiss Unit, Milan, Italy. NCI, HIV Clin Interface Lab, NIH, Frederick, MD 21701 USA. Hosp Pediat JP Garrahan, Lab Biol Celular & Retrovirus, Buenos Aires, DF, Argentina. RP Univ Ioannina, Dept Hyg & Epidemiol, Sch Med, Clin & Mol Epidemiol Unit, GR-45110 Ioannina, Greece. EM jioannid@cc.uoi.gr RI Ioannidis, John/G-9836-2011; De Rossi, Anita/L-3128-2015 OI De Rossi, Anita/0000-0001-6435-7509 NR 39 TC 37 Z9 41 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0269-9370 EI 1473-5571 J9 AIDS JI Aids PD JUL 25 PY 2003 VL 17 IS 11 BP 1631 EP 1638 DI 10.1097/01.aids.0000060411.18106.0f PG 8 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 710BW UT WOS:000184661800007 PM 12853745 ER PT J AU Gould, GG Mehta, AK Frazer, A Ticku, MK AF Gould, GG Mehta, AK Frazer, A Ticku, MK TI Quantitative autoradiographic analysis of the new radioligand [H-3](2E)-(5-hydroxy-5,7,8,9-tetrahydro-6H-benzo[a][7]annulen-6-ylidene) ethanoic acid ([H-3]NCS-382) at gamma-hydroxybutyric acid (GHB) binding sites in rat brain SO BRAIN RESEARCH LA English DT Article DE gamma-hydroxybutyric acid; [H-3]NCS-382; autoradiography; GABA receptors; GHB receptor; GHB antagonist ID RECEPTOR ANTAGONIST; GABA(B) RECEPTOR; NCS-382; SYSTEM; CORTEX AB (2E)-(5-Hydroxy-5,7,8,9-tetrahydro-6H-benzo[a][7]annulen-6-ylidene) ethanoic acid (NCS-382) is an antagonist for gamma-hydroxybutyric acid (GHB) at GHB receptor sites. Advantages of using [H-3]NCS-382 over [H-3]GHB in radioligand binding studies are that unlike GHB, NCS-382 does not appear to bind to, activate, or interfere with the functioning of GABA(B) or GABA(A) receptors, either directly or indirectly. Herein we establish a protocol for use of [H-3]NCS-382 by quantitative autoradiography. GHB was used to define non-specific binding, since it displaced [H-3]NCS-382 to an extent equivalent to NCS-382. Among many areas of brain examined, two regions in which high specific binding of [H-3]NCS-382 occurred were the hippocampus and cerebral cortex. Areas such as the striatum and nucleus accumbens exhibited intermediate levels of specific binding. No or very low binding was observed in other areas such as the cerebellum and dorsal raphe nucleus. The distribution of GHB binding sites as defined by [H-3]NCS-382 suggests that GHB may play a role in neuromodulation or neurotransmission in frontal brain areas. (C) 2003 Elsevier B.V. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Pharmacol 7764, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Gould, GG (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pharmacol 7764, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. OI Gould, Georgianna/0000-0002-5470-8763 FU NIDA NIH HHS [DA14986]; NIMH NIH HHS [MH57001] NR 24 TC 28 Z9 29 U1 0 U2 5 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 25 PY 2003 VL 979 IS 1-2 BP 51 EP 56 DI 10.1016/S0006-8993(03)02865-8 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 705LT UT WOS:000184397100007 PM 12850570 ER PT J AU Tsui, CP Sung, JJY Leung, FW AF Tsui, CP Sung, JJY Leung, FW TI Role of acute elevation of portal venous pressure by exogenous glucagon on gastric mucosal injury in rats with portal hypertension SO LIFE SCIENCES LA English DT Review DE portal hypertension; gastric mucosal injury; portal venous pressure; glucagon; somatostatin ID NITRIC-OXIDE SYNTHASE; ENDOSCOPIC VARICEAL LIGATION; ENDOTHELIAL GROWTH-FACTOR; BLOOD-FLOW DISTRIBUTION; CIRRHOTIC-PATIENTS; CONGESTIVE GASTROPATHY; ACID-SECRETION; HYPERDYNAMIC CIRCULATION; HELICOBACTER-PYLORI; SOMATOSTATIN ANALOG AB Time-course studies revealed the increased susceptibility of the gastric mucosa to noxious injury in portal hypertension correlates with the level of elevated portal venous pressure and hyperglucagonemia. Whether acute elevation of portal venous pressure by exogenous glucagon aggravates such injury is not known. We tested the hypothesis that glucagon in a dose sufficient to acutely elevate portal venous pressure aggravates noxious injury of the gastric mucosa in rats with portal hypertension. Infusion of a portal hypotensive dose of somatostatin should reverse these changes. In anesthetized rats with portal vein ligation, glucagon, somatostatin or the combination was administered intravenously in a randomized, coded fashion. Acidified ethanol-induced gastric mucosal injury was determined. Portal venous pressure and gastric mucosal perfusion and oxygenation (reflectance spectrophotometry) were monitored to confirm the effects of the respective intravenous treatments. Exogenous glucagon exacerbated acidified ethanol-induced gastric mucosal injury. The exacerbation was attenuated by somatostatin. These changes paralleled the portal hypertensive and hypotensive effects. of glucagon and somatostatin, respectively. Our data suggest that a unique mechanism is triggered with the onset of portal hypertension. In an antagonistic manner, glucagon and somatostatin modulate this novel mechanism that controls portal venous pressure and susceptibility of the gastric mucosa to noxious injury. Published by Elsevier Science Inc. C1 W Los Angeles Vet Affairs Med Ctr, Med Res Serv, Sepulveda Ambulatory Care Ctr, Sepulveda, CA 91343 USA. Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Ctr Ulcer Res & Educ, Sepulveda, CA 91343 USA. RP Leung, FW (reprint author), W Los Angeles Vet Affairs Med Ctr, Med Res Serv, Sepulveda Ambulatory Care Ctr, Sepulveda, CA 91343 USA. RI Hossain, Sarah /C-7332-2009 OI Hossain, Sarah /0000-0003-1355-0979 NR 136 TC 6 Z9 6 U1 1 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0024-3205 J9 LIFE SCI JI Life Sci. PD JUL 18 PY 2003 VL 73 IS 9 BP 1115 EP 1129 DI 10.1016/S0024-3205(03)00413-2 PG 15 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 694RK UT WOS:000183787900003 PM 12818720 ER PT J AU Fihn, SD AF Fihn, SD TI Acute uncomplicated urinary tract infection in women SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID SPERMICIDE-COATED CONDOMS; RISK-FACTORS; TRIMETHOPRIM-SULFAMETHOXAZOLE; POSTMENOPAUSAL WOMEN; ESCHERICHIA-COLI; YOUNG-WOMEN; RANDOMIZED TRIAL; ANTIMICROBIAL RESISTANCE; ACUTE CYSTITIS; DOUBLE-BLIND C1 VA Puget Sound Hlth Care Syst, NW Hlth Serv Res & Dev Ctr Excellence, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98195 USA. RP Fihn, SD (reprint author), VA Puget Sound Hlth Care Syst, NW Hlth Serv Res & Dev Ctr Excellence, 152,1660 S Columbian Way, Seattle, WA 98108 USA. FU NIDDK NIH HHS [2-R01-DK431341-07] NR 54 TC 103 Z9 119 U1 1 U2 6 PU MASSACHUSETTS MEDICAL SOC/NEJM PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JUL 17 PY 2003 VL 349 IS 3 BP 259 EP 266 DI 10.1056/NEJMcp030027 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 701KA UT WOS:000184165700011 PM 12867610 ER PT J AU Plomondon, ME Rumsfeld, JS Humble, CG Meterko, M McDonald, GO Grover, FL Perlin, JB Shroyer, ALW AF Plomondon, ME Rumsfeld, JS Humble, CG Meterko, M McDonald, GO Grover, FL Perlin, JB Shroyer, ALW TI Factors influencing risk-adjusted patient satisfaction after coronary artery bypass grafting SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID CARDIAC-SURGERY; HOSPITAL-CARE; QUALITY C1 Denver VA Med Ctr, Denver, CO 80220 USA. Performance Anal Ctr Excellence, Morrisville, NC USA. HSR&D Management Decis & Res Ctr, Boston, MA USA. VA Off Patient Care Serv, Washington, DC USA. Veterans Hlth Adm, Washington, DC USA. RP Plomondon, ME (reprint author), Denver VA Med Ctr, 1055 Clermont St, Denver, CO 80220 USA. NR 13 TC 2 Z9 2 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD JUL 15 PY 2003 VL 92 IS 2 BP 206 EP 208 DI 10.1016/S0002-9149(03)00540-X PG 3 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 701HW UT WOS:000184163000017 PM 12860226 ER PT J AU Levine, GN Kem, MJ Berger, PB Brown, DL Klein, LW Kereiakes, DJ Sanborn, TA Jacobs, AK AF Levine, GN Kem, MJ Berger, PB Brown, DL Klein, LW Kereiakes, DJ Sanborn, TA Jacobs, AK CA American Heart Assoc Diagnostic In TI Management of patients undergoing percutaneous coronary revascularization SO ANNALS OF INTERNAL MEDICINE LA English DT Review ID PLATELET GLYCOPROTEIN-IIB/IIIA; PRACTICE GUIDELINES COMMITTEE; AMERICAN-HEART-ASSOCIATION; PERIPHERAL VASCULAR COMPLICATIONS; ACCESS SITE COMPLICATIONS; IODINATED CONTRAST-MEDIA; PLACEBO-CONTROLLED TRIAL; ADVERSE CARDIAC EVENTS; ACUTE-RENAL-FAILURE; RADIOCONTRAST-INDUCED NEPHROPATHY AB While performance of percutaneous coronary intervention (PCl) remains the domain of specialized cardiologists, patients undergoing PCl are cared for by noninvasive cardiologists, internists, and primary care physicians. Therefore, patient care is optimized when the entire patient care team understands procedural risks and complications as well as optimum patient management before, during, and after PCl. Before PCl, patients with contrast dye allergies should be identified and pretreated with steroids and an H,-blocker. Hydration should be initiated and maintained before and after the procedure to minimize the risks for contrast nephropathy. Periprocedure, patients should be monitored clinically for evidence of ischemia. In patients with significant groin, flank, abdominal, or back pain, as well as those with decrease in hematocrit or unexplained hypotension, the diagnosis of groin or retroperitoneal hematoma should be considered and promptly evaluated. Groin tenderness, pulsatile mass, or bruit should prompt evaluation for possible femoral pseudoaneurysm or arteriovenous fistulae. After the procedure, all patients treated with coronary stents should receive aspirin plus clopidogrel. Patients who develop typical anginal symptoms between the 1st and 6th to 8th months after PCl are likely to have restenosis and can be evaluated by an imaging study or repeated catheterization. C1 Baylor Coll Med, Houston, TX 77030 USA. St Louis Univ, St Louis, MO 63103 USA. Beth Israel Med Ctr, New York, NY 10003 USA. Rush Med Coll, Chicago, IL 60612 USA. Lindner Res Ctr, Cincinnati, OH USA. Ohio Heart Hlth Ctr, Cincinnati, OH USA. Evanston NW Healthcare, Evanston, IL USA. Boston Univ, Sch Med, Boston, MA 02215 USA. RP Levine, GN (reprint author), Houston Vet Affairs Med Ctr, Cardiol Sect, 3C-330,111-B,2002 Holcombe Blvd, Houston, TX 77030 USA. NR 181 TC 58 Z9 60 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 J9 ANN INTERN MED JI Ann. Intern. Med. PD JUL 15 PY 2003 VL 139 IS 2 BP 123 EP 136 PG 14 WC Medicine, General & Internal SC General & Internal Medicine GA 701HX UT WOS:000184163100006 PM 12859162 ER PT J AU Takayama, K Hayes, B Vestling, MM Massey, RJ AF Takayama, K Hayes, B Vestling, MM Massey, RJ TI Transposon-5 mutagenesis transforms Corynebacterium matruchotii to synthesize novel hybrid fatty acids that functionally replace corynomycolic acid SO BIOCHEMICAL JOURNAL LA English DT Article DE Claisen-type condensation; corynomycolic acid; electrospray MS; electron-impact MS; transposon-5 mutagenesis; ultrathin section electron microscopy ID CELL-FREE SYSTEM; MYCOBACTERIUM-TUBERCULOSIS; MYCOLIC ACIDS; BACTERIONEMA-MATRUCHOTII; BIOSYNTHESIS; TREHALOSE; WALL; IDENTIFICATION; DIPHTHERIAE; VIRULENCE AB Enzymes within the biosynthetic pathway of mycolic acid (C-60- C-90 alpha-alkyl, beta-hydroxyl fatty acid) in Mycobacterium tuberculosis are attractive targets for developing new anti-tuberculosis drugs. We have turned to the simple model system of Corynebacterium matruchotii to study the terminal steps in the anabol pathway of a C-32 mycolic acid called corynomycolic acid. By transposon-5 mutagenesis. we transformed C. matruchotii into a mutant that is unable to synthesize corynomycolic acid. Instead, it synthesized two related series of novel fatty acids that were released by saponification front the cell wall fraction and from two chloroform/methanol-extractable glycolipids presumed to be analogues of trehalose mono- and di-corynomycolate. By chemical analyses and MS, we determined the general structure of the two series to be 2.4.6,8, 10-penta-alkyl decanoic acid for the larger series (C-70-C-77) and 2.4,6,8 -tetra-alkyl octanoic acid for the smaller series (C-52-C-64), both containing multiple keto groups, hydroxy groups and double bonds. The mutant was temperaturesensitive, aggregated extensively, grew very slowly relative to the wild type, and was resistant to the presence of lysozyme. We suggest that a regulatory protein that normally prevents the transfer of the condensation product back to P-ketoacyl synthase in the corynomycolate synthase system of the wild type was inactivated in the mutant. This will result in multiple Claisen-type condensation and the formation of two similar series of these complex hybrid fatty acids. A similar protein in M. tuberculosis would be an attractive target for new drug discovery. C1 William S Middleton Mem Vet Adm Med Ctr, Mycobacteriol Res Lab, Madison, WI 53705 USA. Univ Wisconsin, Sch Med, Dept Med Microbiol & Immunol, Madison, WI 53706 USA. Univ Wisconsin, Dept Bacteriol, Madison, WI 53706 USA. Univ Wisconsin, Dept Chem, Madison, WI 53706 USA. Univ Wisconsin, Sch Med, Electron Microscope Facil, Madison, WI 53706 USA. RP Takayama, K (reprint author), William S Middleton Mem Vet Adm Med Ctr, Mycobacteriol Res Lab, 2500 Overlook Terrace, Madison, WI 53705 USA. NR 31 TC 5 Z9 5 U1 0 U2 0 PU PORTLAND PRESS PI LONDON PA 59 PORTLAND PLACE, LONDON W1N 3AJ, ENGLAND SN 0264-6021 J9 BIOCHEM J JI Biochem. J. PD JUL 15 PY 2003 VL 373 BP 465 EP 474 DI 10.1042/BJ20030248 PN 2 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 705HR UT WOS:000184390100015 PM 12879902 ER PT J AU Nabors, LLB Suswam, E Huang, YY Yang, XH Johnson, MJ King, PH AF Nabors, LLB Suswam, E Huang, YY Yang, XH Johnson, MJ King, PH TI Tumor necrosis factor a induces angiogenic factor up-regulation in malignant glioma cells: A role for RNA stabilization and HuR SO CANCER RESEARCH LA English DT Article ID ENDOTHELIAL GROWTH-FACTOR; BINDING PROTEIN HUR; LYMPHOKINE MESSENGER-RNA; 3' UNTRANSLATED REGION; URIDINE-RICH ELEMENTS; FACTOR-ALPHA; BRAIN-TUMORS; 3'-UNTRANSLATED REGION; STABILITY FACTOR; MAMMALIAN-CELLS AB Malignant glioma (MG) cells up-regulate angiogenic factor expression in response to different extracellular signals such as hypoxia and cytokines. This up-regulation in turn promotes angiogenesis and tumor progression. Posttranscriptional gene regulation has been implicated as one mechanism for this tumor response, and we have previously shown that HuR, a protein associated with RNA stabilization, is overexpressed in MGs (L. B. Nabors et al., Cancer Res., 61: 2154-2161, 2001). Here, we demonstrate a marked up-regulation (RNA and protein) of tumor necrosis factor alpha (TNF-alpha), interleukin 8, and, to a lesser extent, vascular endothelial growth factor in U251 glioma cells after stimulation with TNF-alpha. RNA kinetic studies indicated that TNF-alpha induced the stabilization of all three transcripts. Using a luciferase reporter assay, we demonstrate that the AU-rich elements (AREs) in the 3'-untranslated region of these genes significantly contribute to this posttranscriptional regulation. UV cross-linking and immunoprecipitation with glioma extracts indicate that HuR binds to all three ARFs. When HuR is overexpressed in glioma cells, there is enhanced RNA stabilization of all three angiogenic factor transcripts with a concomitant increase in mRNA and protein expression (up to 7-fold). These findings indicate that TNF-alpha up-regulates angiogenic factor expression in MG cells and that RNA stabilization, via the AREs in the 3'-untranslated region, contributes to this up-regulation. C1 Univ Alabama, Dept Neurol, Birmingham, AL 35294 USA. Univ Alabama, Dept Clin Pharmacol, Birmingham, AL 35294 USA. Univ Alabama, Dept Physiol & Biophys, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL 35233 USA. RP King, PH (reprint author), Univ Alabama, Dept Neurol, 1235 Jefferson Tower,625 S 19th St, Birmingham, AL 35294 USA. NR 46 TC 90 Z9 103 U1 0 U2 5 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD JUL 15 PY 2003 VL 63 IS 14 BP 4181 EP 4187 PG 7 WC Oncology SC Oncology GA 705DE UT WOS:000184379800054 PM 12874024 ER PT J AU Bozkurt, B Mann, DL AF Bozkurt, B Mann, DL TI Shortness of breath SO CIRCULATION LA English DT Article C1 Houston VA Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Winters Ctr Heart Failure Res, Houston, TX 77030 USA. RP Bozkurt, B (reprint author), Houston VA Med Ctr, 4C211,2002 Holocombe Blvd, Houston, TX 77030 USA. NR 2 TC 2 Z9 2 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD JUL 15 PY 2003 VL 108 IS 2 BP E11 EP E13 DI 10.1161/01.CIR.000007595.36340.78 PG 3 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 701DL UT WOS:000184152900001 PM 12860894 ER PT J AU Parodi, S Lechner, A Osih, R Vespa, P Pegues, D AF Parodi, S Lechner, A Osih, R Vespa, P Pegues, D TI Nosocomial enterobacter meningitis: Risk factors, management, and treatment outcomes SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID NEGATIVE BACILLARY MENINGITIS; EXTERNAL VENTRICULAR DRAINS; INTRACRANIAL-PRESSURE MONITORS; INTENSIVE-CARE UNIT; BACTERIAL-MENINGITIS; MOLECULAR EPIDEMIOLOGY; NEUROSURGICAL PATIENTS; TRIMETHOPRIM-SULFAMETHOXAZOLE; 3RD-GENERATION CEPHALOSPORINS; RESISTANT ENTEROBACTER AB Enterobacter species are increasingly a cause of nosocomial meningitis among neurosurgery patients, but risk factors for these infections are not well defined. A review of all adult patients hospitalized at the University of California-Los Angeles (UCLA) Medical Center during an 8-year period identified 15 postneurosurgical cases of Enterobacter meningitis (EM). Cure was achieved in 14 cases (93%), and efficacy was similar for carbapenem- and cephalosporin-based treatment. A matched case-control study comparing 26 controls with 13 case patients hospitalized exclusively at the UCLA Medical Center found that external cerebrospinal fluid (CSF) drainage devices (odds ratio [OR], 21.8; P=.001), isolation of Enterobacter species from a non-CSF culture (OR, 24.6; P=.002), and prolonged administration of antimicrobial drugs before the diagnosis of meningitis that were inactive in vitro against Enterobacter species (OR, 13.3; P=.008) were independent risk factors for EM. Despite favorable treatment outcomes, EM is a serious infection associated with Enterobacter species colonization or infection at other surgical sites, with selective antimicrobial pressure, and with invasive CNS devices. C1 Univ Calif Los Angeles, David Geffen Sch Med, Ctr Hlth Sci 32 178, Dept Med,Div Infect Dis, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Div Infect Dis, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Div Lab Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Div Neurosurg, Los Angeles, CA 90095 USA. RP Pegues, D (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Ctr Hlth Sci 32 178, Dept Med,Div Infect Dis, Los Angeles, CA 90095 USA. NR 46 TC 14 Z9 17 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL 15 PY 2003 VL 37 IS 2 BP 159 EP 166 DI 10.1086/375596 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 700DZ UT WOS:000184098500001 PM 12856206 ER PT J AU Neuzil, KM Maynard, C Griffin, MR Heagerty, P AF Neuzil, KM Maynard, C Griffin, MR Heagerty, P TI Winter respiratory viruses and health care use: A population-based study in the Northwest United States SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID CHRONIC LUNG-DISEASE; SYNCYTIAL VIRUS; INFLUENZA EPIDEMICS; YOUNG-CHILDREN; PARAINFLUENZA VIRUS; OUTPATIENT VISITS; ELDERLY PERSONS; IMPACT; MORTALITY; INFECTIONS AB To quantify health care use among adults during influenza and respiratory syncytial virus (RSV) seasons, we identified a cohort of veterans aged greater than or equal to18 years who used Department of Veterans Affairs (VA) facilities in Oregon and Washington states as their source of health care. During 1998-2000, veterans accrued 237,159 person-years of follow-up. Using VA data sources, we measured acute cardiopulmonary hospitalizations and primary care and urgent care visits. Differences between rates of study events when influenza and/or RSV were circulating and event rates when neither virus was circulating were used to calculate winter virus attributable morbidity. Inpatient and outpatient event rates were consistently higher during winter virus season, compared with non-winter virus season. Annual rates of cardiopulmonary hospitalizations attributable to influenza or RSV infection ranged from 0.8 (95% confidence interval [CI], 0.1-1.5) per 1000 low-risk individuals aged 18-49 years, to 10.6 (95% CI, 7.5-13.6) per 1000 high-risk individuals aged greater than or equal to65 years. Each year, circulation of influenza and RSV coincide with predictable increases in medical care use. C1 Univ Washington, Sch Med, Dept Med, Med Serv 111ID, Seattle, WA 98108 USA. Univ Washington, Sch Publ Hlth & Community Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. Vanderbilt Univ, Sch Med, Dept Med, Nashville, TN 37212 USA. Vanderbilt Univ, Sch Med, Dept Prevent Med, Nashville, TN 37212 USA. Vet Affairs Tennessee Valley Healthcare Syst, Ctr Geriatr Res Educ & Clin, Nashville, TN USA. RP Neuzil, KM (reprint author), Univ Washington, Sch Med, Dept Med, Med Serv 111ID, 1660 S Columbian Way, Seattle, WA 98108 USA. RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 NR 41 TC 28 Z9 29 U1 1 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL 15 PY 2003 VL 37 IS 2 BP 201 EP 207 DI 10.1086/375604 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 700DZ UT WOS:000184098500007 PM 12856212 ER PT J AU Ruo, B Rumsfeld, JS Hlatky, MA Liu, HY Browner, WS Whooley, MA AF Ruo, B Rumsfeld, JS Hlatky, MA Liu, HY Browner, WS Whooley, MA TI Depressive symptoms and health-related quality of life - The heart and soul study SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID CORONARY-ARTERY DISEASE; ACTIVITY STATUS INDEX; SELF-RATED HEALTH; FUNCTIONAL STATUS; BYPASS-SURGERY; PRIMARY-CARE; MYOCARDIAL-INFARCTION/; PERCEIVED HEALTH; FOLLOW-UP; PRIME-MD AB Context Little is known regarding the extent to which patient-reported health status, including symptom burden, physical limitation, and quality of life, is determined by psychosocial vs physiological factors among patients with chronic disease. Objective To compare the contributions of depressive symptoms and measures of cardiac function to the health status of patients with coronary artery disease. Design, Setting, and Participants Cross-sectional study of 1024 adults with stable coronary artery disease recruited from outpatient clinics in the San Francisco Bay Area between September 2000 and December 2002. Main Measures Measurement of depressive symptoms using the Patient Health Questionnaire (PHQ); assessment of cardiac function by measuring left ventricular ejection fraction on echocardiography, exercise capacity on treadmill testing, and ischemia on stress echocardiography; and measurement of a range of health status outcomes, including symptom burden, physical limitation, and quality of life, using the Seattle Angina Questionnaire. Participants were also asked to rate their overall health as excellent, very good, good, fair, or poor. Results Of the 1024 participants, 201 (20%) had depressive symptoms (PHQ score :10). Participants with depressive symptoms were more likely than those without depressive symptoms to report at least mild symptom burden (60% vs 33%; P<.001), mild physical limitation (73% vs 40%; P<.001), mildly diminished quality of life (67% vs 31%; P<.001), and fair or poor overall health (66% vs 30%; P<.001). In multivariate analyses adjusting for measures of cardiac function and other patient characteristics, depressive symptoms were strongly associated with greater symptom burden (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.3-2.7; P=.002), greater physical limitation (OR, 3.1; 95% Cl, 2.1-4.6; P<.001), worse quality of life (OR, 3.1; 95% Cl, 2.2-4.6; P<.001), and worse overall health (OR, 2.0; 95% Cl, 1.3-2.9; P<.001). Although decreased exercise capacity was associated with worse health status, left ventricular ejection fraction and ischemia were not. Conclusions Among patients with coronary disease, depressive symptoms are strongly associated with patient-reported health status, including symptom burden, physical limitation, quality of life, and overall health. Conversely, 2 traditional measures of cardiac function-ejection fraction and ischemia-are not. Efforts to improve health status should include assessment and treatment of depressive symptoms. C1 Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. Denver Vet Affairs Med Ctr, Cardiol & Hlth Serv Res, Denver, CO USA. Stanford Univ, Sch Med, Stanford, CA 94305 USA. Calif Pacific Med Ctr, Res Inst, San Francisco, CA USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. RP Whooley, MA (reprint author), Vet Affairs Med Ctr, Gen Internal Med Sect, 111A1,4150 Clement St, San Francisco, CA 94121 USA. FU NHLBI NIH HHS [R01 HL079235-01A1, R01 HL079235] NR 57 TC 432 Z9 443 U1 2 U2 14 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 9 PY 2003 VL 290 IS 2 BP 215 EP 221 DI 10.1001/jama.290.2.215 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 698GH UT WOS:000183989800026 PM 12851276 ER PT J AU Kasman, DL Fryer-Edwards, K Braddock, CH AF Kasman, DL Fryer-Edwards, K Braddock, CH TI Educating for professionalism: Trainees' emotional experiences on IM and pediatrics inpatient wards SO ACADEMIC MEDICINE LA English DT Article; Proceedings Paper CT Annual Meeting of the National-Society-of-Teachers-of-Family-Medicine CY APR, 2001 CL DENVER, COLORADO SP Natl Soc Tearchers Family Med ID US MEDICAL-SCHOOLS; PATIENT SATISFACTION; MOOD STATES; STUDENTS; PHYSICIAN; STRESS; FACULTY; CARE; RESIDENCY; CURRICULUM AB Purpose. To assess day-to-day emotions and the experiences that trigger these emotions for medical trainees in hospital settings. The overarching goal was to illuminate training experiences that affect professional behaviors of physicians. Method. This qualitative study, conducted April-June 2000, used semistructured, open-ended interviews, observations by a non-participant, and a self-report task at two inpatient services (internal medicine and pediatrics) at different hospitals within a single academic institution in the northwestern United States. Twelve team members, including medical students, interns, residents, and attendings, were invited to participate. Ten completed all aspects of the study. Interviews were conducted before and after a one-week period of non-participant observations and self-report tasks. The authors grouped emotional experiences into "positive" or "difficult" emotions. Data were analyzed for coherent themes using grounded theory and content analysis. Results. Positive emotions included gratitude, happiness, compassion, pride, and relief, and were triggered by connections with patients and colleagues, receiving recognition for one's labors, learning, being a part of modern medicine, and receiving emotional support from others. Difficult emotions included anxiety, guilt, sadness, anger, and shame and were triggered by uncertainty, powerlessness, responsibility, liability, lack of respect, and a difference in values. Tragedy and patients' suffering was the only trigger to elicit both positive (compassion) and difficult (sadness) emotions. Conclusion. This study identified common and important emotions experienced by medical trainees and the common triggers for these emotions. Understanding trainees' experiences of uncertainty, powerlessness, differing values, and lack of respect can guide education program designs and reforms to create an environment that fosters professional growth. C1 US Dept Vet Affairs, Puget Sound Healthcare Syst, Seattle, WA USA. Univ Washington, Dept Med Hist & Eth, Sch Med, Seattle, WA USA. Univ Washington, Dept Med, Sch Med, Seattle, WA USA. NR 81 TC 41 Z9 42 U1 1 U2 7 PU HANLEY & BELFUS INC PI PHILADELPHIA PA 210 S 13TH ST, PHILADELPHIA, PA 19107 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD JUL PY 2003 VL 78 IS 7 BP 730 EP 741 DI 10.1097/00001888-200307000-00017 PG 12 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 711LG UT WOS:000184741600011 PM 12857696 ER PT J AU Hung, AM Chertow, GA Young, BS Carey, S Johansen, KL AF Hung, AM Chertow, GA Young, BS Carey, S Johansen, KL TI Inflammatory markers are unrelated to physical activity, performance, and functioning in hemodialysis SO ADVANCES IN RENAL REPLACEMENT THERAPY LA English DT Article; Proceedings Paper CT 34th Annual Meeting of the American-Society-of-Nephrology CY OCT 10-17, 2001 CL SAN FRANCISCO, CALIFORNIA SP Amer Soc Nephrol ID CHRONIC-RENAL-FAILURE; C-REACTIVE PROTEIN; INTERLEUKIN-1 RECEPTOR ANTAGONIST; RECOMBINANT-HUMAN-ERYTHROPOIETIN; MAINTENANCE DIALYSIS PATIENTS; PERITONEAL-DIALYSIS; ENERGY-EXPENDITURE; NUTRITIONAL-STATUS; PLASMA-FIBRINOGEN; HEART-FAILURE AB Objective: To determine the associations among dietary intake and inflammatory cytokines with physical activity, function, and performance in maintenance dialysis patients. Design: Cross-sectional analysis of cohort study. Setting: University-affiliated dialysis units, general clinical research center. Subjects: Multiethnic cohort of maintenance hemodialysis patients. Main Outcome Measures: Physical activity by accelerometry; physical performance by gait speed, stair climbing, and chair raising; physical functioning by the Medical Outcomes Study Short Form 36-item questionnaire subscale scores; and maximal and adjusted activity scores of human activity profile. Results: Levels of inflammatory cytokines were uniformly high. Tumor necrosis factor-a was directly correlated with dietary protein and energy intake; no other cytokines were directly or inversely correlated with intake. Dietary intake was associated with physical activity, as expected, and not significantly associated with performance or function (with the exception of gait speed). There were no significant associations among inflammatory cytokines and physical activity, performance, or function. Conclusion: Although dietary intake and inflammation may independently influence traditional proxies of nutritional status, this analysis provides no evidence for a link between cytokines and physical activity, performance, or function in hemodialysis patients. More research is required to understand the role of cytokines in protein energy malnutrition and the mechanisms of wasting and functional decline in the dialysis population. (C) 2003 by the National Kidney Foundation, Inc. C1 San Francisco VA Med Ctr, Div Nephrol 111J, San Francisco, CA 94121 USA. Univ Calif San Francisco, Mt Zion Med Ctr, San Francisco, CA 94120 USA. Univ Calif San Francisco, Div Nephrol, San Francisco, CA 94143 USA. RP Hung, AM (reprint author), San Francisco VA Med Ctr, Div Nephrol 111J, 4150 Clement St, San Francisco, CA 94121 USA. FU NCRR NIH HHS [RR-00083] NR 56 TC 9 Z9 9 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1073-4449 J9 ADV RENAL REPLACE TH JI Adv. Renal Replace. Ther. PD JUL PY 2003 VL 10 IS 3 BP 232 EP 240 DI 10.1053/j.arrt.2003.10.002 PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 760FE UT WOS:000187800300010 PM 14708079 ER PT J AU Krahn, D Freese, J Hauser, R Barry, K Goodman, B AF Krahn, D Freese, J Hauser, R Barry, K Goodman, B TI Alcohol use and cognition at mid-life: The importance of adjusting for baseline cognitive ability and educational attainment SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE cognition; alcohol; IQ; education; consumption ID CONSUMPTION; DRINKING; PERFORMANCE; SMOKING; COMMUNITY; COHORT; SAMPLE; WINE; MEN AB Background: The nature of the relationship between cognition and alcohol consumption remains controversial. Studies have reported negative, positive, and nonsignificant effects of alcohol consumption on cognition. Problematic throughout the literature is that baseline cognitive ability has not been adequately controlled in previous studies, and even educational attainment is only sometimes controlled. Because such variables may be associated with both alcohol intake and later-life cognition, we hypothesize that the observed relationship between alcohol intake and cognition may change when these variables or other conditions in early life have been controlled. Methods: We examined the relationship of alcohol intake and cognition at age 53 using the Wisconsin Longitudinal Study, which has followed Wisconsin high school graduates from 1957 to 1992. Our measures include cognitive ability test scores from the freshman and junior years of high school, educational attainment, an abstract reasoning test score at age 53, alcohol intake at age 53, and other measures. Results: When no controls were used, both men and women with low levels of alcohol consumption at 53 (i.e., 0-1 drink per day) had better scores on the abstract reasoning subtest of the Wechsler Adult Intelligence Scale (WAIS-R) at age 53 than subjects who never drank or currently did not drink. However, after adjusting for adolescent-measured cognitive ability and educational attainment, men with low levels of consumption no longer had higher abstract reasoning scores than nondrinking men, but they still did have higher abstract reasoning scores than men who drank more than one drink per day. For women, adjusting for cognitive ability and educational attainment eliminated all significant effects of alcohol on cognition, and reversed the nonsignificant result that women with higher consumption had the highest cognition scores. These results demonstrate the importance of adjusting for baseline cognitive ability when attempting to study the effect of long-term alcohol use patterns on cognition, and that educational attainment cannot be considered a valid substitute for baseline cognition scores. Conclusions: Much of the apparent benefit of moderate alcohol intake on cognition in our society may well be explained by differential rates of alcohol consumption among subjects with differing baseline cognitive ability scores. Neither is there evidence that moderate alcohol intake reduces cognitive functioning. C1 William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. Univ Wisconsin, Sch Med, Madison, WI USA. Univ Wisconsin, Dept Sociol, Madison, WI 53706 USA. Univ Wisconsin, Ctr Demog Hlth & Aging, Madison, WI 53706 USA. Univ Michigan, Dept Psychiat, Ann Arbor, MI 48109 USA. RP Krahn, D (reprint author), William S Middleton Mem Vet Adm Med Ctr, 2500 Overlook Terrace, Madison, WI 53705 USA. FU NIA NIH HHS [P01-AG21079-01, R01-AG09775-10] NR 22 TC 19 Z9 19 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUL PY 2003 VL 27 IS 7 BP 1162 EP 1166 DI 10.1097/01.ALC.0000078060.18662.C1 PG 5 WC Substance Abuse SC Substance Abuse GA 704RV UT WOS:000184354500016 PM 12878923 ER PT J AU Breitner, JCS AF Breitner, JCS TI Alzheimer disease in Turkey too SO ALZHEIMER DISEASE & ASSOCIATED DISORDERS LA English DT Editorial Material C1 VA Puget Sound Hlth Care Syst, GRECC S182, Seattle, WA 98108 USA. RP Breitner, JCS (reprint author), VA Puget Sound Hlth Care Syst, GRECC S182, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 1 TC 1 Z9 1 U1 0 U2 0 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 2003 VL 17 IS 3 BP 137 EP 138 DI 10.1097/00002093-200307000-00002 PG 2 WC Clinical Neurology; Pathology SC Neurosciences & Neurology; Pathology GA 728HP UT WOS:000185712000001 PM 14512825 ER PT J AU Ansari, M Alexander, M Tutar, A Massie, BM AF Ansari, M Alexander, M Tutar, A Massie, BM TI Incident cases of heart failure in a community cohort: Importance and outcomes of patients with preserved systolic function SO AMERICAN HEART JOURNAL LA English DT Article ID EJECTION FRACTION; PREVALENCE; PERFORMANCE; MORTALITY AB Background The clinical presentation and outcomes of patients with heart failure and preserved systolic function have not been well characterized in the outpatient setting. Methods This was a retrospective cohort study of 403 patients with new-onset heart failure in a large regional health maintenance organization between July 1996 and December 1996. The clinical characteristics and treatment of patients with preserved ejection fractions (PrEF; >45%) were compared with those of patients with with reduced left ventricular function (Low EF) after excluding patients with terminal comorbidities. The main outcome measure was the combination of death, cardiovascular (CV) hospitalization, or both, which was assessed for as long as 24 months (mean, 22 months) with proportional hazards models. Results Sixty-five patients (16%) did not have an assessment of left ventricular (LV) function. Of the remaining 338 patients, 191 (57%) had an EF <45% (Low EF group) and 147 (44%) had preserved LV function (PrEF group). Patients with PrEF tended to be older, more frequently women, have less coronary disease and myocardial infarction, and have more atria[ fibrillation and other comorbid conditions. They had higher systolic blood pressures and pulse pressures and slower heart rates than the patients with reduced LV function on initial presentation. Overall, mortality and CV hospitalization rates were similar in the 2 groups; however, on multivariate analysis, which took into account baseline differences between groups, low EF was a significant independent predictor of the combined end point (hazard ratio, 1.9; 95% Cl, 1.3-2.9). Conclusions Patients with preserved LV function constitute a significant portion of incident outpatient patients with heart failure and carry a better prognosis than patients with reduced LV function. C1 San Francisco VAMC, Cardiol Div 111C, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Kaiser Permanente Med Care Program, Div Res, Oakland, CA 94611 USA. Univ Calif San Francisco, Med Effectiveness Res Ctr, San Francisco, CA 94143 USA. Univ Calif San Francisco, Inst Cardiovasc Res, San Francisco, CA 94143 USA. RP Massie, BM (reprint author), San Francisco VAMC, Cardiol Div 111C, 4150 Clement St, San Francisco, CA 94121 USA. NR 14 TC 17 Z9 18 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0002-8703 J9 AM HEART J JI Am. Heart J. PD JUL PY 2003 VL 146 IS 1 BP 115 EP 120 DI 10.1016/S0002-8703(03)00123-6 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 703PV UT WOS:000184290900018 PM 12851618 ER PT J AU Eloubeidi, MA Mason, AC Desmond, RA El-Serag, HB AF Eloubeidi, MA Mason, AC Desmond, RA El-Serag, HB TI Temporal trends (1973-1997) in survival of patients with Esophageal adenocarcinoma in the United States: A glimmer of hope? SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID BARRETTS-ESOPHAGUS; RISING INCIDENCE; GASTRIC CARDIA; PATTERNS; CANCER; MEN AB OBJECTIVE: The incidence and mortality related to esophageal adenocarcinoma (EAC) has been rising in the United States. Meanwhile, the number of diagnostic and therapeutic procedures has increased in number and improved technologically. However, the impact of these advances on the survival of EAC in clinical practice remains unknown. METHODS: Patients with histologically proven EAC between 1973 and 1997 were identified in registries of the Surveillance, Epidemiology, and End Results database, and analyzed in 5-yr time periods. The observed and relative survival rates were calculated. The joint influence of the time of diagnosis, stage and grade of cancer, demographic features. surgical therapy, and radiotherapy were assessed in Cox proportional hazard survival analyses. RESULTS: Between 1973 and 1997, we identified 4835 patients with EAC. The 1-yr and 5-yr observed survival rates increased from 34% and 5% during 1973-1977 to 44% and 13% during 1993-1997 (p < 0.05). In the Cox survival analysis. the more recent year of diagnosis, early stage of tumor, younger age at presentation, receiving radiotherapy or surgery were independent predictors of reduced risk of mortality. The proportion of patients with in situ EAC and those with local spread increased progressively from 0.3% and 17.7% in 1973-1977 to 2.3% and 25.3%, respectively, in 1993-1997 (p < 0.05). The proportion of patients receiving radiation therapy either before or after surgery has increased from 7% in 1973-1977 to 16% in 1993-1997 (p < 0.05). CONCLUSIONS: The short- and long-term survival of patients with EAC has improved slightly in the United States over the past 25 yr. Some of the improvement may be related to an increase in the number of younger patients, and in cases with in situ and localized cancers. However, the overall survival of patients with EAC remains dismal. (C) 2003 by Am. Coll. of Gastroenterology. C1 Houston Vet Affairs Med Ctr 152, Sect Gastroenterol & Hlth Serv Res, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Univ Alabama, Gastroenterol Sect, Med Stat Sect, Birmingham, AL USA. Univ Alabama, Ctr Comprehens Canc, Birmingham, AL USA. Albuquerque Vet Affairs Med Ctr, Albuquerque, NM USA. Univ New Mexico, Albuquerque, NM 87131 USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr 152, Sect Gastroenterol & Hlth Serv Res, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 20 TC 139 Z9 141 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD JUL PY 2003 VL 98 IS 7 BP 1627 EP 1633 DI 10.1016/S0002-9270(03)00228-4 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 702GP UT WOS:000184216400029 PM 12873590 ER PT J AU Schneider, LS Katz, IR Park, S Napolitano, J Martinez, RA Azen, SP AF Schneider, LS Katz, IR Park, S Napolitano, J Martinez, RA Azen, SP TI Psychosis of Alzheimer disease - Validity of the construct and response to risperidone SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article AB Objective: The authors evaluated the efficacy of risperidone in reducing psychotic and aggressive symptoms in a subgroup of patients who fulfilled operationalized criteria for psychosis of dementia. Methods: Authors conducted a subgroup analysis of patients in the risperidone database arising from a previous double-blind, randomized, placebo-controlled study. In the primary study, patients age 55 or older, with a DSH-IV diagnosis of Alzheimer disease and/or vascular dementia were randomized to placebo or 0.5 mg, 1.0 mg, or 2.0 mg/day of risperidone. For this analysis, patients were selected who fulfilled operationalized criteria for psychosis of dementia. These criteria were then validated. The primary outcome measures were the newly developed Psychosis and Aggression Severity Indices, derived from Parts 1 and 2 of the BEHAVE-AD rating scale. Results: At Week 12 and endpoint, patients with psychosis of dementia receiving 1 mg or 2 mg/day of risperidone showed significantly more improvement on the Psychosis Severity and Aggressiveness Severity Indices than those receiving placebo. Conclusions: The construct of psychosis of dementia was validated, and the severity of both psychosis and aggressiveness was reduced with risperidone treatment in a robust and dose-related way, with a continuing response over the 12-week trial period. C1 Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, Dept Psychiat, Los Angeles, CA 90033 USA. Univ Penn, Dept Psychiat, Mental Illness Res Educ & Clin Ctr, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Janssen Res Fdn, Titusville, NJ USA. RP Azen, SP (reprint author), Univ So Calif, Keck Sch Med, Dept Prevent Med, 1540 Alcazar St,CHP-218, Los Angeles, CA 90033 USA. FU NIA NIH HHS [5 P50 AG5142]; NIMH NIH HHS [1 MH90001] NR 10 TC 30 Z9 30 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD JUL-AUG PY 2003 VL 11 IS 4 BP 414 EP 425 DI 10.1176/appi.ajgp.11.4.414 PG 12 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 702GM UT WOS:000184216200004 PM 12837670 ER PT J AU Wong-Beringer, A Liao, C Nguyen, M Pallares, J AF Wong-Beringer, A Liao, C Nguyen, M Pallares, J TI Applying patient selection criteria for drotrecogin alfa therapy in practice SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Article ID ACTIVATED PROTEIN-C; SEVERE SEPSIS; SYSTEM C1 Univ So Calif, Sch Pharm, Los Angeles, CA 90089 USA. Huntington Mem Hosp, Serv Pharm, Pasadena, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Western Univ, Coll Pharm, Pomona, CA USA. RP Wong-Beringer, A (reprint author), Univ So Calif, Sch Pharm, 1985 Zonal Ave, Los Angeles, CA 90089 USA. NR 10 TC 10 Z9 10 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 JUL 1 PY 2003 VL 60 IS 13 BP 1345 EP 1352 PG 8 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 699GB UT WOS:000184047400013 PM 12901037 ER PT J AU Cannon, JP Silverman, RM AF Cannon, JP Silverman, RM TI A pharmacist-driven antimicrobial approval program at a Veterans Affairs hospital SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Article; Proceedings Paper CT ASHP Midyear Clinical Meeting CY DEC 03-05, 2001 CL NEW ORLEANS, LOUISIANA SP ASHP ID OUTCOMES; EXPENDITURES AB Management Case Studies describe approaches to real-life management problems in health systems. Each installment is a brief description of a problem and how it was dealt with. The cases are intended to help readers deal with similar experiences in their own work sites. Problem solving, not hypothesis testing, is emphasized. Successful resolution of the management issue is not a criterion for publication-important lessons can be learned from failures, too. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Pharm Serv 119, Dept Pharm Serv, Hines, IL 60141 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Informat Management Serv, Hines, IL 60141 USA. RP Cannon, JP (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Pharm Serv 119, Dept Pharm Serv, Bldg 1,Room B106, Hines, IL 60141 USA. NR 16 TC 8 Z9 8 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 JUL 1 PY 2003 VL 60 IS 13 BP 1358 EP 1362 PG 5 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 699GB UT WOS:000184047400015 PM 12901039 ER PT J AU Ploth, DW Shepp, PH Counts, C Hutchison, F AF Ploth, DW Shepp, PH Counts, C Hutchison, F TI Prospective analysis of global costs for maintenance of patients with ESRD SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE costs of end-stage renal disease (ESRD); hemodialysis (HD); outcomes; hospital resource utilization ID STAGE RENAL-DISEASE; KIDNEY-DISEASE; HEMODIALYSIS; MORBIDITY; CARE AB Background. The prevalence of end-stage renal disease (ESRD) has doubled in the past decade, with total costs projected to exceed $16.5 billion by the end of 2002. Methods: The purpose of this prospective study is to determine all costs related to inpatient and outpatient health care utilization incurred by 76 patients with ESRD in an outpatient hemodialysis setting for 1 year. Costs were derived from a computer-based cost-allocation process that distributed cost components and overhead to designated revenue-producing departments. Results: During the 1-year study period, these patients had 1,459 total inpatient and outpatient hospital visits (mean, 19.2 visits/patient; range, 0 to 84 visits/patient). There were 149 general inpatient hospital admissions. Of 238 total emergency room visits, 89 visits resulted in admission to the hospital (37%). Conclusion: Total hospital costs for all patients for the year were $1,831,880 (actual charges, $2,929,147). As expected, the greatest hospital cost expenditures were attributed to inpatient hospital admissions ($1,419,022; 77.5% of total). Of total hospital costs, inpatient bed costs were the single highest expenditure. The cost for outpatient hemodialysis therapy was $33,784/patient-year, consisting of facility costs of $17,200, outpatient pharmacy costs of $14,100, and outpatient professional costs of $2,500/patient-year. Average costs for hospital facility and/or professional fees were $42,730/patient-year, whereas average costs for outpatient dialysis facility and/or professional fees were $33,784, for an estimated global cost of $76,515/patient-year. Our cost estimate for care of this unique inner-city population substantially exceeds those reported earlier by others. C1 Med Univ S Carolina, Div Nephrol, Charleston, SC 29425 USA. Med Univ S Carolina, MUSC Transplant Ctr, Charleston, SC 29425 USA. Dialysis Clin Inc, Charleston, SC USA. Ralph H Johnson Vet Adm Med Ctr, Charleston, SC USA. RP Ploth, DW (reprint author), Med Univ S Carolina, Div Nephrol, 96 Jonathan Lucas St,POB 250623, Charleston, SC 29425 USA. NR 15 TC 28 Z9 29 U1 0 U2 2 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD JUL PY 2003 VL 42 IS 1 BP 12 EP 21 DI 10.1016/S0272-6386(03)00404-9 PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 696MK UT WOS:000183890500003 PM 12830452 ER PT J AU Cornia, PB Raugi, GJ Miller, RA AF Cornia, PB Raugi, GJ Miller, RA TI Phialophora richardsiae bursitis treated medically SO AMERICAN JOURNAL OF MEDICINE LA English DT Letter ID INFECTION C1 Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Cornia, PB (reprint author), Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 8 TC 3 Z9 3 U1 0 U2 1 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD JUL PY 2003 VL 115 IS 1 BP 77 EP 79 DI 10.1016/S0002-9343(03)00287-0 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 700WV UT WOS:000184134900021 PM 12867246 ER PT J AU Dietrich, AJ Williams, JW Ciotti, MC Schulkin, J Stotland, N Rost, K Baram, D Cornell, J AF Dietrich, AJ Williams, JW Ciotti, MC Schulkin, J Stotland, N Rost, K Baram, D Cornell, J TI Depression care attitudes and practices of newer obstetrician-gynecologists: A national survey SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article DE depressive disorders; depression, postpartum; education, medical, graduate; obstetrics, gynecology ID RANDOMIZED CONTROLLED-TRIAL; PHYSICIANS; RESIDENTS AB OBJECTIVE: The study was undertaken to assess attitudes and behavior of newer obstetricians/gynecologists in depression care. STUDY DESIGN: One thousand randomly selected physicians in their final year of training or recent practice received a survey about depression: training; related attitudes, responsibility, confidence; and self-reported care for the last depressed patient. RESULTS: Of those eligible, 437 (64%) returned the survey Current residents reported more didactic mental health training, but practice patterns were similar to recent graduates. Overall, 94% felt responsible for recognition, whereas about half indicated asking about substance abuse, sexual abuse, or physical abuse, 37% expressed confidence in their ability to treat with medications, and 22% felt confident in their ability to manage depression overall. CONCLUSION: Residents are receiving more didactic mental health training, yet changes in training are not yet reflected in reported practice patterns or confidence. The use of antidepressant medications and assessment of contributing conditions such as abuse deserve more emphasis in training. C1 Dartmouth Coll Sch Med, Dept Community & Family Med, Hanover, NH 03755 USA. Duke Univ, Ctr Hlth Serv Res Primary Care, Durham, NC 27706 USA. Duke Univ, Durham Vet Affairs Med Ctr, Durham, NC 27706 USA. Duke Univ, Dept Med, Durham, NC 27706 USA. Univ Calif Davis, Dept Obstet & Gynecol, Davis, CA 95616 USA. Rush Med Coll, Amer Coll Obstetricians & Gynecologists, Chicago, IL 60612 USA. Rush Med Coll, Dept Psychiat, Chicago, IL 60612 USA. Rush Med Coll, Dept Obstet & Gynecol, Chicago, IL 60612 USA. Univ Colorado, Ctr Hlth Sci, Dept Family Med, Boulder, CO 80309 USA. HealthPartners Med Grp, Dept Obstet & Gynecol, San Antonio, TX USA. San Antonio Ctr Excellence Hlth Serv Res, San Antonio, TX USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Div Geriatr, San Antonio, TX USA. Univ Texas, Ctr Hlth Sci, San Antonio, TX USA. RP Dietrich, AJ (reprint author), Dartmouth Coll Sch Med, Dept Community & Family Med, 7250 Strasenburgh Hall, Hanover, NH 03755 USA. RI Williams, Jr., John/A-3696-2008 OI Williams, Jr., John/0000-0002-5267-5558 NR 21 TC 28 Z9 28 U1 0 U2 2 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD JUL PY 2003 VL 189 IS 1 BP 267 EP 273 DI 10.1067/mob.2003.410 PG 7 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 703TE UT WOS:000184296400047 PM 12861173 ER PT J AU Natarajan, S Glick, H Criqui, M Horowitz, D Lipsitz, SR Kinosian, B AF Natarajan, S Glick, H Criqui, M Horowitz, D Lipsitz, SR Kinosian, B TI Cholesterol measures to identify and treat individuals at risk for coronary heart disease SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID HIGH-DENSITY-LIPOPROTEIN; PRIMARY PREVENTION TRIAL; MYOCARDIAL-INFARCTION; HDL-CHOLESTEROL; PREDICTING RISKS; ARTERY DISEASE; MEN; THERAPY; TRIGLYCERIDE; PRAVASTATIN AB Background: Low-density lipoprotein (LDL)-based guidelines are currently used to initiate and monitor cholesterol-lowering therapy. Methods: Using stratified analyses, data from the Framingham Heart Study and the Coronary Primary Prevention Trial were evaluated to determine whether (1) cholesterol levels total cholesterol [TC] or LDL [low-density lipoprotein]) better discriminated risk for coronary heart disease (CHD) than cholesterol ratios (LDL/HDL [high-density lipoprotein] or TC/HDL); and (2) whether changes in ratios better predicted risk reduction than changes in levels. Results: Individuals with similar LDL/HDL ratios had similar risks for CHD regardless of whether they had high LDL levels or low LDL levels (23% vs 23% for the CPPT, 13.8% vs 14% for FHS men, and 8.6% vs 10.9% for FHS women). Among men with similar initial LDL/HDL ratios and similar changes in LDL/HDL ratios, risks for CHD did not differ (20.3% compared with 21.0%; p =0.96) between those with the largest and smallest reductions in LDL levels (21.3% compared with 6.5%). Among men with similar initial LDL levels and similar LDL reductions, a 20% reduction in risk for CHD was seen (19.5% compared with 24.5%; p =0.005) between those with the largest and smallest reductions in LDL/HDL ratios (23% compared with 4.6%). TC/HDL had predictive ability similar to LDL/HDL. Conclusions: Cholesterol levels do not provide incremental predictive value over cholesterol ratios in identifying people at risk for CHD. Changes in ratios are better predictors of successful CHD risk reduction than changes in levels. Future guidelines should consider incorporating ratios in initiating and monitoring successful lipid-lowering therapy. C1 NYU, Sch Med, New York, NY USA. VA New York Harbor Healthcare Syst, Dept Med, New York, NY USA. Univ Penn, Med Ctr, Div Gen Internal Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Calif San Diego, Dept Family & Prevent Med, San Diego, CA 92103 USA. Med Univ S Carolina, Dept Biometry & Epidemiol, Charleston, SC 29425 USA. RP Natarajan, S (reprint author), 423 E 23rd St,Room 11101-S, New York, NY 10010 USA. FU NHLBI NIH HHS [HL61769]; NIA NIH HHS [R-29-AG09837] NR 36 TC 81 Z9 81 U1 0 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD JUL PY 2003 VL 25 IS 1 BP 50 EP 57 DI 10.1016/S0749-3797(03)00092-8 PG 8 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 693GM UT WOS:000183708800008 PM 12818310 ER PT J AU Grossman, R Yehuda, R New, A Schmeidler, J Silverman, J Mitropoulou, V Maria, NS Golier, J Siever, L AF Grossman, R Yehuda, R New, A Schmeidler, J Silverman, J Mitropoulou, V Maria, NS Golier, J Siever, L TI Dexamethasone suppression test findings in subjects with personality disorders: Associations with posttraumatic stress disorder and major depression SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID CORTISOL EXCRETION; PLASMA-CORTISOL; PHYSICAL ABUSE; GLUCOCORTICOID-RECEPTORS; BORDERLINE PATIENTS; BASAL CORTISOL; 17-OHCS LEVELS; CHILDHOOD; WOMEN; ILLNESS AB Objective: Previous studies using the 1.0-mg dexamethasone suppression test (DST) in subjects with personality disorders have produced mixed results. However, these studies focused on major depression and did not consider the possible effects of the comorbidity of posttraumatic stress disorder (PTSD). PTSD has been shown to be associated with increased cortisol suppression. To investigate the effect of PTSD, the authors conducted a 0.5-mg DST, which is more sensitive than the 1.0-mg DST for detection of increased cortisol suppression, in a group of subjects with personality disorders. Method: Subjects with personality disorders (N=52) ingested 0.5 mg of dexamethasone. Pre- and postfasting blood samples were drawn for measurement of cortisol levels. A three-way analysis of covariance was used to test for the main effects of major depression, PTSD, and gender on percent cortisol suppression, with plasma dexamethasone concentration as a covariate. Secondary analyses assessed for main and interaction effects of age at which trauma(s) occurred and a diagnosis of borderline personality disorder. Results: Neither major depression nor gender had a significant effect on percent cortisol suppression. Subjects with PTSD had significantly higher percent cortisol suppression than subjects with major depression. Age at which trauma(s) occurred and a borderline personality disorder diagnosis had no significant main or interaction effects on cortisol suppression. Conclusions: A high level of cortisol suppression was associated with PTSD in subjects with personality disorder. This finding is similar to published findings for PTSD subjects without personality disorders. Major depression, gender, age when trauma(s) occurred, and a diagnosis of borderline personality disorder did not have significant main or interaction effects on cortisol suppression. C1 CUNY, Mt Sinai Med Ctr, Dept Psychiat, New York, NY 10029 USA. CUNY, Mt Sinai Med Ctr, Dept Biomath Sci, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Dept Psychiat, Bronx, NY USA. Univ Pittsburgh, Dept Psychol, Med Ctr, Pittsburgh, PA USA. RP Grossman, R (reprint author), CUNY, Mt Sinai Med Ctr, Dept Psychiat, Box 1230, New York, NY 10029 USA. FU NCRR NIH HHS [5-M01-RR-0071]; NIMH NIH HHS [MH-49555, MH-58697-01] NR 44 TC 46 Z9 46 U1 1 U2 5 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD JUL PY 2003 VL 160 IS 7 BP 1291 EP 1297 DI 10.1176/appi.ajp.160.7.1291 PG 7 WC Psychiatry SC Psychiatry GA 697RN UT WOS:000183957200014 PM 12832244 ER PT J AU Calsyn, DA DeMarco, FJ Saxon, AJ Sloan, KL Gibbon, KE AF Calsyn, DA DeMarco, FJ Saxon, AJ Sloan, KL Gibbon, KE TI Evaluation of a minimal services treatment track for noncompliant patients in opioid substitution treatment SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID METHADONE-MAINTENANCE TREATMENT C1 VA Puget Sound HCS, Addict Treatment Ctr, Seattle, WA 98108 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. Univ Washington, Sch Pharm, Seattle, WA 98195 USA. RP Calsyn, DA (reprint author), VA Puget Sound HCS, Addict Treatment Ctr, MS-116DDTP,1660 S Columbian Way, Seattle, WA 98108 USA. NR 12 TC 8 Z9 8 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JUL PY 2003 VL 93 IS 7 BP 1086 EP 1088 DI 10.2105/AJPH.93.7.1086 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 695JK UT WOS:000183827200030 PM 12835190 ER PT J AU Gray, SL Hedrick, SC Rhinard, EE Sales, AE Sullivan, JH AF Gray, SL Hedrick, SC Rhinard, EE Sales, AE Sullivan, JH TI Potentially inappropriate medication use in community residential care facilities SO ANNALS OF PHARMACOTHERAPY LA English DT Article DE community residential care; drug utilization; elderly ID DRUG-USE; EXPLICIT CRITERIA; BOARD AB Objective: To describe the prevalence of potentially inappropriate medication use in community residential care (CRC) facilities at baseline, describe exposure to potentially inappropriate drugs during the 1-year follow-up, and examine characteristics associated with potentially inappropriate use. Design: A cohort study was conducted using 282 individuals aged greater than or equal to65 years entering a CRC facility in a 3-county area in the Puget Sound region of Washington State between April 1998 and December 1998 on Medicaid funding. Main Outcome Measure: Use of potentially inappropriate medications as defined by explicit criteria (e.g., drugs that should generally be avoided in the elderly because potential risks outweigh any potential benefits). Results: Sixty-two (22%) residents took a total of 75 potentially inappropriate medications at baseline. The most common agents used at baseline were oxybutynin (3.5%) and amitriptyline (3.5%). The incidence of new use of potentially inappropriate medications was 0.1/100 person-days during the follow-up period. Potentially inappropriate use was related to self-reported fair or poor health (adjusted OR 1.42; 95% CI 1.05 to 1.92) and number of prescription drugs (adjusted OR 1.12; 95% CI 1.05 to 1.19). In the Cox proportional hazard model, no characteristics predicted new potentially inappropriate medication use during the follow-up. Conclusions: Potentially inappropriate medication use is common among residents in CRC facilities. A comprehensive periodic review may be beneficial for reducing potentially inappropriate use, especially for patients taking multiple drugs. C1 Univ Washington, Sch Pharm, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Ctr Excellence, Seattle, WA USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. RP Gray, SL (reprint author), Univ Washington, Sch Pharm, Box 357630, Seattle, WA 98195 USA. OI Sales, Anne/0000-0001-9360-3334 FU NIA NIH HHS [KO8AG00808-01] NR 25 TC 23 Z9 24 U1 0 U2 1 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 JUL-AUG PY 2003 VL 37 IS 7-8 BP 988 EP 993 DI 10.1345/aph.1C365 PG 6 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 699VC UT WOS:000184075800008 PM 12841805 ER PT J AU Pennick, GJ Clark, M Sutton, DA Rinaldi, MG AF Pennick, GJ Clark, M Sutton, DA Rinaldi, MG TI Development and validation of a high-performance liquid chromatography assay for voriconazole SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID PLASMA AB An analytical method for the determination of voriconazole (UK-109,496; Pfizer) in plasma was developed and validated. The method utilizes solid-phase extraction technology and high-performance liquid chromatography. The lower limit of quantitation is 0.2 mug/ml, and the range of linearity tested was 0.2 to 10 mug/ml. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, Fungus Testing Lab, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie Murphy Div, San Antonio, TX USA. Pfizer Ltd, Sandwich CT13 9NJ, Kent, England. RP Pennick, GJ (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, Fungus Testing Lab, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 6 TC 95 Z9 99 U1 0 U2 3 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD JUL PY 2003 VL 47 IS 7 BP 2348 EP 2350 DI 10.1128/AAC.47.7.2348-2350.2003 PG 3 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 694RA UT WOS:000183786700049 PM 12821496 ER PT J AU Doney, K Hagglund, H Leisenring, W Chauncey, T Appelbaum, FR Storb, R AF Doney, K Hagglund, H Leisenring, W Chauncey, T Appelbaum, FR Storb, R TI Predictive factors for outcome of allogeneic hematopoietic cell transplantation for adult acute lymphoblastic leukemia SO BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION LA English DT Article DE acute lymphoblastic leukemia; hematopoietic cell transplantation; adults; Philadelphia chromosome ID BONE-MARROW-TRANSPLANTATION; GRAFT-VERSUS-LEUKEMIA; HOST-DISEASE; CYTOGENETIC ABNORMALITIES; FOLLOW-UP; REMISSION; CANCER; IMMUNOPHENOTYPE; CHEMOTHERAPY; SURVIVAL AB Between January 1990 and December 1997, 182 adults with acute lymphoblastic leukemia (ALL) received allogeneic hematopoietic cell transplants according to Fred Hutchinson Cancer Research Center protocols. Patients eligible for transplantation included those in first remission, especially those at high risk of relapse (n = 41), and any patient in second or later remissions (n = 46) or in relapse (n = 95). The median patient age was 29.4 years (range, 18.0-57.6 years), and the median duration of disease was 13.3 months (range, 2.4-221.9 months). Fifty-six patients had Philadelphia chromosome-positive ALL. Most patients (n = 169) received a conditioning regimen of cyclophosphamide 120 mg/kg plus 12.0 to 15.75 Gy of total body irradiation and a combination of cyclosporine and methotrexate as graft-versus-host disease (GVHD) prophylaxis. One hundred twenty-one patients received stem cells from HLA-identical donors (88 related donors and 33 unrelated donors), and 61 received stem cells from HLA-mismatched donors (26 related donors and 35 unrelated donors). Actuarial disease-free survival at 5 years was 21% for all patients, 43% for patients in first remission, 24% for patients in second or later remissions, and 9% for patients in relapse. Univariate and multivariate Cox regression analyses were performed to identify factors associated with survival, relapse, nonrelapse mortality, and disease-free survival. Factors significantly associated (P <.01) with improved survival and disease-free survival included younger age and being in first remission. Lower disease-free survival was associated with receiving cyclosporine alone as GVHD prophylaxis (P <.01). Risk of relapse correlated only with disease status at transplantation: patients who underwent transplantation in relapse had a 9-fold increased risk compared with patients who underwent transplantation in first remission. Acute or chronic GVHD had no significant effect on relapse. Increased nonrelapse mortality was associated with HLA-mismatched donors, a positive cytomegalovirus serology before transplantation, and GVHD prophylaxis with only cyclosporine. Patients with Philadelphia chromosome-positive ALL had survival and relapse rates similar to patients with normal cytogenetics. (C) 2003 American Society fir Blood and Marrow Transplantation. C1 Univ Washington, Fred Hutchinson Canc Res Ctr, Div Clin Res, Med Ctr, Seattle, WA 98109 USA. Huddinge Univ Hosp, Stockholm, Sweden. Vet Affairs Puget Sound Healthcare Syst, Seattle, WA USA. RP Doney, K (reprint author), Univ Washington, Fred Hutchinson Canc Res Ctr, Div Clin Res, Med Ctr, 1100 Fairview Ave N,D5-280,POB 19024, Seattle, WA 98109 USA. FU NCI NIH HHS [CA 18029, CA 15704, CA 18221] NR 34 TC 46 Z9 51 U1 0 U2 0 PU CARDEN JENNINGS PUBL CO LTD PI CHARLOTTESVILLE PA BLAKE CTR, STE 200, 1224 W MAIN ST, CHARLOTTESVILLE, VA 22903 USA SN 1083-8791 J9 BIOL BLOOD MARROW TR JI Biol. Blood Marrow Transplant. PD JUL PY 2003 VL 9 IS 7 BP 472 EP 481 DI 10.1016/S1083-8791(03)00149-6 PG 10 WC Hematology; Immunology; Transplantation SC Hematology; Immunology; Transplantation GA 708AR UT WOS:000184544600007 PM 12869961 ER PT J AU Thannickal, TC Siegel, JM Nienhuis, R Moore, RY AF Thannickal, TC Siegel, JM Nienhuis, R Moore, RY TI Pattern of hypocretin (orexin) soma and axon loss, and gliosis, in human narcolepsy SO BRAIN PATHOLOGY LA English DT Article ID HISTAMINE-CONTAINING NEURONS; RAT-BRAIN; LOCUS-COERULEUS; MUSCLE TONE; HYPOTHALAMUS; RECEPTOR; PEPTIDES; WAKEFULNESS; CATAPLEXY; MUTATION AB Human narcolepsy is correlated with a greatly reduced number of hypocretin (orexin) containing neurons and axons, and an elevated level of hypothalamic gliosis. We now report that the percentage loss of Hcrt cells and percentage elevation of GFAP staining are variable across forebrain and brain-stem nuclei, and are maximal in the posterior and tuberomammillary hypothalamic region. Regional gliosis and percent loss of hypocretin axons in narcoleptics are not correlated with regional hypocretin cell soma density in normals or with regional percent soma loss in narcoleptics. Rather they are independently and strongly correlated with the regional density of hypocretin axons and the message density for hypocretin receptor 2, as quantified in the rat. These results are consistent with the hypotheses that the loss of hypocretin function in narcolepsy results from a cytotoxic or immunologically mediated attack focused on hypocretin receptor 2 or an antigen anatomically linked to hypocretin receptor 2, and that this process is intensified in regions of high axonal density. C1 Univ Calif Los Angeles, Dept Psychiat, North Hills, CA 91343 USA. VA Greater Los Angeles Healthcare Syst, Neurobiol Res, North Hills, CA 91343 USA. Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15260 USA. RP Siegel, JM (reprint author), Univ Calif Los Angeles, Dept Psychiat, North Hills, CA 91343 USA. EM jsiegel@ucla.edu FU NHLBI NIH HHS [HL41370]; NIMH NIH HHS [MH64109]; NINDS NIH HHS [NS14610] NR 54 TC 81 Z9 84 U1 0 U2 5 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1015-6305 J9 BRAIN PATHOL JI Brain Pathol. PD JUL PY 2003 VL 13 IS 3 BP 340 EP 351 PG 12 WC Clinical Neurology; Neurosciences; Pathology SC Neurosciences & Neurology; Pathology GA 744EC UT WOS:000186614100010 PM 12946023 ER PT J AU Plaskon, LA Penson, DF Vaughan, TL Stanford, JL AF Plaskon, LA Penson, DF Vaughan, TL Stanford, JL TI Cigarette smoking and risk of prostate cancer in middle-aged men SO CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION LA English DT Article ID HEALTHY MEDICAL-STUDENTS; EPSTEIN-BARR-VIRUS; BREAST-CANCER; PSYCHOLOGICAL DISTRESS; NEGATIVE AFFECTIVITY; OVARIAN-CANCER; DNA-REPAIR; STRESS; PSYCHONEUROIMMUNOLOGY; WOMEN AB Cigarette smoking may increase the risk of prostate cancer by affecting circulating hormone levels or through exposure to carcinogens. Although there are plausible mechanisms that could explain an association between smoking and prostate cancer, previous studies are inconsistent. The goal of this population-based case-control study was to assess this association in middle-aged men. Cases (n = 753) were men ages 40-64 years diagnosed with prostate cancer from 1993 to 1996 identified using the Seattle-Puget Sound Cancer Registry. Age-matched controls without prostate cancer from the same region (n = 703) were identified using random digit dialing. Participants completed detailed in-person interviews. Logistic regression was used to compute adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to assess the prostate cancer-cigarette smoking relationship. Current smokers had an increased risk (OR = 1.4, 95% CI 1.0-2.0) relative to nonsmokers. A dose-response relationship was noted between number of pack-years smoked and prostate cancer risk (trend P = 0.03). The OR = 1.6 (95% CI 1.1-2.2) for men with >40 pack-years of smoking, with a stronger association observed in men with more aggressive disease (OR = 2.0, 95% CI 1.3-3.1). Smoking cessation resulted in a decline in risk (trend P = 0.02). Smoking is associated with a moderately increased relative risk of prostate cancer. Furthermore, a dose-response relationship exists between number of pack-years smoked and cancer risk. Given that smoking cessation seems to reduce these risks, results from this study have public health ramifications and suggest that prostate cancer should be added to the list of tumors for which cigarette smoking is a risk factor. C1 Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Program Epidemiol, Seattle, WA 98109 USA. Univ Washington, Dept Urol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Stanford, JL (reprint author), Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Program Epidemiol, 1100 Fairview Ave N,MW-814, Seattle, WA 98109 USA. FU NCI NIH HHS [N01-CN-05230, CA56678]; NIDDK NIH HHS [T32 DK007721] NR 37 TC 54 Z9 56 U1 1 U2 1 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 1055-9965 J9 CANCER EPIDEM BIOMAR JI Cancer Epidemiol. Biomarkers Prev. PD JUL PY 2003 VL 12 IS 7 BP 604 EP 617 PG 14 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 703YW UT WOS:000184311700004 PM 12869398 ER PT J AU Gould, KL Carabello, BA AF Gould, KL Carabello, BA TI Why angina in aortic stenosis with normal coronary arteriograms? SO CIRCULATION LA English DT Editorial Material DE editorials; stenosis; angina; myocardium; hypertrophy ID LEFT-VENTRICULAR HYPERTROPHY; BLOOD-FLOW; VALVE REPLACEMENT; PECTORIS; ARTERIES; MECHANISMS; REGRESSION; PERFUSION; PRESSURE; ISCHEMIA C1 Baylor Coll Med, Houston Vet Affairs Med Ctr, Dept Med, Med Serv 111, Houston, TX 77030 USA. Univ Texas, Sch Med, Dept Internal Med, Div Cardiol, Houston, TX USA. RP Carabello, BA (reprint author), Baylor Coll Med, Houston Vet Affairs Med Ctr, Dept Med, Med Serv 111, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 18 TC 38 Z9 39 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD JUL 1 PY 2003 VL 107 IS 25 BP 3121 EP 3123 DI 10.1161/01.CIR.0000074243.02378.80 PG 3 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 696KY UT WOS:000183887100002 PM 12835405 ER PT J AU Virella, G Lopes-Virella, MF AF Virella, G Lopes-Virella, MF TI Lipoprotein autoantibodies: Measurement and significance SO CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY LA English DT Article ID LOW-DENSITY-LIPOPROTEIN; CORONARY-ARTERY-DISEASE; CONTAINING IMMUNE-COMPLEXES; ADVANCED GLYCATION ENDPRODUCTS; MONOCYTE-DERIVED MACROPHAGES; DEPENDENT DIABETES-MELLITUS; MODIFIED LDL ANTIBODIES; OXIDIZED LDL; CAROTID ATHEROSCLEROSIS; HEART-DISEASE C1 Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Endocrinol Metab Nutr, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Virella, G (reprint author), Med Univ S Carolina, Dept Microbiol & Immunol, 173 Ashley Ave,POB 250504, Charleston, SC 29425 USA. FU NHLBI NIH HHS [P01 HL055782, HL-55782] NR 75 TC 38 Z9 40 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 1071-412X J9 CLIN DIAGN LAB IMMUN JI Clin. Diagn. Lab. Immunol. PD JUL PY 2003 VL 10 IS 4 BP 499 EP 505 DI 10.1128/CDLI.10.4.499-505.2003 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 703MU UT WOS:000184284100001 PM 12853376 ER PT J AU Malik, SN Siu, LL Rowinsky, EK DeGraffenried, L Hammond, LA Rizzo, L Bacus, S Brattain, MG Kreisberg, JI Hidalgo, M AF Malik, SN Siu, LL Rowinsky, EK DeGraffenried, L Hammond, LA Rizzo, L Bacus, S Brattain, MG Kreisberg, JI Hidalgo, M TI Pharmacodynamic evaluation of the epidermal growth factor receptor inhibitor OSI-774 in human epidermis of cancer patients SO CLINICAL CANCER RESEARCH LA English DT Article; Proceedings Paper CT 37th Annual Meeting of the American-Society-of-Clinical-Oncology CY MAY 12-15, 2001 CL SAN FRANCISCO, CALIFORNIA SP Amer Soc Clin Oncol ID EGF RECEPTOR; TYROSINE KINASE; ANTIBODY C225; PHASE-I; FAMILY; CP-358,774; CISPLATIN; THERAPY AB Background: OSI-774 is an inhibitor of the epidermal growth factor receptor tyrosine kinase (EGFR-TK) currently in clinical development. In preclinical models, the antitumor activity of OSI-774 was directly related to its ability to inhibit the EGFR-TK. On the basis of these data, we hypothesized that inhibition of the EGFR-TK will be required for this agent to be effective in the clinic. This study evaluated the pharmacodynamic effects of OSI-774 in normal skin tissues collected from patients treated with the agent in a Phase I study. Methods: Patients with advanced cancer who were treated in a Phase I study of OSI-774 underwent a biopsy of normal skin epidermis at baseline and after the last dose of drug in the first course of treatment. The expression and activation of the EGFR, downstream signaling extracyto-plasmatic-regulated kinase (Erk), and cell cycle regulator p27 were determined in paraffin-embedded skin tissues using an immunohistochemical method (IHC). The IHC data were analyzed using both a semiquantitative scoring system and an automatic absorbance quantitative IHC method. The number of cells with nuclear staining of p27 per 500 cells was determined. Plasma samples were collected to quantitate OSI-774 plasma concentrations. Results: A total of 56 skin specimens was collected from 28 patients treated with OSI-774 at doses ranging from 25 to 200 mg/day. There was a significant decrease in phospho-EGFR (Tyr 1173) expression as determined semiquantitatively with OSI-774 treatment [2.75 +/- 0.51 (mean +/- SD) pretreatment versus 2.36 +/- 0.76 after treatment, pair comparison P = 0.01]. The quantitative ratio [(phopho-EGFR/ EGFR) x 100] of phospho-EGFR (Tyr1173) decreased from 64.16 +/- 36.58 pretreatment to 48.87 +/- 35.37 post-treatment (pair comparison, P = 0.02). No significant differences were observed in phospho-Erk (Thr202/Tyr2O4) expression. The mean number of cells with nuclear staining for p27 increased from 185 +/- 101 (mean +/- SD) pretreatment to 253 +/- 111 post-treatment (pair comparison P = 0.02). A total of 12 (42.8%), 7 (25%), and 14 (50%) patients had >25% variation in the ratio of phospho-EGFR (Tyr1173), phospho-Erk (Thr202/Tyr2O4), and p27 expression, respectively. Only changes in p27 expression were related to the administered dose of OSI-774. Conclusions: OSI-774 exerted pharmacodynamic effects in skin tissues of 30-50% of patients treated with the agent. Up-regulation of p27, which is a downstream effect of EGFR inhibition, was dose related. Although there was a significant decrement in phospho-EGFR (Tyr1173), it was not related to the administered dose of OSI-774. On the basis of these findings and the relatively simple and reliable method to measure p27 expression, this biomarker appears to be the most promising and is being evaluated in Phase II studies as a predictor of clinical outcome. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78285 USA. Canc Therapy & Res Ctr S Texas, Inst Drug Dev, San Antonio, TX 78229 USA. Ventana QDL Inc, Chicago, IL USA. RP Hidalgo, M (reprint author), Johns Hopkins Univ, Sidney Kimmel Comprehens Canc Ctr, 1650 Orleans St,Room 1M88, Baltimore, MD 21231 USA. RI HIDALGO, MANUEL/I-4995-2015 OI HIDALGO, MANUEL/0000-0002-3765-3318 NR 20 TC 96 Z9 106 U1 1 U2 3 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 1078-0432 J9 CLIN CANCER RES JI Clin. Cancer Res. PD JUL PY 2003 VL 9 IS 7 BP 2478 EP 2486 PG 9 WC Oncology SC Oncology GA 700JK UT WOS:000184108700014 PM 12855621 ER PT J AU Ioannou, GN Kowdley, KV AF Ioannou, George N. Kowdley, Kris V. TI Iron, HFE Mutations, and Hepatocellular Carcinoma: Is Hepatic Iron a Carcinogen? SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Editorial Material ID HEREDITARY HEMOCHROMATOSIS; H63D MUTATIONS; CANCER RISK; LIVER IRON; CIRRHOSIS; POPULATION; C282Y; GENE; PREVALENCE; OVERLOAD C1 [Ioannou, George N.; Kowdley, Kris V.] Univ Washington, Sch Med, Dept Med, Div Gastroenterol, Seattle, WA 98195 USA. [Ioannou, George N.] Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA USA. RP Ioannou, GN (reprint author), Univ Washington, Sch Med, Dept Med, Div Gastroenterol, Seattle, WA 98195 USA. NR 24 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 1542-3565 J9 CLIN GASTROENTEROL H JI Clin. Gastroenterol. Hepatol. PD JUL PY 2003 VL 1 IS 4 BP 246 EP 248 DI 10.1016/S1542-3565(03)00126-5 PG 3 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA V19KJ UT WOS:000208071000002 PM 15017663 ER PT J AU Sam, R Chebrolu, B Reyes, CV Pierce, KL Molnar, Z Dhand, R Ing, TS AF Sam, R Chebrolu, B Reyes, CV Pierce, KL Molnar, Z Dhand, R Ing, TS TI Transjugular renal biopsy in an unconscious patient maintained on mechanical ventilation SO CLINICAL NEPHROLOGY LA English DT Article DE transjugular renal biopsy; unconsciousness; mechanical ventilation ID LIVER-DISEASE; EXPERIENCE AB Aim: Transjugular renal biopsy is a relatively new technique that has often been applied to patients with concomitant renal and liver diseases. It is believed that with this particular biopsy approach, one can avoid the high risk of conventional renal biopsy-related bleeding in patients who also often suffer from coagulopathy. However, other indications for this procedure have not been clearly defined. Herein, we describe an unconscious patient afflicted with acute renal failure and maintained on mechanical ventilation in whom the performance of a renal biopsy was deemed necessary. Methods: The transjugular renal biopsy technique was carried out because this unconscious patient could not follow breathing instructions for a conventional biopsy to be performed. Also, it would have been difficult for the patient to lay prone during the conventional biopsy procedure. Results: A total of 7 glomeruli were obtained and a diagnosis of vasculitis-related necrotizing glomerulonephritis and acute tubular necrosis was made. Subsequently, the patient was treated successfully with steroid therapy. Conclusion: Transjugular kidney biopsy should be considered in unconscious renal biopsy-requiring patients maintained on mechanical ventilation. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Dept Med, Hines, IL 60141 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Dept Radiol, Hines, IL 60141 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Dept Pathol, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Maywood, IL 60153 USA. Cook Cty Hosp, Chicago, IL 60612 USA. RP Ing, TS (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Dept Med, Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. NR 18 TC 3 Z9 3 U1 0 U2 0 PU DUSTRI-VERLAG DR KARL FEISTLE PI OBERHACHING PA BAJUWARENRING 4, D-82041 OBERHACHING, GERMANY SN 0301-0430 J9 CLIN NEPHROL JI Clin. Nephrol. PD JUL PY 2003 VL 60 IS 1 BP 53 EP 57 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 696KU UT WOS:000183886700009 PM 12872859 ER PT J AU George, MS Nahas, Z Kozel, FA Li, XB Yamanaka, K Mishory, A Bohning, DE AF George, MS Nahas, Z Kozel, FA Li, XB Yamanaka, K Mishory, A Bohning, DE TI Mechanisms and the current state of transcranial magnetic stimulation SO CNS SPECTRUMS LA English DT Review ID OBSESSIVE-COMPULSIVE DISORDER; POSTTRAUMATIC-STRESS-DISORDER; LEFT PREFRONTAL CORTEX; HUMAN CEREBRAL-CORTEX; LONG-TERM DEPRESSION; MAJOR DEPRESSION; MOTOR CORTEX; SLEEP-DEPRIVATION; ELECTROCONVULSIVE-THERAPY; DOUBLE-BLIND AB Transcranial magnetic stimulation (TMS) is unique among the current brain stimulation techniques because it is relatively non-invasive. TMS markedly differs from vagus nerve stimulation, deep brain stimulation and magnetic seizure therapy, all of which require either an implanted prosthesis or general anesthesia, or both. Since its rebirth in its modern form in 1985, TMS has already shown potential usefulness in at least three important domains-as a basic neuroscience research instrument, as a potential clinical diagnostic tool, and as a therapy for several different neuropsychiatric conditions. The TMS scientific literature has now expanded beyond what a single summary article can adequately cover. This review highlights several new developments in combining TMS with functional brain imaging, using TMS as a psychiatric therapy, potentially using TMS to enhance performance, and finally recent advances in the core technology of TMS. TMS' ability to non-invasively and focally stimulate the brain of an awake human is proving to be a most important development for neuroscience in general, and neuropsychiatry in particular. C1 Med Univ S Carolina, Dept Psychiat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Neurol, Charleston, SC 29425 USA. Med Univ S Carolina, Brain Stimulat Lab, Charleston, SC 29425 USA. Med Univ S Carolina, Ctr Adv Imaging Res, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP George, MS (reprint author), Med Univ S Carolina, Dept Psychiat, 502 N IOP,67 President St, Charleston, SC 29425 USA. RI Kozel, Frank/I-5366-2012 FU NIA NIH HHS [R01-AG40956] NR 151 TC 59 Z9 62 U1 3 U2 7 PU M B L COMMUNICATIONS, INC PI NEW YORK PA 333 HUDSON ST, 7TH FLOOR, NEW YORK, NY 10013 USA SN 1092-8529 J9 CNS SPECTR JI CNS Spectr. PD JUL PY 2003 VL 8 IS 7 BP 496 EP + PG 11 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 710MM UT WOS:000184684000014 PM 12894031 ER PT J AU Keck, PE McElroy, SL Havens, JR Altshuler, LL Nolen, WA Frye, MA Suppes, T Denicoff, KD Kupka, R Leverich, GS Rush, AJ Post, RM AF Keck, PE McElroy, SL Havens, JR Altshuler, LL Nolen, WA Frye, MA Suppes, T Denicoff, KD Kupka, R Leverich, GS Rush, AJ Post, RM TI Psychosis in bipolar disorder: Phenomenology and impact on morbidity and course of illness SO COMPREHENSIVE PSYCHIATRY LA English DT Article ID FOLLOW-UP; MOOD-CONGRUENT; SYMPTOMS; UNIPOLAR; MANIA; SCHIZOPHRENIA; FAMILY; PREDICTION; DIAGNOSIS; FEATURES AB Although psychosis is common in bipolar disorder, few studies have examined the prognostic significance of psychotic features. In addition, some studies suggest that the presence of mood-incongruent psychosis, in particular, is associated with poorer outcome compared with mood-congruent psychosis. We assesses the phenomenology and prevalence of mood-congruent and mood-incongruent psychotic symptoms in 352 patients with bipolar I disorder participating in the Stanley Foundation Bipolar Treatment Network. We compared the demographic and clinical features, and measures of psychosocial and vocational functioning in patients with and without a history of psychosis. The phenomenology of psychosis in this cohort of patients with bipolar disorder was similar to that reported in earlier studies and supported the lack of diagnostic specificity of any one type of psychotic symptom. There were no significant differences between patients with and without a history of psychosis on any demographic, psychosocial, vocational, or course of illness variables. Only family history of bipolar disorder was significantly more common in patients with nonpsychotic bipolar disorder compared to patients with a history of psychosis. Among bipolar patients with a history of psychosis, only the proportion of women and lifetime prevalence rates of anxiety disorders occurred significantly more in patients with mood-incongruent delusions. In this large cohort of outpatients with bipolar I disorder, neither a history of psychosis nor of mood-incongruent psychosis had prognostic significance at entry into the Network. The lack of observable prognostic impact may have been, in part, due to the relatively high morbidity and poor functional outcome of a substantial portion of the total cohort. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Cincinnati, Coll Med, Dept Psychiat, Biol Psychiat Program, Cincinnati, OH 45267 USA. Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. SW Med Ctr, Dallas, TX USA. NIMH, Biol Psychiat Branch, Bethesda, MD 20892 USA. Univ Utrecht, Ctr Med, Altrecht Inst Mental Hlth Care, Utrecht, Netherlands. RP Keck, PE (reprint author), Univ Cincinnati, Coll Med, Dept Psychiat, Biol Psychiat Program, 231 Albert Sabin Way,ML 559, Cincinnati, OH 45267 USA. RI Nolen, Willem/E-9006-2014 OI Rush, Augustus/0000-0003-2004-2382 FU NIMH NIH HHS [R01 MH079261] NR 34 TC 82 Z9 86 U1 2 U2 7 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0010-440X J9 COMPR PSYCHIAT JI Compr. Psychiat. PD JUL-AUG PY 2003 VL 44 IS 4 BP 263 EP 269 DI 10.1016/S0010-440X(03)00089-0 PG 7 WC Psychiatry SC Psychiatry GA 703YV UT WOS:000184311600001 PM 12923703 ER PT J AU Freytes, CO AF Freytes, CO TI Thromboembolic complications related to indwelling central venous catheters in children SO CURRENT OPINION IN ONCOLOGY LA English DT Review DE catheterization; central venous; catheter; indwelling; child; neoplasm; thrombosis ID CANCER-PATIENTS; VEIN-THROMBOSIS; WARFARIN; PROPHYLAXIS; PREVALENCE; TRIAL AB Purpose of review Thrombosis is one of the most frequent complications of indwelling central venous catheters. During the past year, new information has emerged regarding the incidence and predisposing factors of thromboembolic complications of indwelling central venous catheters. Because indwelling central venous catheters are widely used, it is important to be aware of new information regarding thromboembolic complications of these devices. Recent findings Recent studies have better defined the risks of thromboembolic complications in patients with cancer with indwelling central venous catheters. Acquired hypercoagulable disorders such as heparin-induced thrombocytopenia, antiphospholipid syndrome, and therapy with asparaginase are associated with thromboembolic disorders in patients with indwelling central venous catheters. Studies analyzing the association between inherited hypercoagulable disorders and thrombosis have shown conflicting results. Preliminary studies suggest that low molecular weight heparins could have a role in the prevention of catheter-related thromboembolic disorders. Nevertheless, larger prospective studies will be necessary to determine the role of anticoagulants in the prevention of thromboembolic disorders in patients with cancer with indwelling central venous catheters. Summary Recent reports will facilitate the evaluation and risk assessment of children with cancer who have indwelling central venous catheters. Despite these advances, large, controlled studies focusing on specific populations of patients, such as children, should be undertaken to determine the true performance and optimal use of indwelling central venous catheters. Future studies should also address better ways to prevent catheter-related thrombosis and infection. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Freytes, CO (reprint author), Univ Texas, Hlth Sci Ctr, Mail Code 7880,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 14 TC 19 Z9 19 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-8746 J9 CURR OPIN ONCOL JI Curr. Opin. Oncol. PD JUL PY 2003 VL 15 IS 4 BP 289 EP 292 DI 10.1097/00001622-200307000-00002 PG 4 WC Oncology SC Oncology GA 712ME UT WOS:000184800800002 PM 12874506 ER PT J AU Nelson, KM Boyko, EJ AF Nelson, KM Boyko, EJ TI Predicting impaired glucose tolerance using common clinical information - Data from the Third National Health and Nutrition Examination Survey SO DIABETES CARE LA English DT Article; Proceedings Paper CT 63rd Annual Meeting of the American-Diabetes-Association CY JUN 13-17, 2003 CL NEW ORLEANS, LOUISIANA SP Amer Diabetes Assoc ID DIABETES-MELLITUS; FASTING GLUCOSE; CARDIOVASCULAR-DISEASE; RISK-FACTOR; LIFE-STYLE; US ADULTS; INDIVIDUALS; PREVENTION; PREVALENCE; OBESITY AB OBJECTIVE - To develop a score to predict impaired glucose tolerance (IGT) using common clinical data. RESEARCH DESIGN AND METHODS - We analyzed data from the Third National Health and Nutrition Examination Survey (NHANES 111) for 2,746 individuals aged 40-74 years who completed an oral glucose tolerance test. IGT was defined as a 2-h postchallenge glucose greater than or equal to140 mg/dl (7.7 mmol/l). We performed bivariate and multivariate analyses to describe the association of IGT with commonly available clinical information. A numerical score to predict IGT was derived from the results of the multivariate logistic regression models. RESULTS - Fasting glucose levels between 101 and 109 mg/dl (5.6 and 6.0 mmol/l) or between 110 and 125 mg/dl (6.1 and 6.9 mmol/l) were associated with IGT (odds ratio 1.8 and 6.2, respectively; P < 0.05). BMI greater than or equal to25 kg/m(2), Mexican-American ethnicity, age between 60 and 74 years, hypertension, and triglyceride level greater than or equal to150 mg/dl (1.69 mmol/l) were also associated with IGT. The area under the receiver operating characteristic curve for an 8-point scale derive from the multivariate analysis was 0.74 (95% CI 0.72-0.76). Setting a low cut point of 2 on this scale resulted in high sensitivity (86%), whereas a high cut point of 6 yielded high specificity (97%) for the detection of IGT. CONCLUSIONS - A numerical score based on common clinical data can identify individuals with a low or high likelihood of having IGT. C1 VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Epidemiol Res & Informat Ctr, VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Nelson, KM (reprint author), VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, 1660 S Columbian Way,S-111-GIMC, Seattle, WA 98108 USA. OI Boyko, Edward/0000-0002-3695-192X NR 26 TC 28 Z9 29 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD JUL PY 2003 VL 26 IS 7 BP 2058 EP 2062 DI 10.2337/diacare.26.7.2058 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 729RK UT WOS:000185787600019 PM 12832313 ER PT J AU Cuevas, BD Abell, AN Witowsky, JA Yujiri, T Johnson, NL Kesavan, K Ware, M Jones, PL Weed, SA DeBiasi, RL Oka, Y Tyler, KL Johnson, GL AF Cuevas, BD Abell, AN Witowsky, JA Yujiri, T Johnson, NL Kesavan, K Ware, M Jones, PL Weed, SA DeBiasi, RL Oka, Y Tyler, KL Johnson, GL TI MEKK1 regulates calpain-dependent proteolysis of focal adhesion proteins for rear-end detachment of migrating fibroblasts SO EMBO JOURNAL LA English DT Article DE calpain; MEKK1; rear-end detachment ID EPIDERMAL-GROWTH-FACTOR; CELL-MIGRATION; GENE DISRUPTION; ERK/MAP KINASE; ACTIVATION; ACTIN; CYTOSKELETON; FIBRONECTIN; INTERACTS; CLEAVAGE AB Herein, we define how MEKK1, a MAPK kinase kinase, regulates cell migration. MEKK1 is associated with actin fibers and focal adhesions, localizing MEKK1 to sites critical in the control of cell adhesion and migration. EGF-induced ERK1/2 activation and chemotaxis are inhibited in MEKK1-/- fibroblasts. MEKK1 deficiency causes loss of vinculin in focal adhesions of migrating cells, increased cell adhesion and impeded rear-end detachment. MEKK1 is required for activation of the cysteine protease calpain and cleavage of spectrin and talin, proteins linking focal adhesions to the cytoskeleton. Inhibition of ERK1/2 or calpain, but not of JNK, mimics MEKK1 deficiency. Therefore, MEKK1 regulates calpain-mediated substratum release of migrating fibroblasts. C1 Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pediat, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Cell & Struct Biol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Craniofacial Biol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. Yamaguchi Univ Med, Dept Internal Med 3, Yamaguchi, Japan. RP Cuevas, BD (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. OI Tyler, Kenneth/0000-0003-3294-5888 NR 38 TC 86 Z9 90 U1 0 U2 3 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0261-4189 J9 EMBO J JI Embo J. PD JUL 1 PY 2003 VL 22 IS 13 BP 3346 EP 3355 DI 10.1093/emboj/cdg322 PG 10 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 697QD UT WOS:000183954000014 PM 12839996 ER PT J AU Puchalski, SS Green, JN Rasmussen, DD AF Puchalski, SS Green, JN Rasmussen, DD TI Melatonin effect on rat body weight regulation in response to high-fat diet at middle age SO ENDOCRINE LA English DT Article DE melatonin; high-fat diet; body weight; leptin; insulin; visceral fat ID PLASMA LEPTIN; VISCERAL FAT; FOOD-INTAKE; INSULIN; ADIPOSITY; ADIPOCYTES; HUMANS AB We previously demonstrated that daily melatonin administration to middle-aged rats to restore youthful plasma melatonin levels also decreased body weight, visceral fat, plasma leptin, and plasma insulin to more youthful levels, without detectable changes in consumption of chow diet. We now evaluate: (a) whether melatonin alters consumption of a more precisely quantifiable liquid diet similar in high-fat content to the typical American diet; (b) differences between melatonin-induced endocrine responses in the fasted vs fed state; and (c) time course of these responses. Ten-month-old male Sprague-Dawley rats received liquid diet containing either 0.2 mug/mL melatonin (MELATONIN) or vehicle (CONTROL) (n = 14/treatment); the diet was available throughout each night, but was removed for the final 10 h of each daytime. MELATONIN rats gained 4% body weight during the first 2 wk and then stabilized, whereas CONTROL rats continued to gain for an additional week, achieving 8% gain (p < 0.05 vs MELATONIN). During the first 3 wk, afternoon tail-blood leptin, but not insulin, levels decreased in melatonin-treated rats (p < 0.05 vs CONTROL). After 8 wk, half of the rats were killed at the midpoint of the dark period (NIGHT; fed) and half at the end of the light period (DAYTIME; fasted). NIGHT but not DAYTIME plasma leptin levels were decreased in MELATONIN rats, whereas DAYTIME but not NIGHT plasma insulin levels were decreased (p < 0.05 vs CONTROL). Melatonin treatment did not alter cumulative food consumption. Thus, melatonin decreased weight gain in response to high-fat diet, decreased plasma leptin levels within 3 wk-before decreasing plasma insulin-and exerted these metabolic effects independent of total food consumption. C1 VA Puget Sound Hlth Care Syst, Mental Illness Res, Educ & Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat, Seattle, WA 98195 USA. RP Rasmussen, DD (reprint author), VA Puget Sound Hlth Care Syst, Mental Illness Res, Educ & Clin Ctr, S-116 MIRECC,1660 S Columbian Way, Seattle, WA 98108 USA. FU NIAAA NIH HHS [AA10567] NR 24 TC 37 Z9 37 U1 0 U2 4 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0969-711X J9 ENDOCRINE JI Endocrine PD JUL PY 2003 VL 21 IS 2 BP 163 EP 167 DI 10.1385/ENDO:21:2:163 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 707QN UT WOS:000184521500010 PM 12897381 ER PT J AU Puchalski, SS Green, JN Rasmussen, DD AF Puchalski, SS Green, JN Rasmussen, DD TI Melatonin effects on metabolism independent of gonad function SO ENDOCRINE LA English DT Article DE melatonin; testosterone; gonadal steroids; visceral fat; leptin; insulin ID IODOMELATONIN BINDING-SITES; FEMALE RAT-BRAIN; PLASMA LEPTIN; LONG-TERM; SECRETION; INSULIN; IMPACT; WEIGHT; FAT; MEN AB We previously demonstrated that daily melatonin administration to middle-aged rats, restoring nocturnal plasma melatonin to young adult levels, decreased body weight and suppressed visceral fat and plasma leptin. In some species, metabolic and some neuronal responses to melatonin are mediated or dependent at least in part on gonadal steroid levels. Thus, melatonin-induced changes in gonadal steroid secretion may have mediated the aging-dependent melatonin-induced metabolic responses in our previous studies. To address this issue, melatonin (0.4 mug/mL) or vehicle (0.01% ethanol) was administered for 10 wk in the drinking water of both castrate and sham-operated Sprague-Dawley male rats, starting 1 mo after surgery at 9 mo of age. Melatonin treatment decreased (p < 0.05) body weight in sham-operated rats by 7 +/- 2% relative to control (n = 7/treatment), comparable to our previous results; melatonin likewise decreased (p < 0.05) body weight in castrate rats by 6 2% relative to control (n = 7/treatment). Melatonin treatment also decreased both intraabdominal fat and plasma leptin levels in both intact and castrate rats, with no significant differences of percentage suppression in the intact versus castrate rats. These results demonstrate that suppression of body weight, visceral adiposity, and plasma leptin levels by daily melatonin administration to middle-aged rats was independent of gonadal function. C1 VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat, Seattle, WA USA. RP Rasmussen, DD (reprint author), VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, 116 MIRECC,1660 S Columbian Way, Seattle, WA 98108 USA. FU NIAAA NIH HHS [AA10567] NR 27 TC 10 Z9 10 U1 1 U2 1 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0969-711X J9 ENDOCRINE JI Endocrine PD JUL PY 2003 VL 21 IS 2 BP 169 EP 173 DI 10.1385/ENDO:21:2:169 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 707QN UT WOS:000184521500011 PM 12897382 ER PT J AU Williams, DL Cummings, DE Grill, HJ Kaplan, JM AF Williams, DL Cummings, DE Grill, HJ Kaplan, JM TI Meal-related ghrelin suppression requires postgastric feedback SO ENDOCRINOLOGY LA English DT Article ID ACYLATED PEPTIDE; STOMACH; SECRETION; HUMANS; CELLS; RATS AB Plasma ghrelin levels are rapidly suppressed by ingestion or gastric delivery of nutrients. Given that the majority of circulating ghrelin appears to be of gastric origin, we addressed the contribution of gastric distention or nutrient sensitivity to this response. Awake, unrestrained rats received intragastric infusions of glucose or water (1 ml/min for 12 min) with gastric emptying either proceeding normally or prevented by inflation of a pyloric cuff. When emptying was permitted, glucose infusion reduced ghrelin level by approximately 50%, and, in agreement with previous data, water infusions were without effect. Ghrelin level was not affected by either infusate when gastric emptying was prevented, thereby discounting a role for gastric distention in the meal-related ghrelin response. That glucose and water infusions were similarly ineffective when the pylorus was occluded shows, further, that gastric chemosensation is not a sufficient trigger for the ghrelin response. We conclude that the meal-related suppression of plasma ghrelin requires postgastric (pre- or postabsorptive) stimulation. C1 Univ Penn, Dept Psychol, Philadelphia, PA 19104 USA. Univ Washington, Dept Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Williams, DL (reprint author), Univ Penn, Dept Psychol, 3815 Walnut St, Philadelphia, PA 19104 USA. RI Williams, Diana/C-1699-2014 OI Williams, Diana/0000-0002-3548-7440 FU NIDDK NIH HHS [DK 21397, DK 42284, DK 61516] NR 16 TC 131 Z9 132 U1 0 U2 0 PU ENDOCRINE SOC PI BETHESDA PA 4350 EAST WEST HIGHWAY SUITE 500, BETHESDA, MD 20814-4110 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD JUL PY 2003 VL 144 IS 7 BP 2765 EP 2767 DI 10.1210/en.2003-0381 PG 3 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 690KL UT WOS:000183547800003 PM 12810528 ER PT J AU Bucurescu, G Stieritz, DD AF Bucurescu, G Stieritz, DD TI Evidence of an association between Chlamydia pneumoniae and cerebrovascular accidents SO EUROPEAN JOURNAL OF NEUROLOGY LA English DT Article DE cerebrovascular accidents; Chlamydia pneumoniae; stroke ID CAROTID-ARTERY; DISEASE; ANTIBODIES; STROKE; RISK; INFECTION; ASSAYS AB The authors report results of a retrospective pilot study showing a strong association between patients with stroke/TIA and the presence of circulating IgG and IgA antibodies to Chlamydia pneumoniae. These results support the hypothesis that chronic active or persistent infection may play a role in the mechanism of thrombosis. The risk for stroke associated with Chlamydial circulating antibodies appeared to be independent of other risk factors such as diabetes and hypercholesterolemia. C1 Vet Affairs Med Ctr, Neurol Serv, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Pathol & Lab Med Serv, Philadelphia, PA 19104 USA. RP Bucurescu, G (reprint author), Vet Affairs Med Ctr, Neurol Serv, Woodland & Univ Ave, Philadelphia, PA 19104 USA. NR 14 TC 5 Z9 5 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 1351-5101 J9 EUR J NEUROL JI Eur. J. Neurol. PD JUL PY 2003 VL 10 IS 4 BP 449 EP 452 DI 10.1046/j.1468-1331.2003.00605.x PG 4 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 692YD UT WOS:000183687100017 PM 12823500 ER PT J AU Van Remmen, H Hamilton, ML Richardson, A AF Van Remmen, H Hamilton, ML Richardson, A TI Oxidative damage to DNA and aging SO EXERCISE AND SPORT SCIENCES REVIEWS LA English DT Review DE mitochondrial DNA; nuclear DNA; exercise; dietary restriction; oxidative stress ID CALORIC RESTRICTION; 8-HYDROXYDEOXYGUANOSINE; EXERCISE; NUCLEAR; STRESS; REPAIR AB Oxidative damage to DNA increases with age in several tissues and animal models, and mitochondrial DNA has a higher level of oxidative damage than nuclear DNA. Dietary restriction extends lifespan and is associated with reduced levels of damage to mitochondrial and nuclear DNA. The effect of exercise on DNA damage appears to be related to the intensity of the exercise. C1 Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Barshop Ctr Longev Studies, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Van Remmen, H (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, GRECC 182, 7400 Merton Mintoe Blvd, San Antonio, TX 78229 USA. FU NIA NIH HHS [1PO1-AG20591, 1PO1-AG14674] NR 15 TC 33 Z9 33 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0091-6331 J9 EXERC SPORT SCI REV JI Exerc. Sport Sci. Rev. PD JUL PY 2003 VL 31 IS 3 BP 149 EP 153 DI 10.1097/00003677-200307000-00009 PG 5 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 702KD UT WOS:000184222300009 PM 12882482 ER PT J AU Dobscha, SK Gerrity, MS Corson, K Bahr, A Cuilwik, NM AF Dobscha, SK Gerrity, MS Corson, K Bahr, A Cuilwik, NM TI Measuring adherence to depression treatment guidelines in a VA primary care clinic SO GENERAL HOSPITAL PSYCHIATRY LA English DT Article DE depression; primary health care; guideline adherence ID QUALITY IMPROVEMENT PROGRAMS; HEALTH-CARE; COLLABORATIVE CARE; RANDOMIZED TRIAL; DISORDERS; INTERVENTION; MANAGEMENT; VALIDATION; DISABILITY; SYMPTOMS AB The primary objectives of this pilot study were to develop a measure of adherence for depression practice guidelines and to assess the degree to which providers and patients adhere to guidelines in a VA primary care setting. The Depression Guideline Measure (DGM) is based on three national guidelines. The DGM was used to review medical records of 111 patients with Patient Health Questionnaire (PHQ) scores greater than or equal to10. Interrater reliability for 15 of 19 DGM checklist items was excellent (kappa > 0.75). There was a broad range of adherence to guideline criteria: only 13.5% of patients were contacted for follow-up within 2 weeks, while 100% of providers documented follow-up plans. Forty percent of patients saw mental health providers, and 63% were prescribed antidepressants. A secondary objective of the study was to explore the relationship between guideline adherence and changes in PHQ scores. Among 51 patients who completed follow-up PHQs, no associations were detected. The results suggest that the DGM shows promise as a reliable measure of guideline adherence and that guideline criteria are frequently not met in busy primary care clinics. More research is needed to determine the validity of the DGM and the impact of guideline adherence on depression outcomes. (C) 2003 Elsevier Science Inc. All rights reserved. C1 Portland VA Med, Behav Hlth & Clin Neurosci Div, Portland, OR 97207 USA. Portland VA Med Ctr, Div Hosp & Specialty Med, Portland, OR USA. Oregon Hlth Sci Univ, Sch Med, Portland, OR 97201 USA. RP Dobscha, SK (reprint author), Portland VA Med, Behav Hlth & Clin Neurosci Div, Portland, OR 97207 USA. NR 35 TC 19 Z9 19 U1 1 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0163-8343 J9 GEN HOSP PSYCHIAT JI Gen. Hosp. Psych. PD JUL-AUG PY 2003 VL 25 IS 4 BP 230 EP 237 DI 10.1016/S0163-8343(03)00020-3 PG 8 WC Psychiatry SC Psychiatry GA 702AH UT WOS:000184201800003 PM 12850654 ER PT J AU Imboden, M Shi, FS Pugh, TD Freud, AG Thom, NJ Hank, JA Hao, ZL Staelin, ST Sondel, PM Mahvi, DM AF Imboden, M Shi, FS Pugh, TD Freud, AG Thom, NJ Hank, JA Hao, ZL Staelin, ST Sondel, PM Mahvi, DM TI Safety of interleukin-12 gene therapy against cancer: A murine biodistribution and toxicity study SO HUMAN GENE THERAPY LA English DT Article ID MECHANISM AB As a prerequisite for a human clinical trial using interleukin (IL)-12 gene therapy, the biodistribution and safety of IL-12, administered as an intradermal naked DNA injection, was evaluated in mice. The pNGVL3-mIL12 plasmid used in this study is a nonviral vector designed to induce a high level of IL-12 protein expression during a transient transfection of the host cell. The biodistribution was evaluated by a polymerase chain reaction (PCR) assay that is capable of detecting less than 100 copies of the plasmid in the context of host DNA. Twenty-four hours after three intradermal injections of 0.5 mug or 5 mug of pNGVL3-mIL12 plasmid, the plasmid was detectable in various internal organs, the blood, and the injection site. The plasmid was detectable in the gonads of only one animal at the high-dose treatment 24 hr after the injections. In the majority of the organs the plasmid was undetectable throughout the study. Possible side effects were monitored by histology and clinical chemistry, and the level of IL-12 protein expression was assessed by enzyme-linked immunosorbent assay (ELISA). No treatment-related histologic abnormalities were detected and the blood chemistry parameters showed no toxicity. The IL-12 protein was undetectable at all times at the injection site and interferon (IFN)-gamma levels at the injection site and in the serum were at background levels. The results of this murine safety study indicate that based on the distribution pattern of the plasmid in the body and the undetectable toxicities in the tissues, the use of the pNGVL3-hIL12 plasmid in cancer gene therapy clinical trials can be considered as safe. C1 Univ Wisconsin, Dept Human Oncol, Madison, WI 53792 USA. Univ Wisconsin, Dept Surg, Madison, WI 53792 USA. Univ Wisconsin, Wisconsin Reg Primate Res Ctr, Madison, WI 53792 USA. Univ Wisconsin Hosp & Clin, William S Middleton Mem Vet Adm Hosp, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. RP Mahvi, DM (reprint author), H4 724 Univ Wisconsin Hosp & Clin, 600 Highland Ave, Madison, WI 53792 USA. FU NCI NIH HHS [P30-CA 14520]; NIA NIH HHS [AG00650] NR 10 TC 22 Z9 22 U1 0 U2 1 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1043-0342 J9 HUM GENE THER JI Hum. Gene Ther. PD JUL PY 2003 VL 14 IS 11 BP 1037 EP 1048 DI 10.1089/104303403322124765 PG 12 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Medicine, Research & Experimental SC Biotechnology & Applied Microbiology; Genetics & Heredity; Research & Experimental Medicine GA 702BW UT WOS:000184205600001 PM 12885344 ER PT J AU Xu, GL Meyer, JS Huang, YG Du, F Chowdhury, M Quach, M AF Xu, GL Meyer, JS Huang, YG Du, F Chowdhury, M Quach, M TI Adapting Mini-Mental State Examination for dementia screening among illiterate or minimally educated elderly Chinese SO INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE elderly; Chinese; cognitive disorders; cultural influences; dementing disorders; cognitive screening ID MILD COGNITIVE IMPAIRMENT; ALZHEIMERS-DISEASE; CLINICAL-DIAGNOSIS; VASCULAR DEMENTIA; TESTS; AGE; INSTRUMENT; HEALTH; MCI AB Background Illiteracy is prevalent among current elderly Chinese. There are few brief cognitive tests in Chinese designed to screen those possibly demented for more detailed evaluation in a clinical setting. Objectives The present study adapted the Mini-Mental State Examination (MMSE) for screening dementia among illiterate or less educated elderly Chinese. Methods Literacy-dependent items of the MMSE were modified or substituted by equivalent items that are not literacy-dependment. Some items were modified to provide socio-cultural compatibility. After developing it, the Chinese adapted MMSE (CAMSE) was administered to 370 elderly outpatients from Xijing hospitals located in Xi'an, China, 93 of whom were found to be demented and 277 non-demented. Sensitivities and specificities for detecting dementia were evaluated by adjusting for different CAMSE cut-off points. The optimal cut-off points of 22 for literates and 20 for illiterates yielded a sensitivity of 83.87% and a specificity of 84.48%. Corresponding positive predictive value (PPV) was 0.65, and negative predictive value (NPV) was 0.94. The impact of literacy on CAMSE and individual test items was also evaluated. Illiterate subjects got a higher CAMSE total score than literate subjects (p < 0.05). Only one out of 12 test items, serial sevens, was negatively influenced by illiteracy (p < 0.01). After an interval of 4-6 weeks, 32 randomly selected subjects were retested with CAMSE. The test-retest reliability for total scores was 0.75 (p 0.01). Conclusions Results suggest that in the socio-cultural context for Chinese, irrespective of their literacy skills, CAMSE proved feasible for use in clinical settings for dementia screening. Copyright (C) 2003 John Wiley Sons, Ltd. C1 Baylor Coll Med, Cerebrovasc Res Lab, VA Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Hosp PLA, Dept Neurol, Yantai, Peoples R China. Fourth Mil Med Univ, Xijing Hosp, Dept Neurol, Xian 710032, Peoples R China. RP Meyer, JS (reprint author), Baylor Coll Med, Cerebrovasc Res Lab, VA Med Ctr, Bldg 110,Room 225,2002 Holcombe Blvd, Houston, TX 77030 USA. OI Xu, Gelin/0000-0002-6194-0341 NR 34 TC 43 Z9 46 U1 2 U2 16 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0885-6230 J9 INT J GERIATR PSYCH JI Int. J. Geriatr. Psychiatr. PD JUL PY 2003 VL 18 IS 7 BP 609 EP 616 DI 10.1002/gps.890 PG 8 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 701YM UT WOS:000184196600006 PM 12833305 ER PT J AU Giese, MJ Rayner, SA Fardin, B Sumner, HL Rozengurt, N Mondino, BJ Gordon, LK AF Giese, MJ Rayner, SA Fardin, B Sumner, HL Rozengurt, N Mondino, BJ Gordon, LK TI Mitigation of neutrophil infiltration in a rat model of early Staphylococcus aureus endophthalmitis SO INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE LA English DT Article; Proceedings Paper CT Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology CY APR 29-MAY 04, 2001 CL FT LAUDERDALE, FLORIDA SP Assoc Res Vis & Ophthalmol ID POLYMORPHONUCLEAR LEUKOCYTE; LUNG INJURY; EXPRESSION; VIRULENCE; SEPSIS AB PURPOSE. Infectious endophthalmitis is characterized by neutrophil migration into the eye. The purpose of this study was to determine whether systemic neutrophil depletion mitigates the ocular influx of neutrophils during the early phases of experimental endophthalmitis. METHODS. Endophthalmitis was induced in rats by intravitreal injection of Staphylococcus aureus. Animals received a single systemic dose of an anti-neutrophil-depleting antibody (dAb) or normal rabbit serum (NRS) 6 or 12 hours after intravitreal injection. Inflammation was graded both in vivo and by histopathology. Myeloperoxidase (MPO) was used as a biomarker of neutrophil infiltration. Bacterial clearance was evaluated by determining the amount of viable bacteria recovered from ocular specimens. RESULTS. Rats that received dAb 6 hours after bacterial injection exhibited significantly lower clinical scores, MPO activity, fewer vitreous exudates, and higher vitreous bacterial counts at 24 hours (P < 0.05). As the neutrophil population returned in this group, measured by the number in the peripheral blood, increasing intraocular inflammation was observed. Rats receiving dAb 12 hours after vitreous injection also demonstrated significantly lower clinical scores, MPO activity and less vitreous exudates at the 24-hour time point (P < 0.05). No significant differences from the control were detected at any of the subsequent time points, except in bacterial counts and MPO activity. CONCLUSIONS. Depletion of neutrophils early in the inflammatory response delayed the onset of severe ocular inflammation but also prevented adequate bacterial clearance. These results confirm the important role of neutrophils in ocular host defense during the early stages of experimental endophthalmitis. C1 Univ Calif Los Angeles, Sch Med, Ocular Inflammatory Dis Ctr, Jules Stein Eye Inst,Dept Ophthalmol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Ocular Inflammatory Dis Ctr, Jules Stein Eye Inst,Dept Pathol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Ocular Inflammatory Dis Ctr, Jules Stein Eye Inst,Dept Lab Med, Los Angeles, CA USA. Greater Los Angeles VA Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP Giese, MJ (reprint author), Ohio State Univ, Coll Ophthalmol, 320 W 10th Ave,A144, Columbus, OH 43210 USA. NR 25 TC 15 Z9 16 U1 0 U2 1 PU ASSOC RESEARCH VISION OPHTHALMOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0146-0404 J9 INVEST OPHTH VIS SCI JI Invest. Ophthalmol. Vis. Sci. PD JUL PY 2003 VL 44 IS 7 BP 3077 EP 3082 DI 10.1167/iovs.02-1250 PG 6 WC Ophthalmology SC Ophthalmology GA 694VL UT WOS:000183795800038 PM 12824254 ER PT J AU Cummings, DE Shannon, MH AF Cummings, DE Shannon, MH TI Ghrelin and gastric bypass: Is there a hormonal contribution to surgical weight loss? SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID CIRCULATING GHRELIN; ACYLATED PEPTIDE; HUMAN OBESITY; FOOD-INTAKE; SECRETION; SURGERY; RATS; STOMACH; HUMANS; APPETITE C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. RP Cummings, DE (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, 1660 S Columbian Way,S-111 Endo, Seattle, WA 98108 USA. EM davidec@u.washington.edu NR 40 TC 118 Z9 119 U1 1 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 JUL PY 2003 VL 88 IS 7 BP 2999 EP 3002 DI 10.1210/jc.2003-030705 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 697DE UT WOS:000183926300005 PM 12843132 ER PT J AU Azad, N Pitale, S Barnes, WE Friedman, N AF Azad, N Pitale, S Barnes, WE Friedman, N TI Testosterone treatment enhances regional brain perfusion in hypogonadal men SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID CENTRAL-NERVOUS-SYSTEM; HUMAN TEMPORAL-LOBE; ANDROGEN RECEPTOR; RAT-BRAIN; SEX-DIFFERENCES; OLDER MEN; MOOD; EXPRESSION; HORMONES; STEROIDS AB The positive effect of testosterone replacement therapy on psychosocial well-being in hypogonadal men has been demonstrated by various psychometric tests. However, there is no report available that objectively demonstrates the effect of testosterone on the function of the central nervous system in men. In this report we studied cerebral perfusion in seven hypogonadal men on testosterone replacement therapy. The blood perfusion to the central nervous system was assessed using single-photon emission-computed tomography. (99m)Tc-hexamethylpropylene-amine oxime crosses the blood brain barrier and localizes in brain tissue, depending on the intensity of the local blood flow. Psychosocial well-being was assessed with an Androgen Deficiency in Aging Men questionnaire. The study demonstrated that testosterone replacement enhanced cerebral perfusion in midbrain and superior frontal gyrus (Brodman area 8) at 3-5 wk of treatment. At 12 - 14 wk the study continued to show increased perfusion in midbrain in addition to the appearance of a new activated region in the midcingulate gyrus ( Brodman area 24). The results of this study provide objective evidence that testosterone and / or its metabolites increased cerebral perfusion in addition to the improvement in cognitive function. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Med Serv, Endocrinol Sect, Hines, IL 60141 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Nucl Med Serv, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Dept Med, Maywood, IL 60153 USA. Loyola Univ, Stritch Sch Med, Dept Nucl Med, Maywood, IL 60153 USA. RP Azad, N (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Med Serv, Endocrinol Sect, 111A,Bldg 200,Suite 1422, Hines, IL 60141 USA. EM nasrin.azad@med.va.gov NR 37 TC 55 Z9 59 U1 0 U2 1 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 JUL PY 2003 VL 88 IS 7 BP 3064 EP 3068 DI 10.1210/jc.2002-020632 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 697DE UT WOS:000183926300017 PM 12843144 ER PT J AU Abboud, SL Bunegin, M Ghosh-Choudhury, N Woodruff, K AF Abboud, SL Bunegin, M Ghosh-Choudhury, N Woodruff, K TI Analysis of the mouse CSF-1 gene promoter in a transgenic mouse model SO JOURNAL OF HISTOCHEMISTRY & CYTOCHEMISTRY LA English DT Article DE macrophage colony-stimulating factor; gene expression; transgenic mice ID COLONY-STIMULATING FACTOR; FACTOR-I; STROMAL CELLS; GROWTH-FACTOR; TRANSCRIPTIONAL REGULATION; EXPRESSION; MICE; MACROPHAGES; CLONING; BONE AB CSF-1 stimulates monocyte and osteoclast populations. However, the molecular mechanisms involved in regulating CSF-1 gene expression are unclear. To identify regulatory regions that control normal CSF-1 gene expression, a -774/+183-bp fragment of the murine CSF-1 promoter was analyzed in vitro and in vivo. Transcriptional activity was high in cultured osteoblasts that express CSF-1 mRNA compared to ARH-77 B cells that lack CSF-1 gene expression. Transient transfection of osteoblasts with promoter deletion constructs showed that the -774-bp fragment conferred the highest transcriptional activity and contained activator and repressor sequences. To assess the ability of the CSF-1 promoter to confer normal tissue expression of CSF-1, transgenic mice containing the -774/+183-bp region driving the E. coli p-galactosidase (lacZ) reporter gene were generated. P-Gal analysis of whole tissue extracts showed transgene expression in all tissues tested except liver and kidney. At the cellular level, the pattern of P-gal expression in the spleen, thymus, bone, lung, and testes of adult transgenic mice mimicked normal endogenous CSF-1 mRNA expression in non-transgenic littermates detected by in situ hybridization. This region also directed appropriate transgene expression to sites in other tissues known to synthesize CSF-1, with the exception of the liver and kidney. These findings indicate that the -774-bp fragment contains cis-acting elements sufficient to direct CSF-1 gene expression in many tissues. CSF-1 promoter/lacZ mice may be useful for studying the transcriptional mechanisms involved in regulating CSF-1 gene expression in tissues throughout development. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. Univ Texas, Audie L Murphy Div, S Texas Vet Hlth Care Syst, San Antonio, TX 78284 USA. RP Abboud, SL (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. FU NIAMS NIH HHS [AR 42306, R01 AR042306] NR 42 TC 4 Z9 4 U1 0 U2 0 PU HISTOCHEMICAL SOC INC PI SEATTLE PA UNIV WASHINGTON, DEPT BIOSTRUCTURE, BOX 357420, SEATTLE, WA 98195 USA SN 0022-1554 J9 J HISTOCHEM CYTOCHEM JI J. Histochem. Cytochem. PD JUL PY 2003 VL 51 IS 7 BP 941 EP 949 PG 9 WC Cell Biology SC Cell Biology GA 692EK UT WOS:000183647700009 PM 12810844 ER PT J AU Casarett, DJ Karlawish, JHT Hirschman, KB AF Casarett, DJ Karlawish, JHT Hirschman, KB TI Identifying ambulatory cancer patients at risk of impaired capacity to consent to research SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article DE competence; decision-making capacity; ethics; research ethics; informed consent ID RANDOMIZED CONTROLLED-TRIAL; PALLIATIVE CARE RESEARCH; QUALITY-OF-LIFE; INFORMED CONSENT; TREATMENT DECISIONS; SYMPTOM ASSESSMENT; METASTATIC CANCER; ONCOLOGY PATIENTS; PAIN MANAGEMENT; COMPETENCE AB Ethicists and others have expressed concerns that some patients with cancer might lack adequate decision-making capacity to give consent,for research. Although this concern is plausible, it is not known what patient characteristics might be used to identify those Patients who are at risk and who therefore should undergo a formal assessment of decision-making capacity. Forty-five patients with cancer were Presented with a description of a randomized controlled trial, accompanied by an Institutional Review Board-approved consent form. Two raters who were blind to all patient characteristics assessed decision-making capacity using the MacArthur Competency Assessment Tool for Clinical Research. These scores were summarized in overall capacity judgments using criteria established by a panel of experts. Subjects also completed a symptom rating scale and a battery of neuropsychiatric tests. No relationship was observed between symptom severity and any domain of decision-making capacity (understanding, appreciation, reasoning, ability to express a choice) or summary judgments. However, several other patient characteristics, including age, education, and selected neuropsychiatric test results, were found to be strongly associated with capacity scores. These data suggest that several patient characteristics, such as age, education, and tests of cognitive functions, may help investigators to identify patients with impaired capacity to give consent for research. (C) 2003 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved. C1 Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Ctr Bioeth, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Div Geriatr, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Alzheimers Dis Ctr, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Sch Social Work, Philadelphia, PA 19104 USA. RP Casarett, DJ (reprint author), Inst Aging, 3615 Chestnut St, Philadelphia, PA 19104 USA. FU NIA NIH HHS [K01-AG00931] NR 48 TC 28 Z9 28 U1 0 U2 1 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 2003 VL 26 IS 1 BP 615 EP 624 DI 10.1016/S0885-3924(03)00221-5 PG 10 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 702GJ UT WOS:000184215900007 PM 12850644 ER PT J AU Chang, JC Hart, DA Estey, AW Chan, JT AF Chang, JC Hart, DA Estey, AW Chan, JT TI Tensile bond strengths of five luting agents to two CAD-CAM restorative materials and enamel SO JOURNAL OF PROSTHETIC DENTISTRY LA English DT Article ID INLAYS AB Statement of problem. CAD-CAM restorative materials arc popular because they have high esthetic value and short fabrication time. Unfortunately these materials are brittle and tend to fracture under heavy occlusal load. Purpose. The purpose of this in vitro study was to investigate the tensile bond strengths of 5 luting agents to 2 CAD-CAM restorative materials and enamel. Material and methods. One hundred truncated cones, with a 3-mm diameter bonding surface and 5-mm diameter base, were fabricated with Dicor MGC (n=50) or Cerec Vitablocs Mark II (n=50) with the Cercc system. Enamel surfaces of the crowns of 100 freshly extracted noncarious, anterior teeth, stored in 0.9% saline solution with 0.25% sodium azide (NaN3) as disinfectant, were prepared with sandpaper disks (320-grit size) on the Buehler Variable Speed Grinder-Polisher. The bonding surfaces of the Dicor MGC or Cercc Vitablocs Mark II truncated cones from each of the 2 tests systems were airborne particle abraded, chemically etched, and cemented on the prepared enamel surface of the tooth specimens with 5 luting agents: Vita Cerec Duo Cement, EnForce, Panavia 21, C&B Metabond, and Fuji Duct. All specimens were thermocycled 1000 times, in 5degrees C and 55degreesC water with a dwell time of 30 seconds in each temperature. Tensile force (MPa) was applied perpendicular to the bonding surfaces of the specimens with a universal testing machine until fracture. Fracture patterns were examined with a microscope at original magnification x 10. The differences in the tensile bond strengths were analyzed with the Tukey-Kramer test (alpha=.05). Results. The mean tensile bond strengths of Dicor MGC bonding to enamel with luting agents in descending order in MPa were EnForce (10.12 +/- 2.25), Panavia 21 (7.28 +/- 1.77), Cerec Duo (5.32 +/- 1.65), Fuji Duet (3.73 +/- 1.78), and C&B Metabond (3.11 +/- 1.11). EnForce had a significantly higher bond strength than C&B Metabond, Fuji Duet, Cerec Duo, and Panavia 21 (P=.05). The mean tensile bond strengths of Cerec Vitablocs Mark I I bonding to enamel with luting agents in descending order in MPa were as follow: Fuji Duet (11.51 +/- 2.79), EnForce (9.44 +/- 2.03), C&B Metabond (8.98 +/- 3.29), Cerec Duo (8.66 +/- 4.71), and Panavia 21 (5.10 +/- 2.49). Within this group, there was no significant difference between Fuji Duet and EnForce, but the bond strength of Fuji Duet was significantly higher than that of C&B Metabond, Panavia 21, and Cerec Duo (P=.05). The mean tensile strength of all the luting agents bonded to Cerec Vitablocs Mark II and enamel (8.74 MPa) was higher than Dicor MGC and enamel (5.91 MPa). Conclusion. In this in vitro study; within the Dicor MGC group, the mean bond strength of Panavia 21 with enamel was significantly higher than C&B Metabond, Panavia 21, Cerec Duo, and Fuji Duet. Within the Cercc Vitablocs Mark II group, the mean bond strength of Fuji Duet was significantly higher than C&B Metabond, Panavia 21, and Cerec Duo but was not significantly higher than EnForce. C1 Univ Texas, Dept Dent Publ Hlth & Dent Hyg, Houston Dent Branch, Houston, TX 77030 USA. Univ Texas, Dept Basic Sci, Houston Dent Branch, Houston, TX 77030 USA. VA Med Ctr, Adv Prosthodont Program, Dent Serv, Houston, TX USA. RP Chang, JC (reprint author), Univ Texas, Dept Dent Publ Hlth & Dent Hyg, Houston Dent Branch, 6516 MD Anderson Ave, Houston, TX 77030 USA. NR 8 TC 14 Z9 17 U1 2 U2 2 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0022-3913 J9 J PROSTHET DENT JI J. Prosthet. Dent. PD JUL PY 2003 VL 90 IS 1 BP 18 EP 23 DI 10.1016/S0022-3913(03)00217-8 PG 6 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 703KV UT WOS:000184279300005 PM 12869970 ER PT J AU Brambilla, P Harenski, K Nicoletti, M Sassi, RB Mallinger, AG Frank, E Kupfer, DJ Keshavan, MS Soares, JC AF Brambilla, P Harenski, K Nicoletti, M Sassi, RB Mallinger, AG Frank, E Kupfer, DJ Keshavan, MS Soares, JC TI MRI investigation of temporal lobe structures in bipolar patients SO JOURNAL OF PSYCHIATRIC RESEARCH LA English DT Article; Proceedings Paper CT 56th Annual Meeting of the Society-of-Biological-Psychiatry CY MAY 03-05, 2001 CL NEW ORLEANS, LOUISIANA SP Soc Biol Psychiat DE amygdala; hippocampus; temporal lobes; superior temporal gyrus; bipolar disorder; magnetic resonance imaging ID POSTTRAUMATIC-STRESS-DISORDER; MAGNETIC-RESONANCE; HIPPOCAMPAL VOLUME; MAJOR DEPRESSION; HUMAN AMYGDALA; HEALTHY-INDIVIDUALS; ALZHEIMERS-DISEASE; FACIAL EXPRESSIONS; ANATOMICAL MRI; MOOD DISORDERS AB Previous anatomical MRI studies have suggested abnormalities in amygdala volumes in bipolar disorder, whereas hippocampus, temporal lobe (TL), and superior temporal gyri (STG) measures have been reported to be normal. This study further investigated the existence of anatomical abnormalities in these brain structures in bipolar subjects, to attempt to replicate previously reported findings. Twenty-four DSM-IV bipolar patients (mean age+/-S.D. = 35+/-10 years) and 36 healthy controls (mean age+/-S.D. = 37+/-10 years) were studied. 3D SPGR images were obtained with a 1.5T-GE Signa magnet (TR = 25 ms, TE = 5 ms, FOV = 24 cm, slice-thickness = 1.5 mm, matrix-size = 256x192). Volumetric measurements of TL, hippocampus, amygdala, and STG were performed blindly, with a semi-automated software. Bipolar patients had significantly larger left amygdala volumes compared with controls (mean volumes+/-S.D. = 2.57+/-0.69 vs. 2.17+/-0.58 ml, respectively; ANCOVA, age, gender, ICV as covariates; F = 4.42, df = 1155, P = 0.04). The volumes of the other temporal lobe structures did not differ significantly between the two groups (ANCOVA, age, gender, and ICV as covariates, P > 0.05). Our findings of enlarged left amygdala in bipolar patients are in agreement with prior MRI studies, suggesting that abnormalities in this brain structure may be implicated in pathophysiology of the illness. Longitudinal studies in high-risk offspring and first-episode patients will be needed to examine whether such:abnormalities precede the appearance of symptoms, or whether they may appear subsequently as a result of illness course. (C) 2003 Elsevier Science Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, San Antonio, TX 78229 USA. Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat, Sch Med, Pittsburgh, PA 15213 USA. Univ Pavia, Sch Med, Dept Psychiat, IRCCS S Matteo, Pavia, Italy. Univ Genoa, Adv Biotechnol Ctr, Genoa, Italy. Univ Sao Paulo, Sch Med, Dept Psychiat, Inst Psychiat, Sao Paulo, Brazil. Univ Pittsburgh, Dept Psychol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Neurosci, Pittsburgh, PA USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. RI brambilla, paolo/B-4184-2010 OI brambilla, paolo/0000-0002-4021-8456 FU NIMH NIH HHS [MH 30915, MH 01736, MH 29618] NR 57 TC 157 Z9 162 U1 2 U2 10 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0022-3956 J9 J PSYCHIAT RES JI J. Psychiatr. Res. PD JUL-AUG PY 2003 VL 37 IS 4 BP 287 EP 295 DI 10.1016/S0022-3956(03)00024-4 PG 9 WC Psychiatry SC Psychiatry GA 684PE UT WOS:000183215100003 PM 12765851 ER PT J AU Oglesby, AK Minshall, ME Shen, W Xie, S Silverman, SL AF Oglesby, AK Minshall, ME Shen, W Xie, S Silverman, SL TI The impact of incident vertebral and non-vertebral fragility fractures on health-related quality of life in established postmenopausal osteoporosis: Results from the teriparatide randomized, placebo-controlled trial in postmenopausal women SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE health-related quality of life; incident fracture; osteoporosis; OPAQ ID PREVALENT AB Objective. To report the combined impact of both vertebral and non-vertebral fractures on decreased health-related quality of life (HRQOL) in postmenopausal women (mean age 70.7) with osteoporosis who participated in a clinical trial to examine the anti-fracture efficacy of teriparatide [rhPTH(1-34)] injection. Methods. Patients were randomly assigned to 1 of 3 study arms: placebo, 20 mug or 40 mug of teriparatide by daily self-injection. All patients received daily calcium (1000 mg) and vitamin D (4001200 U) supplements. Patients were followed for a median of 21 months. Incident vertebral fractures were assessed by lateral spinal radiograph. Incident non-vertebral fractures were ascertained by patient self-report and verified by a review of radiological reports. HRQOL was assessed at baseline and annually until study termination using the Osteoporosis Assessment Questionnaire (OPAQ), a validated disease-targeted instrument. Results. Of the 365 women in the HRQOL sub-study, 53 had an incident vertebral or non-vertebral fracture during the study period. Compared to women without incident fractures, women who fractured reported significant declines in physical functioning, emotional status, and symptoms (all p < 0.05). Similarly, when analysis was limited to patients with significant loss in HRQOL, patients with incident fracture accounted for a greater proportion of those patients with decreased physical function, emotional status, and increased symptoms (all p < 0.05). Conclusion. Our results confirm and extend previous findings to show that a composite endpoint of incident vertebral and non-vertebral fractures in women with postmenopausal osteoporosis was associated with significant decreases in HRQOL. C1 Eli Lilly & Co, Lilly Corp Ctr, Global Econ Affairs, Indianapolis, IN 46285 USA. Cedars Sinai Med Ctr, Greater Los Angeles Vet Adm Hlth Syst, OMC Clin Res Ctr, Los Angeles, CA USA. RP Oglesby, AK (reprint author), Eli Lilly & Co, Lilly Corp Ctr, Global Econ Affairs, DC 1834, Indianapolis, IN 46285 USA. NR 16 TC 32 Z9 32 U1 2 U2 3 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD JUL PY 2003 VL 30 IS 7 BP 1579 EP 1583 PG 5 WC Rheumatology SC Rheumatology GA 699MT UT WOS:000184061100032 PM 12858462 ER PT J AU Zhou, XH Castelluccio, P AF Zhou, XH Castelluccio, P TI Nonparametric analysis for the ROC areas of two diagnostic tests in the presence of nonignorable verification bias SO JOURNAL OF STATISTICAL PLANNING AND INFERENCE LA English DT Article DE diagnostic tests; the ROC curve; verification bias; missing data; likelihood; EM; nonignorability ID INCOMPLETE DATA; NONRESPONSE; REGRESSION; MECHANISM; MODELS AB A paired design is often used to evaluate the accuracies of competing diagnostic tests. One common problem in a paired design is verification bias which occurs when some patients do not receive disease verification and when the reason for verification depends on the test results and other factors. Most of the existing methods for verification bias correction assume the verification process is ignorable, which means that the probability of verifying a patient depends only on the observed covariates, but not on the unobserved disease status of the patient. In this paper, we develop a bias correction procedure without assuming ignorability of the verification mechanism. As far as we know, this proposed method is the first attempt to combine nonignorable verification with estimation of the ROC areas. At issue is the possible existence of multiple local maxima and boundary solutions for the maximum likelihood (ML) equations, which can complicate the computation of the ML estimates. To deal with this computational difficulty, we propose a profile method combined with the EM algorithm to find the global ML estimators for the parameters of interest under a proposed nonignorable verification model. Furthermore, we also find a simple solution to the boundary point problem. After obtaining the ML estimates, we propose likelihood-based inferences on the relative accuracy of two diagnostic tests. Another issue in the analysis is the goodness-of-fit of the proposed nonignorable model for the verification mechanism. We propose to use a bootstrap-based goodness-of-fit test for the proposed nonignorable model. Finally, we apply our method to data from a real study that has motivated this research. In this example, the aim of our analysis is to compare the relative accuracy of MRI and CT imaging in detecting advanced stage pancreatic cancer. (C) 2002 Elsevier Science B.V. All rights reserved. C1 Indiana Univ, Sch Med, Dept Med, Div Biostat, Indianapolis, IN 46202 USA. VA Puget Sound Hlth Care Syst, NW Ctr Hlth Serv Res & Dev, Seattle, WA 98108 USA. Indiana Univ, Sch Med, Dept Med & Mol Genet, Bloomington, IN 47405 USA. NR 17 TC 10 Z9 11 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0378-3758 J9 J STAT PLAN INFER JI J. Stat. Plan. Infer. PD JUL 1 PY 2003 VL 115 IS 1 BP 193 EP 213 AR PII S0378-3758(02)00146-5 DI 10.1016/S0378-3758(02)00146-5 PG 21 WC Statistics & Probability SC Mathematics GA 680UF UT WOS:000182996400011 ER PT J AU Liu, JH Etzioni, DA O'Connell, JB Maggard, MA Ko, CY AF Liu, JH Etzioni, DA O'Connell, JB Maggard, MA Ko, CY TI Using volume criteria: Do California hospitals measure up? SO JOURNAL OF SURGICAL RESEARCH LA English DT Article; Proceedings Paper CT 36th Annual Meeting of the Association-for-Academic-Surgery CY NOV 07-09, 2002 CL BOSTON, MASSACHUSETTS SP Assoc Acad Surg DE surgery; quality of care; volume; procedural volume; outcome; Leapfrog; California ID NEW-YORK-STATE; AFFAIRS SURGICAL RISK; MORTALITY-RATE; UNITED-STATES; SURGERY; QUALITY; CARE; OUTCOMES; CANCER; OPERATIONS AB Background. Many studies have demonstrated a significant relationship between high procedural volume and better outcomes. As the public becomes increasingly aware of this medical literature, consumer groups have collaborated with medical researchers to operationalize this body of evidence. One such organization, the Leapfrog Group, has proposed annual volume criteria for four operations: coronary bypass grafting (CABG), abdominal aortic aneurysm (AAA), carotid endarterectomy (CEA), and esophageal cancer resection (ECR). This study analyzes California hospitals within the context of these volume criteria. Materials and methods. Using the California inpatient database from 2000, we identified all CABG, AAA, CEA, and ECR operations performed at metropolitan hospitals. The volume of each of the four operations was tabulated by hospital and evaluated. Comparisons were made between academic and nonacademic hospitals. Results. Most hospitals in California did not meet Leapfrog's volume criteria. Only 2 hospitals of 287 (0.7%) met the volume criteria for the operations that it performed. Of the 71 (25%) hospitals that performed all four procedures, none met the volume criteria of all four procedures. In fact, only 10% of California hospitals performing these operations were high-volume hospitals based on Leapfrog's volume criteria. When comparing academic to nonacademic hospitals, academic hospitals performed more AAA operations than nonacademic hospitals (36 vs 12, P = 0.02). Although academic hospitals tended to have higher caseloads for CABG, CEA, and ECR, these did not reach statistical significance. Also, academic hospitals were more likely to be high volume for AAA (43.8% vs 7.0%, P < 0.01) and for ECR (23.1% vs 4.0%, P < 0.01). Conclusions. California's hospital system is far from being regionalized. Although academic hospitals appear better positioned than nonacademic hospitals, the vast majority of all hospitals do not meet Leapfrog's volume criteria. As efforts to use volume as a proxy measure of quality gain momentum, hospitals and physicians will be forced to measure and report quality. As such, surgeons need to decide between accepting volume as an adequate measure of quality and developing other possibly more direct and reliable methods. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90024 USA. W Los Angeles Vet Adm, Dept Surg, Los Angeles, CA USA. W Los Angeles Vet Adm, Dept Gen Internal Med, Los Angeles, CA USA. RP Liu, JH (reprint author), 11301 W Olymp Blvd,648, Los Angeles, CA 90064 USA. NR 23 TC 7 Z9 7 U1 1 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0022-4804 J9 J SURG RES JI J. Surg. Res. PD JUL PY 2003 VL 113 IS 1 BP 96 EP 101 DI 10.1016/S0022-4804(03)00145-8 PG 6 WC Surgery SC Surgery GA 717GZ UT WOS:000185080300014 PM 12943816 ER PT J AU Maggard, MA O'Connell, JB Lane, KE Liu, JH Etzioni, DA Ko, CY AF Maggard, MA O'Connell, JB Lane, KE Liu, JH Etzioni, DA Ko, CY TI Do young breast cancer patients have worse outcomes? SO JOURNAL OF SURGICAL RESEARCH LA English DT Article; Proceedings Paper CT 36th Annual Meeting of the Association-for-Academic-Surgery CY NOV 07-09, 2002 CL BOSTON, MASSACHUSETTS SP Assoc Acad Surg DE breast cancer; young; survival; treatment; outcomes ID WOMEN; AGE; PROGNOSIS; CARCINOMA AB Introduction. Previous studies have suggested that young breast cancer patients have poorer survival as compared with their older counterparts. Most of this research reflects single institution experiences that may not be representative of the population. This study was designed to determine whether young breast cancer patients have poorer survival as compared with an older cohort using a national population-based cancer registry and, more specifically, to determine whether differences in survival are caused by more advanced tumor stage, more aggressive disease, or patient-specific characteristics. Materials and methods. Using the Surveillance, Epidemiology, and End Results cancer database (19921998), data for all patients with a diagnosis of invasive breast cancer were extracted. Two age categories were analyzed: young group (less than or equal to35 years old, n = 4,616) and older group (50-55 years old, n = 20,319). Patient demographics, 5-year survival rates, tumor characteristics (stage, grade, and receptor status), surgical treatment, and use of radiation were compared between the groups. Results. Overall, young patients had worse 5-year survival when compared with the older group (74.3% VS. 85.1%). Stage for stage, the young patients also had poorer survival (except for stage IV). They present with more advanced stage disease and have more aggressive tumor characteristics, that is, higher grade tumors and more estrogen- and progesterone receptor-negative tumors. Even after controlling for patient characteristics, tumor factors, and receipt of treatment, a multivariate regression showed that young age was an independent risk factor for death (HR = 1.095). Conclusions. Young breast cancer patients have poorer outcomes, which are in part attributed to later stage disease, more aggressive tumors, and less favorable receptor status. There still appears to be other important factors, not included in our study, that are contributing to the worse outcomes for these young patients, such as socioeconomic status. Physicians need to have heightened awareness when evaluating this population, and increasingly efficacious adjuvant therapies need to be developed. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Calif Los Angeles, Sch Med, Dept Surg, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Robert Wood Johnson VA Clin Scholars Program, Los Angeles, CA 90095 USA. Univ Calif San Francisco, Sch Med, Dept Surg, San Francisco, CA 94143 USA. W Los Angeles Vet Affairs Med Ctr, Dept Surg, Los Angeles, CA 90073 USA. RP Maggard, MA (reprint author), Univ Calif Los Angeles, Sch Med, Dept Surg, 10833 Conte Ave,CHS,Room 72-215, Los Angeles, CA 90095 USA. NR 10 TC 79 Z9 87 U1 0 U2 1 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 JUL PY 2003 VL 113 IS 1 BP 109 EP 113 DI 10.1016/S0022-4804(03)00179-3 PG 5 WC Surgery SC Surgery GA 717GZ UT WOS:000185080300016 PM 12943818 ER PT J AU Solomon, DH Wenger, NS Saliba, D Young, RT Adelman, AM Besdine, RK Blazer, DG Cassell, CK Cummings, JL Katz, PR Kitzman, DW Lavizzo-Mourey, RJ Mondoux, LC Popovich, R Pories, WJ Wenger, N AF Solomon, DH Wenger, NS Saliba, D Young, RT Adelman, AM Besdine, RK Blazer, DG Cassell, CK Cummings, JL Katz, PR Kitzman, DW Lavizzo-Mourey, RJ Mondoux, LC Popovich, R Pories, WJ Wenger, N CA Clinical Comm TI Appropriateness of quality indicators for older patients with advanced dementia and poor prognosis SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE quality of care; vulnerable elders; geriatric syndromes ID END-STAGE DEMENTIA; VULNERABLE ELDERS; ASSESSING CARE; OF-LIFE; PROJECT; DISEASE AB OBJECTIVES: To evaluate the applicability of process-of-care quality indicators (QIs) to vulnerable elders and to measure the effect of excluding indicators based on patients' preferences and for advanced dementia and poor prognosis. DESIGN: The Assessing Care of Vulnerable Elders (ACOVE) project employed 203 QIs for care of 22 conditions (including six geriatric syndromes and 11 age-associated diseases) for community-based persons aged 65 and older at increased risk of functional decline or death. Relevant QIs were excluded for persons deciding against hospitalization or surgery. A 12-member clinical committee (CC) of geriatric experts rated whether each QI should be applied in scoring quality of care for persons with advanced dementia (AdvDem) or poor prognosis (PoorProg). Using content analysis, CC ratings were formulated into a model of QI exclusion. Quality scores with and without excluded QIs were compared. SETTING: Enrollees in two senior managed care plans, one in the northeast United States and the other in the southwest. PARTICIPANTS: CC members evaluated applicability of QIs. QIs were applied to 372 vulnerable elders in two senior managed care plans. MEASUREMENTS: Frequency and type of QIs excluded and the effect of excluding QIs on quality of care scores. RESULTS: Of the 203 QIs, a patient's preference against hospiitalization or surgery excluded 10 and eight QIs, respectively. The CC voted to exclude 81.5 QIs (40%) for patients with AdvDem and 70 QIs (34%) for patients with PoorProg. Content analysis of the CC votes revealed that QIs aimed at care coordination, safety or prevention of decline, or short-term clinical improvement or prevention with nonburdensome interventions were usually voted for inclusion (90% and 98% included for AdvDem and PoorProg, respectively), but QIs directed at long-term benefit or requiring interventions of moderate to heavy burden were usually excluded (16% and 19% included, respectively). About half of QIs aimed at age-associated diseases were voted for exclusion, whereas fewer than one-quarter of QIs for geriatric syndromes were excluded. Thirty-nine patients (10%) in our field trial held preferences or had clinical conditions that would have excluded 68 QIs. This accounted for 5% of all QIs triggered by these 39 patients and 0.6% of QIs overall. The quality score without exclusion was 0.57 and with exclusion was 0.58 (P = .89). CONCLUSION: Caution is required in applying QIs to vulnerable elders. QIs for geriatric syndromes are more likely to be applicable to these individuals than are QIs for age-associated diseases. The objectives of care, intervention burdens, and interval before anticipated benefit affect QI applicability. At least for patients with AdvDem and PoorProg, identification of applicable or inapplicable QIs is feasible. In a community-based sample of vulnerable elders, few QIs are excluded. C1 Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90049 USA. RAND Corp, Santa Monica, CA USA. Greater Los Angeles VA Med Ctr, Los Angeles, CA USA. Penn State Univ, University Pk, PA 16802 USA. Brown Univ, Providence, RI 02912 USA. Duke Univ, Med Ctr, Durham, NC USA. Univ Oregon, Hlth Sci Ctr, Eugene, OR 97403 USA. Univ Rochester, Sch Med & Dent, Rochester, NY USA. Wake Forest Univ, Bowman Gray Sch Med, Winston Salem, NC USA. Soc Social Work Leadership Hlth Care, Philadelphia, PA USA. E Carolina Univ, Sch Med, Greenville, NC USA. Emory Univ, Atlanta, GA 30322 USA. Robert Wood Johnson Fdn, Princeton, NJ 08540 USA. RP Solomon, DH (reprint author), Univ Calif Los Angeles, Sch Med, 2103 Ridge Dr, Los Angeles, CA 90049 USA. NR 18 TC 24 Z9 24 U1 2 U2 4 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUL PY 2003 VL 51 IS 7 BP 902 EP 907 DI 10.1046/j.1365-2389.2003.513331.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 701TQ UT WOS:000184185400001 PM 12834508 ER PT J AU Foody, JM Wang, Y Kiefe, CI Ellerbeck, EF Gold, J Radford, MJ Krumholz, HM AF Foody, JM Wang, Y Kiefe, CI Ellerbeck, EF Gold, J Radford, MJ Krumholz, HM TI Long-term prognostic importance of total cholesterol in elderly survivors of an acute myocardial infarction: The Cooperative Cardiovascular pilot Project SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE cholesterol; acute myocardial infarction; elderly; prognosis ID CORONARY-HEART-DISEASE; HIGH BLOOD CHOLESTEROL; ADULT TREATMENT PANEL; ALL-CAUSE MORTALITY; SERUM-CHOLESTEROL; OLDER-ADULTS; RISK-FACTORS; HEALTH; PROGRAM; PEOPLE AB OBJECTIVES: To determine the long-term prognostic importance of in-hospital total serum cholesterol in elderly survivors of acute myocardial infarction (AMI). DESIGN: Retrospective medical record review. SETTING: Acute care, nongovernmental hospitals in Alabama, Connecticut, Iowa, and Wisconsin. PARTICIPANTS: Four thousand nine hundred twenty-three Medicare beneficiaries from four states aged 65 and older discharged alive with a principal diagnosis of AMI between June 1, 1992, and February 28, 1993, who had a measurement of total serum cholesterol during hospitalization. MEASUREMENTS: Primary endpoint of all-cause mortality within 6 years of discharge. RESULTS: Of the 7,166 hospitalizations meeting study inclusion criteria, 4,923 (68.7%) had total cholesterol assessed, and 22% had a cholesterol level of 240 mg/dL or greater. Of AMI hospitalization survivors with cholesterol of 240 md/dL or greater, 17.2% died within 1 year and 47.9% died within 6 years, compared with 17.4% (P = .73) and 48.7% (P = .98) of those with a cholesterol level less than 240 mg/dL. The adjusted hazard ratio for elevated total serum cholesterol measured during hospitalization for all-cause mortality in the 6 years after discharge was 0.97 (95% confidence interval (CI) = 0.87-1.09). The unadjusted 1- and 6-year mortality rates for those with total cholesterol less than 160 mg/dL were 22.2% and 55.5%, respectively, not significantly different from mortality for patients with cholesterol of 460 mg/dL or greater, even after adjustment. CONCLUSION: Among elderly survivors of AMI, elevated total serum cholesterol measured postinfarction is not associated with an increased risk of all-cause mortality in the 6 years after discharge. Furthermore, this study found no evidence of an increased risk of all-cause mortality in patients with low total cholesterol. Further studies are needed to determine the relationship of postinfarction lipid subfractions and mortality in older patients with coronary artery disease (CAD). C1 Yale Univ, Sch Med, Dept Med, Sect Cardiovasc Med, New Haven, CT 06520 USA. Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Sect Chron Dis Epidemiol, New Haven, CT 06520 USA. Qualidigm, Middletown, CT USA. Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. Univ Alabama, Ctr Outcome & Effectivness Res & Educ, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Univ Kansas, Sch Med, Dept Prevent Med, Kansas City, KS USA. Metastar, Madison, WI USA. RP Krumholz, HM (reprint author), Yale Univ, Sch Med, Dept Med, Sect Cardiovasc Med, 333 Cedar St,Pob 208025, New Haven, CT 06520 USA. RI Ellerbeck, Edward/I-8438-2014 OI Ellerbeck, Edward/0000-0002-7774-2729 NR 31 TC 14 Z9 14 U1 2 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUL PY 2003 VL 51 IS 7 BP 930 EP 936 DI 10.1046/j.1365-2389.2003.51305.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 701TQ UT WOS:000184185400005 PM 12834512 ER PT J AU Reuben, DB Shekelle, PG Wenger, NS AF Reuben, DB Shekelle, PG Wenger, NS TI Quality of care for older persons at the dawn of the third millennium SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE quality of care; quality improvement; elderly; healthcare delivery ID CLINICAL-PRACTICE GUIDELINES; RANDOMIZED CONTROLLED TRIAL; VULNERABLE ELDERS; MEDICARE BENEFICIARIES; HEART-FAILURE; INTERVENTION; MANAGEMENT; COMMUNITY; PROJECT; PEOPLE AB During the past quarter century, researchers, providers, insurers, and governmental agencies have devoted considerable effort to improving and standardizing the quality of health care provided to older persons. Because older persons differ from younger persons as a result of their life expectancy, disease prevalence and comorbidity, social resources, goals of treatment, and preferences for care, defining and measuring quality of care has been more difficult for this age group. Nevertheless, several decades of research have led to reliable, although imperfect, methods of measuring quality, including those for geriatric conditions. Using these measurement approaches, a variety of studies using different patient populations and sampling strategies have consistently identified deficiencies in quality of care provided to older persons. Moreover, efforts to improve quality of care for older persons have been difficult to design, implement, and sustain. Some have been successful, including having effects on outcome measures, but have not made the transition from research to clinical settings. Others have used quality improvement methods to improve the care of diseases (e.g., diabetes mellitus, congestive heart failure) that commonly affect older persons. However, the lack of alignment of incentives between providers and insurers for most older persons is a major barrier to this approach. In addition, there is no concerted effort among providers, regulatory agencies, and insurers to move the quality-of-care agenda for most Medicare recipients. Despite substantial progress in defining and measuring high-quality care for older persons, the goal of ensuring that older persons receiving such care remains a distant hope. C1 Univ Calif Los Angeles, Multicampus Program Geriatr Med & Gerontol, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Div Gen Internal Med, David Geffen Sch Med, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. RAND Hlth, Santa Monica, CA USA. RP Reuben, DB (reprint author), Univ Calif Los Angeles, Multicampus Program Geriatr Med & Gerontol, David Geffen Sch Med, 10945 Conte Ave,Suite 2339, Los Angeles, CA 90095 USA. NR 38 TC 22 Z9 22 U1 7 U2 8 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUL PY 2003 VL 51 IS 7 SU S BP S346 EP S350 DI 10.1046/j.1365-2389.2003.51346.x PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 694DR UT WOS:000183759000010 PM 12823666 ER PT J AU Payne, TH Hoey, PJ Nichol, P Lovis, C AF Payne, TH Hoey, PJ Nichol, P Lovis, C TI Preparation and use of preconstructed orders, order sets, and order menus in a computerized provider order entry system SO JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION LA English DT Article ID USAGE AB Objective: To describe the configuration and use of the computerized provider order entry (CPOE) system used for inpatient and outpatient care at the authors' facility. Design: Description of order configuration entities, use patterns, and configuration changes in a production CPOE system. Measurements: The authors extracted and analyzed the content of order configuration entities (order dialogs, preconfigured [quick] orders, order sets, and order menus) and determined the number of orders entered in their production order entry system over the previous three years. The authors measured use of these order configuration entities over a six-month period. They repeated the extract two years later to measure changes in these entities. Results: CPOE system configuration, conducted before and after first production use, consisted of preparing 667 order dialogs, 5,982 preconfigured (quick) orders, and 513 order sets organized in 703 order menus for particular contexts, such as admission for a particular diagnosis. Fifty percent of the order dialogs, 57% of the quick orders, and 13% of the order sets were used within a six-month period. Over the subsequent two years, the volume of order configuration entities increased by 26%. Conclusions: These order configuration steps were time-consuming, but the authors believe they were important to increase the ordering speed and acceptability of the order entry software. Lessons learned in the process of configuring the CPOE ordering system are given. Better understanding of ordering patterns may make order configuration more efficient because many of the order configuration entities that were created were not used by clinicians. C1 Univ Washington, Acad Med Ctr Informat Syst, Seattle, WA 98115 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Hosp Geneva, Geneva, Switzerland. RP Payne, TH (reprint author), Univ Washington, Acad Med Ctr Informat Syst, 9725 3rd Ave NE,Room 400,Box 359104, Seattle, WA 98115 USA. EM tpayne@u.washington.edu RI Lovis, Christian/D-2634-2012 OI Lovis, Christian/0000-0002-2681-8076 NR 21 TC 42 Z9 42 U1 1 U2 4 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1067-5027 J9 J AM MED INFORM ASSN JI J. Am. Med. Inf. Assoc. PD JUL-AUG PY 2003 VL 10 IS 4 BP 322 EP 329 DI 10.1197/jamia.M1090 PG 8 WC Computer Science, Information Systems; Computer Science, Interdisciplinary Applications; Information Science & Library Science; Medical Informatics SC Computer Science; Information Science & Library Science; Medical Informatics GA 702UC UT WOS:000184241800005 PM 12668686 ER PT J AU Townsend, TC Saloner, D Pan, XM Rapp, JH AF Townsend, TC Saloner, D Pan, XM Rapp, JH TI Contrast material-enhanced MRA overestimates severity of carotid stenosis, compared with 3D time-of-flight MRA SO JOURNAL OF VASCULAR SURGERY LA English DT Article; Proceedings Paper CT 17th Annual Meeting of the Western-Vascular-Society CY SEP 22-25, 2002 CL NEWPORT BEACH, CALIFORNIA SP Western Vasc Soc ID MAGNETIC-RESONANCE ANGIOGRAPHY; BASIC PRINCIPLES; ARTERY STENOSIS; ULTRASONOGRAPHY; BIFURCATION; ULTRASOUND AB Objective: Non-contrast-enhanced magnetic resonance angiography (MRA) carotid imaging with the time-of-flight (TOF) technique compares favorably with angiography, ultrasound, and excised plaques. However, gadolinium, contrast-enhanced MRA (CE-MRA) has almost universally replaced TOF-MRA, because it reduces imaging time (25 seconds vs 10 minutes) and improves signal-to-noise ratio. In our practice we found alarming discrepancies between CE-MRA and TOF-MRA, which was the impetus for this study. Study design: To compare the two techniques, we measured stenosis, demonstrated on three-dimensional images obtained at TOF and CE-MRA, in 107 carotid arteries in 58 male patients. The measurements were made on a Cemax workstation equipped with enlargement and measurement tools. Measurements to 0.1 mm were made at 90 degrees to the flow channel at the area of maximal stenosis and distal to the bulb where the borders of the internal carotid artery lumen were judged to be parallel (North American Symptomatic Carotid Endarterectomy Trial criteria). Experiments with carotid phantoms were done to test the comtribution of imaging software to image quality. Results: Twelve arteries were occluded. In the remaining 95 arteries, compared with TOF-MRA, CE-MRA demonstrated a greater degree of stenosis in 42 arteries, a lesser degree of stenosis in 14 arteries, and similar (+/-5%) stenosis in 39 arteries (P = .02, chi(2) analysis). The largest discrepancies were arteries with 0% to 70% stenosis. In those arteries in which CE-MRA identified a greater degree of stenosis than shown with TOF-MRA, mean increase was 21% for 0% to 29% stenosis, 36% for 30% to 49% stenosis, and 38% for of 50% to 69% stenosis. The carotid phantom experiments showed that the imaging parameters of CE-MRA, particularly the plane on which frequency encoding gradients were applied, reduced signal acquisition at the area of stenosis. Conclusions. Collectively these data demonstrate that CE-MRA parameters must be retooled if the method is to be considered reliable for determination of severity of carotid artery stenosis. CE-MRA is an excellent screening technique, but only TOF-MRA should be used to determine degree of carotid artery stenosis. C1 San Francisco VA Med Ctr, Vasc Serv, San Francisco, CA USA. San Francisco VA Med Ctr, Serv Radiol, San Francisco, CA USA. RP Rapp, JH (reprint author), San Francisco DVA Med Ctr, Surg Serv 112G, 4150 Clement St, San Francisco, CA 94121 USA. NR 11 TC 24 Z9 24 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD JUL PY 2003 VL 38 IS 1 BP 36 EP 40 DI 10.1016/S0741-5214(03)00332-X PG 5 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 698EZ UT WOS:000183985900006 PM 12844086 ER PT J AU Ahmed, A Allman, RM AF Ahmed, A Allman, RM TI Sex-related difference in long-term mortality in elderly heart failure patients with preserved left ventricular systolic function SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Letter ID COMMUNITY C1 Univ Alabama, Div Geriatr Med, Birmingham, AL 35294 USA. Univ Alabama, Geriatr Heart Failure Clin, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Sect Geriatr, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Geriatr Heart Failure Clin, Birmingham, AL 35294 USA. Alabama Qual Assurance Fdn, Birmingham, AL USA. RP Ahmed, A (reprint author), Univ Alabama, Div Geriatr Med, 1530 3rd Ave S,CH19-219, Birmingham, AL 35294 USA. RI Ahmed, Ali/A-2934-2008 OI Ahmed, Ali/0000-0002-6832-6424 NR 7 TC 1 Z9 1 U1 0 U2 0 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD JUL PY 2003 VL 58 IS 7 BP 671 EP 672 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 702RH UT WOS:000184236700022 PM 12865493 ER PT J AU Hansen, K Abrass, CK AF Hansen, K Abrass, CK TI Laminin-8/9 is synthesized by rat glomerular mesangial cells and is required for PDGF-induced mesangial cell migration SO KIDNEY INTERNATIONAL LA English DT Article DE laminin; mesangial cells; migration; disintegration ID GROWTH-FACTOR; ALPHA-4 CHAIN; EPITHELIAL-CELLS; DEVELOPMENTAL EXPRESSION; EXTRACELLULAR-MATRIX; G-DOMAIN; A-CHAIN; KIDNEY; MICE; CULTURE AB Background. Laminin (LM), the major glycoprotein component of basement membranes is expressed as multiple isoforms in a developmentally regulated and tissue-specific manner. LM alpha4 has a limited tissue distribution and is highly expressed in the developing glomerulus. In the present study, we investigate the in vivo and in vitro expression and function of LM alpha4 in the glomerulus. Methods. LM alpha4 expression was examined by Northern blot, reverse transcription polymerase chain reaction (RT-PCR), Western blot, and immunofluorescence microscopy. Mesangial cells (MC) were plated on purified LM-1, LM-2, and LM-8/9. Immunofluorescence microscopy was performed to examine the cellular phenotypes induced by LM-1 and LM-8/9. A modified Boyden chamber method was used to assess laminin participation in platelet-derived growth factor (PDGF)-stimulated migration. Results. mRNA for LM alpha4 is expressed in cultured rat MC, and isolated rat and mouse glomeruli, but not in cultured rat glomerular epithelial cells or glomerular endothelial cells. Using antibodies specific for LM alpha4, a 240 kD band was detected in MC extract and a slightly smaller band was identified in extracted rat glomeruli. Purified LM-8/9 had MC adhesive activity comparable to LM-1 and LM-2. MC attached to LM-8/9 exhibited a unique phenotype. In contrast to LM-1, attachment of MC to LM-8/9 produced a highly arborized cell morphology with significantly reduced formation of focal contacts or stress fibers. LM alpha4 is utilized by MC during PDGF-stimulated migration. Conclusion. LM alpha4 is synthesized by MC and persists in the mature glomerulus. LM-8/9 stimulates a unique cellular morphology, and they are utilized in PDGF-induced migration. These factors suggest that LM alpha4 plays an important role in MC differentiation and in the maintenance of MC phenotype. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Div Nephrol, Seattle, WA 98195 USA. RP Abrass, CK (reprint author), Vet Affairs Puget Sound Hlth Care Syst, 111A,1660 S Columbian Way, Seattle, WA 98108 USA. FU NIDDK NIH HHS [R01 DK49771] NR 50 TC 12 Z9 13 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD JUL PY 2003 VL 64 IS 1 BP 110 EP 118 DI 10.1046/j.1523-1755.2003.00039.x PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 690KH UT WOS:000183547500014 PM 12787401 ER PT J AU Saab, S Ly, D Nieto, J Kanwal, F Lu, D Raman, S Amado, R Nuesse, B Durazo, F Han, S Farmer, DG Ghobrial, RM Yersiz, H Chen, P Schwegel, K Goldstein, LI Tong, M Busuttil, RW AF Saab, S Ly, D Nieto, J Kanwal, F Lu, D Raman, S Amado, R Nuesse, B Durazo, F Han, S Farmer, DG Ghobrial, RM Yersiz, H Chen, P Schwegel, K Goldstein, LI Tong, M Busuttil, RW TI Hepatocellular carcinoma screening in patients waiting for liver transplantation: A decision analytic model SO LIVER TRANSPLANTATION LA English DT Article ID PERCUTANEOUS ETHANOL INJECTION; TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; RANDOMIZED CONTROLLED TRIAL; COST-EFFECTIVENESS ANALYSIS; CIRRHOTIC-PATIENTS; HEPATITIS-C; RADIOFREQUENCY ABLATION; SURVEILLANCE PROGRAM; TREATMENT STRATEGY; PROGNOSTIC FACTORS AB De novo hepatocellular carcinoma (HCC) may have a large impact on patients waiting for liver transplantation. The presence of HCC can lead to a status upgrade or removal from the waitlist. Our aim is to compare costs and outcomes of different liver cancer surveillance strategies. A Markov-based decision analytic model is created to simulate costs and health outcomes for a hypothetical cohort awaiting liver transplantation undergoing HCC screening. Three strategies of HCC screening are compared with the referent strategy of using alphafetaprotein (AFP) level alone: (1) ultrasound (U/S), (2) AFP plus U/S, and (3) computed tomography (CT). Screening is performed for all strategies at 6-month intervals. Selected tumors are treated locally. Costs and clinical outcomes are discounted. Using baseline assumptions, incremental cost-effectiveness ratios (ICERs) for U/S, U/S plus AFP, and CT are $60,300/life-year saved (LY), $74,000/LY, and $101,100/LY, respectively. The most cost-effective strategy was dependent on the relative costs of each screening modality. U/S screening becomes the dominant strategy when the cost of an AFP test is decreased. Our results show that screening with CT is associated the greatest gain in life expectancy and greatest costs. U/S screening strategy is the preferred screening strategy based on the lowest ICER. Ultimately, costs of the screening modalities determine the most cost-effective strategy. C1 Univ Calif Los Angeles, Med Ctr, Div Digest Dis, Dept Surg, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Radiol, Los Angeles, CA 90095 USA. Dumont UCLA Liver Transplant Ctr, Dept Med, Los Angeles, CA USA. W Los Angeles Vet Adm Med Ctr, Dept Med, Los Angeles, CA 90073 USA. RP Saab, S (reprint author), Univ Calif Los Angeles, Med Ctr, Div Digest Dis, Dept Surg, 44-138 CHS MC 168417,10833 Le Conte Ave, Los Angeles, CA 90095 USA. NR 64 TC 47 Z9 49 U1 1 U2 3 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1527-6465 J9 LIVER TRANSPLANT JI Liver Transplant. PD JUL PY 2003 VL 9 IS 7 BP 672 EP 681 DI 10.1053/jlts.2003.50120 PG 10 WC Gastroenterology & Hepatology; Surgery; Transplantation SC Gastroenterology & Hepatology; Surgery; Transplantation GA 696GD UT WOS:000183878500003 PM 12827551 ER PT J AU LeMaster, JW Reiber, GE Smith, DG Heagerty, PJ Wallace, C AF LeMaster, JW Reiber, GE Smith, DG Heagerty, PJ Wallace, C TI Daily weight-bearing activity does not increase the risk of diabetic foot ulcers SO MEDICINE AND SCIENCE IN SPORTS AND EXERCISE LA English DT Article DE weight-bearing; physical activity; diabetes; insensate; neuropathy; risk; foot ulceration ID CARDIORESPIRATORY FITNESS; PREVENTION; ULCERATION; POPULATION; PREDICTORS; MEN; MORTALITY; PRESSURE; STRESS; TRIAL AB Daily Weight-Bearing Activity Does Not Increase the Risk of Diabetic Foot Ulcers. Med. Sci. Sports Exerc., Vol. 35, No. 7, pp. 1093-1099, 2003. Purpose: This study had two purposes: to identify characteristics associated with participants' usual weight-bearing activity, and to determine whether weight-bearing activity increased the risk of foot ulcer among persons with diabetes and prior foot ulcer. Methods: We conducted a prospective cohort study of 400 participants with diabetes and a prior history of foot ulcer. Participants were from the Veterans Affairs Puget Sound Health Care System and Group Health Cooperative in Seattle, WA, and were originally assembled for a randomized controlled trial of footwear. Feet were examined and demographic and health history information was collected at enrollment. Daily weight-bearing activity was reported at enrollment and every 17 wk thereafter for 2 yr. All incident foot lesions were recorded. Results: Weight-bearing activity was significantly higher among women. Activity was lower among participants who were older, unmarried, or who had a history of congestive heart failure, respiratory disease, stroke, or depression. Activity decreased significantly over the study period but remained similar in those with or without insensate feet. After adjustment for foot-related and health-status characteristics, moderately active participants (4.5-7.4 weight-bearing h(.)d(-1)) were at substantially but nonsignificantly reduced risk of foot ulcer compared with "least active" participants (<4.5 weight-bearing h(.)d(-1)) (OR 0.50, 95% CI 0.22-1.16). "Most active" participants (greater than or equal to7.5 weight-bearing h(.)d(-1)) were at significantly reduced risk (OR 0.20, 95% CI 0.04-0.87). Weight-bearing activity exerted similar effects on foot ulcer risk in participants with insensate versus sensate feet. Conclusion: Increased weight-bearing activity did not increase the risk of foot re-ulceration. Further studies are needed to explore weight-bearing activities that are safe for those with diabetes and insensate feet. C1 Univ Missouri, Dept Family & Community Med, Columbia, MO 65212 USA. Washington Univ, Dept Hlth Serv, Seattle, WA USA. Washington Univ, Dept Epidemiol, Seattle, WA USA. Washington Univ, Dept Orthopaed Surg, Seattle, WA USA. Washington Univ, Dept Biostat, Seattle, WA USA. Dept Vet Affairs, VA Puget Sound Hlth Care Syst, Hlth Serv & Rehabil Res & Dev, Seattle, WA USA. RP LeMaster, JW (reprint author), Univ Missouri, Dept Family & Community Med, 1 Hosp Dr, Columbia, MO 65212 USA. NR 27 TC 45 Z9 45 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0195-9131 J9 MED SCI SPORT EXER JI Med. Sci. Sports Exerc. PD JUL PY 2003 VL 35 IS 7 BP 1093 EP 1099 DI 10.1249/01.MSS.0000074459.41029.75 PG 7 WC Sport Sciences SC Sport Sciences GA 697TG UT WOS:000183958900005 PM 12840628 ER PT J AU Camicioli, R Moore, MM Kinney, A Corbridge, E Glassberg, K Kaye, JA AF Camicioli, R Moore, MM Kinney, A Corbridge, E Glassberg, K Kaye, JA TI Parkinson's disease is associated with hippocampal atrophy SO MOVEMENT DISORDERS LA English DT Review DE Parkinson's disease; dementia; Alzheimer's disease; MRI; hippocampus; atrophy ID LEWY BODY DISEASE; PROGRESSIVE SUPRANUCLEAR PALSY; REGIONAL BRAIN ATROPHY; TEMPORAL-LOBE ATROPHY; ALZHEIMERS-DISEASE; VASCULAR DEMENTIA; CLINICAL-DIAGNOSIS; BODIES; MRI; HALLUCINATIONS AB Patients with Parkinson's disease (PD) may have hippocampal atrophy compared with controls. We compared hippocampal, and extra-hippocampal volumes between PD, PDD (patients with PD who have mild cognitive impairment or dementia), Alzheimer's disease (AD) and controls using volumetric magnetic resonance imaging (MRI). Participants (10 patients with PD, 10 with PDD, I I with AD, and 12 control subjects) had an informant interview, neurological examination, and psychometric testing. Established, reliable methods were used to measure the hippocampus, parahippocampal gyrus, temporal, frontal, and parieto-occipital lobes. Correction for intracranial volume was carried out before comparison . There was no age difference between groups (mean age, 74 years). On the Clinical Dementia Rating scale (CDR) cognitive impairment was mild (CDR = 0.5) in the majority of PDD and AD patients. Hippocampal (P < 0.0004) volumes were smaller in the patient groups. Effect sizes compared with the control group were: PD, 0.66; PDD, 1.22; and AD, 1.81. The other volumes did not differ significantly. Among PD and PDD patients, recognition memory (r = 0.54, P = 0.015) and Mini-Mental State Examination scores (r = 0.56, P = 0.01) correlated with left, but not right hippocampal volume. In conclusion, hippocampal volume showed a pattern (Control > PD > PDD > AD) suggesting progressive hippocampal volume loss in PD. Volumetric MRI imaging might provide an early marker for dementia in PD. (C) 2003 Movement Disorder Society. C1 Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR USA. Portland Vet Affairs Med Ctr, Portland, OR USA. Univ Alberta, Dept Med Neurol, Edmonton, AB, Canada. RP Camicioli, R (reprint author), Univ Alberta, Dept Med, Glenrose Rehabil Hosp, Room E-223,10230-11 Ave, Edmonton, AB T5G 0B7, Canada. OI Kaye, Jeffrey/0000-0002-9971-3478; Camicioli, Richard/0000-0003-2977-8660 FU NCRR NIH HHS [5M01RR0034]; NIA NIH HHS [AG08017] NR 48 TC 160 Z9 169 U1 2 U2 8 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD JUL PY 2003 VL 18 IS 7 BP 784 EP 790 DI 10.1002/mds.10444 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 701CA UT WOS:000184148300007 PM 12815657 ER PT J AU Davalos, DB Kisley, MA Polk, SD Ross, RG AF Davalos, DB Kisley, MA Polk, SD Ross, RG TI Mismatch negativity in detection of interval duration deviation in schizophrenia SO NEUROREPORT LA English DT Article DE interval discrimination; MMN; schizophrenia; time perception ID EVENT-RELATED POTENTIALS; TIME-ESTIMATION; AUDITORY-STIMULI; ATTENTION; DEFICITS; ERPS AB Temporal processing deficits have been noted in behavioral studies assessing patients with schizophrenia. The current study sought to explore the physiology of temporal perception while controlling the effects of motivation, attention and other cognitive processes that may contribute to behavioral measures of temporal processing. Mismatch negativity (MMN) waveforms were measured in response to variations in the temporal parameters of an ongoing train of pure tones. A standard inter-stimulus interval of 400 ms was interrupted, on average, every 20th tone by an inter-stimulus interval of 340 ms. Amplitude of MMN waveform elicited by the temporal deviance was significantly reduced in the schizophrenia group compared with controls (p=0.016). Results suggest that behavioral difficulties on time processing tasks in schizophrenia may reflect a physiological deficit in temporal perception in this population rather than simply more general difficulties in attention or motivation. C1 Univ Colorado, Hlth Sci Ctr, Denver, CO 80262 USA. Denver VA Med Ctr, Denver, CO 80262 USA. Univ Colorado, Colorado Springs, CO 80907 USA. RP Davalos, DB (reprint author), Univ Colorado, Hlth Sci Ctr, 4200 E 9th Ave,Campus Box C268-71, Denver, CO 80262 USA. FU NIMH NIH HHS [MH56539, MH152442] NR 25 TC 29 Z9 30 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0959-4965 J9 NEUROREPORT JI Neuroreport PD JUL 1 PY 2003 VL 14 IS 9 BP 1283 EP 1286 DI 10.1097/01.wnr.0000081874.45938.98 PG 4 WC Neurosciences SC Neurosciences & Neurology GA 707AC UT WOS:000184486400019 PM 12824776 ER PT J AU Ostrow, JD Pascolo, L Tiribelli, C AF Ostrow, JD Pascolo, L Tiribelli, C TI Reassessment of the unbound concentrations of unconjugated bilirubin in relation to neurotoxicity in vitro SO PEDIATRIC RESEARCH LA English DT Article ID DEVELOPING RAT-BRAIN; SERUM-ALBUMIN; OXIDATIVE STRESS; TOXICITY; NEURONS; ASTROCYTES; APOPTOSIS; BINDING; ENCEPHALOPATHY; INHIBITION AB Most studies of the cellular toxicity of unconjugated bilirubin (UCB) have been performed at concentrations of unbound UCB (B-F) that exceed those in the plasma of neonates with bilirubin encephalopathy. We assessed whether UCB could be toxic to neurons and astrocytes at clinically relevant B-F values (less than or equal to 1.0 muM), a range in which spontaneous precipitation of UCB would be unlikely to occur, even though B-F exceeded the aqueous saturation limit of 70 nM. A meta-analysis yielded twelve published studies that had determined the in vitro effects of UCB on the function of cultured neurons or astrocytes at calculable BF values less than or equal to 1.0 muM. B-F values were recalculated from the stated UCB, albumin, and chloride concentrations by applying affinity constants derived from ultrafiltration of comparable solutions containing C-14-UCB and delipidated human serum albumin. At B-F slightly above aqueous solubility, UCB impaired mitochondrial function and viability of astrocytes. Exposure of neuroblastoma and embryonic neuronal cell lines to B-F above 250 nM impaired cellular proliferation and mitochondrial function and increased apoptosis. Purified UCB inhibited the uptake of glutamate into astrocytes at B-F as low as 309 nM and induced apoptosis in brain neurons at B-F as low as 85 nM. UCB can impair various cellular functions of astrocytes and neurons exposed to BF near or modestly above its aqueous solubility limit, at which UCB exists as soluble oligomers and metastable micro-aggregates. The results render doubtful the long-held concept that precipitation of UCB in or on cells is required to produce neurotoxicity. C1 VA Puget Sound Hlth Care Syst, Seattle Div, Res Serv 151L, Seattle, WA USA. Univ Washington, Sch Med, Dept Med, GI Hepatol Div, Seattle, WA 98195 USA. Univ Trieste, Liver Study Ctr, I-34012 Trieste, Italy. RP Ostrow, JD (reprint author), VA Puget Sound Hlth Care Syst, Seattle Div, Res Serv 151L, 1660 S Columbian Way, Seattle, WA USA. NR 46 TC 51 Z9 58 U1 0 U2 2 PU INT PEDIATRIC RESEARCH FOUNDATION, INC PI BALTIMORE PA 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436 USA SN 0031-3998 J9 PEDIATR RES JI Pediatr. Res. PD JUL PY 2003 VL 54 IS 1 BP 98 EP 104 DI 10.1203/01.PDR.0000067486.79854.D5 PG 7 WC Pediatrics SC Pediatrics GA 692YC UT WOS:000183687000017 PM 12646712 ER PT J AU Corey, E Quinn, JE Vessella, RL AF Corey, E Quinn, JE Vessella, RL TI A novel method of generating prostate cancer metastases from orthotopic implants SO PROSTATE LA English DT Article DE prostate cancer; prostate specific antigen; xenografts; metastasis ID NUDE-MICE; CELL-LINES; MODEL; LNCAP; BONE; PROGRESSION AB BACKGROUND. Spontaneous metastasis following implantation at the orthotopic site is a highly desired feature in prostate cancer (CaP) models, since it would enable studies of mechanisms associated with tumor cell dissemination. METHODS. LuCaP 23.8 and LuCaP 35, hormone-sensitive CaP xenografts that express PSA and the wild-type androgen receptor, were grown orthotopically in SCID mice. When tumor volumes reached similar to250-500 mg, primary tumors were removed to allow micrometastases to grow. RESULTS. Using this procedure we generated macroscopic metastases (>20 mg) in 71% (LuCaP 23.8) and 100% (LuCaP 35) of animals, respectively. CONCLUSIONS. These models may be used to evaluate new treatment modalities and study mechanisms associated with development of metastases. (C) 2003 Wiley-Liss, Inc. C1 Univ Washington, Dept Urol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Corey, E (reprint author), Univ Washington, Dept Urol, Mail Stop 356510,1959 NE Pacific St, Seattle, WA 98195 USA. FU NIDDK NIH HHS [2 P0 DK47656-08] NR 14 TC 20 Z9 23 U1 0 U2 2 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0270-4137 J9 PROSTATE JI Prostate PD JUL 1 PY 2003 VL 56 IS 2 BP 110 EP 114 DI 10.1002/pros.10235 PG 5 WC Endocrinology & Metabolism; Urology & Nephrology SC Endocrinology & Metabolism; Urology & Nephrology GA 693TC UT WOS:000183733600004 PM 12746835 ER PT J AU Green, MF Nuechterlein, KH Breitmeyer, B Tsuang, J Mintz, J AF Green, MF Nuechterlein, KH Breitmeyer, B Tsuang, J Mintz, J TI Forward and backward visual masking in schizophrenia: influence of age SO PSYCHOLOGICAL MEDICINE LA English DT Article ID INFORMATION-PROCESSING DEFICITS; NEGATIVE-SYMPTOM SCHIZOPHRENIA; MEDICATION STATUS; POSITIVE-SYMPTOM; VULNERABILITY; OSCILLATIONS; PERFORMANCE; TRANSIENT; DISORDER; CHANNELS AB Background. Visual masking tasks assess the earliest stages of visual processing. This study was conducted to address: (1) whether schizophrenia patients show masking deficits after controlling for sensory input factors; (2) whether patients have relatively intact forward masking (when the mask precedes the target) compared with backward masking (when the mask follows the target); and (3) whether the masking deficits in schizophrenia reflect an accelerated age-related decline in performance. Method. A staircase method was used to ensure that the unmasked target identification was equivalent across subjects to eliminate any confounding due to differences in discrimination of simple perceptual inputs. Three computerized visual masking tasks were administered to 120 schizophrenia patients (ages 18-56) and 55 normal comparison subjects (ages 19-54) under both forward and backward masking conditions. The tasks included: (1) locating a target; (2) identifying a target with a high-energy mask; and (3) identifying a target with a low-energy mask. Results. Patients showed deficits across all three masking tasks. Interactions of group by forward versus backward masking were not significant, suggesting that deficits in forward and backward masking were comparable. All three conditions showed an age-related decline in performance and rates of decline were comparable between patients and controls. Two of the masking conditions showed increased rates of decline in backward, compared to forward, masking. Conclusions. We found age-related decline in performance that was comparable for the two groups. In addition, we failed to find evidence of a relative sparing of forward masking in schizophrenia. These results suggest that: (1) early visual processing deficits in schizophrenia are not due to a simple perceptual input problem; (2) sustained channels are involved in the masking deficit (in addition to transient channels); and (3) for the age range in this study, these deficits in schizophrenia are not age-related. C1 Univ Calif Los Angeles, Inst Neuropsychiat, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Harbor Med Ctr, Los Angeles, CA 90024 USA. VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Univ Houston, Dept Psychol, Houston, TX USA. RP Green, MF (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, Dept Psychiat & Biobehav Sci, 76 Westwood Plaza,C9-420, Los Angeles, CA 90024 USA. FU NIMH NIH HHS [MH-43292, MH-37705, MH-30911] NR 41 TC 33 Z9 33 U1 0 U2 3 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0033-2917 J9 PSYCHOL MED JI Psychol. Med. PD JUL PY 2003 VL 33 IS 5 BP 887 EP 895 DI 10.1017/S003329170200716X PG 9 WC Psychology, Clinical; Psychiatry; Psychology SC Psychology; Psychiatry GA 704VZ UT WOS:000184362600014 PM 12877403 ER PT J AU Berger, DH Ko, CY Spain, DA AF Berger, DH Ko, CY Spain, DA CA Social Legislative Issues Comm Soc TI Society of University Surgeons position statement on the volume-outcome relationship for surgical procedures SO SURGERY LA English DT Article ID QUALITY-IMPROVEMENT-PROGRAM; IN-HOSPITAL MORTALITY; NEW-YORK-STATE; CANCER RESECTION; PATIENT OUTCOMES; UNITED-STATES; RISK-FACTORS; HEALTH-CARE; PREDICTORS; OPERATIONS C1 Baylor Coll Med, Houston Vet Affairs Med Ctr, Dept Surg, Houston, TX 77030 USA. Baylor Coll Med, Michael E DeBakey Dept Surg, Houston, TX 77030 USA. RP Berger, DH (reprint author), Baylor Coll Med, Houston Vet Affairs Med Ctr, Dept Surg, 112 OCL,2002 Holcombe Blvd, Houston, TX 77030 USA. NR 32 TC 22 Z9 22 U1 1 U2 1 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0039-6060 J9 SURGERY JI Surgery PD JUL PY 2003 VL 134 IS 1 BP 34 EP 40 DI 10.1067/msy.2003.157 PG 7 WC Surgery SC Surgery GA 706MD UT WOS:000184456700010 PM 12874580 ER PT J AU Krieger, JN Ross, SO Deutsch, LA Fritsche, TR Riley, DE AF Krieger, JN Ross, SO Deutsch, LA Fritsche, TR Riley, DE TI Counting leukocytes in expressed prostatic secretions from patients with chronic prostatitis/chronic pelvic pain syndrome SO UROLOGY LA English DT Article ID NON-BACTERIAL PROSTATITIS; INFLAMMATION; CLASSIFICATION; CYTOKINES; SYMPTOMS; COHORT; FLUID; MEN AB Objectives. The evaluation of WBCs in EPS is recommended for classifying patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) but no agreement has been reached on the optimal method. We sought to determine the relationship between the expressed prostatic secretions (EPS) leukocyte (WBC) count per high-power field (evaluated by a more quantitative wet mount method and the traditional gram-stained smear method used in clinical microbiology laboratories) and the EPS WBC concentration to determine whether quantitative methods are necessary for accurate patient classification. Methods. EPS collected from 94 patients with CP/CPPS were evaluated by gram-stained smear, a standardized wet mount, and a hemocytometer method. Results. The gram-stained smear detected EPS WBCs in 21 (22%) of 94 subjects compared with 78 (83%) by the standardized wet mount and 57 (60%) by the hemocytometer method. The gram-stained EPS WBC count correlated poorly with the WBC concentration by hemocytometer (R-2=0.051, P=0.03). Although the standardized EPS WBC count correlated better with the concentration by hemocytometer, the correlation coefficient remained low (R-2=0.244, P<0.0001). Conclusions. The standardized wet mount proved superior to the gram-stained smear, but both methods lacked precision. Quantitative determination of the EPS WBC concentration by a counting chamber method proved to be the superior evaluation for research studies of CP/CPPS. C1 Univ Washington, Sch Med, Dept Urol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Lab Med, Seattle, WA 98195 USA. RP Krieger, JN (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Urol Sect, 112-GU,1660 S Columbian Way,Univ Washington Campu, Seattle, WA 98108 USA. FU NIDDK NIH HHS [R01-DK38955] NR 20 TC 6 Z9 8 U1 0 U2 0 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 JUL PY 2003 VL 62 IS 1 BP 30 EP 34 DI 10.1016/S0090-4295(03)00237-1 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 696NH UT WOS:000183892600010 PM 12837417 ER PT J AU McGlynn, EA Asch, SM Adams, J Keesey, J Hicks, J DeCristofaro, A Kerr, EA AF McGlynn, EA Asch, SM Adams, J Keesey, J Hicks, J DeCristofaro, A Kerr, EA TI The quality of health care delivered to adults in the United States SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; ELDERLY MEDICARE BENEFICIARIES; STANDARDIZED PATIENTS; MANAGED CARE; UNDERUSE; APPROPRIATENESS; OUTCOMES; TRIALS; SYSTEM; HYPERTENSION AB BACKGROUND: We have little systematic information about the extent to which standard processes involved in health care -- a key element of quality -- are delivered in the United States. METHODS: We telephoned a random sample of adults living in 12 metropolitan areas in the United States and asked them about selected health care experiences. We also received written consent to copy their medical records for the most recent two-year period and used this information to evaluate performance on 439 indicators of quality of care for 30 acute and chronic conditions as well as preventive care. We then constructed aggregate scores. RESULTS: Participants received 54.9 percent (95 percent confidence interval, 54.3 to 55.5) of recommended care. We found little difference among the proportion of recommended preventive care provided (54.9 percent), the proportion of recommended acute care provided (53.5 percent), and the proportion of recommended care provided for chronic conditions (56.1 percent). Among different medical functions, adherence to the processes involved in care ranged from 52.2 percent for screening to 58.5 percent for follow-up care. Quality varied substantially according to the particular medical condition, ranging from 78.7 percent of recommended care (95 percent confidence interval, 73.3 to 84.2) for senile cataract to 10.5 percent of recommended care (95 percent confidence interval, 6.8 to 14.6) for alcohol dependence. CONCLUSIONS: The deficits we have identified in adherence to recommended processes for basic care pose serious threats to the health of the American public. Strategies to reduce these deficits in care are warranted. C1 RAND Corp, Santa Monica, CA 90407 USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. VA Ann Arbor Hlth Care Syst, VA Ctr Practice Management & Outcomes Res, Ann Arbor, MI USA. Univ Michigan, Dept Med, Ann Arbor, MI 48109 USA. RP McGlynn, EA (reprint author), RAND Corp, 1700 Main St,POB 2138, Santa Monica, CA 90407 USA. NR 51 TC 2532 Z9 2555 U1 13 U2 98 PU MASSACHUSETTS MEDICAL SOC/NEJM 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 26 PY 2003 VL 348 IS 26 BP 2635 EP 2645 DI 10.1056/NEJMsa022615 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 693PN UT WOS:000183726400008 PM 12826639 ER PT J AU Watson, GS Peskind, ER Asthana, S Purganan, K Wait, C Chapman, D Schwartz, MW Plymate, S Craft, S AF Watson, GS Peskind, ER Asthana, S Purganan, K Wait, C Chapman, D Schwartz, MW Plymate, S Craft, S TI Insulin increases CSF A beta 42 levels in normal older adults SO NEUROLOGY LA English DT Article ID AMYLOID BETA-PROTEIN; APOLIPOPROTEIN-E GENOTYPE; ALZHEIMERS-DISEASE; DEGRADING ENZYME; CEREBROSPINAL-FLUID; EXTRACELLULAR LEVELS; DIABETES-MELLITUS; A-BETA; DEGRADATION; MEMORY AB Background: Abnormal insulin metabolism may contribute to the clinical symptoms and pathophysiology of AD. In vitro studies show that insulin enhances the release of beta- amyloid protein ( Abeta) or inhibits its degradation, either of which might increase amyloid burden. Methods: On separate mornings, 16 healthy older adults ( 10 women, 6 men; mean age 68.7 years, SD 8.6 years) each underwent two infusions consisting of either saline ( placebo) or insulin ( 1.0 mU. kg(-1).min(-1)) plus dextrose to maintain euglycemia. After 120 minutes of infusion, blood, CSF, and cognitive measures were acquired. Results: As expected, insulin infusion produced an increase in CSF insulin concentration. Insulin infusion also led to an increase in CSF Abeta42 levels, most notably in older subjects. As has been observed previously, insulin infusion facilitated declarative memory, but such facilitation was attenuated in the subjects with the greatest increase in CSF Abeta42 levels. Conclusions: These findings are consistent with recent in vitro studies of insulin effects on Abeta and support the notion that insulin may modulate Abeta42 levels acutely in humans. C1 Washington Univ, Sch Med, VAPSHCS, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Washington Univ, Sch Med, VAPSHCS, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. Washington Univ, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98108 USA. Washington Univ, Sch Med, Dept Med, Seattle, WA 98108 USA. Univ Wisconsin, Sch Med, Dept Med, Madison, WI USA. Univ Wisconsin, Sch Med, William S Middleton Mem Vet Hosp, Ctr Geriatr Res Educ & Clin, Madison, WI USA. RP Craft, S (reprint author), Washington Univ, Sch Med, VAPSHCS, Ctr Geriatr Res Educ & Clin, S-182,1660 S Columbian Way, Seattle, WA 98108 USA. RI Schwartz, Michael/H-9950-2012 FU NIA NIH HHS [T32 AG00258, R01 AG10880] NR 33 TC 155 Z9 168 U1 2 U2 10 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD JUN 24 PY 2003 VL 60 IS 12 BP 1899 EP 1903 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 693CF UT WOS:000183696500005 PM 12821730 ER PT J AU Collins, TC Petersen, NJ Suarez-Almazor, M Ashton, CM AF Collins, TC Petersen, NJ Suarez-Almazor, M Ashton, CM TI The prevalence of peripheral arterial disease in a racially diverse population SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 20th Annual Meeting of the Veterans-Affairs-Health-Services-Research-and-Development-Service CY FEB 14, 2002 CL WASHINGTON, D.C. SP Veterans Affairs Hlth Serv Res Dev Serv ID ANKLE-BRACHIAL INDEX; INTERMITTENT CLAUDICATION; DEFINED POPULATION; PREDICTOR; MORTALITY; ADULTS; EVENTS; TRIAL; RISK AB Background: The purpose of this study was to determine the prevalence of peripheral arterial disease (PAD) in white, African American, and English- and Spanish-speaking Hispanic patients. Methods: We screened patients older than 50 years for PAD at 4 primary care clinics located in the Houston Veterans Affairs Medical Center and the Harris County Hospital District. The disease was diagnosed by an ankle-brachial index of less than 0.9. Patients also completed questionnaires to ascertain symptoms of intermittent claudication, walking difficulty, medical history, and quality of life. Results: We enrolled 403 patients (136 whites-, 136 African Americans, and 131 Hispanics, 81 of whom were Spanish speaking). The prevalence of PAD was 13.2% among whites, 22.8% among African Americans, and 13.7% among Hispanics (P=.06). African Americans had a significantly higher prevalence of PAD than whites and Hispanics combined (P=.02). Among all patients who were diagnosed as having PAD on the basis of their ankle-brachial index, only 5 (7.5%) had symptoms of intermittent claudication. Conclusions: Peripheral arterial disease is a prevalent illness in the primary care setting. Its prevalence varies by race and is higher in African Americans than in whites and Hispanics. Relative to the prevalence of PAD, the prevalence of intermittent claudication is low. Since measurement of the ankle-brachial index is not part of the routine clinic visit, many patients with PAD are not diagnosed unless they develop symptoms of intermittent claudication. Because of this, it is likely that many patients remain undiagnosed. Efforts are needed to improve PAD detection in the primary care setting. C1 Dept Vet Affairs, Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. RP Collins, TC (reprint author), Dept Vet Affairs, Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. NR 27 TC 79 Z9 83 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JUN 23 PY 2003 VL 163 IS 12 BP 1469 EP 1474 DI 10.1001/archinte.163.12.1469 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 693FC UT WOS:000183705400012 PM 12824097 ER PT J AU Garnovskaya, MN Mukhin, YV Turner, JH Vlasova, TM Ullian, ME Raymond, JR AF Garnovskaya, MN Mukhin, YV Turner, JH Vlasova, TM Ullian, ME Raymond, JR TI Mitogen-induced activation of Na+/H+ exchange in vascular smooth muscle cells involves Janus kinase 2 and Ca2+/calmodulin SO BIOCHEMISTRY LA English DT Article ID SODIUM-PROTON EXCHANGE; ANGIOTENSIN-II; PROTEIN-KINASE; TYROSINE PHOSPHORYLATION; SIGNAL-TRANSDUCTION; GROWTH-FACTOR; H+ EXCHANGER; LYSOPHOSPHATIDIC ACID; INTRACELLULAR CALCIUM; 5-HT1A RECEPTOR AB The sodium/proton exchanger type 1 (NHE-1) plays an important role in the proliferation of vascular smooth muscle cells (VSMC). We have examined the regulation of NHE-1 by two potent mitogens, serotonin (5-HT, 5-hydroxytryptamine) and angiotensin II (Ang II), in cultured VSMC derived from rat aorta. 5-HT and Ang II rapidly activated NHE-1 via their G protein-coupled receptors (5-HT2A and AT(1)) as assessed by proton microphysiometry of quiescent cells and by measurements of intracellular pH on a FLIPR (fluorometric imaging plate reader). Activation of NHE-1 was blocked by inhibitors of phospholipase C, CaM, and Jak2 but not by pertussis toxin or inhibitors of protein kinase C. Immunoprecipitation/immunoblot studies showed that 5-HT and Ang II induce phosphorylation of Jak2 and induce the formation of signal transduction complexes that included Jak2, CaM, and NHE-1. The cell-permeable Ca2+ chelator BAPTA-AM blocked activation of Jak2, complex formation between Jak2 and CaM, and tyrosine phosphorylation of CaM, demonstrating that elevated intracellular Ca2+ is essential for those events. Thus, mitogen-induced activation of NHE-1 in VSMC is dependent upon elevated intracellular Ca2+ and is mediated by the Jak2-dependent tyrosine phosphorylation of CaM and subsequent increased binding of CaM to NHE-1, similar to the pathway previously described for the bradykinin B-2 receptor in inner medullary collecting duct cells of the kidney [Mukhin, Y. V., et al. (2001) J. Biol. Chem. 276, 17339-17346]. We propose that this pathway represents a fundamental mechanism for the rapid regulation of NHE-1 by G(q/11) protein-coupled receptors in multiple cell types. C1 Med Univ S Carolina, Med Serv, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Res Serv, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. RP Garnovskaya, MN (reprint author), Med Univ S Carolina, Med Serv, Ralph H Johnson Vet Affairs Med Ctr, 96 Jonathan Lucas St,Room 829 CSB,POB 250623, Charleston, SC 29425 USA. FU NCRR NIH HHS [S10RR013005]; NIDDK NIH HHS [DK52448, K01-DK02694] NR 58 TC 20 Z9 21 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 17 PY 2003 VL 42 IS 23 BP 7178 EP 7187 DI 10.1021/bi034563+ PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 689FQ UT WOS:000183481300028 PM 12795614 ER PT J AU Reyes, M Freeman, GL Escobedo, D Lee, SK Steinhelper, ME Feldman, MD AF Reyes, M Freeman, GL Escobedo, D Lee, SK Steinhelper, ME Feldman, MD TI Enhancement of contractility with sustained afterload in the intact murine heart - Blunting of length-dependent activation SO CIRCULATION LA English DT Article DE pressure; afterload; hemodynamics; ontractility; diastole ID CARDIAC TROPONIN-T; FAMILIAL HYPERTROPHIC CARDIOMYOPATHY; PRESSURE-VOLUME RELATIONSHIP; CLOSED-CHEST DOGS; CONDUCTANCE CATHETER; HOMEOMETRIC AUTOREGULATION; CONSCIOUS DOGS; MOUSE; RELAXATION; MUSCLE AB Background-It has been hypothesized that because of its rapid heart rate, the intact murine heart functions near maximal contractility in the basal state. If this hypothesis is correct, then the fast and slow components of myocardial length-dependent activation should be blunted compared with larger mammals. Methods and Results-Mice (n = 24) were anesthetized, and via an open chest, LV pressure-volume relationships were determined by a dual-frequency conductance catheter system. Baseline pressure-volume relationships were determined during transient occlusion of the inferior vena cava, and repeat measurements were made after 1 (n = 10) and 7 (n = 21) minutes of sustained aortic occlusion. Control experiments were performed in a subset of mice (n = 3). For baseline to 1 minute, an increase in afterload (maximal pressure 95 +/- 9 to 126 +/- 7 mm Hg; P < 0.001) and effective arterial elastance (5.9 +/- 3.1 to 9.2 +/- 3.9 mm Hg/μl; P < 0.001) resulted in an increase in end-diastolic volume (31 +/- 8 to 35 +/- 9 muL; P < 0.001). The result was maintenance of stroke volume (17 +/- 6 to 15 +/- 6; P = NS) owing to an increase in contractility (leftward shift in V-100 [the volume of end-systolic elastance at 100 mm Hg], 24 +/- 9 to 16 +/- 5 μL; P < 0.001). No additional augmentation of systolic function was found at 7 minutes. Conclusions-This study demonstrates that the fast phase of length-dependent activation is intact but not the slow phase, consistent with murine myocardium functioning near maximal contractility in the basal state. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Cardiol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Feldman, MD (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Cardiol, Room 5-642 U,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NHLBI NIH HHS [HL-67475] NR 39 TC 12 Z9 12 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD JUN 17 PY 2003 VL 107 IS 23 BP 2962 EP 2968 DI 10.1161/01.CIR.0000070964.96190.67 PG 7 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 691NQ UT WOS:000183612700017 PM 12771002 ER PT J AU Wallace, MB Block, M Hoffman, BJ Hawes, RH Silvestri, G Reed, CE Mitas, M Ravenel, J Fraig, M Miller, S Jones, ET Boylan, A AF Wallace, MB Block, M Hoffman, BJ Hawes, RH Silvestri, G Reed, CE Mitas, M Ravenel, J Fraig, M Miller, S Jones, ET Boylan, A TI Detection of telomerase expression in mediastinal lymph nodes of patients with lung cancer SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE non-small cell lung cancer; staging; biomarkers; endoscopic ultrasound; micrometastases ID POLYMERASE-CHAIN-REACTION; FINE-NEEDLE ASPIRATION; MINIMAL RESIDUAL DISEASE; QUANTITATIVE RT-PCR; REVERSE-TRANSCRIPTASE; BREAST-CANCER; PROGNOSTIC-SIGNIFICANCE; ENDOSCOPIC ULTRASONOGRAPHY; OCCULT MICROMETASTASES; COMPUTED-TOMOGRAPHY AB Mediastinal lymph nodes are the most common site of tumor spread in non-small cell lung cancer (NSCLC). We hypothesized that micro-metastatic disease could be detected by reverse transcription-polymerase chain reaction (RT-PCR) for expression of human telomerase reverse transcriptase (hTERT) in mediastinal lymph nodes and that a minimally invasive technique (endoscopic ultrasound-guided fine-needle aspiration [EUS-FNA]) is capable of sampling lymph nodes for PCR analysis without surgery. Mediastinal lymph nodes were sampled with EUS-FNA in patients with NSCLC and negative control subjects undergoing EUS for benign disease. Total RNA was harvested from samples, and RT-PCR was performed to detect telomerase gene expression. RNA was available from 87 of 100 lymph node aspirates from 39 patients with NSCLC and from 12 negative control patients. hTERT was expressed in 0 of 14 negative control lymph nodes in 18 of 57 pathologically negative lymph nodes from cancer patients and in 10 of 16 pathologically positive lymph nodes (p < 0.05). Five of 18 (28%) patients with no pathologically evident mediastinal disease expressed telomerase in at least one lymph node. Minimally invasive EUS-FNA with RT-PCR is capable of detecting expression of cancer specific mRNA in lymph nodes. Approximately one-third of pathologically negative mediastinal lymph nodes in NSCLC patients express hTERT mRNA. The clinical significance of this observation is yet to be determined. C1 Med Univ S Carolina, Div Gastroenterol, Ctr Digest Dis, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Surg, Div Pulm Med & Crit Care, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA. Ralph H Johnson Vet Adm Med Ctr, Dept Pathol, Charleston, SC USA. RP Wallace, MB (reprint author), Med Univ S Carolina, Div Gastroenterol, Ctr Digest Dis, 96 Jonathon Lucas St,Suite 210 CSB,POB 250327, Charleston, SC 29425 USA. RI Fraig, Mostafa/I-1670-2016 OI Fraig, Mostafa/0000-0003-1119-3672 FU NCI NIH HHS [R21/R33 CA97875-01] NR 58 TC 38 Z9 41 U1 0 U2 1 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD JUN 15 PY 2003 VL 167 IS 12 BP 1670 EP 1675 DI 10.1164/rccm.200211.1297OC PG 6 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 689CD UT WOS:000183473300015 PM 12615614 ER PT J AU Quintana, J Wong, T Ortiz-Portillo, E Marder, SR Mazziotta, JC AF Quintana, J Wong, T Ortiz-Portillo, E Marder, SR Mazziotta, JC TI Right lateral fusiform gyrus dysfunction during facial information processing in schizophrenia SO BIOLOGICAL PSYCHIATRY LA English DT Article DE schizophrenia; cognitive deficits; fusiform gyrus; face processing; social cognition ID CEREBRAL-BLOOD-FLOW; DORSOLATERAL PREFRONTAL CORTEX; AUTOMATED IMAGE REGISTRATION; AFFECT RECOGNITION; WORKING-MEMORY; DIFFERENTIAL DEFICIT; ANTERIOR CINGULATE; HUMAN BRAIN; PHYSIOLOGICAL DYSFUNCTION; FUNCTIONAL NEUROANATOMY AB Background: Patients with schizophrenia exhibit facial information processing deficits that likely contribute to their social dysfunction. Whether the deficits involve facial affect and/or identity processing or result from other cognitive abnormalities in schizophrenia remains controversial, and a brain dysfunction specifically related to them has never been reported. If such dysfunction existed, it should be consistently observed across groups of patients and during performance of different facial information processing tasks, independently of whether such tasks demand working memory (WM), semantic, or other cognitive processes. We hypothesized that the right lateral fusiform gyrus (rLFG), one of several human brain areas involved in facial information processing, would consistently show activation abnormalities during both facial affect and identify discrimination in schizophrenia. Methods: We used functional magnetic resonance imaging to measure brain activation in two groups of six chronic, stable schizophrenic outpatients and two of six age- and gender-matched healthy controls. One group of patients and one of controls performed facial affect-with or without semantic processing-and identity discrimination tasks, and the other two groups WM tasks with facial expression cues and varying attentional demands. Results: Patients from either group failed to activate the rLFG when compared to controls in any task. Other activation abnormalities were task-specific (i.e., seen only during performance of one set of tasks) and not consistently observed in both groups of patients, and thus could not be directly and solely linked to facial information discrimination. Conclusions: These results indicate a specific rLFG dysfunction during early facial information-identity or affect-processing, independent from other cognitive deficits, in schizophrenia. C1 Univ Calif Los Angeles, Neuropsychiat Inst & Hosp, W Los Angeles VA Hlth Care Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Brain Mapping Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Radiol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Pharmacol, Los Angeles, CA 90024 USA. RP Quintana, J (reprint author), Univ Calif Los Angeles, Neuropsychiat Inst & Hosp, W Los Angeles VA Hlth Care Ctr, 760 Westwood Plaza,Room C8-846, Los Angeles, CA 90024 USA. FU NCRR NIH HHS [RR08655, RR12169] NR 75 TC 60 Z9 65 U1 2 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD JUN 15 PY 2003 VL 53 IS 12 BP 1099 EP 1112 DI 10.1016/S0006-3223(02)01784-5 PG 14 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 690YU UT WOS:000183578700004 PM 12814861 ER PT J AU Green, MF Mintz, J Salveson, D Nuechterlein, KH Breitmeyer, B Light, GA Braff, DL AF Green, MF Mintz, J Salveson, D Nuechterlein, KH Breitmeyer, B Light, GA Braff, DL TI Visual masking as a probe for abnormal gamma range activity in schizophrenia SO BIOLOGICAL PSYCHIATRY LA English DT Article DE schizophrenia; visual masking; gamma frequency; backward masking; visual processing; neurocognition ID POSTTRAUMATIC-STRESS-DISORDER; TEMPORAL CORRELATION HYPOTHESIS; BACKWARD-MASKING; FEATURE INTEGRATION; OSCILLATIONS; TRANSIENT; CHANNELS; VULNERABILITY; SUPPRESSION; PERFORMANCE AB Background: Visual masking procedures assess very early stages of visual perception. Patients with schizophrenia consistently show deficits on visual masking tasks, and these deficits likely reflect vulnerability to schizophrenia. We conducted two experiments to determine whether visual masking procedures can reveal underlying abnormalities in gamma range oscillations in schizophrenia. Methods: In the first experiment, we conducted nonlinear modeling of visual masking performance data from 89 male schizophrenic patients and 20 male comparison subjects. In the second experiment, electrophysiological recordings of event-related gamma activity were taken during a visual masking task in a subset of eight patients and seven control subjects. Results: In the first experiment, nonlinear modeling of the performance data revealed evidence of oscillations in the gamma range (30 and 35 Hz) for the comparison group but not patients. In the second experiment, the comparison group, but not the patients, showed a burst of gamma range activity 200-400 msec following target presentation. The difference between patients and comparison subjects in this time period was significant (p < .05). Conclusions: Visual masking procedures can serve as a probe for underlying gamma range activity, which appears to be aberrant in schizophrenia. Perceptual problems in schizophrenia may, at least in part, be due to a failure to establish and/or maintain gamma range oscillations. C1 Univ Calif Los Angeles, Inst Neuropsychiat, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Houston, Dept Psychol, Houston, TX USA. Univ Calif San Diego, Dept Psychiat, La Jolla, CA 92093 USA. RP Green, MF (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, Dept Psychiat & Biobehav Sci, 760 Westwood Plaza,C9-420, Los Angeles, CA 90024 USA. FU NIMH NIH HHS [MH-030911, MH-43292] NR 39 TC 51 Z9 53 U1 2 U2 2 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 2003 VL 53 IS 12 BP 1113 EP 1119 DI 10.1016/S0006-3223(02)01813-9 PG 7 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 690YU UT WOS:000183578700005 PM 12814862 ER PT J AU Thompson, PM Kelley, M Yao, J Tsai, GC van Kammen, DP AF Thompson, PM Kelley, M Yao, J Tsai, GC van Kammen, DP TI Elevated cerebrospinal fluid SNAP-25 in schizophrenia SO BIOLOGICAL PSYCHIATRY LA English DT Article DE SNAP-25; schizophrenia; cerebrospinal fluid; postmortem; synapse; exocytosis; psychosis ID CELL-ADHESION MOLECULE; SEVERE MENTAL-ILLNESS; PREFRONTAL CORTEX; GENE-EXPRESSION; MESSENGER-RNAS; ALTERED LEVELS; SYNAPTIC PATHOLOGY; PROTEIN SNAP-25; DEFICIENT MICE; RAT-BRAIN AB Background: Research suggests an association between abnormal exocytosis and schizophrenia. We previously demonstrated increased synaptosomal associated protein, 25 kDa (SNAP-25), a member of the exocytotic mechanism, in the cerebrospinal fluid (CSF) of schizophrenia subjects. In this study, we explored SNAP-25 level and clinical variables in a new group of subjects. Methods: Twenty-five haloperidol-treated subjects with chronic schizophrenia and twenty-five healthy control subjects participated in the study. Subjects received haloperidol treatment for at least 3 months and then had a lumbar puncture (n = 19). Medication was replaced by placebo, and the lumbar puncture was repeated (n = 25) after 6 weeks or sooner if limited psychotic symptoms occurred. We measured the level of SNAP-25 in the CSF and symptoms with the Brief Psychiatric Rating Scale (BPRS). Results: In both haloperidol (p = .001) and placebo (p = .001) treatment conditions, SNAP-25 was elevated. There was no significant difference in SNAP-25 level between conditions. We identified significant positive correlations among SNAP-25 and the BPRS total score and psychosis and thinking disturbance subscales in subjects on haloperidol. Conclusions: These observations confirm our previous report of elevated CSF SNAP-25 and suggest that synaptic pathology may be linked with the pathophysiology of schizophrenia. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78229 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA. Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA. Johnson & Johnson Pharmaceut Res & Dev, Raritan, NJ USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. RP Thompson, PM (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 46 TC 29 Z9 30 U1 0 U2 3 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 2003 VL 53 IS 12 BP 1132 EP 1137 DI 10.1016/S0006-3223(02)01599-8 PG 6 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 690YU UT WOS:000183578700007 PM 12814864 ER PT J AU Back, AL Arnold, RM Tulsky, JA Baile, WF Fryer-Edwards, KA AF Back, AL Arnold, RM Tulsky, JA Baile, WF Fryer-Edwards, KA TI Teaching communication skills to medical oncology fellows SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID PHYSICIANS C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Washington, Dept Med Hist & Eth, Seattle, WA 98195 USA. Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. Univ Pittsburgh, Dept Med, Sect Med Eth & Palliat Care, Pittsburgh, PA USA. Vet Affairs Med Ctr, Program Med Encounter & Palliat Care, Durham, NC USA. Duke Univ, Dept Med, Durham, NC USA. Duke Univ, Inst Care End Life, Durham, NC USA. Univ Texas, MD Anderson Canc Ctr, Sect Psychiat, Houston, TX 77030 USA. Univ Texas, MD Anderson Canc Ctr, Dept Neurooncol, Houston, TX 77030 USA. RP Back, AL (reprint author), Vet Affairs Puget Sound Hlth Care Syst, 1660 S Columbian Way,S-111, Seattle, WA 98108 USA. FU NCI NIH HHS [R25 CA92055] NR 5 TC 119 Z9 120 U1 0 U2 7 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 330 JOHN CARLYLE ST, STE 300, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD JUN 15 PY 2003 VL 21 IS 12 BP 2433 EP 2436 DI 10.1200/JCO.2003.09.073 PG 4 WC Oncology SC Oncology GA 690TG UT WOS:000183564800031 PM 12805343 ER PT J AU Piqueras, L Tache, Y Martinez, V AF Piqueras, L Tache, Y Martinez, V TI Somatostatin receptor type 2 mediates bombesin-induced inhibition of gastric acid secretion in mice SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Article ID ENTEROCHROMAFFIN-LIKE CELLS; SUBTYPE-2 KNOCKOUT MICE; ISOLATED MOUSE STOMACH; GASTROINTESTINAL-TRACT; MONOCLONAL-ANTIBODY; HISTAMINE-RELEASE; ANTAGONIST ANALOG; RAT STOMACH; NEURONS; PEPTIDE AB Studies in isolated mouse stomach showed that bombesin releases somatostatin. We characterized the effects of exogenous bombesin on gastric acid secretion in mice and determined the involvement of somatostatin and somatostatin receptor type 2 (SSTR2) by using somatostatin immunoneutralization, the SSTR2 antagonist, PRL-2903, and SSTR2 knockout mice. Gastric acid secretion was monitored under basal and pentagastrin-, histamine- or bethanechol-stimulated conditions in urethane-anaesthetized mice. Bombesin (10-40 mug kg(-1) h(-1)) and somatostatin-14 (20 mug kg(-1) h(-1)) were infused I.V. 10 and 30 min after PRL-2903 or somatostatin antibody pretreatment, respectively. Urethane-anaesthetized wild-type mice had low basal acid secretion ( 0.12 +/- 0.01 mumol (10 min)(-1)) compared with SSTR2 knockout mice (1.43 +/- 0.10 mumol (10 min)(-1)). Somatostatin antibody and PRL-2903 increased basal secretion in wild-type mice but not in SSTR2 knockout animals. In wildtype mice, bombesin inhibited secretagogue-stimulated acid secretion in a dose-dependent manner, and somatostatin-14 inhibited pentagastrin-stimulated secretion. In wild-type mice pretreated with somatostatin antibody or PRL-2903 and in SSTR2 knockout mice, bombesin and somatostatin-14 I.V. infusion did not alter the increased gastric acid secretion. These results indicate that, in mice, bombesin inhibits gastric acid secretion through the release of somatostatin and the activation of SSTR2. These observations strengthen the important role of SSTR2 in mediating somatostatin inhibitory actions on gastric acid secretion. C1 Cardenal Herrera CEU Univ, Dept Physiol Pharmacol & Toxicol, Valencia, Spain. Univ Calif Los Angeles, Dept Med, VA Greater Los Angeles Hlth Care Syst, CURE,Digest Dis Res Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Inst Brain Res, Los Angeles, CA 90024 USA. RP Martinez, V (reprint author), AstraZeneca R&D Molndal, Dept Integrat Pharmacol, S-43183 Molndal, Sweden. RI Martinez, Vicente/N-1189-2014 FU NIDDK NIH HHS [DK-41301, DK-30110, P30 DK041301] NR 50 TC 22 Z9 24 U1 0 U2 1 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD JUN 15 PY 2003 VL 549 IS 3 BP 889 EP 901 DI 10.1113/jphysiol.2003.039750 PG 13 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 695DE UT WOS:000183815200021 PM 12692184 ER PT J AU Horan, WP Goldstein, G AF Horan, WP Goldstein, G TI A retrospective study of premorbid ability and aging differences in cognitive clusters of schizophrenia SO PSYCHIATRY RESEARCH LA English DT Article DE schizophrenia; cognitive functioning; Wisconsin Card Sorting Test ID NEUROPSYCHOLOGICALLY NORMAL SCHIZOPHRENIA; HETEROGENEITY; DECLINE; AGE; IMPAIRMENTS; HALOPERIDOL; QUETIAPINE; YOUNG AB This retrospective, cross-sectional study evaluated whether age-related differences in patterns of cognitive deficit exist among four cognitively based schizophrenia subgroups. These subgroups had previously been identified through cluster analyses of a battery of abstraction and problem-solving tests in large samples. Evaluation of estimated premorbid intellectual ability and postmorbid cognitive functioning stratified by decade from the twenties through the fifties revealed different patterns across the schizophrenia subgroups and a clinical comparison sample. A near normal cognitive subgroup demonstrated relatively high premorbid intellectual ability and a pattern of age differences similar to the comparison sample, with the exception of deficits on the Wisconsin Card Sorting Test that were detectable in the twenties and remained stable thereafter. In contrast, a subgroup characterized by severe, pervasive cognitive deficit demonstrated low premorbid intellectual ability and extremely low test scores across the four decades studied. The remaining clusters were characterized by moderate cognitive impairment and showed age differences suggestive of a decline in cognitive function around the time of illness onset that remained stable. Results provide further support for the validity of these subgroups and encourage continued efforts to identify cognitively based candidate schizophrenia subtypes. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. RP Goldstein, G (reprint author), VA Pittsburgh Healthcare Syst, 7180 Highland Dr,151R, Pittsburgh, PA 15206 USA. NR 47 TC 17 Z9 18 U1 2 U2 3 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0165-1781 J9 PSYCHIAT RES JI Psychiatry Res. PD JUN 15 PY 2003 VL 118 IS 3 BP 209 EP 221 DI 10.1016/S0165-1781(03)00078-7 PG 13 WC Psychiatry SC Psychiatry GA 700LB UT WOS:000184112500002 PM 12834815 ER PT J AU Ghosh-Choudhury, NG Abboud, SL Mahimainathan, L Chandrasekar, B Choudhury, GG AF Ghosh-Choudhury, NG Abboud, SL Mahimainathan, L Chandrasekar, B Choudhury, GG TI Phosphatidylinositol 3-kinase regulates bone morphogenetic protein-2 (BMP-2)-induced myocyte enhancer factor 2A-dependent transcription of BMP-2 gene in cardiomyocyte precursor cells SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID GLOMERULAR MESANGIAL CELLS; C-FOS; PHOSPHOINOSITIDE 3-KINASE; RETINOBLASTOMA PROTEIN; MUSCLE DIFFERENTIATION; MEF2 PROTEINS; DNA-SYNTHESIS; KINASE; GROWTH; ACTIVATION AB The growth and differentiation factor bone morphogenetic protein-2 (BMP-2) regulates cardiac development during vertebrate embryogenesis. In cardiac precursor cells, BMP-2 has recently been shown to induce expression of cardiac transcription factors, including myocyte enhancer factor 2A (MEF-2A). The specific signal transduction mechanism by which BMP-2 regulates these actions is not known. We investigated the role of phosphatidylinositol (PI) 3-kinase in regulating these processes in cardiomyocyte precursor CL6 cells. BMP-2 increased PI 3-kinase activity in these cells in a time-dependent manner, resulting in increased expression of sarcomeric myosin heavy chain (MHC) and MEF-2A. Inhibition of PI 3-kinase abolished these actions of BMP-2, indicating the involvement of PI 3-kinase in these processes. Furthermore, BMP-2 stimulated specific protein.DNA complex formation when an MEF-2 DNA recognition element was used as probe. Antibody supershift assay confirmed the presence of MEF-2A in this protein.DNA complex. Inhibition of PI 3-kinase activity completely prevented the MEF-2A.DNA complex formation. BMP-2 also increased transcription of a reporter gene driven by an MEF-2-specific DNA element in a PI 3-kinase-dependent manner. Ectopic expression of MEF-2A increased BMP-2 transcription to the same extent induced by BMP-2, indicating that MEF-2A may participate in BMP-2 autoregulation in CL6 cells. Expression of dominant negative PI 3-kinase completely abolished BMP-2-induced as well as MEF-2A-mediated BMP-2 transcription. Furthermore expression of MEF-2A increased MHC expression in a PI 3-kinase-dependent manner. Together these data provide the first evidence that BMP-2-induced PI 3-kinase signaling regulates MEF-2A expression and define a mechanism of MEF-2A-dependent BMP-2 transcription. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Ghosh-Choudhury, NG (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. OI /0000-0001-5077-3552 FU NHLBI NIH HHS [HL 68020]; NIAMS NIH HHS [AR 42306]; NIDDK NIH HHS [R01 DK 55815] NR 50 TC 27 Z9 29 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JUN 13 PY 2003 VL 278 IS 24 BP 21998 EP 22005 DI 10.1074/jbc.M302277200 PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 687AT UT WOS:000183354200086 PM 12663654 ER PT J AU Ansari, M Shlipak, MG Heidenreich, PA Van Ostaeyen, D Pohl, EC Browner, WS Massie, BM AF Ansari, M Shlipak, MG Heidenreich, PA Van Ostaeyen, D Pohl, EC Browner, WS Massie, BM TI Improving guideline adherence - A randomized trial evaluating strategies to increase beta-blocker use in heart failure SO CIRCULATION LA English DT Article DE heart failure; drugs; trials ID PRIMARY-CARE; MANAGEMENT; PHYSICIANS; COMPUTER; OUTCOMES; QUALITY; INTERVENTION; IMPROVEMENT; INFORMATION; REMINDERS AB Background-The dissemination of clinical practice guidelines often has not been accompanied by desired improvements in guideline adherence. This study evaluated interventions for implementing a new practice guideline advocating the use of beta-blockers for heart failure patients. Methods and Results-This was a randomized controlled trial involving heart failure patients (n = 169) with an ejection fraction less than or equal to45% and no contraindications to beta-blockers. Patients' primary providers were randomized in a stratified design to 1 of 3 interventions: (1) control: provider education; (2) provider and patient notification: computerized provider reminders and patient letters advocating beta-blockers; and (3) nurse facilitator: supervised nurse to initiate and titrate beta-blockers. The primary outcome, the proportion of patients who were initiated or uptitrated and maintained on beta-blockers, analyzed by intention to treat, was achieved in 67% (36 of 54) of patients in the nurse facilitator group compared with 16% (10 of 64) in the provider/patient notification and 27% (14 of 51) in the control groups (P < 0.001 for the comparisons between the nurse facilitator group and both other groups). The proportion of patients on target β-blocker doses at the study end (median follow-up, 12 months) was also highest in the nurse facilitator group (43%) compared with the control (10%) and provider/patient notification groups (2%) (P < 0.001). There were no differences in adverse events among groups. Conclusions-The use of a nurse facilitator was a successful approach for implementing a beta-blocker guideline in heart failure patients. The use of provider education, clinical reminders, and patient education was of limited value in this setting. C1 San Francisco VA Med Ctr, Div Cardiol, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco, CA 94143 USA. Palo Alto VA Med Ctr, Div Cardiol, San Francisco, CA USA. Calif Pacific Med Ctr, Res Inst, San Francisco, CA USA. RP Massie, BM (reprint author), VAMC, Cardiol Div 111C, 4150 Clement St, San Francisco, CA 94121 USA. OI Heidenreich, Paul/0000-0001-7730-8490 NR 29 TC 102 Z9 102 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD JUN 10 PY 2003 VL 107 IS 22 BP 2799 EP 2804 DI 10.1161/01.CIR.0000070952.08969.5B PG 6 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 687WT UT WOS:000183400500008 PM 12756157 ER PT J AU Maillot, C Wang, LX Million, M Tache, Y AF Maillot, C Wang, LX Million, M Tache, Y TI Intraperitoneal corticotropin-releasing factor and urocortin induce Fos expression in brain and spinal autonomic nuclei and long lasting stimulation of colonic motility in rats SO BRAIN RESEARCH LA English DT Article DE CRF; Fos; colonic motility; urocortin; lumbosacral spinal cord; central amygdala; parabrachial nucleus; locus coeruleus; area postrema; nucleus tractus solitarius ID PHASEOLUS-VULGARIS LEUKOAGGLUTININ; SACRAL PARASYMPATHETIC NUCLEUS; DORSAL MOTOR NUCLEUS; C-FOS; SOLITARY TRACT; EFFERENT PROJECTIONS; AREA POSTREMA; PARAVENTRICULAR NUCLEUS; PARABRACHIAL NUCLEUS; NERVOUS-SYSTEM AB CRF injected intraperitoneally (i.p.) stimulates colonic, motor function and induces Fos expression in colonic myenteric neurons. We investigated central and spinal Fos expression and changes. in colonic motility in response to i.p. injection of CRF and urocortin. Ovine CRF9-33 that is devoid of intrinsic activity at the CRF receptors, was used as control peptide. Myoelectrical activity was monitored for I h before and after peptide injection (10 mug/kg, i.p.) in conscious non fasted rats with chronically implanted intraparietal electrodes in the cecum and proximal colon. Brain and lumbosacral spinal cord were processed for Fos immunohistochemistry at I h postinjection. CRF and urocortin elicited defecation and a new pattern of ceco-colonic clustered spike bursts that peaked within, 15 m,in and lasted for the I h experimental period while CRF9-33 did not modify baseline myoelectrical activity and defecation. CRF increased significantly Fos expression in the central nucleus of the amygdala (lateral part), parabrachial nucleus (external lateral subnucleus), area postrema, nucleus tractus solitarius, locus coeruleus, paraventricular nucleus of the hypothalamus, the intermediolateral column and area I-VII, X at the L6-S1 level of the spinal cord by 11-, 6.5-, 5.3-, 5.0-, 4.7-, 2.7- and 1.4-fold, respectively compared with i.p. CRF9-33 injected rats that had little Fos expression. Urocortin induced a similar pattern of Fos response in the brain and the spinal cord. These results indicate that i.p. CRF and urocortin induce a peptide specific activation of brain nuclei receiving viscerosensory inputs and involved in autonomic circuitries whose effector limbs may impact on visceral function. (C) 2003 Elsevier Science B.V. All rights reserved. C1 Univ Calif Los Angeles, Vet Adm Greater Los Angeles Healthcare Syst, Digest Dis Res Ctr, Dept Med,Digest Dis Div, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Vet Adm Greater Los Angeles Healthcare Syst, Brain Res Inst, Los Angeles, CA 90073 USA. RP Tache, Y (reprint author), Univ Calif Los Angeles, Vet Adm Greater Los Angeles Healthcare Syst, Digest Dis Res Ctr, Dept Med,Digest Dis Div, 11301 Wilshire Blvd,Bldg 115,Rm 117, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK-41301, DK-57238, DK 57238-01A1S1] NR 83 TC 31 Z9 31 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD JUN 6 PY 2003 VL 974 IS 1-2 BP 70 EP 81 DI 10.1016/S0006-8993(03)02553-8 PG 12 WC Neurosciences SC Neurosciences & Neurology GA 684NV UT WOS:000183214200007 PM 12742625 ER PT J AU Harendza, S Lovett, DH Panzer, U Lukacs, Z Kuhnl, P Stahl, RAK AF Harendza, S Lovett, DH Panzer, U Lukacs, Z Kuhnl, P Stahl, RAK TI Linked common polymorphisms in the gelatinase A promoter are associated with diminished transcriptional response to estrogen and genetic fitness SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID MATRIX METALLOPROTEINASE-2 GENE; GLOMERULAR MESANGIAL CELLS; IV COLLAGENASE GENE; BREAST-CANCER CELLS; A-DEFICIENT MICE; EXPRESSION; ACTIVATION; ANGIOGENESIS; ELEMENTS; YB-1 AB Gelatinase A ( matrix metalloproteinase- 2) plays a prominent role in multiple biologic processes. Prior studies have established critical roles for gelatinase A transcriptional regulation by defined enhancer elements. To determine possible functional single nucleotide polymorphisms within these elements, we determined the single nucleotide polymorphism distribution within 1,665 bp of the gelatinase A 5'-flanking region, using a healthy homogeneous Caucasian study group of 463 individuals. Among the polymorphisms detected, a G -->A transition at bp - 1575 was located immediately 5' to a half-palindromic potential estrogen receptor binding site. In estrogen receptor-positive MCF-7 cells the - 1575G allele functioned as an enhancer, whereas the - 1575A allele reduced transcription activity significantly. Gel shift assays confirmed that the differences in allelic expression affected binding of the estrogen receptor-alpha to this region. Cotransfection experiments with an estrogen receptor-alpha expression vector in MDA-MB-231 cells, which do not constitutively express an estrogen receptor, revealed that estrogen receptor is absolutely required for enhancing activity. Allelic distribution analysis indicated that a previously reported C-->T transition within an Sp1 binding site at - 1306 was in linkage disequilibrium with the - 1575G 3 A transition. Luciferase reporter studies of the linked variant - 1575A - 1306T allele versus the wild type - 1575G - 1306C allele demonstrated an additive reduction in estrogen-dependent reporter activity. The frequency of the - 1575G 3 A transition deviated significantly from the expected Hardy-Weinberg distribution in two independently assembled study populations consisting of healthy adult blood donors and newborns of Caucasian origin, both with a calculated 21% reduction in genetic fitness. Gelatinase A is a known estrogen-responsive gene and the demonstration of a loss of function polymorphism within an operational estrogen receptor binding site associated with a decrease in genetic fitness underscores the biologic significance of promoter polymorphism analyses. C1 Univ Hamburg, Dept Med, D-20246 Hamburg, Germany. Univ Hamburg, Div Nephrol, D-20246 Hamburg, Germany. Univ Hamburg, Dept Pediat, D-20246 Hamburg, Germany. Univ Hamburg, Dept Transfus Med & Transplantat Immunol, D-20246 Hamburg, Germany. Univ Calif San Francisco, Dept Med, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. RP Harendza, S (reprint author), Univ Klinikum Hamburg Eppendorf, Zentrum Innere Med, Med Klin 4, Pavillon N26,Martinistr 52, D-20246 Hamburg, Germany. FU NIDDK NIH HHS [DK39776] NR 41 TC 52 Z9 54 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JUN 6 PY 2003 VL 278 IS 23 BP 20490 EP 20499 DI 10.1074/jbc.M211536200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 684WY UT WOS:000183230500008 PM 12657623 ER PT J AU Yehuda, R Halligan, SL Yang, RK Guo, LS Makotkine, I Singh, B Pickholtz, D AF Yehuda, R Halligan, SL Yang, RK Guo, LS Makotkine, I Singh, B Pickholtz, D TI Relationship between 24-hour urinary-free cortisol excretion and salivary cortisol levels sampled from awakening to bedtime in healthy subjects SO LIFE SCIENCES LA English DT Article DE saliva; urine; cortisol; methodology ID ORAL DIFFUSION SINK; SERUM CORTISOL; RECOVERY AB The utility of repeated salivary cortisol sampling as a substitute for 24-hour urinary-free cortisol (UFC) assessment was examined. Forty-four participants completed both 24-hour collections and 6 salivary collections at wake-up, 08:00, 12:00, 16:00, 20:00 and bedtime, during the same 24-hour period. The results demonstrated that mean, maximum, and amplitude (maximum minus minimum) for salivary cortisol all correlated positively with urinary cortisol, but the associations of these variables with urinary-free cortisol excretion were relatively small. Furthermore, a single salivary sample taken at wake-up was as good an indicator of overall cortisol production as the measures derived from multiple salivary samples. An examination of subject compliance indicated that many subjects failed to collect the timed salivary collections as instructed. The authors conclude that diurnal salivary cortisol sampling versus 24-hour urinary cortisol collections are likely to provide different information about ambient hypothalamic-pituitary-adrenal productivity, and therefore these measures should not be used interchangeably. In addition, subject compliance is a serious consideration in designing studies that employ home salivary collections. Published by Elsevier Science Inc. C1 Mt Sinai Sch Med, Psychiat OOMH, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Bronx, NY 10468 USA. Univ Reading, Sch Psychol, Reading RG6 6AH, Berks, England. RP Yehuda, R (reprint author), Mt Sinai Sch Med, Psychiat OOMH, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. OI Halligan, Sarah/0000-0002-3436-3358 FU NIMH NIH HHS [MH 64104, MH-49555] NR 22 TC 43 Z9 45 U1 0 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0024-3205 J9 LIFE SCI JI Life Sci. PD JUN 6 PY 2003 VL 73 IS 3 BP 349 EP 358 DI 10.1016/S0024-3205(03)00286-8 PG 10 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 682VX UT WOS:000183114000010 PM 12757842 ER PT J AU Kampman, KM Pettinati, H Lynch, KG Sparkman, T O'Brien, CP AF Kampman, KM Pettinati, H Lynch, KG Sparkman, T O'Brien, CP TI A pilot trial of olanzapine for the treatment of cocaine dependence SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE cocaine; olanzapine; clinical trial; double-blind ID D2 DOPAMINE ANTAGONISTS; PATTERN-MIXTURE MODELS; CRACK COCAINE; RISPERIDONE; RAT; HALOPERIDOL; REINFORCEMENT; SCHEDULES; D-1; D1 AB Background: Multiple lines of evidence suggest both dopaminergic and serotonergic involvement in the reinforcing effects of cocaine. Medications such as olanzapine, which block dopamine D2 receptors, as well as serotonin receptors 5HT2A and 5HT2C may be able to reduce cocaine use in cocaine dependent patients by reducing the euphoric effects of cocaine and attenuating cocaine craving. Methods: This was a 12-week, double blind, placebo controlled, pilot trial involving 30 cocaine dependent subjects. Subjects received either olanzapine (10 mg/day) or identical placebo. Outcome measures included treatment retention, qualitative urine benzoylecgonine tests, cocaine craving, clinical global impression scores, and results from the addiction severity index. Results: Treatment retention was slightly, but significantly, better in the placebo-treated subjects. Placebo-treated subjects were more likely to be abstinent from cocaine during the trial compared to olanzapine-treated subjects, based on urine benzoylecgonine results. Olanzapine was not superior to placebo in any outcome measure. Conclusions: The results of this trial do not support the usefulness of olanzapine for the treatment of cocaine dependence. In fact, olanzapine may worsen cocaine treatment outcome. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved. C1 Univ Penn, Sch Med, Treatment Res Ctr, Dept Psychiat, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. RP Kampman, KM (reprint author), Univ Penn, Sch Med, Treatment Res Ctr, Dept Psychiat, 3900 Chestnut St, Philadelphia, PA 19104 USA. NR 43 TC 57 Z9 58 U1 0 U2 0 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0376-8716 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD JUN 5 PY 2003 VL 70 IS 3 BP 265 EP 273 DI 10.1016/S0376-8716(03)00009-7 PG 9 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 690WC UT WOS:000183572600005 PM 12757964 ER PT J AU Ghosh-Choudhury, N Abboud, SL Chandrasekar, B Choudhury, GG AF Ghosh-Choudhury, N Abboud, SL Chandrasekar, B Choudhury, GG TI BMP-2 regulates cardiomyocyte contractility in a phosphatidylinositol 3 kinase-dependent manner SO FEBS LETTERS LA English DT Article DE cardiomyocyte contraction; bone morphogenetic protein-2; phosphatidylinositol 3 kinase ID BONE MORPHOGENETIC PROTEINS; PHOSPHOINOSITIDE 3-KINASE; OSTEOBLAST DIFFERENTIATION; SIGNALING PATHWAYS; CARDIAC MYOCYTES; MESANGIAL CELLS; ACTIVATION; HYPERTROPHY; HEART; SMAD AB Bone morphogenetic protein-2 (BMP-2) regulates development of heart during vertebrate embryogenesis. In vitro BMP-2 induces differentiation of precardiac cells into mature cardiomyocytes by inducing the expression of cardiac-specific genes. However, the role of BMP-2 and its signaling in other cardiac functions have not been studied. We examined the action of phosphatidylinositol (PI) 3 kinase in isolated adult rat cardiomyocytes. Incubation of rat ventricular cardiomyocytes with BMP-2 increased the PI 3 kinase activity. Ly294002, a pharmacological inhibitor of PI 3 kinase, blocked BMP-2-induced PI 3 kinase activity completely. To investigate the contractility of isolated cardiomyocytes, fractional shortening was examined. BMP-2 significantly increased the percent fractional shortening of the cardiomyocytes. Inhibition of PI 3 kinase activity completely abolished this action of BMP-2. These data indicate that PI 3 kinase regulates BMP-2-induced myocyte contractility. To further confirm this observation, we used adenovirus-mediated gene transfer to express a constitutively active myristoylated catalytic subunit of PI 3 kinase in rat cardiomyocytes. Infection of cardiomyocytes with the adenovirus vector increased the expression of constitutively active PI 3 kinase within 24 h. Expression of constitutively active PI 3 kinase significantly increased cardiomyocyte contractility. Together, these data show for the first time that the growth and differentiation factor, BMP-2, stimulates cardiomyocyte contractility. Also we provide the first evidence that BMP-2-induced PI 3 kinase activity regulates this cardiomyocyte function. (C) 2003 Published by Elsevier Science B.V. on behalf of the Federation of European Biochemical Societies. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX USA. GRECC, San Antonio, TX USA. RP Ghosh-Choudhury, N (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NHLBI NIH HHS [HL68020]; NIAMS NIH HHS [AR-42306]; NIDDK NIH HHS [R01 DK55815] NR 39 TC 21 Z9 23 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0014-5793 J9 FEBS LETT JI FEBS Lett. PD JUN 5 PY 2003 VL 544 IS 1-3 BP 181 EP 184 DI 10.1016/S0014-5793(03)00507-6 PG 4 WC Biochemistry & Molecular Biology; Biophysics; Cell Biology SC Biochemistry & Molecular Biology; Biophysics; Cell Biology GA 687TR UT WOS:000183393500033 PM 12782312 ER PT J AU Medrano, FJ Wenck, MA Engel, JC Craig, SP AF Medrano, FJ Wenck, MA Engel, JC Craig, SP TI Analysis of 6-(2,2-dichloroacetamido)chrysene interaction with the hypoxanthine phosphoribosyltransferase from Trypanosoma cruzi SO JOURNAL OF MEDICINAL CHEMISTRY LA English DT Article ID GUANINE PHOSPHORIBOSYLTRANSFERASE; HPRT AB Selective inhibition is needed for drugs targeting the hypoxanthine phosphoribosyltransferase of Trypanosoma cruzi, etiologic agent of Chagas' disease. 6-(2,2-Dichloroacetamido)chrysene, was shown herein to be a selective inhibitor of the trypanosomal enzyme. SAR analysis revealed that the 6-amido moiety was essential, but the dichloroaceto moiety was not essential for achieving the low K-i for this inhibitor. Understanding the molecular basis for these interactions could facilitate the design of selective inhibitors without a chrysene moiety. C1 Univ Connecticut, Lab Mol Parasitol & Drug Design, Dept Mol & Cell Biol, Storrs, CT 06269 USA. San Francisco VA Med Ctr, San Francisco, CA 94121 USA. RP Craig, SP (reprint author), Univ Connecticut, Lab Mol Parasitol & Drug Design, Dept Mol & Cell Biol, Storrs, CT 06269 USA. OI Medrano, Francisco/0000-0002-8185-9751 FU NIAID NIH HHS [P01-AI35707, R01-AI45021] NR 12 TC 9 Z9 9 U1 0 U2 1 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0022-2623 J9 J MED CHEM JI J. Med. Chem. PD JUN 5 PY 2003 VL 46 IS 12 BP 2548 EP 2550 DI 10.1021/jm030061i PG 3 WC Chemistry, Medicinal SC Pharmacology & Pharmacy GA 684RM UT WOS:000183220400030 PM 12773058 ER PT J AU Shah, AP Rubin, SA AF Shah, AP Rubin, SA TI Ventricular ectopy after exercise as a predictor of death SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 VA Greater Los Angeles, Los Angeles, CA 90073 USA. RP Shah, AP (reprint author), VA Greater Los Angeles, Los Angeles, CA 90073 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC/NEJM 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 5 PY 2003 VL 348 IS 23 BP 2357 EP 2357 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 686AA UT WOS:000183296300015 PM 12789003 ER PT J AU Steinman, MA Landefeld, CS Gonzales, R AF Steinman, MA Landefeld, CS Gonzales, R TI Variation in use of broad-spectrum antibiotics for acute respiratory tract infection - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 San Francisco VA Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Steinman, MA (reprint author), San Francisco VA Med Ctr, San Francisco, CA 94121 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 4 PY 2003 VL 289 IS 21 BP 2797 EP 2798 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 684KH UT WOS:000183205500025 ER PT J AU Massie, BM AF Massie, BM TI Natriuretic peptide measurements for the diagnosis of "nonsystolic" heart failure - Good news and bad SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Editorial Material ID PRESERVED SYSTOLIC FUNCTION; EMERGENCY DIAGNOSIS; EJECTION FRACTION; DYSFUNCTION; AGE; COMMUNITY; IMPACT; HEALTH C1 San Francisco Vet Affairs Med Ctr, Div Cardiol, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, Inst Cardiovasc Res, San Francisco, CA USA. RP Massie, BM (reprint author), VA Hosp, Cardiol 111C,4150 Clement St, San Francisco, CA 94121 USA. NR 20 TC 15 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 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD JUN 4 PY 2003 VL 41 IS 11 BP 2018 EP 2021 DI 10.1016/S0735-1097(03)00395-4 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 684QY UT WOS:000183219100018 PM 12798575 ER PT J AU Stratton, JR Levy, WC Caldwell, JH Jacobson, A May, J Matsuoka, D Madden, K AF Stratton, JR Levy, WC Caldwell, JH Jacobson, A May, J Matsuoka, D Madden, K TI Effects of aging on cardiovascular responses to parasympathetic withdrawal SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID HEART-RATE-VARIABILITY; POSTMENOPAUSAL WOMEN; SYMPATHETIC-STIMULATION; VAGAL-STIMULATION; BLOOD-PRESSURE; HEALTHY-YOUNG; OLDER MEN; AGE; EXERCISE; GENDER AB OBJECTIVES The study was done to determine whether the effects of parasympathetic withdrawal on heart rate, blood pressure (BP), and systolic and diastolic function are altered with normal aging. BACKGROUND Cardiac responses to beta-adrenergic sympathetic stimulation decline with aging as does the heart rate response to parasympathetic withdrawal, but the extent to which other responses to parasympathetic withdrawal decrease is less clear. METHODS Heart rate, BP, systolic function, and diastolic filling responses to parasympathetic withdrawal induced by atropine (0.02 mg/kg) were compared in 50 healthy subjects, 28 older (ages 65 to 80 years, mean 70 years; 18 females all on estrogen) and 22 young (age 18 to 32 years, mean 26 years; 12 females) subjects, using radionuclide angiography. RESULTS Parasympathetic withdrawal in the older group caused less of an increase in heart rate (+33 vs. +48 beats/min), cardiac index (+0.6 vs. +1.5 l/m(2)), systolic blood pressure (-1 vs. +7 mm Hg), and early diastolic filling rate (+1.7 vs. +2.4 end-diastolic volumes/s) (all p less than or equal to 0.01). At similar declines in the diastolic filling period, end-diastolic volume index (EDVI) fell substantially more in the older group (-11.6 vs. -2.4 ml/m(2), p < 0.001). The only gender difference was in diastolic filling rate, which was similar in the young males and females, but significantly less in older males than in older females. CONCLUSIONS The responses to parasympathetic withdrawal as well as sympathetic stimulation decline with aging, and both contribute to the reduced cardiovascular responses to stress with advancing age. (C) 2003 by the American College of Cardiology Foundation. C1 VA Puget Sound Healthcare Syst, Seattle, WA 98108 USA. Univ Washington, Div Cardiol, Seattle, WA 98195 USA. Univ Washington, Div Nucl Med, Seattle, WA 98195 USA. RP Stratton, JR (reprint author), VA Puget Sound Healthcare Syst, Cardiol S111C,1660 S Columbian Way, Seattle, WA 98108 USA. EM jrs@u.washington.edu FU NHLBI NIH HHS [HL 50293]; NIA NIH HHS [R01 AG 15462, K12 AG 00503] NR 41 TC 34 Z9 35 U1 0 U2 2 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 4 PY 2003 VL 41 IS 11 BP 2077 EP 2083 DI 10.1016/S0735-1097(03)00418-2 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 684QY UT WOS:000183219100028 PM 12798585 ER PT J AU Assendelft, WJJ Morton, SC Yu, EI Suttorp, MJ Shekelle, PG AF Assendelft, WJJ Morton, SC Yu, EI Suttorp, MJ Shekelle, PG TI Spinal manipulative therapy for low back pain - A meta-analysis of effectiveness relative to other therapies SO ANNALS OF INTERNAL MEDICINE LA English DT Review ID RANDOMIZED CLINICAL-TRIAL; SYSTEMATIC REVIEWS; MANUAL THERAPY; NECK COMPLAINTS; FOLLOW-UP; OUTCOME MEASURES; PRIMARY-CARE; HEALTH-CARE; CONSERVATIVE TREATMENT; MULTICENTER TRIAL AB Background: Low back pain is a costly illness for which spinal manipulative therapy is commonly recommended. Previous systematic reviews and practice guidelines have reached discordant results on the effectiveness of this therapy for low back pain. Purpose: To resolve the discrepancies related to use of spinal manipulative therapy and to update previous estimates of effectiveness by comparing spinal manipulative therapy with other therapies and then incorporating data from recent high-quality randomized, controlled trials (RCTs) into the analysis. Data Sources: MEDLINE, EMBASE, CINAHL, the Cochrane Controlled Trials Register, and previous systematic reviews. Study Selection: Randomized, controlled trials of patients with low back pain that evaluated spinal manipulative therapy with at least 1 day of follow-up and at least one clinically relevant outcome measure. Data Extraction: Two authors, who served as the reviewers for all stages of the meta-analysis, independently extracted data from unmasked articles. Comparison treatments were classified into the following seven categories: sham, conventional general practitioner care, analgesics, physical therapy, exercises, back school, or a collection of therapies judged to be ineffective or even harmful (traction, corset, bed rest, home care, topical gel, no treatment, diathermy, and minimal massage). Data Synthesis: Thirty-nine RCTs were identified. Meta-regression models were developed for acute or chronic pain and short-term and long-term pain and function. For patients with acute low back pain, spinal manipulative therapy was superior only to sham therapy (10-mm difference [95% CI, 2 to 17 mm] on a 100-mm visual analogue scale) or therapies judged to be ineffective or even harmful. Spinal manipulative therapy had no statistically or clinically significant advantage over general practitioner care, analgesics, physical therapy, exercises, or back school. Results for patients with chronic low back pain were similar. Radiation of pain, study quality, profession of manipulator, and use of manipulation alone or in combination with other therapies did not affect these results. Conclusions: There is no evidence that spinal manipulative therapy is superior to other standard treatments for patients with acute or chronic low back pain. C1 RAND Corp, Santa Monica, CA 90407 USA. Cochrane Back Review Grp, Toronto, ON, Canada. Dutch Coll Gen Practitioners, Utrecht, Netherlands. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RP Shekelle, PG (reprint author), RAND Corp, 1700 Main St,POB 2138, Santa Monica, CA 90407 USA. RI Assendelft, W.J.J./H-8008-2014 NR 117 TC 186 Z9 189 U1 0 U2 15 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JUN 3 PY 2003 VL 138 IS 11 BP 871 EP 881 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 686AB UT WOS:000183296400002 PM 12779297 ER PT J AU Cherkin, DC Sherman, KJ Deyo, RA Shekelle, PG AF Cherkin, DC Sherman, KJ Deyo, RA Shekelle, PG TI A review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID RANDOMIZED CONTROLLED TRIALS; FOLLOW-UP; SYSTEMATIC REVIEWS; CLINICAL-TRIALS; HEALTH; CARE; PHYSIOTHERAPISTS; COMPLICATIONS; EXPECTATIONS; MANAGEMENT AB Background: Few treatments for back pain are supported by strong scientific evidence. Conventional treatments, although widely used, have had limited success. Dissatisfied patients have, therefore, turned to complementary and alternative medical therapies and providers for care for back pain. Purpose: To provide a rigorous and balanced summary of the best available evidence about the effectiveness, safety, and costs of the most popular complementary and alternative medical therapies used to treat back pain. Data Sources: MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. Study Selection: Systematic reviews of randomized, controlled trials (RCTs) that were published since 1995 and that evaluated acupuncture, massage therapy, or spinal manipulation for nonspecific back pain and RCTs published since the reviews were conducted. Data Extraction: Two authors independently extracted data from the reviews (including number of RCTs, type of back pain, quality assessment, and conclusions) and original articles (including type of pain, comparison treatments, sample size, outcomes, follow-up intervals, loss to follow-up, and authors' conclusions). Data Synthesis: Because the quality of the 20 RCTs that evaluated acupuncture was generally poor, the effectiveness of acupuncture for treating acute or chronic back pain is unclear. The three RCTs that evaluated massage reported that this therapy is effective for subacute and chronic back pain. A meta-regression analysis of the results of 26 RCTs evaluating spinal manipulation for acute and chronic back pain reported that spinal manipulation was superior to sham therapies and therapies judged to have no evidence of a benefit but was not superior to effective conventional treatments. Conclusions: Initial studies have found massage to be effective for persistent back pain. Spinal manipulation has small clinical benefits that are equivalent to those of other commonly used therapies. The effectiveness of acupuncture remains unclear. All of these treatments seem to be relatively safe. Preliminary evidence suggests that massage, but not acupuncture or spinal manipulation, may reduce the costs of care after an initial course of therapy. C1 Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. Univ Washington, Seattle, WA 98195 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RAND Corp, Santa Monica, CA USA. RP Cherkin, DC (reprint author), Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, 1730 Minor Ave,Suite 1600, Seattle, WA 98101 USA. FU AHRQ HHS [R01 HS 09989]; NCCIH NIH HHS [AT00606, AT00622] NR 47 TC 196 Z9 202 U1 5 U2 17 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JUN 3 PY 2003 VL 138 IS 11 BP 898 EP 906 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 686AB UT WOS:000183296400005 PM 12779300 ER PT J AU Siscovick, DS Lemaitre, RN Mozaffarian, D AF Siscovick, DS Lemaitre, RN Mozaffarian, D TI The fish story - A diet-heart hypothesis with clinical implications: n-3 polyunsaturated fatty acids, myocardial vulnerability, and sudden death SO CIRCULATION LA English DT Editorial Material DE editorials; fish oils; fatty acids, n-3 polyunsaturated; diet; sudden death ID PRIMARY CARDIAC-ARREST; RISK; DISEASE; CONSUMPTION; HEALTH; WOMEN C1 Univ Washington, Dept Med, Cardiovasc Hlth Res Unit, Seattle, WA USA. Univ Washington, Dept Epidemiol, Cardiovasc Hlth Res Unit, Seattle, WA USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RP Siscovick, DS (reprint author), CHRU, 1730 Minor Ave 1360, Seattle, WA 98101 USA. RI Mozaffarian, Dariush/B-2276-2008 NR 18 TC 44 Z9 45 U1 0 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 JUN 3 PY 2003 VL 107 IS 21 BP 2632 EP 2634 DI 10.1161/01.CIR.0000074779.11379.62 PG 3 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 685UE UT WOS:000183281000001 PM 12782612 ER PT J AU Chew, LD Watanabe, JM Buchwald, D Lessler, DS AF Chew, LD Watanabe, JM Buchwald, D Lessler, DS TI Junior faculty's perspectives on mentoring SO ACADEMIC MEDICINE LA English DT Article ID ACADEMIC MEDICINE; WOMEN AB The prevalence and characteristics of mentorship among junior faculty in clinician-scientist and clinician-educator tracks were evaluated. Comprehensive improvement strategies are needed. C1 VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Ctr Excellence, Seattle, WA 98108 USA. Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA 98195 USA. Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA USA. Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA. RP Chew, LD (reprint author), VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Ctr Excellence, S-152,1660 S Columbian Way, Seattle, WA 98108 USA. NR 3 TC 37 Z9 37 U1 0 U2 5 PU HANLEY & BELFUS INC PI PHILADELPHIA PA 210 S 13TH ST, PHILADELPHIA, PA 19107 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD JUN PY 2003 VL 78 IS 6 BP 652 EP 652 DI 10.1097/00001888-200306000-00022 PG 1 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 711LE UT WOS:000184741400016 PM 12805052 ER PT J AU Huynh-Hohnbaum, ALT Damron-Rodriguez, J Washington, DL Villa, V Harada, N AF Huynh-Hohnbaum, ALT Damron-Rodriguez, J Washington, DL Villa, V Harada, N TI Exploring the diversity of women veterans' identity to improve the delivery of veterans' health services SO AFFILIA-JOURNAL OF WOMEN AND SOCIAL WORK LA English DT Article DE health care; qualitative research; veteran identity; women veterans ID CARE AB This qualitative study explored the domains of gender, ethnicity, and military association in a population of women veterans as these domains related to the women's access to and use of health care services and assessed barriers to the use of health services and suggestions for improving them. The study found that a significant proportion of the participants had experienced some form of gender discrimination in the military, through segregation or sexual harassment, and that their perceptions of the Veterans Administration health care system were framed by their military, ethnic/racial, and gender experiences. C1 Univ Calif Los Angeles, Sch Publ Policy & Social Res, Dept Social Welf, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, VA Hlth Serv Res & Dev Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. RP Huynh-Hohnbaum, ALT (reprint author), Univ Calif Los Angeles, Sch Publ Policy & Social Res, Dept Social Welf, 3250 Publ Policy Bldg, Los Angeles, CA 90095 USA. NR 13 TC 5 Z9 5 U1 1 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0886-1099 J9 AFFILIA J WOM SOC WO JI Affil. J. Women Soc. Work PD SUM PY 2003 VL 18 IS 2 BP 165 EP 176 DI 10.1177/0886109903251422 PG 12 WC Social Work; Women's Studies SC Social Work; Women's Studies GA 666FV UT WOS:000182167200006 ER PT J AU Kopjar, B Sales, AEB Pineros, SL Sun, HL Li, YF Hedeen, AN AF Kopjar, B Sales, AEB Pineros, SL Sun, HL Li, YF Hedeen, AN TI Comparison of characteristics of patients with coronary heart disease receiving lipid-lowering therapy versus those not receiving such therapy SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article C1 Univ Washington, Dept Hlth Serv, Ctr Cost & Outcome Res, Hlth Sci Ctr H688, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Dev Ctr Excellence, Seattle, WA USA. RP Kopjar, B (reprint author), Univ Washington, Dept Hlth Serv, Ctr Cost & Outcome Res, Hlth Sci Ctr H688, Box 357660, Seattle, WA 98195 USA. OI Sales, Anne/0000-0001-9360-3334 NR 2 TC 2 Z9 2 U1 0 U2 1 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD JUN 1 PY 2003 VL 91 IS 11 BP 1352 EP 1354 DI 10.1016/S0002-9149(03)00329-1 PG 3 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 685EE UT WOS:000183247200015 PM 12767433 ER PT J AU Asch, DA Jepson, C Hershey, JC Baron, J Ubel, PA AF Asch, DA Jepson, C Hershey, JC Baron, J Ubel, PA TI When money is saved by reducing healthcare costs, where do US primary care physicians think the money goes? SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article AB Background: Physician willingness to reduce medical costs is mixed. Some physicians, might be unwilling to reduce medical costs because they are concerned about where the savings would go. Objective: To determine whether primary care physicians might be less willing to choose a less expensive, less effective cancer screening alternative if they believe that the money saved goes to insurance companies. Design: Anonymous mailed survey. Participants: A total of 865 US primary care physicians. Main Outcome Measures: Responses to one of several clinical vignettes presenting a choice between a less expensive, less effective cancer screening option and a more expensive, more effective alternative and responses to where physicians thought the savings might go if they chose the cheaper alternative. Results: Fifty-three percent of physicians chose the most expensive screening alternative. in aggregate, physicians responded that more of any money saved would go to the managers or owners of insurance companies than to increased clinical services or reduced insurance premiums. Physicians choosing the more expensive screening test were more likely to believe that money saved from choosing the less expensive test would go to insurance company profits and salaries rather than to increased clinical services or reduced premiums (P < .001). Conclusions: Although US primary care physicians vary in where they think money saved in healthcare goes, most believe that more of it goes to the salaries of insurance company executives and the profits of insurance company owners than to improved clinical services or reduced premiums. The more physicians believe that this is where the money goes, the less willing they are to reduce healthcare costs. C1 Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. Univ Penn, Wharton Sch, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Ann Arbor, MI USA. Univ Michigan, Div Gen Internal Med, Ann Arbor, MI 48109 USA. Univ Michigan, Program Improving Hlth Care Decis, Ann Arbor, MI 48109 USA. RP Asch, DA (reprint author), Leonard Davis Inst Hlth Econ, 3641 Locust Walk, Philadelphia, PA 19104 USA. FU NCI NIH HHS [R01-CA78052-01] NR 6 TC 5 Z9 5 U1 0 U2 0 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD JUN PY 2003 VL 9 IS 6 BP 438 EP 442 PG 5 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 690XC UT WOS:000183574900003 PM 12816173 ER PT J AU Bruder, ED Ball, DL Goodfriend, TL Raff, H AF Bruder, ED Ball, DL Goodfriend, TL Raff, H TI An oxidized metabolite of linoleic acid stimulates corticosterone production by rat adrenal cells SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE steroidogenesis; glucocorticoid; fatty acid; zona fasciculata; epoxide ID INDUCED INSULIN-RESISTANCE; ACUTE REGULATORY PROTEIN; STAR PROTEIN; IN-VITRO; KINASE-C; ALDOSTERONE; STEROIDOGENESIS; ACTIVATION; ACTH; INVOLVEMENT AB Oxidized derivatives of linoleic acid have the potential to alter steroidogenesis. One such derivative is 12,13-epoxy-9-keto-10-( trans)-octadecenoic acid (EKODE). To evaluate the effect of EKODE on corticosterone production, dispersed rat zona fasciculata/reticularis ( subcapsular) cells were incubated for 2 h with EKODE alone or together with rat ACTH ( 0, 0.2, or 2.0 ng/ml). In the absence of ACTH, EKODE ( 26 muM) increased corticosterone production from 5.3 +/- 2.3 to 14.7 +/- 5.0 ng . 10(6) cells . h(-1). The stimulatory effect of ACTH was increased threefold in the presence of EKODE (26.0 muM). Cholesterol transport/P-450scc activity was assessed by measuring basal and cAMP-stimulated pregnenolone production in the presence of cyanoketone (1.1 muM). EKODE (13.1 and 26.0 muM) significantly increased basal and cAMP-stimulated (0.1 mM) pregnenolone production. In contrast, EKODE decreased the effect of 1.0 mM cAMP. EKODE had no effect on early or late-pathway activity in isolated mitochondria. We conclude that EKODE stimulates corticosterone biosynthesis and amplifies the effect of ACTH. Increased levels of fatty acid metabolites may be involved in the increased glucocorticoid production observed in obese humans. C1 St Lukes Hosp, Endocrine Res Lab, Milwaukee, WI 53215 USA. William S Middleton Mem Vet Adm Med Ctr, Dept Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Dept Pharmacol, Madison, WI 53705 USA. Univ Wisconsin, Madison, WI 53705 USA. Med Coll Wisconsin, Dept Med, Milwaukee, WI 53226 USA. RP Raff, H (reprint author), Endocrinol & Metab, St Lukes Phys Off Bldg,2801 W KK River Pkwy,Suite, Milwaukee, WI 53215 USA. FU NIDDK NIH HHS [DK-54685] NR 30 TC 10 Z9 10 U1 0 U2 0 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 JUN PY 2003 VL 284 IS 6 BP R1631 EP R1635 DI 10.1152/ajpregu.00753.2002 PG 5 WC Physiology SC Physiology GA 675MW UT WOS:000182700000037 PM 12689852 ER PT J AU Thongboonkerd V Klein, JB Pierce, WM Jevans, AW Arthur, JM AF Thongboonkerd, V Klein, JB Pierce, WM Jevans, AW Arthur, JM TI Sodium loading changes urinary protein excretion: a proteomic analysis SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE urine; tubular transport ID 2-DIMENSIONAL ELECTROPHORESIS; RENAL-CORTEX; HIGH-SALT; EXPRESSION; RATS; AQUAPORIN-2; MEDULLA AB Plasma sodium concentration is maintained even when sodium intake is altered. Sodium homeostasis may involve changes in renal tubular protein expression that are reflected in the urine. We used proteomic analysis to investigate changes in urinary protein excretion in response to acute sodium loading. Rats were given deionized water followed by hypertonic (2.7%) saline for 28 h each. Urinary protein expression was determined during the final 4 h of each treatment. Acute sodium loading increased urinary sodium excretion (4.53 +/- 1.74 vs. 1.70 +/- 0.27 mmol/day, P = 0.029). Urinary proteins were separated by two-dimensional PAGE and visualized by Sypro ruby staining. Differentially expressed proteins were identified by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry followed by peptide mass fingerprinting. The abundance of a total of 45 protein components was changed after acute sodium loading. Neutral endopeptidase, solute carrier family 3, meprin 1alpha, diphor-1, chaperone heat shock protein 72, vacuolar H(+)-ATPase, ezrin, ezrin/radixin/moesin-binding protein, glutamine synthetase, guanine nucleotide-binding protein, Rho GDI-1, and chloride intracellular channel protein 1 were decreased, whereas albumin and alpha-2u globulin were increased. Some of these proteins have previously been shown to be associated with tubular transport. These data indicate that alterations in the excretion of several urinary proteins occur during acute sodium loading. C1 Univ Louisville, Dept Med, Kidney Dis Program, Core Proteom Lab, Louisville, KY 40202 USA. Univ Louisville, Dept Biochem & Mol Biol, Louisville, KY 40202 USA. Univ Louisville, Dept Pharmacol & Toxicol, Louisville, KY 40202 USA. Vet Affairs Med Ctr, Louisville, KY 40202 USA. Jewish Hosp, Dept Pathol, Louisville, KY 40202 USA. Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. RP Thongboonkerd V (reprint author), Univ Louisville, Dept Med, Kidney Dis Program, Core Proteom Lab, 570 S Preston St,Suite 102, Louisville, KY 40202 USA. EM visith.thongboonkerd@louisville.edu RI THONGBOONKERD, VISITH /C-6920-2009; Klein, Jon/B-9833-2013 FU NHLBI NIH HHS [R01-HL-66358-01]; NIDDK NIH HHS [21-DK-629686-01] NR 30 TC 29 Z9 32 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD JUN PY 2003 VL 284 IS 6 BP F1155 EP F1163 DI 10.1152/ajprenal.00140.2002 PG 9 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 675MY UT WOS:000182700200004 PM 12582004 ER PT J AU Szanto, K Mulsant, BH Houck, P Dew, MA Reynolds, CF AF Szanto, K Mulsant, BH Houck, P Dew, MA Reynolds, CF TI Occurrence and course of suicidality during short-term treatment of late-life depression SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article ID PSYCHOLOGICAL AUTOPSY; COMPLETED SUICIDE; ELDERLY PATIENTS; DOUBLE-BLIND; IDEATION; BEHAVIOR; NORTRIPTYLINE; POPULATION; PAROXETINE; INPATIENTS AB Background: Elderly persons (greater than or equal to65 years) have the highest rate of suicide; still, little is known about the occurrence, course, and responsivity of suicidal ideation during treatment of depression in late life and how suicidality affects treatment response. Methods: This study was undertaken to determine (1) how suicidal ideation changes during short-term depression treatment and (2) whether treatment response differs among 3 groups of patients based on their levels of suicidality at baseline and during treatment (those with a recent suicide attempt or current suicidal ideation [high-risk group; n=46], those with recurrent thoughts of death [moderate-risk group; n=143], or those with no suicide attempt, suicidal ideation, or thoughts of death [low-risk group; n=206]). This is a secondary analysis of pooled data from 3 treatment studies of late-life major depression. Participants were 395 elderly persons with a current major depressive episode, treated as inpatients or outpatients under protocolized conditions with paroxetine hydrochloride or nortriptyline hydrochloride, with or without interpersonal psychotherapy. Changes in suicidal ideation over time, rate of responses, and time to response in each group were compared. Results: Suicidal ideation decreased rapidly early in the course of treatment, with more gradual change thereafter. At the beginning of treatment, 77.5% of the patients reported suicidal ideation, thoughts of death, or feelings that life is empty. After 12 weeks of treatment, suicidal ideation had resolved in all treated patients; 4.6% still reported thoughts of death. However, 6-week (P=.001) and 12-week (P=.02) rates of response were significantly lower in high-fisk patients than in low- and moderate-risk patients. High- and moderate-risk patients needed a significantly (P<.001) longer time to respond than low-risk patients (median time to response, 6 and 5 vs; 3 weeks). Conclusions: While suicidal ideation resolves rapidly, the resolution of thoughts about death is more gradual. Suicidal elderly persons with depression require special attention during depression treatment because they have a lower response rate and need a longer. time to respond. C1 VA Pittsburgh Healthcare Syst, Dept Psychiat, Intervent Res Ctr Study Late Life Mood Disorders, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Dept Psychiat, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Mulsant, BH (reprint author), Western Psychiat Inst & Clin, 3811 OHara St,Room E-837, Pittsburgh, PA 15213 USA. RI Szanto, Katalin/B-8389-2014 FU NIA NIH HHS [AG05133]; NIMH NIH HHS [K05 MH00295, MH01613, MH37869, MH43832, MH52247] NR 34 TC 82 Z9 82 U1 1 U2 5 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD JUN PY 2003 VL 60 IS 6 BP 610 EP 617 DI 10.1001/archpsyc.60.6.610 PG 8 WC Psychiatry SC Psychiatry GA 688GB UT WOS:000183424900008 PM 12796224 ER PT J AU Bsoul, S Terezhalmy, G Abboud, H Woodruff, K Abboud, SL AF Bsoul, S Terezhalmy, G Abboud, H Woodruff, K Abboud, SL TI PDGF BB and bFGF stimulate DNA synthesis and upregulate CSF-1 and MCP-1 gene expression in dental follicle cells SO ARCHIVES OF ORAL BIOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Academy-of-Oral-Medicine CY APR 23-28, 2002 CL FT LAUDERDALE, FLORIDA SP Amer Acad Oral Med DE CFS-1; MCP-1; gene expression; PDGF; bFGF; dental follicle cells ID MONOCYTE CHEMOATTRACTANT PROTEIN-1; TOOTH ERUPTION MOLECULES; IMMEDIATE-EARLY GENE; GROWTH-FACTOR; FACTOR-I; STROMAL CELLS; MESSENGER-RNA; RAT MOLARS; MOUSE; BONE AB CSF-1 and MCP-1, released by dental follicle cells, stimulate the influx of monocytes into the follicle sac and enhance the formation of osteoclasts that, in turn, resorb alveolar bone for the eruption pathway. PDGF and bFGF, released by cells adjacent to the follicle or by activated monocytes, are prime candidates that may regulate CSF-1 and MCP-1 gene expression. The present study demonstrates that PDGF and bFGF are mitogens for dental follicle cells and stimulate CSF-1 and MCP-1 mRNA, but with different time course kinetics. Peak induction of CSF-1 mRNA was observed at 6-8 h, while maximal MCP-1 induction was observed at 2 h. These findings suggest that MCP-1 is an early chemotactic signal for monocytes and that subsequent release of CSF-1 may act synergistically with MCP-1 to enhance monocyte influx. Further understanding of the molecular mechanisms by which cytokines regulate CSF-1 and MCP-1 may lead to more effective treatment regimens for disorders associated with abnormal tooth eruption. (C) 2003 Elsevier Science Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Dent Diagnost Sci, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. RP Abboud, SL (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. FU NIAMS NIH HHS [AR42306]; NIDCR NIH HHS [R01 DE015857] NR 34 TC 9 Z9 10 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0003-9969 J9 ARCH ORAL BIOL JI Arch. Oral Biol. PD JUN PY 2003 VL 48 IS 6 BP 459 EP 465 DI 10.1016/S0003-9969(03)00084-0 PG 7 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 689CN UT WOS:000183474200007 PM 12749918 ER PT J AU Ko, CW Lee, SR AF Ko, CW Lee, SR TI Biliary sludge and cholecystitis SO BEST PRACTICE & RESEARCH IN CLINICAL GASTROENTEROLOGY LA English DT Article DE biliary sludge; cholelithiasis; cholecystitis; cholecystectomy ID ACUTE ACALCULOUS CHOLECYSTITIS; POSITIVE-PRESSURE VENTILATION; CHOLESTEROL CRYSTAL-FORMATION; TOTAL PARENTERAL-NUTRITION; BONE-MARROW TRANSPLANT; HIGH-RISK PATIENTS; PERCUTANEOUS CHOLECYSTOSTOMY; GALLSTONE FORMATION; GALLBLADDER SLUDGE; LIPID SECRETION AB Biliary sludge develops commonly in critically ill patients and may be associated with biliary colic, acute pancreatitis or acute cholecystitis. Sludge often resolves upon resolution of the underlying pathogenetic factor. It is generally diagnosed on sonography. Treatment of sludge itself is unnecessary unless further complications develop. Acute acalculous cholecystitis also develops frequently in critically ill patients. It may be difficult to diagnose in these patients, manifesting only as unexplained fever, leukocytosis or sepsis. Sonography and hepatobiliary scintigraphy are the most useful diagnostic tests. Management decisions should take into account the underlying co-morbid conditions. For many patients, percutaneous cholecystostomy may be the best management option. Cholecystostomy may also provide definitive drainage as patients recover and underlying critical illness resolves. C1 Univ Washington, Dept Med, Div Gastroenterol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Ko, CW (reprint author), Univ Washington, Dept Med, Div Gastroenterol, Box 356424, Seattle, WA 98195 USA. NR 74 TC 8 Z9 8 U1 0 U2 1 PU BAILLIERE TINDALL PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1521-6918 J9 BEST PRACT RES CL GA JI Best Pract. Res. Clin. Gastroenterol. PD JUN PY 2003 VL 17 IS 3 BP 383 EP 396 DI 10.1053/ybega.2003.384 PG 14 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 687VD UT WOS:000183396900006 PM 12763503 ER PT J AU Au, DH Udris, EM Fan, VS Curtis, JR McDonell, MB Fihn, SD AF Au, DH Udris, EM Fan, VS Curtis, JR McDonell, MB Fihn, SD TI Risk of mortality and heart failure exacerbations associated with inhaled beta-adrenoceptor agonists among patients with known left ventricular systolic dysfunction SO CHEST LA English DT Article DE adreaergic beta-agonists; COPD; echocardiography; heart failure; mortality ID IDIOPATHIC DILATED CARDIOMYOPATHY; ADRENERGIC-RECEPTOR BLOCKADE; PHARMACY RECORDS; MERIT-HF; METOPROLOL; TERBUTALINE; RESPONSES; DISEASE; DENSITY; TRIAL AB Objectives: Recent studies suggest that myocardial beta(2)-adrenoceptors may be important in chronic heart failure. We sought to determine if use of selective beta(2)-agonists was associated with hospitalization for heart failure and all-cause mortality. Methods: We studied a cohort of patients with left ventricular systolic dysfunction (LVSD). The outcome was the first hospitalization with a primary diagnosis of chronic heart failure or death from any cause. The exposure was the average number of R-agonist canisters filled per month in the 90 days prior to and 15 days after enrollment. Results: Among 1,529 subjects, the relative risk (RR) of chronic heart failure hospital admission associated with inhaled beta-agonists followed a dose-response relationship: RR for one canister per month, 1.4 (95% confidence interval [CI], 0.9 to 2.0), RR for two canisters per month, 1.7 (95% CI, 1.2 to 2.5), and RR for three canisters per month, 2.1 (95% CI, 1.4 to 3.1). The RR of death demonstrated a similar finding: RR for one canister per month, 0.9 (95% CI, 0.5 to 1.5), RR for two canisters per month, 1.3 (95% CI, 0.9 to 2.1), and RR for three canisters per month, 2.0 (95% CI, 1.3 to 3.1). Adjusting for potential confounding factors did not affect the estimates, Conclusion: Among subjects with LVSD, inhaled beta-agonists were associated with an increased risk of heart failure hospitalization, and all-cause mortality. Clinicians should carefully consider the etiology of dyspnea when prescribing beta-agonists to patients with LVSD. C1 VA Puget Sound Hlth Care Syst, Div Pulm & Crit Care Med, NW Ctr Excellence, Dept Vet Affairs, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. RP Au, DH (reprint author), VA Puget Sound Hlth Care Syst, Div Pulm & Crit Care Med, NW Ctr Excellence, Dept Vet Affairs, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 31 TC 69 Z9 69 U1 1 U2 1 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD JUN PY 2003 VL 123 IS 6 BP 1964 EP 1969 DI 10.1378/chest.123.6.1964 PG 6 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 689XV UT WOS:000183519000031 PM 12796175 ER PT J AU Dinovo, EC Singh, M Renner, SW Baria, AM Schieffer, B Korobkin, S Naliboff, BD AF Dinovo, EC Singh, M Renner, SW Baria, AM Schieffer, B Korobkin, S Naliboff, BD TI Comparison of opiate test results obtained from the LX20, AxSYM, REMEDi HS and the RapidOne Oxy testing systems with prescribed medications. SO CLINICAL CHEMISTRY LA English DT Meeting Abstract CT 55th Annual Meeting of the American-Association-for-Clinical-Chemiatry CY JUL 20-24, 2003 CL PHILADELPHIA, PENNSYLVANIA C1 VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC CLINICAL CHEMISTRY PI WASHINGTON PA 2101 L STREET NW, SUITE 202, WASHINGTON, DC 20037-1526 USA SN 0009-9147 J9 CLIN CHEM JI Clin. Chem. PD JUN PY 2003 VL 49 IS 6 SU S BP A77 EP A77 PN 2 PG 1 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 682JP UT WOS:000183088700241 ER PT J AU Molano, ID Redmond, S Sekine, H Zhang, XK Reilly, C Hutchison, F Ruiz, P Gilkeson, GS AF Molano, ID Redmond, S Sekine, H Zhang, XK Reilly, C Hutchison, F Ruiz, P Gilkeson, GS TI Effect of genetic deficiency of terminal deoxynucleotidyl transferase on autoantibody production and renal disease in MRL/lpr mice SO CLINICAL IMMUNOLOGY LA English DT Article DE MRLMpJ/Fas(lpr); MRL/lpr; TdT; N additions; autoimmune; autoantibodies; lupus; nephritis; albuminuria; CDR3 sequence ID ANTI-DNA ANTIBODIES; SYSTEMIC LUPUS-ERYTHEMATOSUS; MRL-LPR MICE; BACTERIAL-DNA; AUTOIMMUNE ANTIBODIES; T-CELLS; B-CELLS; SPECIFICITY; NEPHRITIS; MODEL AB Terminal deoxynucleotidyl transferase (TdT) places non-template-coded nucleotides (N additions) in the VH CDR3 of T cell receptors and immunoglobulins. Amino acids coded for by N additions are important in autoantibody binding of dsDNA in lupus. We hypothesized that a genetic lack of TdT would modulate disease in lupus-prone mice. To test this hypothesis, we derived TdT-deficient MRL/lpr mice. Serum levels of anti-dsDNA antibodies and anti-dsDNA producing splenocytes were significantly lower in the TdT(-) versus TdT(+) littermates. Albuminuria, glomerular IgG deposition, and pathologic renal disease were significantly reduced in the TdT(-) mice. Sequence analysis of anti-dsDNA hybridomas derived from TdT(-) mice revealed a lack of N additions, short VH CDR3 segments, yet the presence of VH CDR3 arginines. Thus, the genetic absence of TdT reduces autoantibody production and clinical disease in MRL/lpr mice, confirming the importance of N additions in the autoimmune response in these mice. (C) 2003 Elsevier Science (USA). All rights reserved. C1 Med Univ S Carolina, Ralph H Johnson VAMC, Med Res Serv, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Univ Miami, Med Ctr, Dept Pathol, Miami, FL 33136 USA. RP Gilkeson, GS (reprint author), 96 Jonathan Lucas Blvd,Ste 912,POB 250623, Charleston, SC 29425 USA. FU NIAMS NIH HHS [R01 AR056670, R03 AR054546] NR 36 TC 11 Z9 11 U1 0 U2 0 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1521-6616 J9 CLIN IMMUNOL JI Clin. Immunol. PD JUN PY 2003 VL 107 IS 3 BP 186 EP 197 DI 10.1016/S1521-6616(03)00035-4 PG 12 WC Immunology SC Immunology GA 692MR UT WOS:000183665300007 PM 12804532 ER PT J AU Brickman, AM Buchsbaum, MS Shihabuddin, L Hazlett, EA Borod, JC Mohs, RC AF Brickman, AM Buchsbaum, MS Shihabuddin, L Hazlett, EA Borod, JC Mohs, RC TI Striatal size, glucose metabolic rate, and verbal learning in normal aging SO COGNITIVE BRAIN RESEARCH LA English DT Article DE FDG; positron emission tomography (PET); normal aging; striatum (caudate and putamen); regional glucose metabolism; verbal learning ID POSITRON EMISSION TOMOGRAPHY; BRAIN DOPAMINE ACTIVITY; CEREBRAL BLOOD-FLOW; AGE-RELATED-CHANGES; PARKINSONS-DISEASE; BASAL GANGLIA; HEALTHY-MEN; IN-VIVO; MEDICATED SCHIZOPHRENICS; SEX-DIFFERENCES AB The striatum has recently been implicated as an area that may mediate age-associated cognitive decline because of diminution of volume and functional activity. We used F-18-fluorodeoxyglucose (FDG) with positron emission tomography (PET) and high-resolution magnetic resonance imaging (MRI) to examine the effects of age on striatal glucose metabolic rate and size in 70 healthy, normal subjects. During the FDG tracer uptake period, subjects performed a serial verbal learning task, based on the California Verbal Learning Test. PET images were co-registered to the MR images. The interrelations among striatal glucose metabolic rate, size, and performance on the verbal learning task were examined with repeated-measures analysis of variance and correlational analysis. As age increased, relative glucose metabolic rate (GMR) increased in the putamen and decreased in the caudate. Female subjects had lower relative GMR than male subjects in the caudate, but equal in the putamen. Striatal size remained relatively constant across the lifespan in men but was lower in women aged 50-70 than in men. While there were significant associations between striatal activity and performance on the uptake task, these findings were mostly accounted for by age. The findings are consistent with our earlier report on the same cohort that demonstrated an age-related shift from anterior to posterior cortical metabolism, as the putamen receives primarily posterior cortical input and the caudate receives relatively more anterior cortical input. Findings of significant involvement of striatal functioning in verbal learning are most likely accounted for by age and suggest an age-related shift from anterior to posterior circuitry in the human telencephalon. Published by Elsevier Science B.V. C1 Mt Sinai Sch Med, Neurosci PET Lab, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Psychiat Serv, Bronx, NY 10468 USA. CUNY Queens Coll, Dept Psychol, Flushing, NY 11367 USA. CUNY Ctr, Flushing, NY 11367 USA. Mt Sinai Sch Med, Dept Neurol, New York, NY 10029 USA. Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA. RP Brickman, AM (reprint author), Mt Sinai Sch Med, Neurosci PET Lab, Dept Psychiat, Box 1505,1 Gustave L Levy Pl, New York, NY 10029 USA. NR 63 TC 13 Z9 13 U1 1 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0926-6410 J9 COGNITIVE BRAIN RES JI Cognit. Brain Res. PD JUN PY 2003 VL 17 IS 1 BP 106 EP 116 DI 10.1016/S0926-6410(03)00085-5 PG 11 WC Computer Science, Artificial Intelligence; Neurosciences; Neuroimaging SC Computer Science; Neurosciences & Neurology GA 733CP UT WOS:000185982600011 ER PT J AU Menzies, BE AF Menzies, BE TI The role of fibronectin binding proteins in the pathogenesis of Staphylococcus aureus infections SO CURRENT OPINION IN INFECTIOUS DISEASES LA English DT Review DE Staphylococcus aureus; fibronectin; adherence; invasion ID ENDOTHELIAL-CELLS; NUCLEOTIDE-SEQUENCE; EPITHELIAL-CELLS; FNB GENES; ADHERENCE; INVASION; INTERNALIZATION; ENDOCARDITIS; EXPRESSION; APOPTOSIS AB Purpose of review Staphylococcus aureus; produces two closely-related fibronectin-binding proteins (FnBPs) that facilitate attachment by this versatile pathogen. Recent studies of staphylococcal FnBP have increased our understanding of the molecular mechanisms that are critical in bacterial-host cell interactions and in infection. Recent findings This review will summarize current knowledge of the role of the FnBPs of Staphylococcus aureus in the pathogenesis of infection. The FnBPs, which facilitate attachment of this pathogen to host cells and to fibronectin-coated biomaterials, are important mediators of infection in experimental endocarditis. In addition, recent vaccine studies utilizing FnBP derivatives have shown partial protection in animals. FnBPs also act as invasins permitting uptake of the staphylococcus by cultured non-professional phagocytes using host fibronectin to bridge with integrins on the cell surface. However, the precise role of FnBP in tissue invasion and the relevance of intracellular invasion in disease remain to be elucidated. Summary FnBP is one of many adhesins expressed by S. aureus; that influence host tissue adherence by binding to host fibronectin. FnBP-based vaccine strategies and novel anti-adherence tools based upon FnBP derivatives are in the early stages of investigation but may show promise in preventing staphylococcal infections. C1 VA Puget Sound Hlth Care Syst, Infect Dis Sect, Seattle, WA 98108 USA. Univ Washington, Washington, DC USA. RP Menzies, BE (reprint author), VA Puget Sound Hlth Care Syst, Infect Dis Sect, 111-1D,1660 S Columbia Way, Seattle, WA 98108 USA. NR 37 TC 72 Z9 74 U1 1 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0951-7375 J9 CURR OPIN INFECT DIS JI Curr. Opin. Infect. Dis. PD JUN PY 2003 VL 16 IS 3 BP 225 EP 229 DI 10.1097/01.qco.0000073771.11390.75 PG 5 WC Infectious Diseases SC Infectious Diseases GA 688KP UT WOS:000183434100007 PM 12821812 ER PT J AU LeMaster, JW Sugarman, JR Baumgardner, G Reiber, GE AF LeMaster, JW Sugarman, JR Baumgardner, G Reiber, GE TI Motivational brochures increase the number of Medicare-eligible persons with diabetes making therapeutic footwear claims SO DIABETES CARE LA English DT Article ID POSTCARD REMINDERS; MAMMOGRAPHY USE; INTERVENTIONS; BENEFICIARIES; PREVENTION; VACCINE; SHOES; TRIAL; RATES; CARE AB OBJECTIVE - This study tests the hypothesis that Medicare beneficiaries at high risk of foot complications who are mailed a motivational brochure describing the Medicare diabetes-related therapeutic footwear benefit will increase their therapeutic footwear-related Medicare claims. RESEARCH DESIGN AND METHODS - in this quasi-experimental study, a motivational brochure was mailed in the summer of 1997 to 5,872 Medicare beneficiaries in Washington, Alaska, and Idaho who were identified as being at high risk for foot-related claims on the basis of their prior Medicare claims history. Beneficiaries were identified through footwear claims made in these states-and also in three comparison states (Oregon, Montana, and Wyoming) during the 18 months before and after the mailing. Linear regression was used to compare the number of persons making claims in the intervention states with the comparison states before, at the time of, and after the mailing. RESULTS - Before the intervention, the number of persons making claims was increasing in the nonintervention states and decreasing in the intervention states. During the first month after the intervention mailing, the number of persons making claims remained nearly the same in nonintervention states, but increased 13 persons per month in intervention states (95% Cl 3.5-11 persons/month). After the intervention, the number of persons making claims continued to increase similarly in both intervention and nonintervention states. CONCLUSIONS - Mailed motivational brochures were associated with an increase in the number of persons making therapeutic footwear claims. Randomized trials should confirm these findings. C1 Univ Missouri, Dept Family & Community Med, Columbia, MO 65212 USA. Qualis Hlth, Seattle, WA USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Dept Vet Affairs, VA Puget Sound Hlth Care Syst, Hlth Serv & Rehabil Res & Dev, Seattle, WA USA. RP LeMaster, JW (reprint author), Univ Missouri, Dept Family & Community Med, 1 Hosp Dr, Columbia, MO 65212 USA. FU PHS HHS [500-99-WA02] NR 19 TC 1 Z9 1 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD JUN PY 2003 VL 26 IS 6 BP 1679 EP 1684 DI 10.2337/diacare.26.6.1679 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 724UR UT WOS:000185505500003 PM 12766093 ER PT J AU Nurgalieva, ZZ Graham, DY AF Nurgalieva, ZZ Graham, DY TI Pearls and pitfalls of assessing Helicobacter pylori status SO DIGESTIVE AND LIVER DISEASE LA English DT Article DE Helicobacter pylori; stool antigen; urea breath test ID C-13-UREA BREATH TEST; CITRIC-ACID; INFECTION; ERADICATION; COHORT C1 VA Med Ctr, Dept Med, Houston, TX 77211 USA. Baylor Coll Med, Houston, TX 77030 USA. RP Graham, DY (reprint author), VA Med Ctr, Dept Med, Houston, TX 77211 USA. NR 14 TC 13 Z9 13 U1 0 U2 0 PU PACINI EDITORE PI PISA PA VIA DELLA GHERARDESCA-ZONA INDUSTRIALE OSPEDALETTO, 56121 PISA, ITALY SN 1590-8658 J9 DIGEST LIVER DIS JI Dig. Liver Dis. PD JUN PY 2003 VL 35 IS 6 BP 375 EP 377 DI 10.1016/S1590-8658(03)00166-X PG 3 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 700LY UT WOS:000184114500001 PM 12868671 ER PT J AU Olson, SL Ledoux, WR Ching, RP Sangeorzan, BJ AF Olson, SL Ledoux, WR Ching, RP Sangeorzan, BJ TI Muscular imbalances resulting in a clawed hallux SO FOOT & ANKLE INTERNATIONAL LA English DT Article DE toes; hammer toe syndrome; foot; biomechanics; pressure ID FOOT PRESSURE; RISK-FACTORS; TENDON; FORCE; MANAGEMENT; MODEL AB A clawed hallux is a deformity of the great toe resulting from a muscular imbalance. Using a cadaveric foot-loading frame, we quantitatively assessed the role of the peroneus longus (PL), extensor hallucis longus (EHL), and flexor hallucis longus (FHL) on position and pressure distribution of the first ray by simulating muscle imbalances. The experimental protocol included applying seven different combinations of simulated disproportionate loads ("overpulls") for these three muscles using midstance force values derived from the literature. This study quantified the angular change in the joints of the first ray and measured the plantar pressure beneath the head of the first metatarsal and the hallux. The results indicated that the peroneus longus was statistically the greatest contributor to the elevation of plantar pressure beneath the first metatarsal, while the EHL and FHL were primarily responsible for the angular changes resuilting in the clawed hallux deformity. C1 VA Puget Sound Hlth Care Syst, RR&D Ctr Excellence Limb Loss Prevent & Prosthet, Dept Vet Affairs, Seattle, WA 98108 USA. Univ Washington, Dept Orthopaed & Sports Med, Seattle, WA 98195 USA. Univ Washington, Dept Mech Engn, Seattle, WA 98195 USA. RP Ledoux, WR (reprint author), VA Puget Sound Hlth Care Syst, RR&D Ctr Excellence Limb Loss Prevent & Prosthet, Dept Vet Affairs, MS 151,1660 S Columbian Way, Seattle, WA 98108 USA. RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 NR 22 TC 22 Z9 22 U1 0 U2 1 PU AMER ORTHOPAEDIC FOOT & ANKLE SOC, INC PI SEATTLE PA 2517 EASTLAKE AVE EAST, STE 200, SEATTLE, WA 98102 USA SN 1071-1007 J9 FOOT ANKLE INT JI Foot Ankle Int. PD JUN PY 2003 VL 24 IS 6 BP 477 EP 485 PG 9 WC Orthopedics SC Orthopedics GA 695ME UT WOS:000183834000005 PM 12854668 ER PT J AU Sonnenberg, A Fennerty, MB AF Sonnenberg, A Fennerty, MB TI Medical decision analysis of chemoprevention against esophageal adenocarcinoma SO GASTROENTEROLOGY LA English DT Article ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; HIGH-GRADE DYSPLASIA; BARRETTS-ESOPHAGUS; COLORECTAL-CANCER; CYCLOOXYGENASE-2 EXPRESSION; ENDOSCOPIC SURVEILLANCE; ASPIRIN USE; RISK; PREVENTION; MANAGEMENT AB Background & Aims: Chemoprevention of esophageal adenocarcinoma using nonsteroldal anti-inflammatory drugs (NSAIDs) may reduce the risk of cancer in patients with Barrett's esophagus. The aim of the study was to assess the cost-effectiveness of this strategy. Metho The Incremental cost-effectiveness ratio (ICER) of chemoprevention (compared with endoscopic surveillance or with no surveillance) was analyzed with a computer model of a Markov process. Results: Under baseline conditions for all patients with Barrett's esophagus (neoplastic and nonneoplastic), the ICER of chemoprevention ranges between $12,700 and $18,500 per life-year saved. However, these cost values are sensitive to variations in the costs of chemoprevention, incidence of cancer in patients with Barrett's esophagus, and efficacy of NSAlDs in reducing the incidence of cancer, which can shift the ICER into a cost range that is prohibitively expensive. Conversely, in those patients with Barrett's esophagus and high-grade dysplasia, the ICER ranges between $3900 and $5000. Chemoprevention remains a cost-effective option even under rather unfavorable conditions, such as higher cost and lower efficacy of chemoprevention and lower incidence of cancer. Conclusions. This model suggests that a high incidence of esophageal adenocarcinoma in high-grade dysplasia renders chemoprevention cost-effective even in the presence of less-favorable conditions. However, chemoprevention may not be a cost-effective measure in the general population of all patients with Barrett's esohagus, depending on unknown factors such as cost and efficacy of chemoprevention as well as true incidence of cancer. C1 Oregon Hlth Sci Univ, Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Div Gastroenterol Hepatol, Portland, OR 97239 USA. RP Sonnenberg, A (reprint author), Oregon Hlth Sci Univ, Portland VA Med Ctr, P3-GI,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. NR 33 TC 26 Z9 27 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD JUN PY 2003 VL 124 IS 7 BP 1758 EP 1766 DI 10.1016/S0016-5085(03)00393-7 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 684ZK UT WOS:000183236200008 PM 12806608 ER PT J AU Kearney, DJ Crump, C Maynard, C Boyko, EJ AF Kearney, DJ Crump, C Maynard, C Boyko, EJ TI A case-control study of endoscopy and mortality from adenocarcinoma of the esophagus or gastric cardia in persons with GERD SO GASTROINTESTINAL ENDOSCOPY LA English DT Article ID GASTROESOPHAGEAL REFLUX DISEASE; BARRETTS-ESOPHAGUS; SURVEILLANCE; POPULATION; DYSPLASIA; SURVIVAL; EFFICACY; RECORDS; CANCER; STAGE AB Background. This study assessed whether EGD reduces mortality from adenocarcinoma of the esophagus or gastric cardia for patients with gastroesophageal reflux. Methods: A case-control study was performed. A total of 245 incident cases of death caused by adenocarcinoma of the esophagus or gastric cardia (1995-1999) in which reflux was present were identified using Veterans Health Administration databases. A total of 980 controls with reflux but no death from adenocarcinoma were frequency matched for age, gender, and race. The occurrences of EGD from 1990 onward were compared for cases and controls. Logistic regression analysis with adjustment for potential confounding factors was performed. Results: All the subjects were men. Cases were significantly less likely to have had an EGD in the time period of interest as compared with controls (adjusted odds ratio 0.66: 95% Cl [0.45, 0.96], p = 0.03). This negative association was as strong for any EGD performed within 1 to 8 years before diagnosis as for a more recent EGD. However, there were no controls that included esophagectomy and no controls with a nonfatal diagnosis of adenocarcinoma, raising the question of whether EGD and reduced mortality are causally linked. The risk of dying from adenocarcinoma was significantly lower for men with a diagnosis of GERD as an inpatient relative to men in whom the diagnosis was made as an outpatient (adjusted odds ratio 0.21: 95% Cl [0.15, 0.31], p < 0.01). Conclusions: For patients with GERD, performing an EGD is associated with reduced mortality from adenocarcinoma of the esophagus or gastric cardia, but whether this is a causative association remains unclear. C1 VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Vet Affairs Epidemiol Res & Informat Ctr, Seattle, WA USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. RP Kearney, DJ (reprint author), Univ Washington, Gastroenterol Sect, VAMC 111G1, 1660 S Columbian Way, Seattle, WA 98108 USA. RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814; Boyko, Edward/0000-0002-3695-192X NR 39 TC 21 Z9 21 U1 0 U2 3 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD JUN PY 2003 VL 57 IS 7 BP 823 EP 829 DI 10.1067/mge.2003.249 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 685WP UT WOS:000183287300004 PM 12776027 ER PT J AU Kier, FJ Molinari, V AF Kier, FJ Molinari, V TI "Do-it-yourself" dementia testing: Issues regarding an Alzheimer's Home Screening Test SO GERONTOLOGIST LA English DT Article ID SMELL IDENTIFICATION TEST; OLFACTORY IDENTIFICATION; COGNITIVE IMPAIRMENT; LONGITUDINAL CHANGES; HIV-INFECTION; FOLLOW-UP; DEFICITS; DISEASE; CARE; SCHIZOPHRENIA C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA 15260 USA. Univ S Florida, Louis Parte Florida Mental Hlth Inst, Tampa, FL USA. RP Kier, FJ (reprint author), VA Pittsburgh Healthcare Syst, Highland Dr Div 116 A-H,7180 Highland Dr, Pittsburgh, PA 15206 USA. NR 50 TC 12 Z9 13 U1 3 U2 5 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD JUN PY 2003 VL 43 IS 3 BP 295 EP 301 PG 7 WC Gerontology SC Geriatrics & Gerontology GA 691JY UT WOS:000183603900002 PM 12810892 ER PT J AU Kieseier, BC Pischel, H Neuen-Jacob, E Tourtellotte, WW Hartung, HP AF Kieseier, BC Pischel, H Neuen-Jacob, E Tourtellotte, WW Hartung, HP TI ADAM-10 and ADAM-17 in the inflamed human CNS SO GLIA LA English DT Article DE TNF-alpha; TNFR-2; multiple sclerosis; astrocyte; T lymphocyte ID TUMOR-NECROSIS-FACTOR; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; MULTIPLE-SCLEROSIS; FACTOR-ALPHA; MATRIX METALLOPROTEINASES; MEDIATED DEMYELINATION; DISINTEGRIN; EXPRESSION; TNF; PATHOGENESIS AB Inflammatory demyelinating disorders of the CNS, such as multiple sclerosis (MS), are mediated, at least in part, by various cytokines and proteases. In the present study, we investigated the expression of A disintegrin and metalloproteinase (ADAM)-17, an important sheddase for various proteins, including tumor necrosis factor-alpha (TNF-alpha), and the p75- and p55-TNF receptors, as well as ADAM-10, a protease implicated in myelin degradation, in post mortem CNS tissue samples from patients with MS, and normal brain tissue (as control) by immunohistochemistry. ADAM-10 was found to be expressed by astrocytes in all MS and control sections studied; however, in some MS sections, perivascular macrophages were determined as an additional cellular source as well. ADAM-17 could be observed exclusively in acute and chronic active MS plaques and localized to invading T lymphocytes. The staining pattern of ADAM-17 in MS plaques was mirrored in distribution and extent by the pattern obtained with an antibody against the p75-TNF-receptor (TNFR-2), whereas TNF-a was found to be expressed primarily by perivascular macrophages. In studying cerebrospinal fluid (CSF) samples from MS patients, we were able to detect increased protein levels of ADAM-17 as compared with noninflammatory controls. In addition, increased levels of soluble TNFR-2 could be measured, suggestive of an active shedding process mediated by ADAM-17. The stimulation of peripheral blood mononuclear cells (PBMC) obtained from MS patients and healthy individuals corroborated these findings by revealing expression of ADAM-17 by T lymphocytes and ADAM-10 by macrophages in vitro. Our results indicate that ADAM-10 is expressed constitutively by astrocytes in the normal and inflamed human CNS. In contrast, under inflammatory conditions, ADAM-10, expressed by perivascular macrophages, and ADAM-17, expressed by invading T cells, may actively contribute to the pathogenesis of inflammatory disorders of the CNS. (C) 2003 Wiley-Liss, Inc. C1 Univ Dusseldorf, Dept Neurol, Res Grp Clin & Expt Neuroimmunol, D-40225 Dusseldorf, Germany. Univ Dusseldorf, Dept Neuropathol, D-40225 Dusseldorf, Germany. W Los Angeles Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Kieseier, BC (reprint author), Univ Dusseldorf, Dept Neurol, Res Grp Clin & Expt Neuroimmunol, Moorenstr 5, D-40225 Dusseldorf, Germany. NR 32 TC 38 Z9 38 U1 0 U2 2 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0894-1491 J9 GLIA JI Glia PD JUN PY 2003 VL 42 IS 4 BP 398 EP 405 DI 10.1002/glia.10226 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 685PH UT WOS:000183272100009 PM 12730960 ER PT J AU Tanaka, S Chu, S Hirokawa, M Montrose, MH Kaunitz, JD AF Tanaka, S Chu, S Hirokawa, M Montrose, MH Kaunitz, JD TI Direct measurement of acid permeation into rat oesophagus SO GUT LA English DT Article ID RABBIT ESOPHAGEAL EPITHELIUM; MUCOSAL BLOOD-FLOW; MUCUS GEL THICKNESS; INTRACELLULAR PH; NITRIC-OXIDE; BARRETTS-ESOPHAGUS; ALKALINE SECRETION; DYNAMIC REGULATION; SPECIAL EMPHASIS; SURFACE PH AB Background and aims: The early responses of the oesophageal mucosa to acid perfusion may predict subsequent pathology. Mucosal responses to luminal acid may result either from acid permeating through the mucosa or from other unknown transduction mechanisms. In order to better understand the dynamics of acid permeation into the oesophageal mucosa, we measured interstitial pH (pH(int)) of the oesophageal basal epithelial layer, pre-epithelial layer thickness, and blood flow in rats in vivo during luminal acid challenge. A novel confocal microscopic technique was used in vitro to measure pH(int) from defined cellular sites in response to luminal and basolateral acidification. Methods: 5-(and-6)-Carboxyfluorescein (CF) and carboxy- seminapthorhodofluor-1 (SNARF-1) fluorescence was used to measure pH(int) by conventional and confocal microscopy, respectively, in urethane anaesthetised rats. Pre-epithelial layer thickness was measured optically with carbon particles as markers. Blood flow was measured with laser Doppler flowmetry. Results: Luminal acidification failed to alter pH(int) in vivo and in vitro, but pH(int) was lowered by modest serosal acidification. Pre-epithelial layer thickness and blood flow increased significantly during luminal surface acid perfusion. Indomethacin had no effect on any acid related response. Conclusion: In this first dynamic measurement of oesophageal acid permeation and pre-epithelial layer thickness, pH(int) was preserved in spite of high luminal acidity by two complementary techniques. Despite the apparent permeability barrier to acid permeation, oesophageal blood flow and thickness responded to luminal acid perfusion. C1 W Los Angeles Vet Affairs Med Ctr, CURE, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90073 USA. Indiana Univ, Sch Med, Dept Physiol, Indianapolis, IN 46202 USA. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, CURE, Digest Dis Res Ctr, Bldg 114,Room 217,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [P30 DK041301, 5P30DK041301, R01 DK054940, R01 DK054221, R01 DK54940, R01 DK54221] NR 57 TC 22 Z9 24 U1 0 U2 2 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD JUN PY 2003 VL 52 IS 6 BP 775 EP 783 DI 10.1136/gut.52.6.775 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 676FU UT WOS:000182741300001 PM 12740330 ER PT J AU Feil, D Razani, J Boone, K Lesser, I AF Feil, D Razani, J Boone, K Lesser, I TI Apathy and cognitive performance in older adults with depression SO INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE executive function; cognition; apathy; geriatric depression; motivation; emotions; neuropsychological tests; Stroop C; Wisconsin Card Sorting ID ACQUIRED BRAIN-DAMAGE; GERIATRIC DEPRESSION; ALZHEIMERS-DISEASE; EXECUTIVE DYSFUNCTION; VASCULAR DEPRESSION; RATING-SCALE; DOUBLE-BLIND; LATE-LIFE; DEMENTIA; VALIDITY AB Objectives Recent studies have linked apathy to frontal lobe dysfunction in persons with dementia, but few studies have explored this relationship in older, depressed persons without dementia. We examined the association between apathy and cognitive function in a group of older persons with major depression using standardized neuropsychological tests. We hypothesized that presence of apathy in depression is associated with poorer frontal executive performance. Methods We analyzed data from 89 older adults with major depression. We defined apathy using four items from the Hamilton Psychiatric Rating Scale for Depression which reflect the clinical state of apathy, including 'diminished work/interest,' 'psychomotor retardation,' 'anergy' and 'lack of insight.' Results Apathy most strongly correlated with two verbal executive measures (Stroop C and FAS), a nonverbal executive measure (Wisconsin Card Sorting Test-Other Responses), and a measure of information processing speed (Stroop B). Apathy was not associated with age, sex, education, medical illness burden, Mini-Mental State Examination score and Full Scale IQ score. Stepwise regression analyses of significant cognitive tests showed that apathy alone or apathy plus depression severity, age, or education accounted for a significant amount of the variance. Conclusions The results of this study provide support for an apathy syndrome associated with poorer executive function in older adults with major depression. Copyright (C) 2003 John Wiley Sons, Ltd. C1 Univ Calif Los Angeles, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. Calif State Univ Northridge, Northridge, CA 91330 USA. Harbor UCLA Med Ctr, Torrance, CA 90509 USA. RP Feil, D (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Hlth Care Syst, 11301 Wilshire Blvd,116-AF,Bldg 500,Room 3416, Los Angeles, CA 90073 USA. FU NCRR NIH HHS [RR-00425]; NIMH NIH HHS [MH43960] NR 56 TC 53 Z9 57 U1 2 U2 4 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0885-6230 J9 INT J GERIATR PSYCH JI Int. J. Geriatr. Psychiatr. PD JUN PY 2003 VL 18 IS 6 BP 479 EP 485 DI 10.1002/gps.869 PG 7 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 691JN UT WOS:000183603000002 PM 12789667 ER PT J AU Zekry, D Epperson, TK Krause, KH AF Zekry, D Epperson, TK Krause, KH TI A role for NOX NADPH oxidases in Alzheimer's disease and other types of dementia? SO IUBMB LIFE LA English DT Review DE ageing (aging); Alzheimer; dementia; NADPH oxidase; reactive oxygen species; neuronal death ID QUALITY STANDARDS SUBCOMMITTEE; SUPEROXIDE-GENERATING OXIDASE; ACADEMY-OF-NEUROLOGY; VASCULAR DEMENTIA; NAD(P)H OXIDASE; CEREBROVASCULAR-DISEASE; INFLAMMATORY MECHANISMS; DIFFERENTIAL-DIAGNOSIS; PRACTICE PARAMETER; MIXED DEMENTIA AB Because of population ageing, dementias are likely to become a major scourge of the 21st century. Causes of dementia include Alzheimer's disease, cerebrovascular disease, and lesser known entities such as frontotemporal dementia or dementia with Lewy bodies. Neuroinflammation is likely to play an important role in the pathogenesis of dementia by the killing of neurons through inflammatory mechanisms. Such a role of neuroinflammation is well documented for Alzheimer's disease, and it is likely to play a role in other types of dementia as well. Reactive oxygen species (ROS) play a key role in inflammatory tissue destruction. The phagocyte NADPH oxidase NOX2 is the best studied ROS-generating system. In the central nervous system, it is expressed in microglia and--to a lesser extent--in neurons. Indeed, there is emerging experimental evidence for a role of NOX2 in Alzheimer's and cerebrovascular disease. Recently, six novel ROS-generating NADPH oxidases with homology to NOX2 have been discovered. Several of them are also expressed in the central nervous system. In this article, we hypothesize a role of NOX-type NADPH oxidases in inflammatory neuronal loss. We review presently available evidence and suggest that NOX-type NADPH oxidases may become promising pharmacological targets for the treatment and prevention of dementia. C1 Univ Hosp Geneva, Dept Geriatr, Geneva, Switzerland. S Texas Vet Hlth Care Syst, Dept Med, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. RP Krause, KH (reprint author), Biol Ageing Lab, 2 Chemin Petit Bel Air, CH-1225 Geneva, Switzerland. RI Krause, Karl-Heinz/E-8030-2011 NR 62 TC 67 Z9 68 U1 0 U2 1 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1521-6543 J9 IUBMB LIFE JI IUBMB Life PD JUN PY 2003 VL 55 IS 6 BP 307 EP 313 DI 10.1080/1521654031000153049 PG 7 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 706NP UT WOS:000184460000004 PM 12938732 ER PT J AU Durante, W AF Durante, W TI Heme oxygenase-1 in growth control and its clinical application to vascular disease SO JOURNAL OF CELLULAR PHYSIOLOGY LA English DT Review ID SMOOTH-MUSCLE-CELLS; SPONTANEOUSLY HYPERTENSIVE-RATS; SOLUBLE GUANYLYL CYCLASE; CORONARY-ARTERY DISEASE; CARBON-MONOXIDE PATHWAY; PROTEIN-KINASE PATHWAY; HUMAN-SKIN FIBROBLASTS; GENE-TRANSFER; OXIDATIVE STRESS; ENDOTHELIAL-CELLS AB Heme oxygenase-1 (HO-1) catalyzes the degradation of heme to carbon monoxide (CO), iron, and biliverdin. Biliverdin is subsequently metabolized to bilirubin by the enzyme biliverdin reductase. Although interest in HO-1 originally centered on its heme-degrading function, recent findings indicate that HO-1 exerts other biologically important actions. Emerging evidence suggests that HO-1 plays a critical role in growth regulation. Deletion of the HO-1 gene or inhibition of HO-1 activity results in growth retardation and impaired fetal development, whereas HO-1 overexpression increases body size. Although the mechanisms responsible for the growth promoting properties of HO-1 are not well established, HO-1 can indirectly influence growth by regulating the synthesis of growth factors and by modulating the delivery of oxygen or nutrients to specific target tissues. In addition, HO-1 exerts important effects on critical determinants of tissue size, including cell proliferation, apoptosis, and hypertrophy. However, the actions of HO-1 are highly variable and may reflect a role for HO-1 in maintaining tissue homeostasis. Considerable evidence supports a crucial role for HO-1 in blocking the growth of vascular smooth muscle cells (SMCs). This antiproliferative effect of HO-1 is mediated primarily via the release of CO, which inhibits vascular SMC growth via multiple pathways. Pharmacologic or genetic approaches targeting HO-1 or CO to the blood vessel wall may represent a promising, novel therapeutic approach in treating vascular proliferative disorders. (C) 2003 Wiley-Liss, Inc. C1 Baylor Coll Med, VA Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Pharmacol, Houston, TX 77030 USA. RP Durante, W (reprint author), Baylor Coll Med, VA Med Ctr, Bldg 109,Room 130,2002 Holcombe Blvd, Houston, TX 77030 USA. EM wdurante@bcm.tmc.edu FU NHLBI NIH HHS [R01 HL-59976] NR 128 TC 127 Z9 137 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0021-9541 J9 J CELL PHYSIOL JI J. Cell. Physiol. PD JUN PY 2003 VL 195 IS 3 BP 373 EP 382 DI 10.1002/jcp.10274 PG 10 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 675BV UT WOS:000182673900005 PM 12704646 ER PT J AU O'Connell, TD Ishizaka, S Nakamura, A Swigart, PM Rodrigo, MC Simpson, GL Cotecchia, S Rokosh, DG Grossman, W Foster, E Simpson, PC AF O'Connell, TD Ishizaka, S Nakamura, A Swigart, PM Rodrigo, MC Simpson, GL Cotecchia, S Rokosh, DG Grossman, W Foster, E Simpson, PC TI The alpha(1A/C)- and alpha(1B)-adrenergic receptors are required for physiological cardiac hypertrophy in the double-knockout mouse SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID ARTERIAL BLOOD-PRESSURE; TRANSGENIC MICE; IN-VIVO; GENDER DIFFERENCES; MESSENGER-RNAS; MYOCYTES; RAT; OVEREXPRESSION; GROWTH; NOREPINEPHRINE AB Catecholamines and alpha(1)-adrenergic receptors (alpha(1)-ARs) cause cardiac hypertrophy in cultured myocytes and transgenic mice, but heart size is normal in single KOs of the main alpha(1)-AR subtypes, alpha(1A/C) and alpha(1B). Here we tested whether alpha(1)-ARs are required for developmental cardiac hypertrophy by generating alpha(1A/C) and alpha(1B) double KO (ABKO) mice, which had no cardiac alpha(1)-AR binding. In male ABKO mice, heart growth after weaning was 40% less than in WT, and the smaller heart was due to smaller myocytes. Body and other organ weights were unchanged, indicating a specific effect on the heart. Blood pressure in ABKO mice was the same as in WT, showing that the smaller heart was not due to decreased load. Contractile function was normal by echocardiography in awake mice, but the smaller heart and a slower heart rate reduced cardiac output. alpha(1)-AR stimulation did not activate extracellular signal-regulated kinase (Erk) and downstream kinases in ABKO myocytes, and basal Erk activity was lower in the intact ABKO heart. In female ABKO mice, heart size was normal, even after ovariectomy. Male ABKO mice had reduced exercise capacity and increased mortality with pressure overload. Thus, alpha(1)-ARs in male mice are required for the physiological hypertrophy of normal postnatal cardiac development and for an adaptive response to cardiac stress. C1 San Francisco Vet Affairs Med Ctr, Div Cardiol, San Francisco, CA 94121 USA. Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Div Cardiol, Dept Med, San Francisco, CA 94143 USA. Univ Lausanne, Inst Pharmacol & Toxocol, CH-1015 Lausanne, Switzerland. Univ Louisville, Dept Med, Div Cardiol, Louisville, KY 40292 USA. RP Simpson, PC (reprint author), San Francisco Vet Affairs Med Ctr, Div Cardiol, 111C8,4150 Clement St, San Francisco, CA 94121 USA. RI Rokosh, Gregg/J-2730-2013; O'Connell, Timothy/D-5048-2013 FU NHLBI NIH HHS [R01 HL031113, T32 HL007731] NR 33 TC 117 Z9 119 U1 0 U2 4 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 JUN PY 2003 VL 111 IS 11 BP 1783 EP 1791 DI 10.1172/JCI200316100 PG 9 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 686GQ UT WOS:000183313400021 PM 12782680 ER PT J AU Koenigsberg, HW Reynolds, D Goodman, M New, AS Mitropoulou, V Trestman, RL Silverman, J Siever, LJ AF Koenigsberg, HW Reynolds, D Goodman, M New, AS Mitropoulou, V Trestman, RL Silverman, J Siever, LJ TI Risperidone in the treatment of schizotypal personality disorder SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID COGNITIVE PERFORMANCE; NEGATIVE SYMPTOMS; SCHIZOPHRENIA; BORDERLINE; HALOPERIDOL; THIOTHIXENE; STRATEGIES; CRITERIA; SCALE AB Objective: Schizotypal personality disorder (SPD) has many phenomenological, genetic, physiologic, and neuroanatomical commonalities with schizophrenia. Patients with the disorder often suffer from marked social and occupational impairment, yet they have been difficult to treat with medications because of their unusual sensitivity to side effects. This study was designed to determine whether low-dose risperidone treatment is acceptable to SPD patients and can reduce characteristic schizotypal symptoms. In addition, if SPD patients respond to an antipsychotic medication, this will provide support for the notion of a commonality in treatment response between SPD and schizophrenia. Method. Twenty-five patients with DSM-IV-defined SPD were entered into a 9-week randomized, double-blind, placebo-controlled study of low-dose risperidone (starting dose of 0.25 mg/day, titrated upward to 2 mg/day) in the treatment of SPD. Patients were rated with the Positive and Negative Syndrome Scale (PANSS), the Schizotypal Personality Disorder Questionnaire, the Hamilton Rating Scale for Depression, and the Clinical Global Impressions scale. Data were collected from 1995 to 2001. Results: The subjects had a low incidence of depression and of comorbid borderline personality disorder. Patients receiving active medication had significantly (p < .05) lower scores on the PANSS negative and general symptom scales by week 3 and on the PANSS positive symptom scale by week 7 compared with patients receiving placebo. Side effects were generally well tolerated, and there was no group difference in dropout rate for side effects. Conclusion: Low-dose risperidone appears to be effective in reducing symptom severity in SPD and is generally well tolerated. C1 Bronx Vet Affairs Med Ctr, Mental Hlth Patient Care Ctr 116A, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. RP Koenigsberg, HW (reprint author), Bronx Vet Affairs Med Ctr, Mental Hlth Patient Care Ctr 116A, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. FU NCRR NIH HHS [5M01 RR00071] NR 27 TC 56 Z9 57 U1 1 U2 5 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 JUN PY 2003 VL 64 IS 6 BP 628 EP 634 PG 9 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 693YR UT WOS:000183746400002 PM 12823075 ER PT J AU Croyle, KL Troster, AI Fields, JA Straits-Troster, KA Lyons, KE Pahwa, R AF Croyle, KL Troster, AI Fields, JA Straits-Troster, KA Lyons, KE Pahwa, R TI Presurgical coping, depression, and quality of life in persons with Parkinson's disease SO JOURNAL OF CLINICAL PSYCHOLOGY IN MEDICAL SETTINGS LA English DT Article DE Parkinson's disease; depression; quality of life; coping; deep brain stimulation ID OF-LIFE; HEALTH; QUESTIONNAIRE; ILLNESS; INDIVIDUALS; INVENTORY; AVOIDANCE; STROKE; IMPACT; STRESS AB This study describes utilization of coping strategies and evaluates the interaction between coping strategies, depression, and quality of life (QOL) in patients with Parkinson's disease (PD) who are being considered for neurosurgical intervention. Eighty patients (mean age 61.7 years) with PD being evaluated for possible deep brain stimulation completed self-report instruments of coping strategies (Coping Responses Inventory), depression (Beck Depression Inventory), and disease-specific QOL (Parkinson's Disease Questionnaire-39). Analyses showed that patients with PD cope with the acute stressor of approaching neurosurgery through a variety of strategies, but particularly avoidant and behavioral strategies. When the correlated but apparently opposing effects of cognitive and behavioral strategies were teased apart, greater use of cognitive strategies was associated with more severe depressive symptomatology (and poorer QOL), while greater use of behavioral strategies appeared to be associated with less depression. Depressive symptomatology, in turn, was associated with poorer QOL. However, coping had minimal direct association with QOL. From this it was concluded that patients with advanced PD generate a variety of coping responses to an acute stressor such as surgery, and the use of behavioral strategies, in particular seeking of alternative enjoyable activities, may be associated with better mood if salutary effects are not overwhelmed by less helpful cognitive coping techniques. The minimization of depressive symptomatology, in turn, is associated with better QOL. C1 Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Texas Pan Amer, Dept Psychol & Anthropol, Edinburg, TX USA. Univ Washington, Dept Neurol Surg, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle Div, PADRECC, Seattle, WA USA. Univ Miami, Dept Neurol, Miami, FL 33152 USA. Univ Kansas, Med Ctr, Dept Neurol, Kansas City, KS 66103 USA. RP Troster, AI (reprint author), Univ Washington, Dept Psychiat & Behav Sci, Box 356560,1959 NE Pacific St,BB1623, Seattle, WA 98195 USA. NR 39 TC 8 Z9 10 U1 1 U2 3 PU KLUWER ACADEMIC/PLENUM PUBL PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1068-9583 J9 J CLIN PSYCHOL MED S JI J. Clin. Psychol. Med. Settings PD JUN PY 2003 VL 10 IS 2 BP 101 EP 107 DI 10.1023/A:1023342021244 PG 7 WC Psychology, Clinical SC Psychology GA 668PD UT WOS:000182301600004 ER PT J AU Asch, SM Kilbourne, AM Gifford, AL Burnam, MA Turner, B Shapiro, MF Bozzette, SA AF Asch, SM Kilbourne, AM Gifford, AL Burnam, MA Turner, B Shapiro, MF Bozzette, SA TI Underdiagnosis of depression in HIV - Who are we missing? SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE depression; HIV; diagnosis ID HUMAN-IMMUNODEFICIENCY-VIRUS; NATIONAL PROBABILITY SAMPLES; LOW-PREVALENCE DISEASES; MAJOR DEPRESSION; MENTAL-HEALTH; UNITED-STATES; PRIMARY-CARE; ANTIRETROVIRAL THERAPY; SERVICES UTILIZATION; PATIENT ADHERENCE AB OBJECTIVE: To determine the sociodemographic and service delivery correlates of depression underdiagnosis in HIV. DESIGN: Cross-sectional survey. PATIENTS/PARTICPANTS: National probability sample of HIV-infected persons in care in the contiguous United States who have available medical record data. MEASUREMENTS AND MAIN RESULTS: We interviewed patients using the Composite International Diagnostic Interview (CIDI) survey from the Mental Health Supplement. Patients also provided information regarding demographics, socioeconomic status, and HIV disease severity. We extracted patient medical record data between July 1995 and December 1997, and we defined depression underdiagnosis as a diagnosis of major depressive disorder based on the CIDI and no recorded depression diagnosis by their principal health care provider in their medical records between July 1995 and December 1997. Of the 1,140 HIV Cost and Services Utilization Study patients with medical record data who completed the CIDI, 448 (37%) had CIDI-defined major depression, and of these, 203 (45%) did not have a diagnosis of depression documented in their medical record. Multiple logistic regression analysis revealed that patients who had less than a high school education (P < .05) were less likely to have their depression documented in the medical record compared to those with at least a college education. Patients with Medicare insurance coverage compared to those with private health insurance (P < .01) and those with greater than or equal to3 outpatient visits (P < .05) compared to <3 visits were less likely to have their depression diagnosis missed by providers. CONCLUSIONS: Our results suggest that providers should be more attentive to diagnosing comorbid depression in HIV-infected patients. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA USA. Ctr Hlth Equity Res & Promot & VA, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA. VA San Diego Healthcare Syst, San Diego, CA USA. Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA. Univ Penn, Gen Internal Med Sect, Philadelphia, PA 19104 USA. RP Asch, SM (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd 111G, Los Angeles, CA 90073 USA. FU AHRQ HHS [U-01HS08578, U01 HS008578] NR 59 TC 110 Z9 111 U1 2 U2 9 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JUN PY 2003 VL 18 IS 6 BP 450 EP 460 DI 10.1046/j.1525-1497.2003.20938.x PG 11 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 694VP UT WOS:000183796100006 PM 12823652 ER PT J AU Weintraub, D Streim, JE Datto, CJ Katz, IR DiFilippo, SD Oslin, DW AF Weintraub, D Streim, JE Datto, CJ Katz, IR DiFilippo, SD Oslin, DW TI Effect of increasing the dose and duration of sertraline trial in the treatment of depressed nursing home residents SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article DE sertraline; elderly; depression ID ANTIDEPRESSANT TRIAL; SCALE AB There has been limited research into defining what constitutes an adequate first-line antidepressant trial in elderly patients. The authors report the outcome of extended, high-dosage sertraline treatment in a sample of nursing home residents experiencing residual significant depressive symptoms after 10 weeks of treatment with sertraline at a final dosage of 100 mg/day, Subjects who had a Hamilton Depression Rating Scale score : 12 after 10 weeks of treatment with sertraline were eligible for the 8-week open-label extension phase, which involved titrating the sertraline dosage to 200 mg/day. The cumulative response rate was 52% for the extension phase, compared. with 37% for the acute phase. Examining acute phase nonresponders, 39% responded during the extension phase. Rates of discontinuation due to adverse events were comparable in the 2 phases. Our findings suggest that an extended trial or high dosages of sertraline may benefit some depressed elderly patients with persistent depression after acute treatment. C1 Univ Penn, Sect Geriatr Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. RP Weintraub, D (reprint author), Univ Penn, Sect Geriatr Psychiat, 3535 Market St,Room 3003, Philadelphia, PA 19104 USA. EM weintrau@mail.med.upenn.edu FU NIMH NIH HHS [1-37MH 52147-06] NR 12 TC 6 Z9 6 U1 0 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD JUN PY 2003 VL 16 IS 2 BP 109 EP 111 DI 10.1177/0891988703252546 PG 3 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 847GI UT WOS:000223380300008 PM 12801161 ER PT J AU Marin, RS Butters, MA Mulsant, BH Pollock, BG Reynolds, CF AF Marin, RS Butters, MA Mulsant, BH Pollock, BG Reynolds, CF TI Apathy and executive function in depressed elderly SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article DE apathy; executive cognitive function; major depression; geriatrics; executive inter-view; cardiovascular risk factors ID DEFINED VASCULAR DEPRESSION; GERIATRIC DEPRESSION; DYSFUNCTION; DISEASE; RELIABILITY; DISABILITY; DISORDERS; VALIDITY; SCALE AB Apathy and executive cognitive dysfunction (ECD) are important though conceptually different aspects of late-life depression. The primary objective of this study was to evaluate the relationship of apathy to ECD. The authors also evaluated the relationship of apathy and ECD to global cognitive impairment and word generation. Fifty-two elderly subjects with major depression and MMSE scores of 15 or greater were evaluated with apathy-related items from the Hamilton rating scale for depression (ApHRSD), the Executive Interview (EXIT), the Dementia Rating Scale (DRS), and the Controlled Oral Word Association test (COWA). ApHRSD scores were not significantly correlated with any of these variables. EXIT scores were correlated significantly with DRS and COWA. The results suggest that apathy and ECD may be independent of each other in some samples of elderly with late-life depression. Correlations may have been reduced by low variance for the variables of interest and by psychometric limitations of the ApHRSD. C1 Univ Pittsburgh, Sch Med, Intervent Res Ctr Study Late Life Mood Disorders, Dept Psychiat, Pittsburgh, PA 15260 USA. VA Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Marin, RS (reprint author), Western Psychiat Inst & Clin, 3811 OHara St, Pittsburgh, PA 15213 USA. EM rmarin@pitt.edu FU NIMH NIH HHS [MH01509, MH01613, K05 MH00295, P30 MH52247, MH01684] NR 36 TC 26 Z9 27 U1 0 U2 6 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD JUN PY 2003 VL 16 IS 2 BP 112 EP 116 DI 10.1177/0891988702250593 PG 5 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 847GI UT WOS:000223380300009 PM 12801162 ER PT J AU Brau, N Bini, EJ Stancic, S Finch, DA Aytaman, A AF Brau, N Bini, EJ Stancic, S Finch, DA Aytaman, A TI Severe migraine headaches are caused by ribavirin but not by interferon alpha-2B in combination therapy for chronic hepatitis C SO JOURNAL OF HEPATOLOGY LA English DT Letter C1 New Jersey VISN 3, New York, NY USA. Bronx Vet Affairs Med Ctr, Mt Sinai Sch Med, Med Serv, Infect Dis Sect, Bronx, NY 10468 USA. Vet Affairs New York Harbor Healthcare Syst, Med Serv, New York, NY USA. Vet Affairs Hudson Valley Healthcare Syst, Med Serv, Montrose, NY USA. Vet Affairs New York Harbor Healthcare Syst, Med Serv, Brooklyn, NY USA. RP Brau, N (reprint author), New Jersey VISN 3, New York, NY USA. NR 5 TC 2 Z9 2 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-8278 J9 J HEPATOL JI J. Hepatol. PD JUN PY 2003 VL 38 IS 6 BP 871 EP 872 DI 10.1016/S0168-8278(03)00091-6 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 681ZJ UT WOS:000183065200026 PM 12763386 ER PT J AU Maslow, JN Brar, I Smith, G Newman, GW Mehta, R Thornton, C Didier, P AF Maslow, JN Brar, I Smith, G Newman, GW Mehta, R Thornton, C Didier, P TI Latent infection as a source of disseminated disease caused by organisms of the Mycobacterium avium complex in simian immunodeficiency virus-infected rhesus macaques SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID FIELD GEL-ELECTROPHORESIS; AIDS; BACTEREMIA; TUBERCULOSIS; SENSITIN; MONKEYS; WATER; RETROVIRUS; INDUCTION; STRAIN AB Whether infection with Mycobacterium avium complex (MAC) among patients with acquired immune deficiency syndrome results from recent exposure to virulent strains or reactivation of latent infection acquired years earlier is unknown. To address this question, tissue samples from 47 simian immunodeficiency virus (SIV)-infected and 63 SIV-uninfected rhesus macaques were cultured. MAC was cultured from 14 SIV-uninfected macaques (22.2%) and 32 SIV-infected macaques (68.1%); median bacterial burdens were 33.3 and 998.7 cfu/g, respectively. Genetically distinct strains of MAC were identified for 13 SIV-uninfected macaques (20.6%) and 15 SIV-infected macaques (31.9%). A genetically identical MAC strain (K128A) was identified for 25 SIV-infected macaques (53.2%) and 1 SIV-uninfected macaque (1.6%). Multivariate analysis identified infection with SIV/Delta(B670), diagnosis of an SIV-related tumor or opportunistic infection, and birth on site as risks for MAC infection. SIV-uninfected and SIV-infected macaques yielding unique strains of MAC were considered to have latent and reactivation infection, respectively, whereas animals infected with strain K128A were considered to have recent infection, demonstrating that both mechanisms occur among rhesus macaques. C1 Dept Vet Affairs Med Ctr, Res Serv, Div Infect Dis, Philadelphia, PA 19104 USA. Univ Penn, Philadelphia, PA 19104 USA. Univ Penn, Sch Vet Med, Sect Epidemiol & Publ Hlth, Kennett Sq, PA 19348 USA. Henry Ford Hosp, Dept Med, Div Infect Dis, Detroit, MI 48202 USA. Morehouse Sch Med, Dept Microbiol Biochem & Immunol, Atlanta, GA 30310 USA. Quest Diagnost, Integrated Res Technol, Baltimore, MD USA. Tulane Reg Primate Ctr, Dept Pathol, Covington, LA USA. Tulane Univ, Sch Med, Covington, LA USA. RP Maslow, JN (reprint author), Dept Vet Affairs Med Ctr, Res Serv, Div Infect Dis, Univ & Woodland Aves, Philadelphia, PA 19104 USA. NR 37 TC 15 Z9 16 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUN 1 PY 2003 VL 187 IS 11 BP 1748 EP 1755 DI 10.1086/374985 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 685TK UT WOS:000183279200009 PM 12751032 ER PT J AU Dallalio, G Means, RT AF Dallalio, G Means, RT TI Effects of oxidative stress on human erythroid colony formation: Modulation by gamma-interferon SO JOURNAL OF LABORATORY AND CLINICAL MEDICINE LA English DT Article; Proceedings Paper CT 43rd Annual Meeting of the American-Society-of-Hematology CY DEC 07-11, 2001 CL ORLANDO, FLORIDA SP Amer Soc Hematol ID IMMUNODEFICIENCY-VIRUS-INFECTION; PROGRAMMED CELL-DEATH; TUMOR-NECROSIS-FACTOR; FORMING-UNITS; CHRONIC DISEASE; THIOREDOXIN; APOPTOSIS; CERAMIDE; ANEMIA; INHIBITION AB Evidence of increased oxidative stress is a hallmark of many chronic diseases associated with anemia. The current study was undertaken to evaluate the effects of oxidative stress on erythroid colony formation in vitro by bone marrow light density mononuclear cells (LDMN) and by peripheral blood derived cells enriched for erythroid colony forming units (CFU-E), and how these effects can be modified by a cytokine implicated in the anemia of chronic disease. When blood-derived and marrow cells were cultured with 50 muM H2O2, CFU-E colony formation by blood-derived cells but not by marrow cells was significantly inhibited, suggesting a protective effect of marrow accessory cells. This inhibitory effect on peripheral blood-derived CFU-E was shown to be caspase-dependent. rhgammaIFN at concentrations which did not inhibit CFU-E colony formation sensitized LDMN marrow cells to inhibition by H2O2. Exposure of LDMN marrow cells to rhgammaIFN at concentrations of 10U/mL or higher significantly decreased the concentration of thioredoxin (Trx) in cell supernatant. Addition of recombinant Trx to LDMN marrow cells cultured with H2O2 and rhgammaIFN partially (although not completely) reversed inhibition of CFU-E colony formation. These findings suggest that inflammatory cytokines implicated in the pathogenesis of the anemia of chronic disease may exert their effects at least in part through modulation of oxidative stress. C1 Med Univ S Carolina, Div Hematol Oncol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Div Hematol Oncol, Charleston, SC 29425 USA. RP Means, RT (reprint author), Med Univ S Carolina, Div Hematol Oncol, 903 CSB,96 Jonathan Lucas St, Charleston, SC 29425 USA. RI Means, Robert/A-4454-2008 FU NHLBI NIH HHS [HL-53703] NR 43 TC 5 Z9 5 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0022-2143 J9 J LAB CLIN MED JI J. Lab. Clin. Med. PD JUN PY 2003 VL 141 IS 6 BP 395 EP 400 DI 10.1016/S0022-2143(03)00041-6 PG 6 WC Medical Laboratory Technology; Medicine, General & Internal; Medicine, Research & Experimental SC Medical Laboratory Technology; General & Internal Medicine; Research & Experimental Medicine GA 693LF UT WOS:000183718500005 PM 12819637 ER PT J AU McClain, MT Rapp, EC Harley, JB James, JA AF McClain, MT Rapp, EC Harley, JB James, JA TI Infectious mononucleosis patients temporarily recognize a unique, cross-reactive epitope of Epstein-Barr virus nuclear antigen-1 SO JOURNAL OF MEDICAL VIROLOGY LA English DT Article DE EBV; EBNA-1; autoimmunity; SLE; SM B ' ID INDUCED AUTOIMMUNE RESPONSES; ALANINE REPEATING REGION; AUTOANTIBODIES; IMMUNOGLOBULIN; ANTIBODIES; MIMICKING AB The spectrum of antibodies against Epstein-Barr virus nuclear antigen-1 (EBNA-1) in patients with a recent history of infectious mononucleosis and nonaffected EBV-positive individuals has been characterized by epitope mapping. Sera were evaluated for antibodies to all unique maximally overlapping octapeptides of EBNA-1. Both normal controls and patients with infectious mononucleosis produce IgG antibodies that recognize the glycine-alanine-rich portion of EBNA-1, as previously described. All EBNA-1 IgG-positive infectious mononucleosis patients tested, however, consistently produce IgG specific for an additional epitope (aa 398-412 PPPGRRPFFHPVGEA) near the middle of the EBNA-1 protein. This region was not found to be antigenic in healthy EBV-seropositive individuals. This region does, however, cross-react with the sequence PPPGMRPP from the common lupus spliceosomal autoantigen Sm B' several infectious mononucleosis patient sera. Patients with recent clinical infectious mononucleosis temporarily recognize a unique cross-reactive epitope of EBNA-1 not bound by antibodies from non-infectious mononucleosis EBV-positive sera or those with a distant history of IM. C1 Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA. US Dept Vet Affairs, Oklahoma City, OK USA. RP McClain, MT (reprint author), Oklahoma Med Res Fdn, 825 NE 13th St, Oklahoma City, OK 73104 USA. FU NIAID NIH HHS [AI31584]; NIAMS NIH HHS [AR01981, AR45084, AR45451] NR 12 TC 32 Z9 33 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0146-6615 J9 J MED VIROL JI J. Med. Virol. PD JUN PY 2003 VL 70 IS 2 BP 253 EP 257 DI 10.1002/jmv.10385 PG 5 WC Virology SC Virology GA 673DC UT WOS:000182564000010 PM 12696112 ER PT J AU Willey, CD Balasubramanian, S Rosas, MCR Ross, RS Kuppuswamy, D AF Willey, CD Balasubramanian, S Rosas, MCR Ross, RS Kuppuswamy, D TI Focal complex formation in adult cardiomyocytes is accompanied by the activation of beta 3 integrin and c-Src SO JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY LA English DT Article DE c-Src; FAK; integrins; focal adhesion complex; cardiomyocytes; hypertrophy ID CARDIAC-HYPERTROPHY; EXTRACELLULAR-MATRIX; TYROSINE PHOSPHORYLATION; SIGNAL-TRANSDUCTION; CYTOPLASMIC DOMAIN; ADHESION KINASE; FAMILY KINASES; GROWTH-CONTROL; SHEAR-STRESS; CELLS AB In pressure-overloaded myocardium, our recent study demonstrated cytoskeletal assembly of c-Src and other signaling proteins which was partially mimicked in vitro using adult feline cardiomyocytes embedded in three-dimensional (3D) collagen matrix and stimulated with an integrin-binding Arg-Gly-Asp (RGD) peptide. In the present study, we improved this model further to activate c-Src and obtain a full assembly of the focal adhesion complex (FAC), and characterized c-Src localization and integrin subtype(s) involved. RGD dose response experiments revealed that c-Src activation occurs subsequent to its cytoskeletal recruitment and is accompanied by p130Cas cytoskeletal binding and focal adhesion kinase (FAK) Tyr925 phosphorylation. When cardiomyocytes expressing hexahistidine-tagged c-Src via adenoviral gene delivery were used for RGD stimulation, the expressed c-Src exhibited relocation: (i) biochemical analysis revealed c-Src movement from the detergent-soluble to the -insoluble cytoskeletal fraction and (ii) confocal microscopic analysis showed c-Src movement from a nuclear/perinuclear to a sarcolemmal region. RGD treatment also caused sarcolemmal co-localization of FAK and vinculin. Characterization of integrin subtypes revealed that beta3, but not beta1, integrin plays a predominant role: (i) expression of cytoplasmic domain of beta1A integrin did not affect the RGD-stimulated FAC formation and (ii) both pressure-overloaded myocardium and RGD-stimulated cardiomyocytes exhibited phosphorylation of beta3 integrin at Tyr773/785 sites but not beta1 integrin at Thr788/789 sites. Together these data indicate that RGD treatment in cardiomyocytes causes beta3 integrin activation and c-Src sarcolemmal localization, that subsequent c-Src activation is accompanied by p130Cas binding and FAK Tyr925 phosphorylation, and that these events might be crucial for growth and remodeling of hypertrophying adult cardiomyocytes. (C) 2003 Elsevier Science Ltd. All fights reserved. C1 Med Univ S Carolina, Div Cardiol, Dept Med, Gazes Cardiac Res Inst, Charleston, SC 29425 USA. Univ Calif Los Angeles, Dept Physiol & Med, Gessen Sch Med, Los Angeles, CA 90095 USA. Dept Vet Affairs Med Ctr, Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC 29425 USA. RP Kuppuswamy, D (reprint author), Med Univ S Carolina, Div Cardiol, Dept Med, Gazes Cardiac Res Inst, 114 Doughty St, Charleston, SC 29425 USA. EM kuppusd@musc.edu OI Willey, Christopher/0000-0001-9953-0279 FU NHLBI NIH HHS [HL-48788, HL-57872]; NIGMS NIH HHS [GM08716] NR 55 TC 25 Z9 26 U1 0 U2 1 PU ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0022-2828 EI 1095-8584 J9 J MOL CELL CARDIOL JI J. Mol. Cell. Cardiol. PD JUN PY 2003 VL 35 IS 6 BP 671 EP 683 DI 10.1016/S0022-2828(03)00112-3 PG 13 WC Cardiac & Cardiovascular Systems; Cell Biology SC Cardiovascular System & Cardiology; Cell Biology GA 692QZ UT WOS:000183672900014 PM 12788385 ER PT J AU Linseman, DA Cornejo, BJ Le, SS Meintzer, MK Laessig, TA Bouchard, RJ Heidenreich, KA AF Linseman, DA Cornejo, BJ Le, SS Meintzer, MK Laessig, TA Bouchard, RJ Heidenreich, KA TI A myocyte enhancer factor 2D (MEF2D) kinase activated during neuronal apoptosis is a novel target inhibited by lithium SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE apoptosis; cerebellar granule neuron; glycogen synthase kinase; lithium; MEF2 transcription factor; phosphorylation ID CEREBELLAR GRANULE NEURONS; GLYCOGEN-SYNTHASE KINASE-3-BETA; TRANSCRIPTION FACTOR MEF2C; DNA-BINDING ACTIVITY; CENTRAL-NERVOUS-SYSTEM; GROWTH-FACTOR-I; CASPASE-3 ACTIVATION; BIPOLAR DISORDER; CELL-DEATH; PROTECTION AB Depolarization promotes the survival of cerebellar granule neurons via activation of the transcription factor myocyte enhancer factor 2D (MEF2D). Removal of depolarization induces hyperphosphorylation of MEF2D on serine/threonine residues, resulting in its decreased DNA binding and susceptibility to caspases. The subsequent loss of MEF2-dependent gene transcription contributes to the apoptosis of granule neurons. The kinase(s) that phosphorylates MEF2D during apoptosis is currently unknown. The serine/threonine kinase, glycogen synthase kinase-3beta (GSK-3beta), plays a pro-apoptotic role in granule neurons. To investigate a potential role for GSK-3beta in MEF2D phosphorylation, we examined the effects of lithium, a non-competitive inhibitor of GSK-3beta, on MEF2D activity in cultured cerebellar granule neurons. Lithium inhibited caspase-3 activation and chromatin condensation in granule neurons induced to undergo apoptosis by removal of depolarizing potassium and serum. Concurrently, lithium suppressed the hyperphosphorylation and caspase-mediated degradation of MEF2D. Moreover, lithium sustained MEF2 DNA binding and transcriptional activity in the absence of depolarization. Lithium also attenuated MEF2D hyperphosphorylation and apoptosis induced by calcineurin inhibition under depolarizing conditions, a GSK-3beta-independent model of neuronal death. In contrast to lithium, MEF2D hyperphosphorylation was not inhibited by forskolin, insulin-like growth factor-I, or valproate, three mechanistically distinct inhibitors of GSK-3beta. These results demonstrate that the kinase that phosphorylates and inhibits the pro-survival function of MEF2D in cerebellar granule neurons is a novel lithium target distinct from GSK-3beta. C1 Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Heidenreich, KA (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Pharmacol C236, 4200 E 9th Ave, Denver, CO 80262 USA. FU NINDS NIH HHS [NS38619-01A1] NR 54 TC 31 Z9 31 U1 0 U2 3 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD JUN PY 2003 VL 85 IS 6 BP 1488 EP 1499 DI 10.1046/j.1471-4159.2003.01790.x PG 12 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 686EK UT WOS:000183308300014 PM 12787068 ER PT J AU Black, DN Taber, KH Hurley, RA AF Black, DN Taber, KH Hurley, RA TI Metachromatic leukodystrophy: A model for the study of psychosis SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article ID ARYLSULFATASE-A ACTIVITY; WHITE-MATTER; NEUROPSYCHIATRIC DISORDERS; CORPUS-CALLOSUM; SCHIZOPHRENIA; BRAIN; MR; ABNORMALITIES; ANISOTROPY; DTI C1 Univ Vermont, Dept Neurol, Burlington, VT USA. Baylor Coll Med, Dept Radiol, Houston, TX 77030 USA. Baylor Coll Med, Dept Psychiat, Houston, TX 77030 USA. Baylor Coll Med, Dept Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Herbert J Frensley Ctr Imaging Res, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Psychiat Serv, Houston, TX USA. RP Taber, KH (reprint author), Univ Texas, Sch Hlth Informat Sci, 7000 Fannin,UCT 880, Houston, TX 77030 USA. NR 42 TC 20 Z9 20 U1 1 U2 2 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD SUM PY 2003 VL 15 IS 3 BP 289 EP 293 DI 10.1176/appi.neuropsych.15.3.289 PG 5 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 715JR UT WOS:000184968800001 PM 12928504 ER PT J AU Anderson, CA Arciniegas, DB Huddle, DC Leehey, MA AF Anderson, CA Arciniegas, DB Huddle, DC Leehey, MA TI Akinetic mutism following unilateral anterior cerebral artery occlusion SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Letter C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Radiol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Anderson, CA (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. RI Arciniegas, David/A-3792-2009 NR 5 TC 10 Z9 11 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD SUM PY 2003 VL 15 IS 3 BP 385 EP 386 DI 10.1176/appi.neuropsych.15.3.385 PG 2 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 715JR UT WOS:000184968800018 PM 12928521 ER PT J AU Royal, W Dupont, B McGuire, D Chang, L Goodkin, K Ernst, T Post, MJ Fish, D Pailloux, G Poncelet, H Concha, M Apuzzo, L Singer, E AF Royal, W Dupont, B McGuire, D Chang, L Goodkin, K Ernst, T Post, MJ Fish, D Pailloux, G Poncelet, H Concha, M Apuzzo, L Singer, E TI Topotecan in the treatment of acquired immunodeficiency syndrome-related progressive multifocal leukoencephalopathy SO JOURNAL OF NEUROVIROLOGY LA English DT Article DE HIV-1; MRI; polyomavirus; topoisomerases; viral encephalitis ID ACTIVE ANTIRETROVIRAL THERAPY; JC VIRUS LOAD; ALPHA-INTERFERON; NATURAL-HISTORY; DNA-REPLICATION; HIV-INFECTION; AIDS; SURVIVAL; CYTARABINE; CIDOFOVIR AB Progressive multifocal leukoencephalopathy (PML) affects about 1 in 20 individuals with the acquired immunodeficiency syndrome (AIDS) and has been associated with poor survival. This report describes the results of a phase II clinical trial using the drug topotecan, a semisynthetic analogue of camptothecan, administered to a cohort of subjects with AIDS-related PML. Data were evaluated on 11 of 12 subjects enrolled in the study. Three responded to therapy. Additionally, one patient was treated off-protocol and showed a response to treatment. Progression occurred after the first course; however, a partial response was noted after five courses. One study patient died from accidental overdose of topotecan. Overall, responders had higher pretreatment Karnofsky and lower Kurtzke expanded disability status scale scores than non-responders. The most frequent toxicities were hematologic (anemia, neutropenia, and thrombocytopenia). Five patients had dose delays; all delays were due to hematologic adverse events. This study demonstrates that topotecan treatment may be associated with decreased lesion size and prolonged survival from the infection. Because of the small number of subjects in the study, further studies are required to evaluate the efficacy of topotecan in treating this disease. C1 Morehouse Sch Med, Inst Neurosci, Atlanta, GA 30310 USA. Hop Necker Enfants Malad, Paris, France. HIV Inst, San Francisco, CA USA. Brookhaven Inst, Staten Isl, NY USA. Univ Miami, Sch Med, Miami, FL USA. Albany Med Ctr, Albany, NY USA. Hop Inst Pasteur, Paris, France. Johns Hopkins Univ Hosp, Baltimore, MD 21287 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Royal, W (reprint author), Morehouse Sch Med, Inst Neurosci, Med Res Bldg,Room 218,720 Westview Dr SW, Atlanta, GA 30310 USA. NR 35 TC 45 Z9 49 U1 0 U2 1 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 JUN PY 2003 VL 9 IS 3 BP 411 EP 419 DI 10.1080/13550280390201740 PG 9 WC Neurosciences; Virology SC Neurosciences & Neurology; Virology GA 683XJ UT WOS:000183176100014 PM 12775425 ER PT J AU Kutka, N AF Kutka, N TI Letter to the Newsline editor SO JOURNAL OF NUCLEAR MEDICINE LA English DT Letter C1 Houston VA Med Ctr, Houston, TX USA. RP Kutka, N (reprint author), Houston VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SOC NUCLEAR MEDICINE INC PI RESTON PA 1850 SAMUEL MORSE DR, RESTON, VA 20190-5316 USA SN 0161-5505 J9 J NUCL MED JI J. Nucl. Med. PD JUN PY 2003 VL 44 IS 6 BP 46N EP 46N PG 1 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 688GN UT WOS:000183426000010 PM 12820611 ER PT J AU Guzman-Marin, R Suntsova, N Stewart, DR Gong, H Szymusiak, R McGinty, D AF Guzman-Marin, R Suntsova, N Stewart, DR Gong, H Szymusiak, R McGinty, D TI Sleep deprivation reduces proliferation of cells in the dentate gyrus of the hippocampus in rats SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Article ID UNBIASED STEREOLOGICAL ESTIMATION; RECURRENT MAJOR DEPRESSION; ADULT-RAT; PARADOXICAL SLEEP; ANTIDEPRESSANT TREATMENT; RECEPTOR ACTIVATION; PHYSICAL EXERCISE; ENERGY-METABOLISM; GROWTH-FACTOR; WATER MAZE AB The dentate gyrus (DG) of the adult hippocampus gives rise to progenitor cells, which have the potential to differentiate into neurons. To date it is not known whether sleep or sleep loss has any effect on proliferation of cells in the DG. Male rats were implanted for polysomnographic recording, and divided into treadmill sleep-deprived (SD), treadmill control (TC) and cage control (CC) groups. SD and TC rats were kept for 96 h on a treadmill that moved either for 3 s on/ 12 s off (SD group) or for 15 min on/60 min off (TC group) to equate total movement but permit sustained rest periods in TC animals. To label proliferating cells the thymidine analogue 5-bromo-2'deoxyuridine (BrdU) was injected after the first 48 h of the experimental procedure in all groups (50 mg kg(-1), I.P.). The percentage of time awake per day was 93.2% in the SD group vs. 59.6% in the TC group and 49.9% in the CC group (P < 0.001). Stereological analysis showed that the number of BrdU-positive cells in the DG of the dorsal hippocampus was reduced by 54% in the SD group in comparison with the TC and by 68% in comparison with the CC group. These results suggest that sleep deprivation reduces proliferation of cells in the DG of the dorsal hippocampus. C1 VA Greater Los Angeles Healthcare Syst, Res Serv, North Hills, CA 91343 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Rostov State Univ, AB Kogan Res Inst Neurocybernet, Rostov Na Donu, Russia. RP McGinty, D (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv 151A3, 16111 Plummer St, North Hills, CA 91343 USA. FU NHLBI NIH HHS [HL60296, P50 HL060296]; NIMH NIH HHS [MH 47480, R01 MH047480] NR 85 TC 94 Z9 97 U1 4 U2 13 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD JUN 1 PY 2003 VL 549 IS 2 BP 563 EP 571 DI 10.1113/jphysiol.2003.041665 PG 9 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 692JR UT WOS:000183658400019 PM 12679377 ER PT J AU Nalbant, S Corominas, H Hsu, B Chen, LX Schumacher, HR Kitumnuaypong, T AF Nalbant, S Corominas, H Hsu, B Chen, LX Schumacher, HR Kitumnuaypong, T TI Ultrasonography for assessment of subcutaneous nodules SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE ultrasonography; subcutaneous nodules; tophi; rheumatoid nodules; musculoskeletal system ID RHEUMATOID-ARTHRITIS; BONE EROSIONS; ULTRASOUND; SONOGRAPHY; APPEARANCES AB Objective. To characterize a variety of subcutaneous lesions by their ultrasonographic (US) appearance, and establish these images as a starting point to measure changes with treatments. Methods. Twenty-six patients with 48 subcutaneous nodular swellings of various types were imaged using a portable US machine equipped with a 10 MHz linear transducer. All patients had a known diagnosis of a rheumatic disease. We used US to examine subcutaneous lesions and the underlying cortical surface of the bone or joint. Two measurements of some tophi and rheumatoid nodules were done on different dates to examine reproducibility of the measurements. Results. Nodular lesions included 20 tophi and 20 rheumatoid nodules, 2 sarcoid nodules, 2 lipomas, and 4 synovial cysts. Tophi most often appeared as heterogeneous masses; hypoechoic areas in 2 tophi were decreased after aspiration of chalky liquid tophaceous material. Occasionally tophi had calcifications appearing hyperechoic with acoustic shadowing. Cortical bone erosions could be seen adjacent to some tophi. The nodules in patients with rheumatoid arthritis were often attached closely to the bone surface and less erosive to bone, allowing the cortical bone to be seen easily. The nodules were more homogeneous. Some showed a central sharply demarcated hypoechoic area, possibly corresponding to necrosis inside the rheumatoid nodules. Nodules were easily measured. The repeated measurements of both tophi and rheumatoid nodules showed excellent reproducibility. Lipomas had different echogenic patterns depending on composition of the associated connective tissue and position of the mass. They could be hypoechogenic, hyperechogenic, or mixed, but were easily distinguished by oval shapes with well demarcated capsules. Synovial cysts seen in this study had a characteristic hypoechoic pattern. Conclusion. Subcutaneous nodules examined by sonography show characteristics and patterns that, although not diagnostic, can be used to help distinguish their etiology. Tophi and rheumatoid nodules can be easily measured and these measurements used to help follow disease progression or response to therapy. C1 Hosp Univ Penn, Div Rheumatol, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Rheumatol Sect, Philadelphia, PA USA. RP Schumacher, HR (reprint author), Univ Penn, VA Med Ctr, Woodland Ave, Philadelphia, PA 19104 USA. NR 34 TC 40 Z9 42 U1 0 U2 0 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD JUN PY 2003 VL 30 IS 6 BP 1191 EP 1195 PG 5 WC Rheumatology SC Rheumatology GA 687BV UT WOS:000183356700011 PM 12784388 ER PT J AU Ang, DC Ibrahim, SA Burant, CJ Kwoh, CK AF Ang, DC Ibrahim, SA Burant, CJ Kwoh, CK TI Is there a difference in the perception of symptoms between African Americans and whites with osteoarthritis? SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE osteoarthritis; joint arthroplasty; ethnicity; health service ID NUTRITION EXAMINATION SURVEY; INDIVIDUAL RADIOGRAPHIC FEATURES; REPORTED FUNCTIONAL STATUS; TOTAL HIP-ARTHROPLASTY; 1ST NATIONAL-HEALTH; OSTEO-ARTHRITIS; RHEUMATOID-ARTHRITIS; KNEE OSTEOARTHRITIS; RACIAL-DIFFERENCES; ETHNIC-DIFFERENCES AB Objective. To determine if there is a difference in the perception of pain and functional disability between African Americans and Whites at any given radiographic severity of osteoarthritis (OA). Ethnic differences in utilization of joint replacement may reflect differences in the perception of symptoms of OA. Methods. A cross-sectional survey included 596 male veterans (44% African Americans and 56% Whites) with chronic moderate to severe knee and/or hip pain at the General Medicine Clinics. The average age of the total cohort was 65.63 +/- 9.5 years. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain and function were the primary outcome measures of interest. All knee and or hip radiographs were graded using the Kellgren-Lawrence (K/L) grading system. Results. African Americans and Whites were comparable with respect to age (65 +/- 9.5 vs 66 +/- 9, respectively); body mass index greater than or equal to 30 kg/m(2) (53.9% vs 58.8%); Lequesne severity score (11 +/- 4 vs 11 +/- 4); geriatric depression score (4.5 +/- 3.3 vs 5.0 +/- 3.8) and Charlson Comorbidity Index (2.3 +/- 2 vs 2.5 +/- 2). African Americans had lower socioeconomic status with fewer high school graduates (57% vs 71%, p = 0.001), lower employment rate (8.4% vs 14.7%, p = 0.017), and lower total household incomes (41.4% vs 20.4% reported income < $10,000, p = 0.000). African Americans and Whites were. not different in mean scores for WOMAC pain and WOMAC function when stratified by joint space narrowing, osteophyte and Kellgren Lawrence grades. After controlling for important covariates, ethnicity was not a significant predictor of WOMAC pain and function. Conclusion. In this sample of male veterans, African Americans and Whites perceived the same degree of pain and functional difficulties at any given radiographic severity of OA. Differences in the perception of symptoms cannot explain the observed ethnic disparity in utilization of joint replacement. C1 Indiana Univ, Dept Med, Div Rheumatol, Indianapolis, IN 46202 USA. Case Western Reserve Univ, Sch Med, Dept Bioeth, Cleveland, OH 44106 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Dept Med, Div Rheumatol & Clin Immunol, Pittsburgh, PA USA. RP Ang, DC (reprint author), Indiana Univ, Dept Med, Div Rheumatol, 1110 W Michigan St,Room 545, Indianapolis, IN 46202 USA. NR 47 TC 40 Z9 43 U1 2 U2 4 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD JUN PY 2003 VL 30 IS 6 BP 1305 EP 1310 PG 6 WC Rheumatology SC Rheumatology GA 687BV UT WOS:000183356700030 PM 12784407 ER PT J AU Petchkrua, W Little, JW Burns, SP Stiens, SA James, JJ AF Petchkrua, W Little, JW Burns, SP Stiens, SA James, JJ TI Vitamin B-12 deficiency in spinal cord injury: A retrospective study SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE spinal cord injuries; cyanocobalamin; vitamin B-12 deficiency; anemia; rehabilitation; weakness; paresthesias ID SERUM METHYLMALONIC ACID; COBALAMIN DEFICIENCY; TOTAL HOMOCYSTEINE; PREVALENCE; FOLATE; MACROCYTOSIS; OUTPATIENTS; DIAGNOSIS; SPECTRUM; ANEMIA AB Background/Objective: Vitamin B-12 (or cobalamin) deficiency is well known in geriatric patients, but not in those with spinal cord injury (SCI). This retrospective study describes vitamin B-12 deficiency in SCI. Methods: This study utilized a retrospective chart review of patients with SCI who had received serum vitamin B-12 testing over the last 10 years. Results: Probable vitamin B-12 deficiency was noted in 16 patients with SCI. Twelve patients had subnormal serum vitamin B-12 levels (<220 pg/mL), whereas 4 patients had low-normal vitamin B-12 levels (<300 pg/mL) with neurologic and/or psychiatric symptoms that improved following vitamin B-12 replacement. Classic findings of paresthesias and numbness often were not evident; such findings likely were masked by the pre-existing sensory impairment caused by SCI. Of the 16 SCI patients, 7 were ambulatory; 4 of the 7 presented with deterioration of gait. In addition, 3 of the 16 SCI patients presented with depression and fatigue, 2 had worsening pain, 2 had worsening upper limb weakness, and 2 had memory decline. Of the 12 patients with subnormal serum vitamin B-12 levels, 6 were asymptomatic. Classic laboratory findings of low serum vitamin B-12, macrocytic red blood cell indices, and megaloblastic anemia were not always present. Anemia was identified in 7 of the 16 patients and macrocytic red blood cells were found in 3 of the 16 patients. Only I of the 16 SCI patients had a clear pathophysiologic mechanism to explain the vitamin B-12 deficiency (ie, partial gastrectomy); none of the patients were vegetarian. Twelve of the SCI patients appeared to experience clinical benefits from cyanocobalamin replacement (some patients experienced more than I benefit), including reversal of anemia (5 patients), improved gait (4 patients), improved mood (3 patients), improved memory (2 patients), reduced pain (2 patients), strength gain (I patient), and reduced numbness (I patient). Conclusion: It is recommended that physicians consider vitamin B-12 deficiency in their patients with SCI, particularly in those with neurologic and/or psychiatric symptoms. These symptoms often are reversible if treatment is initiated early. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv S 128, Seattle, WA 98108 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Little, JW (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv S 128, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 29 TC 9 Z9 10 U1 1 U2 3 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PD SUM PY 2003 VL 26 IS 2 BP 116 EP 121 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 739PH UT WOS:000186355300003 PM 12828286 ER PT J AU Barber, D Foster, D Rogers, S AF Barber, D Foster, D Rogers, S TI The importance of nutrition in the care of persons with spinal cord injury SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Editorial Material ID VITAMIN-B-12 DEFICIENCY; METFORMIN C1 S Texas Vet Healthcare Syst, Spinal Cord Injury Ctr, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Rehabil Med, San Antonio, TX USA. RP Barber, D (reprint author), S Texas Vet Healthcare Syst, Spinal Cord Injury Ctr, San Antonio, TX USA. NR 5 TC 2 Z9 2 U1 0 U2 3 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PD SUM PY 2003 VL 26 IS 2 BP 122 EP 123 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 739PH UT WOS:000186355300004 PM 12828287 ER PT J AU Guihan, M Goldstein, B Smith, BM Schwartz, A Manheim, LM AF Guihan, M Goldstein, B Smith, BM Schwartz, A Manheim, LM TI SCI health care provider attitudes about pressure ulcer management SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE spinal cord injuries; pressure ulcers; clinical practice variations; medical decision making; quality enhancement research initiative (QUERI) AB Background/Objective: To evaluate the variability in clinical decisions about pressure ulcer management for persons with spinal cord injury (SCI) and expand understanding of the various factors influencing variability. Methods: Eighty-one SCI physicians and nurses completed a survey on pressure ulcer management. Patient scenarios were used to assess the effect of patient characteristics on provider decisions regarding inpatient treatment of severe pressure ulcers, surgery vs medical management, and amount of healing before discharge. Results: The availability of social support to facilitate bed rest appears to be a more important factor in deciding whether the patient is managed at home vs in the hospital than is the level of injury. Medical condition does not appear to influence surgical vs medical management of severe pressure ulcers. For patients with poor social support, more healing was required before discharge, regardless of their medical condition. Providers were queried about other issues that influence management, including inpatient resource availability, patient preferences, the availability and quality of local home care, and the availability and use of formal care protocols. Respondents were virtually unanimous in their agreement that patients who are compliant with prevention measures can avoid ulcer development. Conclusion: Like many health care providers, those who provide care to people with SCI are struggling to provide quality care to improve their patients' lives in the absence of good evidence to guide their treatment decisions. The results of the present study indicate that in situations in which there is no strong empirical evidence, variation in care provided is extensive. C1 Edward Hines Jr Vet Adm Hosp, Midwest Ctr Hlth Serv & Policy Res, Hines, IL 60141 USA. VA Puget Sound Hlth Care Syst, Spinal Cord Injury & Disorders Strateg Healthcare, Seattle, WA USA. Edward Hines Jr Vet Adm Hosp, Spinal Cord Qual Enhancement Res Initiat, Dept Vet Affairs Hlth Serv Res & Dev Serv, Hines, IL USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Illinois, Coll Med, Dept Med Educ, Chicago, IL USA. Northwestern Univ, Inst Hlth Serv Res & Policy Studies, Evanston, IL USA. RP Guihan, M (reprint author), Edward Hines Jr Vet Adm Hosp, Midwest Ctr Hlth Serv & Policy Res, 151H,5th Ave & Roosevelt Rd, Hines, IL 60141 USA. RI Schwartz, Alan/G-2814-2010 OI Schwartz, Alan/0000-0003-3809-6637 NR 10 TC 2 Z9 2 U1 0 U2 1 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PD SUM PY 2003 VL 26 IS 2 BP 129 EP 134 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 739PH UT WOS:000186355300006 PM 12828289 ER PT J AU Corfman, TA Cooper, RA Boninger, ML Koontz, AM Fitzgerald, SG AF Corfman, TA Cooper, RA Boninger, ML Koontz, AM Fitzgerald, SG TI Range of motion and stroke frequency differences between manual wheelchair propulsion and pushrim-activated power-assisted wheelchair propulsion SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE wheelchair propulsion; range of motion; upper limb; kinematics ID SPINAL-CORD INJURY; UPPER EXTREMITY; MECHANICAL EFFICIENCY; COORDINATE SYSTEM; BIOMECHANICS; KINEMATICS; SHOULDER; RESPONSES; POSITION; KINETICS AB Background/Objective: The objective of this study was to examine the use and efficacy of a pushrim-activated power-assist wheelchair (PAPAW) in the reduction of upper extremity range of motion (ROM) and stroke frequency in manual wheelchair users. Methods: Ten manual wheelchair users were evaluated using a repeated-measures design with and without the use of a PAPAW for maximum ROM of shoulder flexion/extension, abduction/adduction, internal/external rotation, and horizontal flexion/extension; elbow flexion/extension; wrist flexion/extension, supination/pronation, and ulnar/radial deviation; and stroke frequency. Participants propelled a Quickie 2 manual wheelchair configured as a PAPAW and their own wheelchair on a computer-controlled dynamometer at 3 different resistance levels and 2 different speeds. Results: The use of the PAPAW significantly (P < 0.05) decreased shoulder flexion/extension and horizontal flexion/extension, elbow flexion/extension, and wrist flexion/extension and ulnar/radial deviation for many speed and resistance combinations. Univariate analysis revealed that stroke frequency was unaltered in all cases. Conclusion: These findings provide the foundation for studying the utility of the PAPAW in reducing the risk of upper limb injury and neuropathy in the manual wheelchair user population. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Ctr Excellence Wheelchairs & Related Technol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Ctr Excellence Wheelchairs & Related Technol, 151 R1,7180 Highland Dr, Pittsburgh, PA 15261 USA. OI Boninger, Michael/0000-0001-6966-919X NR 31 TC 23 Z9 24 U1 1 U2 6 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PD SUM PY 2003 VL 26 IS 2 BP 135 EP 140 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 739PH UT WOS:000186355300007 PM 12828290 ER PT J AU McRae, AL Budney, AJ Brady, KT AF McRae, AL Budney, AJ Brady, KT TI Treatment of marijuana dependence: a review of the literature SO JOURNAL OF SUBSTANCE ABUSE TREATMENT LA English DT Review DE marijuana; substance use disorders; psychotherapy; pharmacotherapy; cannabinoid receptors ID RANDOMIZED CONTROLLED TRIAL; ADULTS SEEKING TREATMENT; CANNABIS USE; AVERSION THERAPY; WITHDRAWAL; RECEPTOR; ALCOHOLICS; INCENTIVES; PLACEBO; HUMANS AB Until recently, relatively little research has focused on the treatment of marijuana abuse or dependence; however, marijuana use disorders are now receiving increased attention. This paper reviews the initial clinical trials evaluating the efficacy of outpatient treatments for adult marijuana dependence. Findings from five controlled trials of psychotherapeutic interventions suggest that this disorder appears responsive to the same types of treatment as other substance dependencies. Moreover, these initial studies suggest that many patients do not show a positive treatment response, indicating that marijuana dependence is not easily treated. Strengths and weaknesses of the data are presented. Preliminary data from less controlled studies relevant to the treatment of marijuana dependence are discussed to suggest future research areas. Although very few studies on treatment for marijuana abuse and dependence have been completed, the initial reports identify promising treatment approaches and demonstrate a need for more research on the development of effective interventions. (C) 2003 Elsevier Inc. All rights reserved. C1 Ralph H Johnson VAMC, MUSC CTN, Charleston, SC 29401 USA. Treatment Res Ctr, S Burlington, VT 05403 USA. RP McRae, AL (reprint author), Ralph H Johnson VAMC, MUSC CTN, 109 Bee St, Charleston, SC 29401 USA. RI McRae-Clark, Aimee/I-3341-2013 OI McRae-Clark, Aimee/0000-0002-9774-318X FU NIDA NIH HHS [DA12157, DA00435, DA15440] NR 44 TC 65 Z9 67 U1 4 U2 15 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0740-5472 J9 J SUBST ABUSE TREAT JI J. Subst. Abus. Treat. PD JUN PY 2003 VL 24 IS 4 BP 369 EP 376 DI 10.1016/S0740-5472(03)00041-2 PG 8 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 705JX UT WOS:000184392900012 PM 12867212 ER PT J AU Friedlander, AH Marder, SR Pisegna, JR Yagiela, JA AF Friedlander, AH Marder, SR Pisegna, JR Yagiela, JA TI Alcohol abuse and dependence - Psychopathology, medical management and dental implications SO JOURNAL OF THE AMERICAN DENTAL ASSOCIATION LA English DT Article ID GASTROESOPHAGEAL REFLUX DISEASE; PLACEBO-CONTROLLED TRIAL; EPIDERMAL GROWTH-FACTOR; ORAL HYGIENE; MANDIBULAR FRACTURES; NUCLEUS-ACCUMBENS; DOPAMINE RELEASE; SUBSTANCE-ABUSE; HEAVY DRINKERS; OPIOID SYSTEM AB Background. The authors review the clinical features, epidemiology, pathophysiology, medical management, dental findings and dental treatment of patients with alcoholism. Literature Reviewed. The authors conducted a MEDLINE search for 1995 through 2001 using the key terms of alcoholism, epidemiology, pathophysiology, treatment and dentistry. Reports selected for further review included those published in English in peer-reviewed journals. The authors gave preference to articles reporting randomized, controlled trials. Conclusions. Alcoholism is a chronic and progressive psychiatric illness that afflicts more than 14 million Americans. It is characterized by a loss of control over the use of alcohol, resulting in impaired social functioning, and the consequent development of medical illnesses. The disease arises in genetically vulnerable people when they are overwhelmed by their cravings for the alcohol-associated euphoria that results from the actions of several neurotransmitter systems in the brain's pleasure center. New medications to counteract alcohol-induced neurotransmission imbalance may assist patients in reducing their craving. Clinical Implications. The prevalence of dental disease usually is extensive because of a disinterest in performing appropriate oral hygiene techniques and diminished salivary flow. Concurrent abuse of tobacco products worsens dental disease and heightens the risk of developing oral cancer. Identification of the alcohol-abusing patient, a cancer-screening examination, preventive dental education, and use of saliva substitutes and anticaries agents are indicated. Special precautions must be taken when performing surgery and when prescribing or administering analgesics, antibiotics or sedative agents that are likely to have an adverse interaction with alcohol or psychiatric medications. C1 VA Greater Los Angeles Healthcare Syst, Chair Psychiat, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Med Ctr, Qual Assurance Hosp Dent Serv, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Dept Vet Affairs, VISN 22, Mental Illness Res Educ & Clin Ctr, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Div Gastroenterol & Hepatol, Los Angeles, CA 90073 USA. RP Friedlander, AH (reprint author), VA Greater Los Angeles Healthcare Syst, Chair Psychiat, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Reis, Aline/G-9573-2012 NR 96 TC 25 Z9 30 U1 3 U2 10 PU AMER DENTAL ASSN PI CHICAGO PA 211 E CHICAGO AVE, CHICAGO, IL 60611 USA SN 0002-8177 J9 J AM DENT ASSOC JI J. Am. Dent. Assoc. PD JUN PY 2003 VL 134 IS 6 BP 731 EP 740 PG 10 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 693LK UT WOS:000183718900018 PM 12839410 ER PT J AU Saunders, MJ AF Saunders, MJ TI Still waiting for the revolution in aging SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Editorial Material C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. S Texas Vet Hlth Care Syst, GRECC, San Antonio, TX USA. RP Saunders, MJ (reprint author), UTHSCSA, MC 7921,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 12 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUN PY 2003 VL 51 IS 6 BP 877 EP 878 DI 10.1046/j.1365-2389.2003.51274.x PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 681RM UT WOS:000183049200023 PM 12757580 ER PT J AU Borthakur, G Cruz, MA Dong, JF McIntire, L Li, F Lopez, JA Thiagarajan, P AF Borthakur, G Cruz, MA Dong, JF McIntire, L Li, F Lopez, JA Thiagarajan, P TI Sulfatides inhibit platelet adhesion to von Willebrand factor in flowing blood SO JOURNAL OF THROMBOSIS AND HAEMOSTASIS LA English DT Article DE glycoprotein Ib; sulfatides; von Willebrand factor ID FACTOR A1 DOMAIN; GLYCOPROTEIN IB-ALPHA; HUMAN VONWILLEBRAND-FACTOR; VIII-RELATED PROTEIN; CRYSTAL-STRUCTURE; TERMINAL DOMAIN; BINDING DOMAIN; HUMAN-PLASMA; COLLAGEN; SEQUENCE AB Sulfatides are sulfated glycosphingolipids present on cell surfaces that bind to adhesive proteins such as von Willebrand factor (VWF), P-selectin, laminin and thrombospondin. Previous Studies have localized the sulfatide-binding site of VWF to amino acid residues Gln626-Val646 in the At domain. The A1 domain also contains the binding site for platelet glycoprotein Ib (GP Ib), a site that has been reported to be distinct from the sulfatide-binding site. In this study, we analyzed the interaction of sulfatides with VWF and its effect on GP Ib-mediated platelet adhesion under flow conditions. Recombinant VWF A I domain (rVWF-A1) bound specifically and saturably to sulfatides (half-maximal concentration of similar to 12.5 mug mL(-1)), binding that was blocked by dextran sulfate (IC50 approximate to 100 mug mL(-1)) but not by heparin at concentrations up to 100 U mL(-1). Furthermore, sulfatides (125 mug mL(-1)) prevented the adhesion of platelets or glycocalicin-coupled polystyrene beads to a rVWF-A1-coated surface under high shear stress. In addition, plasma VWF prebound to a sulfatide-coated surface failed to support subsequent platelet adhesion. These results provide firm evidence that sulfatides bind the VWFA1 domain at a site overlapping the GP Ib-binding site. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Hematol, Houston, TX USA. Baylor Coll Med, Thrombosis Res Sect, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. Rice Univ, Cox Lab Biomed Engn, Houston, TX 77251 USA. RP Thiagarajan, P (reprint author), VA Med Ctr, Mail 113,2002 Holcombe Blvd, Houston, TX 77030 USA. FU NHLBI NIH HHS [HL 65096, P50 HL 65967] NR 34 TC 26 Z9 26 U1 1 U2 4 PU BLACKWELL PUBL LTD PI OXFORD PA 108 COWLEY RD, OXFORD OX4 1JF, OXON, ENGLAND SN 1538-7933 J9 J THROMB HAEMOST JI J. Thromb. Haemost. PD JUN PY 2003 VL 1 IS 6 BP 1288 EP 1295 DI 10.1046/j.1538-7836.2003.00156.x PG 8 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 695GV UT WOS:000183823500028 PM 12871332 ER PT J AU Piontek, FA Coscia, R Marselle, CS Korn, RL Zarling, EJ AF Piontek, FA Coscia, R Marselle, CS Korn, RL Zarling, EJ TI Impact of American College of Surgeons verification on trauma outcomes SO JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE LA English DT Article DE trauma system; outcomes; mortality; cost; American College of Surgeons verification ID LEVEL-I; SEVERITY SCORE; CARE; MORTALITY; CENTERS; SYSTEM; VOLUME; STATE; REGIONALIZATION; COMPLICATIONS AB Objective: The purpose of this study was to compare the impact of trauma patient outcomes before and after Level 11 American College of Surgeons (ACS) verification was received in a not-for-profit community hospital. Methods: This was a retrospective analysis of hospital discharge data for timeframes before and after Level II ACS verification was conducted. Originally, 8,674 patients were identified using the International Classification of Diseases, 9th Revision codes for trauma. These data were parsed to 7,811 patients by using International Classification of Diseases, 9th Revision codes 800xx through 959.9x, which signify an admitting diagnosis of trauma; 3,835 of the patients were admitted after the July 28, 1998, verification date. Blunt injuries constituted the vast majority of the patients (n = 7,488). Outcome measures studied included changes in length of stay (LOS), mortality, and total cost. Internal control was coronary artery bypass graft patients at the same hospital, and external control was trauma patients at a non-ACS hospital over the same time period. Data are presented with p values and SE and the ratio of observed/expected values on the basis of the all-payer severity-adjusted diagnosis-related group severity model. Results: The two timeframes exhibited statistically different outcomes in several variables. Adjusting for severity postverification, LOS was 10% less (p < 0.000). Similarly, severity-adjusted mortality observed/expected ratios were significantly different: 0.81 before versus 0.59 after (p < 0.000). The severity-adjusted ratio of costs found that the postverification era was 5% lower (p < 0.000). The contribution margin of the trauma patient population to the hospital well exceeded any postverification costs. Both control groups exhibited no significant changes in their severity-adjusted outcomes, which could have invalidated these results. Conclusion: This study suggests that the efforts and resources consumed achieving ACS Level II trauma center verification appear to result in desired outcomes as evidenced by decreased LOS, reduced in-hospital mortality rates, reduced cost, and improved contribution margins. C1 Trin Hlth Informat Syst, South Bend, IN 46628 USA. St Alphonsus Reg Med Ctr, Boise, ID USA. Loyola Univ, Med Ctr, Maywood, IL 60153 USA. US Dept Vet Affairs, Hines, IL USA. RP Piontek, FA (reprint author), Trin Hlth Informat Syst, 3575 Moreau Court, South Bend, IN 46628 USA. OI Luchette, Fred/0000-0002-8857-9111 NR 27 TC 31 Z9 32 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5282 J9 J TRAUMA JI J. Trauma-Injury Infect. Crit. Care PD JUN PY 2003 VL 54 IS 6 BP 1041 EP 1046 DI 10.1097/01.TA.0000061107.55798.31 PG 6 WC Critical Care Medicine; Surgery SC General & Internal Medicine; Surgery GA 693PR UT WOS:000183727400001 PM 12813321 ER PT J AU Freedland, SJ Presti, JC Terris, MK Kane, CJ Aronson, WJ Dorey, F Amling, CL AF Freedland, SJ Presti, JC Terris, MK Kane, CJ Aronson, WJ Dorey, F Amling, CL CA Search Database Study Grp TI Improved clinical staging system combining biopsy laterality and TNM stage for men with T1C and T2 prostate cancer: Results from the search database SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; neoplasm staging; biopsy; recurrence ID PROGRESSION-FREE SURVIVAL; AMERICAN JOINT COMMITTEE; RADICAL PROSTATECTOMY; BIOCHEMICAL FAILURE; RECURRENCE; ANTIGEN; DISEASE; ABILITY AB Purpose: A number of studies have failed to show significant differences in outcome following radical prostatectomy between men with palpable, clinically localized prostate cancer (cT2) and those whose tumors are not palpable (cT1c). We determined whether we could improve the prognostic value of the TNM staging system in men with cT1c and cT2 cancers by including information on whether prostate needle biopsy was unilaterally or bilaterally positive. Materials and Methods: A retrospective survey of 992 patients from the SEARCH (Shared Equal Access Regional Cancer Hospital) Database treated with radical prostatectomy at 4 equal access medical centers between 1988 and 2002 was done. TNM 1992 clinical stage was T1c in 421 patients, T2a in 287, T2b in 202 and T2c in 82. Multivariate analysis was used to examine whether biopsy laterality and clinical stage were significant predictors of surgical margin status, nonorgan confined disease, seminal vesicle invasion, and time to prostate specific antigen (PSA) recurrence following radical prostatectomy. Results: Patients with clinical stages T2b and T2c cancers had similar rates of PSA recurrence, which were significantly higher than in patients with T1c and T2a disease, who also had similar rates of PSA recurrence. Bilateral positive biopsy further stratified patients with T1c and T2a disease (p = 0.01) but not those with T2b and T2c cancers (p = 0.207). Grouping these 1992 clinical stages with biopsy laterality resulted in a new clinical staging system, which was a significant predictor of PSA recurrence following radical prostatectomy (p <0.001). On multivariate analysis whether TNM clinical stage was evaluated as a categorical or continuous variable only PSA, biopsy Gleason score and the new clinical staging system (1992 TNM stage groupings combined with biopsy laterality) were significant independent predictors of time to biochemical recurrence following radical prostatectomy. Conclusions: Combining low (T1c and T2a) and high (T2b and T2c) risk 1992 clinical stages with biopsy laterality (unilateral versus bilateral positive) resulted in a new clinical staging system that was a stronger predictor of PSA recurrence following radical prostatectomy than the 1992 or 1997 TNM clinical staging system. If confirmed at other centers and in men who undergo with other treatment modalities, consideration should be given to revising the current TNM staging system to reflect these findings. C1 Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Biostat, Los Angeles, CA 90095 USA. Vet Adm Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. Stanford Univ, Dept Urol, Sch Med, Urol Sect, San Francisco, CA USA. Vet Adm Med Ctr, Dept Surg, San Francisco, CA 94121 USA. USN, Ctr Med, Dept Urol, San Diego, CA 92152 USA. Med Coll Georgia, Div Urol, Augusta, GA 30912 USA. RP Freedland, SJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Urol, Box 951738, Los Angeles, CA 90095 USA. OI Terris, Martha/0000-0002-3843-7270 NR 24 TC 16 Z9 16 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD JUN PY 2003 VL 169 IS 6 BP 2129 EP 2135 DI 10.1097/01.ju.0000065763.21602.14 PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 679NU UT WOS:000182929500033 PM 12771734 ER PT J AU Freedland, SJ Aronson, WJ Terris, MK Kane, CJ Amling, CL Dorey, F Presti, JC AF Freedland, SJ Aronson, WJ Terris, MK Kane, CJ Amling, CL Dorey, F Presti, JC CA Search Database Study Grp TI Percent of prostate needle biopsy cores with cancer is a significant independent predictor of prostate specific antigen recurrence following radical prostatectomy: Results from the search database SO JOURNAL OF UROLOGY LA English DT Article DE prostatic neoplasms, prostatectomy; biopsy, needle; prostate-specific antigen, recurrence ID BEAM RADIATION-THERAPY; SEXTANT BIOPSIES; EXTRACAPSULAR EXTENSION; DISEASE RECURRENCE; CLINICAL UTILITY; GLEASON SCORE; RISK; INTERMEDIATE; RELAPSE; RACE AB Purpose: Recent studies have suggested that the percent of positive cores in the prostate needle biopsy is a significant predictor of outcome among men undergoing radical prostatectomy or radiation therapy for prostate cancer. We evaluate whether either percent of cores with cancer or percent of cores positive from the most and least involved side of the prostate needle biopsy was associated with a worse outcome among men treated with radical prostatectomy. Materials and Methods: A retrospective survey of 1,094 patients from the SEARCH Database treated with radical prostatectomy at 4 different equal access medical centers in California between 1988 and 2002 was undertaken. We used multivariate analysis to examine whether total percent of prostate needle biopsy cores with cancer, percent of cores positive from each side of the prostate and other clinical variables were significant predictors of adverse pathology and time to prostate specific antigen (PSA) recurrence following radical prostatectomy. Results: On multivariate analysis serum PSA and percent of positive cores were significant predictors of positive surgical margins, nonorgan confined disease and seminal vesicle invasion. Percent of positive cores (p <0.001), serum PSA (p = 0.008) and biopsy Gleason score (p = 0.014) were significant independent predictors of time to biochemical recurrence. On a separate multivariate analysis that included the variables of total percent of positive cores, percent of positive cores from the most involved side of the biopsy, percent of positive cores from the least involved side of the biopsy and whether the biopsy was positive unilaterally or bilaterally, only the percent of positive cores from the most involved side of the biopsy was a significant independent predictor of PSA failure following radical prostatectomy. Percent of positive cores was used to separate patients into a low risk (less than 34%), intermediate risk (34% to 50%) and high risk (greater than 50%) groups, which provided significant preoperative risk stratification for PSA recurrence following radical prostatectomy (p <0.001). Percent of positive cores cut points were able to further risk stratify men who were at low (p = 0.001) or intermediate (p = 0.036) but not high (p = 0.674) risk for biochemical failure based on serum PSA and biopsy Gleason score. Conclusions: Percent of positive cores in the prostate needle biopsy was a significant predictor of adverse pathology and biochemical failure following radical prostatectomy, and the cut points of less than 34%, 34% to 50% and greater than 50% can be used to risk stratify patients preoperatively. The finding that percent of positive cores from the most involved side of the biopsy was a stronger predictor of PSA failure than the total percent of cores involved suggests that multiple positive biopsies from a single side might be a better predictor of a larger total cancer volume and thus correlate with clinical outcome. C1 Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Biostat, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Dept Surg, Los Angeles, CA USA. Stanford Univ, Med Ctr, Urol Sect,Sch Med, Vet Affairs Palo Alto Hlth Care Syst,Dept Urol, Palo Alto, CA 94304 USA. Univ Calif San Francisco, Dept Urol, San Francisco, CA 94143 USA. USN, Ctr Med, San Diego, CA 92152 USA. RP Freedland, SJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Urol, Box 951738, Los Angeles, CA 90095 USA. NR 20 TC 61 Z9 65 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD JUN PY 2003 VL 169 IS 6 BP 2136 EP 2141 DI 10.1097/01.ju.0000065588.82511.06 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 679NU UT WOS:000182929500034 PM 12771735 ER PT J AU Freedland, SJ Aronson, WJ Presti, JC Kane, CJ Terris, MK Elashoff, D Amling, CL AF Freedland, SJ Aronson, WJ Presti, JC Kane, CJ Terris, MK Elashoff, D Amling, CL CA Search Database Study Grp TI Should a positive surgical margin following radical prostatectomy be pathological stage T2 or T3? Results from the search database SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; prostatectomy; prostate-specific antigen; neoplasm staging ID RETROPUBIC PROSTATECTOMY; SEXTANT BIOPSIES; BIOCHEMICAL RECURRENCE; CANCER; IMPACT; CARCINOMA; SPECIMENS; SITE; PROGRESSION; EXTENSION AB Purpose: The finding of a positive surgical margin associated with extracapsular extension at radical prostatectomy is a poor prognostic factor. However, whether a positive surgical margin with no documented extracapsular extension portends a similarly poor prognosis is unclear. We examined the significance of the pathological features of positive surgical margin and extracapsular extension for predicting biochemical failure following radical prostatectomy. Materials and Methods: We examined data on 1,621 men from the SEARCH Database of patients treated with radical prostatectomy without lymph node metastasis. Patients were separated into 5 groups based on the pathological findings of positive surgical margin, extracapsular extension, and/or seminal vesicle invasion. Preoperative clinical variables were compared across the groups and the groups were compared for time to biochemical recurrence using Cox proportional hazards analysis. Results: Men with seminal vesicle invasion had the highest prostate specific antigen (PSA) recurrence rates, while men with a negative surgical margin and no extracapsular extension had the lowest PSA recurrence rates. There were no differences in PSA failure rates between men with a positive surgical margin and no extracapsular extension versus men with a negative surgical margin and extracapsular extension versus men with extracapsular extension and a positive surgical margin. In this subset of patients with a positive surgical margin and/or extracapsular extension but no seminal vesicle invasion only serum PSA was a significant independent predictor of biochemical recurrence. Conclusions: Men with a positive surgical margin but no extracapsular extension had PSA recurrence rates similar to those in men with extracapsular extension with or without positive margins. Men with extracapsular extension had similar biochemical recurrence rates whether the surgical margin was positive or negative. If confirmed at other institutions, consideration should be given to modifying the current TNM staging system to reflect these findings. C1 Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Biostat, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Dept Surg, Los Angeles, CA USA. Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA. Univ Calif San Francisco, Dept Urol, San Francisco, CA 94143 USA. USN, Ctr Med, Dept Urol, San Diego, CA 92152 USA. Med Coll Georgia, Div Urol, Augusta, GA 30912 USA. RP Freedland, SJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Urol, Box 951738, Los Angeles, CA 90095 USA. OI Terris, Martha/0000-0002-3843-7270 NR 20 TC 51 Z9 52 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD JUN PY 2003 VL 169 IS 6 BP 2142 EP 2146 DI 10.1097/01.ju.0000061760.23169.be PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 679NU UT WOS:000182929500035 PM 12771736 ER PT J AU Coburn, JW Maung, HM AF Coburn, JW Maung, HM TI Use of active vitamin D sterols in patients with chronic kidney disease, stages 3 and 4 SO KIDNEY INTERNATIONAL LA English DT Article; Proceedings Paper CT 4th Symposium on Advances in Renal Osteodystrophy CY JUN 06-07, 2002 CL OVIEDO, SPAIN SP Plan Reg Invest Principado Asturias, FICYT, Consejeria Salud Serv Sanitar Principado Asturias, Cajastur, Abbott Labs, Genzyme, Amgen, Fresenius, Agua Mineral Bezoya DE secondary hyperparathyroidism; calcitriol; alfacalcidol; doxercalciferol; mild to moderate renal insufficiency; treatment; guidelines; bone density; hypercalcemia ID CHRONIC-RENAL-FAILURE; LOW-DOSE CALCITRIOL; BONE-DISEASE; SECONDARY HYPERPARATHYROIDISM; 1,25-DIHYDROXYVITAMIN D-3; THERAPY; 1,25(OH)2D3; CALCIUM; PLACEBO; TRIAL AB This paper reviews randomized controlled trials and other reported data on the use of the active vitamin D sterols, such as calcitriol, alfacalcidol, and doxercalciferol, in the management of secondary hyperparathyroidism in patients with mild-to-moderate renal insufficiency (stage 3 or 4 chronic kidney disease). Data on potential benefits, including improved histologic abnormalities of bone from secondary hyperparathyroidism, increased bone mineral density, and a reduction of elevated parathyroid hormone levels, are documented. Consideration is given to the risks of such therapy, which include the production of hypercalcemia, more rapid progression of renal insufficiency, the induction of adynamic bone "disease," and accelerated vascular and soft tissue calcification. The low therapeutic index, or "benefit/risk ratio" of calcitriol and alfacalcidol, the sterols currently licensed for such treatment, is recognized. It is recommended that phosphate-restricted diets, phosphate-binding agents, and oral calcium supplements be given adequate trials before starting calcitriol or alfacalcidol. If PTH levels cannot be controlled by these measures, initial doses of these sterols and the proper surveillance during treatment are given. It is emphasized that the risks of hypercalcemia are likely to increase as the degree of kidney failure worsens. Further research using the "less calcemic" vitamin D sterols is clearly needed. C1 W Los Angeles VA Healthcare Ctr, Nephrol Sect 111L, Med Serv, Los Angeles, CA 90073 USA. W Los Angeles VA Healthcare Ctr, Res Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. RP Coburn, JW (reprint author), W Los Angeles VA Healthcare Ctr, Nephrol Sect 111L, Med Serv, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jcoburn@ucla.edu NR 22 TC 9 Z9 9 U1 0 U2 0 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 JUN PY 2003 VL 63 SU 85 BP S49 EP S53 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 680TG UT WOS:000182994200012 ER PT J AU Sales, AE Liu, CF Sloan, KL Malkin, J Fishman, PA Rosen, AK Loveland, S Nichol, WP Suzuki, NT Perrin, E Sharp, ND Todd-Stenberg, J AF Sales, AE Liu, CF Sloan, KL Malkin, J Fishman, PA Rosen, AK Loveland, S Nichol, WP Suzuki, NT Perrin, E Sharp, ND Todd-Stenberg, J TI Predicting costs of care using a pharmacy-based measure risk adjustment in a veteran population SO MEDICAL CARE LA English DT Article DE case-mix; pharmacy; veterans; risk adjustment ID CHRONIC DISEASE SCORE; MEDICARE CAPITATION PAYMENTS; CASE-MIX; DIAGNOSES AB BACKGROUND. Although most widely used risk adjustment systems use diagnosis data to classify patients, there is growing interest in risk adjustment based on computerized pharmacy data. The Veterans Health Administration (VHA) is an ideal environment in which to test the efficacy of a pharmacy-based approach. OBJECTIVE. To examine the ability of RxRisk-V to predict concurrent and prospective costs of care in VHA and compare the performance of RxRisk-V to a simple age/gender model, the original RxRisk, and two leading diagnosis-based risk adjustment approaches: Adjusted Clinical Groups and Diagnostic Cost Groups/Hierarchical Condition Categories. METHODS. The study population consisted of 161,202 users of VHA services in Washington, Oregon, Idaho, and Alaska during fiscal years (FY) 1996 to 1998. We examined both concurrent and predictive model fit for two sequential 12-month periods (FY 98 and FY 99) with the patient-year as the unit of analysis, using split-half validation. RESULTS. Our results show that the Diagnostic Cost Group/Hierarchical Condition Categories model performs best (R-2 = 0.45) among concurrent cost models, followed by ADG (0.31), RxRisk-V (0.20), and age/sex model (0.01). However, prospective cost models other than age/sex showed comparable R-2: Diagnostic Cost Group/Hierarchical Condition Categories R-2 = 0.15, followed by ADG (0.12), RxRisk-V (0.12), and age/sex (0.01). CONCLUSIONS. RxRisk-V is a clinically relevant, open source risk adjustment system that is easily tailored to fit specific questions, populations, or needs. Although it does not perform better than diagnosis-based measures available on the market, it may provide a reasonable alternative to proprietary systems where accurate computerized pharmacy data are available. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Pharm, Seattle, WA 98195 USA. RAND Corp, Arlington, VA USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. Bedford VA Med Ctr, Ctr Hlth Qual Outcomes & Econ, Bedford, MA USA. Boston Univ, Sch Publ Hlth, Boston, MA 02215 USA. RP Sales, AE (reprint author), VA Puget Sound Hlth Care Syst, 152 HSRD,1660 S Columbian Way, Seattle, WA 98108 USA. OI Sales, Anne/0000-0001-9360-3334 NR 23 TC 61 Z9 61 U1 2 U2 5 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 JUN PY 2003 VL 41 IS 6 BP 753 EP 760 DI 10.1097/00005650-200306000-00008 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 685XC UT WOS:000183288800008 PM 12773841 ER PT J AU Sloan, KL Sales, AE Liu, CF Fishman, P Nichol, P Suzuki, NT Sharp, ND AF Sloan, KL Sales, AE Liu, CF Fishman, P Nichol, P Suzuki, NT Sharp, ND TI Construction and characteristics of the RxRisk-V - A VA-adapted pharmacy-based case-mix instrument SO MEDICAL CARE LA English DT Article; Proceedings Paper CT Annual Meeting of the Academy-for-Health-Services-Research-and-Health-Policy CY JUN 10-11, 2001 CL ATLANTA, GEORGIA SP Acad Hlth Serv Res & Hlth Policy DE case-mix; pharmacy; veterans; risk adjustment ID CHRONIC DISEASE SCORE; OF-VETERANS-AFFAIRS; HEALTH-STATUS; CARE AB BACKGROUND. Assessment of disease burden is the key to many aspects of health care management. Patient diagnoses are commonly used for case-mix assessment. However, issues pertaining to diagnostic data availability and reliability make pharmacy-based strategies attractive. Our goal was to provide a reliable and valid pharmacy-based case-mix classification system for chronic diseases found in the Veterans Health Administration (VHA) population. OBJECTIVE. To detail the development and category definitions of a VA-adapted version of the RxRisk (formerly the Chronic Disease Score); to describe category prevalence and reliability; to check category criterion validity against ICD-9 diagnoses; and to assess category-specific regression coefficients in concurrent and prospective cost models. RESEARCH DESIGN. Clinical and pharmacological review followed by cohort analysis of diagnostic, pharmacy, and utilization databases. SUBJECTS. 126,075 veteran users of VHA services in Washington, Oregon, Idaho, and Alaska. METHODS. We used Kappa statistics to evaluate RxRisk category reliability and criterion validity, and multivariate regression to estimate concurrent and prospective cost models. RESULTS. The RxRisk-V classified 70.5% of the VHA Northwest Network 1998 users into an average of 2.61 categories. Of the 45 classes, 33 classes had good-excellent 1-year reliability and 25 classes had good-excellent criterion validity against ICD-9 diagnoses. The RxRisk-V accounts for a distinct proportion of the variance in concurrent (R-2 = 0.18) and prospective cost (R-2 = 0.10) models. CONCLUSIONS. The RxRisk-V provides a reliable and valid method for administrators to describe and understand better chronic disease burden of their treated populations. Tailoring to the VHA permits assessment of disease burden specific to this population. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Pharm, Seattle, WA 98195 USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. RP Sloan, KL (reprint author), VA Puget Sound Hlth Care Syst, 116-DDTP,1660 S Columbian Way, Seattle, WA 98108 USA. OI Sales, Anne/0000-0001-9360-3334 NR 41 TC 103 Z9 105 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 JUN PY 2003 VL 41 IS 6 BP 761 EP 774 DI 10.1097/00005650-200306000-00009 PG 14 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 685XC UT WOS:000183288800009 PM 12773842 ER PT J AU Durand, RJ Castracane, VD Hollander, DB Tryniecki, JL Bamman, MM O'Neal, S Hebert, EP Kraemer, RR AF Durand, RJ Castracane, VD Hollander, DB Tryniecki, JL Bamman, MM O'Neal, S Hebert, EP Kraemer, RR TI Hormonal responses from concentric and eccentric muscle contractions SO MEDICINE AND SCIENCE IN SPORTS AND EXERCISE LA English DT Article DE testosterone; growth hormone; lactate; eccentric contractions ID HEAVY-RESISTANCE EXERCISE; BIOASSAYABLE GROWTH-HORMONE; TESTOSTERONE; PROTOCOLS; MEN; YOUNG AB Intense resistance exercise can acutely increase testosterone (T), free testosterone (FT), and growth hormone (GH) concentrations. but there are few investigations concerning acute endocrine responses to concentric (CON) and eccentric (ECC) contractile actions. Purpose: The purpose of the study was to compare acute anabolic hormonal responses to bouts of dynamic CON and ECC contractions from multiple exercises at the same absolute load. Methods: Ten young men (age: 24.7+/-1.2 yr, weight: 85.45+/-24.2 kg, and height: 178+/-0.2 cm) completed two trials in counterbalanced fashion consisting of only CON or FCC contractions at the same absolute workload. Subjects performed four sets of 12 repetitions of bench press, leg extension, military press, and leg curl at 80% of a 10-repetition maximum with 90-s rest periods. Blood samples were collected pre-, post-, and 15-min postexercise. Results: There were significant increases in GH, T, and FT and lactate for both trials, but only GH and lactate were greater for the CON trial. Conclusion: CON exercise increases GH concentrations to a much greater extent than ECC exercise at the same absolute load, and it is likely that greater GH responses were related to intensity rather than mode of contraction. Also, CON and ECC dynamic contraction trials at the same absolute workload elicited similar small but significant increases in T and FT, indicating that the greater metabolic stress produced by during the CON trial did not affect these hormone responses. C1 SE Louisiana Univ, Dept Kinesiol & Hlth Studies, Hammond, LA 70402 USA. Univ Alabama, Dept Physiol & Biophys, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, GRECC Muscle Res Lab, Birmingham, AL USA. Texas Tech Univ, Hlth Sci Ctr, Dept Obstet & Gynecol, Amarillo, TX USA. RP Durand, RJ (reprint author), Pennington Biomed Res Ctr, Hlth & Fitness Ctr, 6400 Perkins Rd, Baton Rouge, LA 70808 USA. RI Hollander, Daniel/A-8725-2009 NR 31 TC 49 Z9 53 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0195-9131 J9 MED SCI SPORT EXER JI Med. Sci. Sports Exerc. PD JUN PY 2003 VL 35 IS 6 BP 937 EP 943 DI 10.1249/01.MSS.0000069522.38141.0B PG 7 WC Sport Sciences SC Sport Sciences GA 687PK UT WOS:000183385500008 PM 12783041 ER PT J AU Shi, YJ Gera, J Hsu, JH Van Ness, B Lichtenstein, A AF Shi, YJ Gera, J Hsu, JH Van Ness, B Lichtenstein, A TI Cytoreductive effects of farnesyl transferase inhibitors on multiple myeloma tumor cells SO MOLECULAR CANCER THERAPEUTICS LA English DT Article ID GERANYLGERANYLTRANSFERASE-I INHIBITORS; K-RAS ONCOGENES; NF-KAPPA-B; FARNESYLTRANSFERASE INHIBITORS; ACTIVATING MUTATIONS; PROTEIN-KINASES; CANCER-THERAPY; LINE ANBL6; AKT KINASE; GROWTH AB Farnesyl transferase inhibitors (FTIs) are anticancer agents designed to target ras processing and ras-dependent signal pathways. Because oncogenic ras mutations are found in up to 50% of multiple myeloma (MM) specimens, these agents may be effective in this disease. However, some preclinical studies suggest that FTI antitumor responses are unrelated to effects on ras. To address this issue in myeloma, we used the ANBL-6 myeloma cell line where interleukin (IL)-6-dependent cells are stably transfected with mutated N-ras or K-ras genes. Because expression of mutated ras allows for IL-6-independent growth, this is a good model to test whether FTIs specifically target growth-promoting ras-activated pathways in myeloma. Although they had little effect in 10% serum, two separate FTIs induced apoptosis of myeloma cells when cultured in low serum, and mutated ras-expressing cells were more sensitive than wild-type (WT) ras-expressing cells. However, induction of apoptosis did not correlate with inhibition of ras processing. Although they had no effect on AKT activity, under low serum conditions FTIs inhibited constitutive activation of the p70S6kinase and nuclear factor kappaB signal proteins in both mutated ras-expressing MM lines and extracellular signal-regulated kinase (ERK) activity in mutated N-ras-expressing cells. However, in studies where p70, nuclear factor kappaB, and ERK were comparably inhibited by other inhibitors or by gene transfer, we could not identify effects on these pathways as participating in the apoptotic response. FTIs were also able to abrogate the IL-6 proliferative response of WT ras-expressing MM cells, and this was associated with inhibition of IL-6-induced activation of ERK, AKT, and p70. The induction of apoptosis and prevention of the IL-6 response in MM cells containing mutated or WT ras provide support for the therapeutic potential of FTIs in this disease. C1 Univ Calif Los Angeles, W Los Angeles VA Med Ctr, Hematol Oncol Div W111H, Los Angeles, CA 90073 USA. Univ Minnesota, Dept Lab Med & Pathol, Minneapolis, MN 55455 USA. RP Lichtenstein, A (reprint author), Univ Calif Los Angeles, W Los Angeles VA Med Ctr, Hematol Oncol Div W111H, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NCI NIH HHS [CA 62242, CA 96920] NR 47 TC 13 Z9 14 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 1535-7163 J9 MOL CANCER THER JI Mol. Cancer Ther. PD JUN PY 2003 VL 2 IS 6 BP 563 EP 572 PG 10 WC Oncology SC Oncology GA 691LC UT WOS:000183606900008 PM 12813136 ER PT J AU Estepa, JC Lopez, I Felsenfeld, AJ Gao, P Cantor, T Rodriguez, M Aguilera-Tejero, E AF Estepa, JC Lopez, I Felsenfeld, AJ Gao, P Cantor, T Rodriguez, M Aguilera-Tejero, E TI Dynamics of secretion and metabolism of PTH during hypo- and hypercalcaemia in the dog as determined by the 'intact' and 'whole' PTH assays SO NEPHROLOGY DIALYSIS TRANSPLANTATION LA English DT Article DE calcium; hypercalcaemia; hypocalcaemia; intact PTH; parathyroid hormone; whole PTH ID PARATHYROID-HORMONE SECRETION; IONIZED CALCIUM-CONCENTRATION; CARBOXYL-TERMINAL FRAGMENTS; RENAL-FAILURE; IMPROVEMENT; STIMULATION; PHOSPHATE; DECREASE; RECEPTOR; DIET AB Background. Recent evidence has shown that the assay for 'intact' parathyroid hormone (I-PTH) not only reacts with 1-84 PTH but also with large non-1-84 PTH fragments, most of which is probably 7-84 PTH. As a result, an assay specific for 1-84 PTH named whole' PTH (W-PTH) has been developed. The present study was designed: (i) to determine whether the W-PTH assay reliably measures PTH values in the dog; (ii) to evaluate differences between the W-PTH and I-PTH assays during hypo- and hypercalcaemia; and (iii) to assess the peripheral metabolism of W-PTH and I-PTH. Methods. In normal dogs, hypocalcaemia was induced by EDTA infusion and was followed with a 90 min hypocalcaemic clamp. Hypercalcaemia was induced with a calcium infusion. Results. I-PTH and W-PTH values increased from 36 +/- 8 and 13 +/- 3 pg/ml (P = 0.01) at baseline to a maximum of 158 40 and 62 15 pg/ml (P = 0.02 vs I-PTH) during hypocalcaemia. The W-PTH/I-PTH ratio, 38 +/- 4% at baseline, did not change during the induction of hypocalcaemia, but sustained hypocalcaemia increased (P < 0.05) this ratio. During hypercalcaemia, maximal suppression for I-PTH was 2.0 +/- 0.5 and only 5.7 +/- 0.6 pg/ml for W-PTH, due to a decreased sensitivity of the W-PTH assay at values < 5 pg/ml. The disappearance rate of PTH was determined in five additional dogs which underwent a parathyroidectomy (PTX). At 2.5 min after PTX1 W-PTH was metabolized more rapidly, with a value of 25 +/- 2% of the pre-PTX value vs 30 +/- 3% for I-PTH (P < 0.05). Conclusions. (i) The W-PTH/I-PTH ratio is less in the normal dog than in the normal human, suggesting that the percentage of non-1-84 PTH measured with the I-PTH assay is greater in normal dogs than in normal humans; (ii) the lack of change in the W-PTH/I-PTH ratio during acute hypocalcaemia is different from the situation observed in humans; and (iii) the dog appears to be a good model to study I-PTH and W-PTH assays during hypocalcaemia. C1 Univ Cordoba, Dept Med & Cirugia Anim, Cordoba 14014, Spain. Hosp Univ Reina Sofia, Dept Nefrol, Cordoba 14004, Spain. Hosp Univ Reina Sofia, Unidad Invest, Cordoba 14004, Spain. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. Scantibodies Lab Inc, Dept R&D & Diagnost, Santee, CA USA. RP Aguilera-Tejero, E (reprint author), Univ Cordoba, Dept Med & Cirugia Anim, Campus Univ Rabanales,Ctra Madrid Cadiz km 396, Cordoba 14014, Spain. RI Rodriguez, teresa/H-5452-2011 NR 25 TC 6 Z9 6 U1 0 U2 5 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0931-0509 J9 NEPHROL DIAL TRANSPL JI Nephrol. Dial. Transplant. PD JUN PY 2003 VL 18 IS 6 BP 1101 EP 1107 DI 10.1093/ndt/gfg104 PG 7 WC Transplantation; Urology & Nephrology SC Transplantation; Urology & Nephrology GA 689VF UT WOS:000183513100012 PM 12748341 ER PT J AU Nahas, Z George, MS Horner, MD Markowitz, JS Li, XB Lorberbaum, JP Owens, SD McGurk, S DeVane, L Risch, SC AF Nahas, Z George, MS Horner, MD Markowitz, JS Li, XB Lorberbaum, JP Owens, SD McGurk, S DeVane, L Risch, SC TI Augmenting atypical Antipsychotics with a cognitive enhancer (donepezil) improves regional brain activity in schizophrenia patients: A pilot double-blind placebo controlled BOLD fMRI study SO NEUROCASE LA English DT Article DE donepezil; schizophrenia; prefrontal; cingulate; fMRI; cognition; verbal fluency ID POSITRON-EMISSION-TOMOGRAPHY; ATTENUATED FRONTAL ACTIVATION; VERBAL FLUENCY TASK; PREFRONTAL CORTEX; FUNCTIONAL-ANATOMY; ALZHEIMERS-DISEASE; WORKING-MEMORY; FIRST-EPISODE; GENETIC RISK; WORD LISTS AB Cognitive impairments are cardinal features of schizophrenia and predictors of poor vocational and social outcome. Imaging studies with verbal fluency tasks (VFT) lead some to suggest that in schizophrenia, the combination of a failure to deactivate the left temporal lobe and a hypoactive frontal lobe reflects a functional disconnectivity between the left prefrontal cortex and temporal lobe. Others have theorized that an abnormal cingulate gyrus modulates such fronto-temporal connectivity. Thus addition of a cognitive enhancing medication to current antipsychotic therapy might improve functionality of networks necessary in working memory and internal concept generation. To test this hypothesis, we serially measured brain activity in 6 subjects on stable atypical antipsychotics performing a VFT, using BOLD fMRI. Measurements were made at baseline and again after groups were randomized to receive 12 weeks of donepezil (an acetylcholinesterase inhibitor) and placebo in a blind cross-over design. Donepezil addition provided a functional normalization with an increase in left frontal lobe and cingulate activity when compared to placebo and from baseline scans. This pilot study supports the cingulate's role in modulating cognition and neuronal connectivity in schizophrenia. C1 Med Univ S Carolina, Inst Psychiat & Behav Sci, Ctr Adv Imaging Res, Dept Psychiat,Brain Stimulat Lab, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Neurol, Charleston, SC 29425 USA. Ralph H Johnson Vet Hosp, Charleston, SC USA. Mt Sinai Med Ctr, Northport, NY USA. RP Nahas, Z (reprint author), Med Univ S Carolina, Inst Psychiat & Behav Sci, Ctr Adv Imaging Res, Dept Psychiat,Brain Stimulat Lab, POB 25086167,President St,Room 502 N, Charleston, SC 29425 USA. NR 52 TC 38 Z9 40 U1 2 U2 2 PU SWETS ZEITLINGER PUBLISHERS PI LISSE PA P O BOX 825, 2160 SZ LISSE, NETHERLANDS SN 1355-4794 J9 NEUROCASE JI Neurocase PD JUN PY 2003 VL 9 IS 3 BP 274 EP 282 PG 9 WC Clinical Neurology; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 707YR UT WOS:000184538000009 PM 12925933 ER PT J AU Berman, SM Mandelkern, MA Phan, H Zaidel, E AF Berman, SM Mandelkern, MA Phan, H Zaidel, E TI Complementary hemispheric specialization for word and accent detection SO NEUROIMAGE LA English DT Article DE hemispheric laterality; dichotic listening; language; prosodic processing; brain imaging ID CORPUS-CALLOSUM MORPHOMETRY; AUDITORY-VERBAL MEMORY; BASE-LINE CONDITIONS; IMAGING COGNITION; PREFRONTAL CORTEX; EPISODIC MEMORY; FUNCTIONAL MRI; BRAIN SYSTEMS; PET; RETRIEVAL AB When we hear a familiar word pronounced in a foreign accent, which parts of the brain identify the word and which identify the accent? Here we present converging evidence from PET blood flow, event-related scalp potentials, and behavioral responses during dichotic listening, showing homologous and complementary hemispheric specialization for word and accent detection. Accuracy of detecting target words was greater when stimuli were presented to the right ear, indicating left hemisphere specialization, with no ear advantage for detecting target accents. Detection of words also produced increased blood flow in a left frontal area associated with motor and phonetic processing, and a left temporal area associated with semantic memory. Homologous areas of the right hemisphere, together with right prefrontal and precuneus regions, showed increased blood flow during detection of accents. Separate analyses for each detection task indicated that voxels whose activity maximally correlated with accuracy were in the left hemisphere for word detection, but in the right hemisphere for accent detection. Voxels whose activity maximally correlated with inaccuracy were in the opposite hemisphere for both tasks, strengthening the interpretation that between-task differences in brain activation are related to lateralized specializations for task performance. ERP waveforms and reaction times suggested that greater left hemisphere activation during word detection preceded greater right hemisphere activation during accent detection. The results are interpreted as supporting left hemisphere specialization for extraction of the linguistic, phonetic, and semantic information contained in speech, and right hemisphere specialization for pragmatics, the social context of linguistic communication. (C) 2003 Elsevier Science (USA). All rights reserved. C1 W Los Angeles Vet Affairs Med Ctr, Nucl Med Serv, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA USA. Univ Calif Irvine, Dept Phys, Irvine, CA 92717 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Inst Brain Res, Los Angeles, CA 90024 USA. RP Berman, SM (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, Box 11,760 Westwood Plaza, Los Angeles, CA 90024 USA. FU NINDS NIH HHS [NS20187] NR 60 TC 13 Z9 13 U1 3 U2 5 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 JUN PY 2003 VL 19 IS 2 BP 319 EP 331 DI 10.1016/S1053-8119(03)00120-4 PN 1 PG 13 WC Neurosciences; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging GA 690UP UT WOS:000183568900011 PM 12814582 ER PT J AU Bartzokis, G AF Bartzokis, G TI Myelination and brain electrophysiology in healthy and schizophrenic individuals SO NEUROPSYCHOPHARMACOLOGY LA English DT Letter ID P300 C1 Univ Calif Los Angeles, Rush Alzheimers Dis Ctr, Dept Neurol, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90095 USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, Rush Alzheimers Dis Ctr, Dept Neurol, 710 Westwood Plaza,Room 2-238, Los Angeles, CA 90095 USA. RI Bartzokis, George/K-2409-2013 NR 10 TC 4 Z9 4 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD JUN PY 2003 VL 28 IS 6 BP 1217 EP 1218 DI 10.1038/sj.npp.1300180 PG 2 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 686HT UT WOS:000183316100024 PM 12700692 ER PT J AU Corey, E Quinn, JE Buhler, KR Nelson, PS Macoska, JA True, LD Vessella, RL AF Corey, E Quinn, JE Buhler, KR Nelson, PS Macoska, JA True, LD Vessella, RL TI LuCaP 35: A new model of prostate cancer progression to androgen independence SO PROSTATE LA English DT Article DE prostate cancer; prostate specific antigen; xenografts; metastasis ID XENOGRAFT MODEL; RECEPTOR GENE; CHROMOSOME 8P; CARCINOMA; ESTABLISHMENT; DELETION; CELLS; CWR22 AB BACKGROUND. Generation of suitable in vivo models is critical for understanding of processes associated with development and progression of prostate cancer (CaP). METHODS. Lymph nodes containing metastatic androgen-independent CaP were implanted into athymic mice. A xenograft designated LuCaP 35 and its hormone-independent variant LuCaP 35V were established and characterized. RESULTS. LuCaP 35 is an androgen-sensitive, prostate-specific antigen (PSA)-producing xenograft. It expresses the wild-type androgen receptor and exhibits deletions in chromosome 8p, but not in chromosome 10. The response of LuCaP 35 to androgen ablation is similar to that observed in man. Using recurring LuCaP 35 tumors we have also established an androgen-insensitive variant of LuCaP 35. CONCLUSIONS. The availability of hormone-dependent and -independent variants of LuCaP 35, which exhibit many properties analogous to those of CaP in man, provides an excellent model system to study the processes associated with development of androgen independence and to evaluate new treatment modalities. Prostate 55: 239-246, 2003. (C) 2003 Wiley-Liss, Inc. C1 Univ Washington, Dept Urol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Michigan, Ctr Comprehens Canc, Dept Urol, Ann Arbor, MI 48109 USA. Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. RP Corey, E (reprint author), Univ Washington, Dept Urol, Mail Stop 356510,1959 NE Pacific St, Seattle, WA 98195 USA. FU NCI NIH HHS [5 R01 CA60948-08]; NIDDK NIH HHS [2 P50 DK47656-07] NR 27 TC 92 Z9 95 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0270-4137 J9 PROSTATE JI Prostate PD JUN 1 PY 2003 VL 55 IS 4 BP 239 EP 246 DI 10.1002/pros.10198 PG 8 WC Endocrinology & Metabolism; Urology & Nephrology SC Endocrinology & Metabolism; Urology & Nephrology GA 681PX UT WOS:000183045500001 PM 12712403 ER PT J AU Straits-Troster, KA Sloan, KL Dominitz, JA AF Straits-Troster, KA Sloan, KL Dominitz, JA TI Psychiatric and substance use disorders comorbidity with hepatitis C SO PSYCHIATRIC ANNALS LA English DT Article; Proceedings Paper CT Annual Meeting on VA Health Services Research and Development CY 2001 CL WASHINGTON, D.C. ID METHADONE-MAINTENANCE PATIENTS; VIRUS-INFECTION; INTERFERON-ALPHA; DRUG-USERS; PREVALENCE; VETERANS; RIBAVIRIN; DISEASE; ILLNESS; HIV C1 VA Puget Sound Hlth Care Syst, NW Hepatitis C Resource Ctr, VA Ctr Excellence Substance Abuse Treatment & Edu, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, NW Hepatitis, Seattle, WA 98195 USA. RP Straits-Troster, KA (reprint author), VA Puget Sound Hlth Care Syst, NW Hepatitis C Resource Ctr, VA Ctr Excellence Substance Abuse Treatment & Edu, 116-ATC,1660 S Columbian Way, Seattle, WA 98108 USA. NR 30 TC 4 Z9 4 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0048-5713 J9 PSYCHIAT ANN JI Psychiatr. Ann. PD JUN PY 2003 VL 33 IS 6 BP 362 EP 366 PG 5 WC Psychiatry SC Psychiatry GA 687PM UT WOS:000183385800003 ER PT J AU Loftis, JM Hauser, P AF Loftis, JM Hauser, P TI Comanagement of depression and HCV treatment SO PSYCHIATRIC ANNALS LA English DT Article ID CHRONIC HEPATITIS-C; INTERFERON-ALPHA TREATMENT; CHRONIC VIRAL-HEPATITIS; INITIAL TREATMENT; PLUS RIBAVIRIN; THERAPY; INFECTION; DISORDER; RETINOPATHY; PAROXETINE C1 Portland VA Med Ctr, Behav Hlth & Clin Neurosci Div, NW Hepatitis C Resource Ctr, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR USA. RP Loftis, JM (reprint author), Portland VA Med Ctr, Behav Hlth & Clin Neurosci Div, NW Hepatitis C Resource Ctr, P3MHAdm,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. NR 42 TC 11 Z9 15 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0048-5713 J9 PSYCHIAT ANN JI Psychiatr. Ann. PD JUN PY 2003 VL 33 IS 6 BP 385 EP 391 PG 7 WC Psychiatry SC Psychiatry GA 687PM UT WOS:000183385800006 ER PT J AU Fireman, M AF Fireman, M TI Hepatitis C treatment and substance use disorders SO PSYCHIATRIC ANNALS LA English DT Article ID INTERFERON THERAPY; LIVER-DISEASE; DRUG USERS; ALCOHOL-CONSUMPTION; VIRUS-INFECTION; NATURAL-HISTORY; PROGRESSION; DRINKING; DRINKERS; LESIONS C1 Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97239 USA. RP Fireman, M (reprint author), Oregon Hlth & Sci Univ, Portland VA Med Ctr, P-3-MHDC,3710 SW Vet Hosp Rd, Portland, OR 97239 USA. NR 31 TC 3 Z9 3 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0048-5713 J9 PSYCHIAT ANN JI Psychiatr. Ann. PD JUN PY 2003 VL 33 IS 6 BP 402 EP 408 PG 7 WC Psychiatry SC Psychiatry GA 687PM UT WOS:000183385800008 ER PT J AU Butterfield, MI Bosworth, HB Meador, KQ Stechuchak, KM Essock, SM Osher, FC Goodman, SA Swanson, JW Bastian, LA Horner, RD AF Butterfield, MI Bosworth, HB Meador, KQ Stechuchak, KM Essock, SM Osher, FC Goodman, SA Swanson, JW Bastian, LA Horner, RD CA Five-Site Hlth Risk Study Res Comm TI Gender differences in hepatitis C infection and risks among persons with severe mental illness SO PSYCHIATRIC SERVICES LA English DT Article ID INTRAVENOUS-DRUG-USERS; SUBSTANCE USE DISORDER; SEXUAL TRANSMISSION; VIRUS-INFECTION; HIV RISK; PREVALENCE; COMORBIDITY; WOMEN; EPIDEMIOLOGY; ALCOHOL AB Objectives: The authors assessed gender differences in hepatitis C infection and associated risk behaviors among persons with severe mental illness. Methods: The, sample consisted of 777 patients (251 women and 526 men) from four sites. Results: Across sites, the rate of hepatitis C infection among men was nearly twice that among women. Clear differences were noted in hepatitis C risk behaviors. Men had higher rates of lifetime drug-related risk behaviors: needle use (23.1 percent compared with 12.5 percent), needle sharing (17.6 percent compared with, 7.7 percent), and crack cocaine use (45.2 percent compared with 30.8 percent). Women had significantly higher rates of lifetime sexual risk behaviors: unprotected sex in exchange for drugs (17.8 percent compared with 11.2 percent), unprotected sex in exchange for money or gifts (30.6 percent compared with 17 percent), unprotected vaginal sex (94 percent compared with 89.7 percent), and anal sex (33.7 percent compared with 22.6 percent). Gender appeared to modify some sex risks. Unprotected sex in exchange for drugs 'increased the risk of hepatitis C seropositivity for both men and women. In the multivariate model, gender was not significantly associated with hepatitis C seropositivity after adjustment for otherrisk factors. Conclusions: Gender differences in the lifetime rates of drug risks explain the higher rates of hepatitis C infection among men with severe mental illness. C1 Dept Vet Affairs Med Ctr, Hlth Serv Res & Dev Serv, Durham, NC 27705 USA. CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Adm Med Ctr, New York, NY USA. Univ Maryland, Sch Med, Dept Psychiat, Baltimore, MD 21201 USA. Boston Coll, Dept Counseling Dev & Educ Psychol, Chestnut Hill, MA 02167 USA. Duke Univ, Med Ctr, Dept Psychiat, Durham, NC USA. RP Butterfield, MI (reprint author), Dept Vet Affairs Med Ctr, Hlth Serv Res & Dev Serv, 508 Fulton St, Durham, NC 27705 USA. EM mimi@acpub.duke.edu NR 31 TC 21 Z9 22 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD JUN PY 2003 VL 54 IS 6 BP 848 EP 853 DI 10.1176/appi.ps.54.6.848 PG 6 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 839BM UT WOS:000222758300011 PM 12773599 ER PT J AU Horan, WP Goldstein, G AF Horan, WP Goldstein, G TI Correlations between age and higher cognitive function in schizophrenia subgroups SO SCHIZOPHRENIA RESEARCH LA English DT Letter ID HETEROGENEITY C1 Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. RP Goldstein, G (reprint author), Univ Pittsburgh, VA Pittsburgh Healthcare Syst, 7180 Highland Dr, Pittsburgh, PA 15206 USA. NR 6 TC 2 Z9 2 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD JUN 1 PY 2003 VL 61 IS 2-3 BP 325 EP 326 DI 10.1016/S0920-9964(02)00313-4 PG 2 WC Psychiatry SC Psychiatry GA 678XL UT WOS:000182891900022 PM 12729885 ER PT J AU Ellsworth, JL Garcia, R Yu, J Kindy, MS AF Ellsworth, JL Garcia, R Yu, J Kindy, MS TI Fibroblast growth factor-18 reduced infarct volumes and behavioral deficits after transient occlusion of the middle cerebral artery in rats SO STROKE LA English DT Article DE animal models; growth factors; neuroprotection; rats ID BRAIN INJURY; EXPRESSION; ISCHEMIA; STROKE; FGF18 AB Background and Purpose-Fibroblast growth factor 18 (FGF18) is expressed in rodent brain and is a trophic factor for neuron-derived cells in culture. The purpose of the present study was to evaluate whether FGF18 was neuroprotective in a rat model of cerebral ischemia and to compare the results with those obtained with FGF2. Methods-Cerebral ischemia was produced in rats by a transient 2-hour occlusion of the middle cerebral artery (MCAo) with an intraluminal filament followed by 22-hour reperfusion. Starting 15 minutes after MCAo, FGF18 or FGF2 was administered by a 3-hour intravenous infusion. Infarct volumes and behavioral deficits were measured 24 hours after MCAo. Results-Infusion of FGF18 produced dose-dependent reductions in infarct volumes and improvements in tests of reference and working memory, motor ability, and exploratory behavior. FGF18 was more efficacious than FGF2 on virtually all measures examined. The reductions in infarct volume and behavioral deficit were associated with FGF-mediated increases in regional cerebral blood flow. Conclusions-These results demonstrate that FGF18 is an effective neuroprotective agent in a rat model of transient MCAo. C1 Zymogenet Inc, Seattle, WA 98102 USA. Med Univ S Carolina, Dept Physiol & Neurosci, Stroke Program, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Mol Therapeut Inc, Mt Pleasant, SC USA. RP Ellsworth, JL (reprint author), Zymogenet Inc, 1201 Eastlake Ave E, Seattle, WA 98102 USA. NR 29 TC 25 Z9 27 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD JUN PY 2003 VL 34 IS 6 BP 1507 EP 1512 DI 10.1161/01.STR.0000071760.66720.5F PG 6 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 686YJ UT WOS:000183348300033 PM 12738892 ER PT J AU Freedland, SJ DeGregorio, F Sacoolidge, JC Elshimali, YI Csathy, GS Elashoff, DA Reiter, RE Aronson, WJ AF Freedland, SJ DeGregorio, F Sacoolidge, JC Elshimali, YI Csathy, GS Elashoff, DA Reiter, RE Aronson, WJ TI Predicting biochemical recurrence after radical prostatectomy for patients with organ-confined disease using p27 expression SO UROLOGY LA English DT Article ID DEPENDENT KINASE INHIBITOR; INDEPENDENT PREDICTOR; CANCER-CELLS; P27(KIP1); SURVIVAL; MARKERS; STAGE; MIB-1; CD44S; RACE AB Objectives. It is unclear why men who undergo radical prostatectomy (RP) and are found to have pathologically organ-confined disease develop prostate-specific antigen (PSA) recurrences. We previously found that patients with less than 45% of cells in the prostate needle biopsy specimen (PNBx) staining positive for the cell cycle regulator p27 had a significantly increased risk of biochemical recurrence after RP. We sought to determine whether p27 staining in the PNBx specimen might serve as a molecular marker for PSA failure in the subset of patients who develop PSA recurrence despite organ-confined disease at RP. Methods. The PNBx specimens of 161 men treated with RP between 1991 and 2000 were examined for p27 expression using immunohistochemistry. The p27 cutpoint of less than 45% expression was used to define the high and low-risk categories. Patients were separated into two groups for analysis: organ-confined (pT2 and negative surgical margins) and non-organ-confined (pT2 with positive surgical margins, pT3, pT4, or lymph node involvement). The mean and median follow-up for patients with organ-confined and non-organ-confined disease was 47 and 43 months and 42 and 38 months, respectively. Multivariate Cox proportional hazards analysis was used to examine the preoperative clinical variables that were the strongest predictors of biochemical recurrence after RP among each group. Results. Among organ-confined patients, p27 expression was the only significant independent predictor of the time to biochemical recurrence after RP (hazard ratio 5.15, 95% confidence interval 1.41 to 18.83, P = 0.013). Among patients with non-organ-confined disease, the percentage of biopsy tissue with cancer, biopsy Gleason score, and PSA level were independent predictors of PSA recurrence. p27 expression was not a significant independent predictor of PSA recurrence among men with non-organ-confined disease. Conclusions. p27 expression in the PNBx was a significant independent predictor of PSA failure for patients with pathologically organ-confined disease, but not for those with non-organ-confined disease. Patients with organ-confined disease but low p27 expression had a greater than fivefold risk of developing PSA recurrence than were men with high p27 expression, suggesting that p27 may be a molecular marker associated with micrometastatic disease at the time of RP. (C) 2003 Elsevier Inc. C1 Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Biostat, Los Angeles, CA 90095 USA. Olive View UCLA Med Ctr, Dept Pathol, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Pathol, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP Aronson, WJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Urol, Box 951738,1359 Brinkley Ave, Los Angeles, CA 90095 USA. FU NCI NIH HHS [P50 CA92131-01A1] NR 23 TC 10 Z9 11 U1 0 U2 0 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 JUN PY 2003 VL 61 IS 6 BP 1187 EP 1192 DI 10.1016/S0090-4295(03)00034-7 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 690KD UT WOS:000183547000031 PM 12809895 ER PT J AU Vielma, SA Krings, G Lopes-Virella, MF AF Vielma, SA Krings, G Lopes-Virella, MF TI Chlamydophila pneumoniae induces ICAM-1 expression in human aortic endothelial cells via protein kinase C-dependent activation of nuclear factor-kappa B SO CIRCULATION RESEARCH LA English DT Article DE Chlamydophila pneumoniae; intercellular adhesion molecule-1; nuclear factor-kappa B; protein kinase C; mitogen-activated protein kinase pathway ID ADHESION MOLECULE-1 ICAM-1; LOW-DENSITY-LIPOPROTEIN; CHLAMYDIA-PNEUMONIAE; GENE-EXPRESSION; MONOCYTE ADHESION; TYROSINE KINASE; SMOOTH-MUSCLE; OXIDIZED LDL; IN-VITRO; INFECTION AB Chlamydophila pneumoniae has an epidemiological link with atherosclerosis and acute cardiovascular events. One mechanism that may explain such a link is the increased expression of intracellular adhesion molecule-1 (ICAM-1) in C pneumoniae - infected endothelial cells. Upregulation of ICAM-1 by C pneumoniae is well recognized and has been extensively studied, but the signaling pathways involved are not yet defined. Because upregulation of ICAM-1 by cytokines and other stimuli has been shown to be mediated by either mitogen-activated protein kinase, protein kinase C (PKC), or nuclear factor-kappaB (NF-kappaB) pathways, we examined whether these pathways were involved in the ICAM-1 upregulation induced by C pneumoniae. Our data show a time-dependent phosphorylation of p44/p42 and SAPK/JNK pathways in C pneumoniae - infected cells. However, inhibition of the classic mitogen-activated protein kinase pathway using the PD98059 and U0126 inhibitors and inhibition of SAPK/JNK pathway did not suppress C pneumoniae - induced ICAM-1 expression. C pneumoniae also activates the NF-kappaB pathway at 30 minutes after infection. Treatment of human aortic endothelial cells (HAECs) with the NF-kappaB inhibitors BAY117085 and caffeic acid phenethyl ester led to a concentration-dependent inhibition of C pneumoniae - induced ICAM-1 upregulation. Finally, C pneumoniae - infected HAECs show membrane translocation of total PKC 30 minutes after cell infection. Calphostin C, a general PKC inhibitor, blocked both C pneumoniae - induced ICAM-1 expression and C pneumoniae - induced NF-kappaB translocation. In conclusion, we demonstrated that C pneumoniae - induced ICAM-1 expression in HAECs requires NF-kappaB and PKC activation and that NF-kappaB activation is PKC dependent. C1 Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Microbiol & Immunol, Grad Program Mol & Cellular Biol & Pathobiol, Div Endocrinol Metab Nutr, Charleston, SC 29425 USA. RP Lopes-Virella, MF (reprint author), Ralph H Johnson VA Med Ctr, Strom Thurmon Res Bldg,114 Doughty St, Charleston, SC 29425 USA. FU NHLBI NIH HHS [HL-46815] NR 41 TC 18 Z9 19 U1 0 U2 1 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 MAY 30 PY 2003 VL 92 IS 10 BP 1130 EP 1137 DI 10.1161/01.RES.0000074001.46892.1C PG 8 WC Cardiac & Cardiovascular Systems; Hematology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Hematology GA 684HV UT WOS:000183200100012 PM 12714566 ER PT J AU Basa, NR Wang, LX Arteaga, JR Heber, D Livingston, EH Tache, Y AF Basa, NR Wang, LX Arteaga, JR Heber, D Livingston, EH Tache, Y TI Bacterial lipopolysaccharide shifts fasted plasma ghrelin to postprandial levels in rats SO NEUROSCIENCE LETTERS LA English DT Article DE lipopolysaccharide; circulating ghrelin; food intake; rat; rectal temperature ID INDUCED ANOREXIA; EXPRESSION; RODENTS; HUMANS AB Lipopolysaccharide (LPS) injected intraperitoneally (i.p.) is known to decrease food intake. Ghrelin is a peptide hormone produced by the stomach with a potent orexigenic effect and plasma levels that are inversely correlated with the fed state. We examined changes in plasma ghrelin levels 3 h after LPS (100 mug/kg, i.p.) in fasted rats with or without a 1 h re-feeding period. LPS injection decreased the fasting levels of ghrelin by 51 +/- 5% compared with preinjection values while i.p. vehicle did not modify ghrelin levels in fasted rats. LPS at this dose reduced fasting-induced food intake by 60% compared with the i.p. vehicle group. Re-feeding decreased plasma ghrelin levels by 58 +/- 3% compared with pre-feeding fasting values in i.p. vehicle group. These data provide the first evidence that LPS shifts fasting ghrelin levels to those observed postprandially. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved. C1 Univ Calif Los Angeles, CURE, Dept Med,David Geffen Sch Med, Digest Dis Res Ctr,Digest Dis Div,VAGLAHS, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Ctr Human Nutr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA 90073 USA. RP Basa, NR (reprint author), Univ Calif Los Angeles, CURE, Dept Med,David Geffen Sch Med, Digest Dis Res Ctr,Digest Dis Div,VAGLAHS, Bldg 115,Room 117B,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK 41301, P50DK 64539] NR 21 TC 56 Z9 57 U1 1 U2 1 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0304-3940 J9 NEUROSCI LETT JI Neurosci. Lett. PD MAY 29 PY 2003 VL 343 IS 1 BP 25 EP 28 DI 10.1016/S0304-3940903)00312-4 PG 4 WC Neurosciences SC Neurosciences & Neurology GA 683CE UT WOS:000183128900007 PM 12749989 ER PT J AU Jha, AK Perlin, JB Kizer, KW Dudley, RA AF Jha, AK Perlin, JB Kizer, KW Dudley, RA TI Effect of the transformation of the Veterans Affairs health care system on the quality of care. SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID MEDICARE BENEFICIARIES; FEE SCHEDULE; MANAGED CARE; VA; DISPARITIES AB BACKGROUND: In the mid-1990s, the Department of Veterans Affairs (VA) health care system initiated a systemwide reengineering to, among other things, improve its quality of care. We sought to determine the subsequent change in the quality of health care and to compare the quality with that of the Medicare fee-for-service program. METHODS: Using data from an ongoing performance-evaluation program in the VA, we evaluated the quality of preventive, acute, and chronic care. We assessed the change in quality-of-care indicators from 1994 (before reengineering) through 2000 and compared the quality of care with that afforded by the Medicare fee- for-service system, using the same indicators of quality. RESULTS: In fiscal year 2000, throughout the VA system, the percentage of patients receiving appropriate care was 90 percent or greater for 9 of 17 quality-of-care indicators and exceeded 70 percent for 13 of 17 indicators. There were statistically significant improvements in quality from 1994-1995 through 2000 for all nine indicators that were collected in all years. As compared with the Medicare fee-for-service program, the VA performed significantly better on all 11 similar quality indicators for the period from 1997 through 1999. In 2000, the VA outperformed Medicare on 12 of 13 indicators. CONCLUSIONS: The quality of care in the VA health care system substantially improved after the implementation of a systemwide reengineering and, during the period from 1997 through 2000, was significantly better than that in the Medicare fee-for-service program. These data suggest that the quality-improvement initiatives adopted by the VA in the mid-1990s were effective. C1 Univ Calif San Francisco, Inst Hlth Policy Studies, San Francisco, CA 94118 USA. Vet Hlth Adm, Off Qual & Performance, Washington, DC USA. San Francisco Vet Affairs Med Ctr, Div Gen Internal Med, San Francisco, CA USA. Brigham & Womens Hosp, Div Gen Internal Med, Boston, MA 02115 USA. Natl Qual Forum, Washington, DC USA. RP Dudley, RA (reprint author), Univ Calif San Francisco, Inst Hlth Policy Studies, Box 0936,333 Calif St,Suite 265, San Francisco, CA 94118 USA. NR 35 TC 435 Z9 437 U1 0 U2 13 PU MASSACHUSETTS MEDICAL SOC/NEJM 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 MAY 29 PY 2003 VL 348 IS 22 BP 2218 EP 2227 DI 10.1056/NEJMsa021899 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 683EK UT WOS:000183134700009 PM 12773650 ER PT J AU Volpp, K Grande, D AF Volpp, K Grande, D TI Residents' suggestions for reducing medical errors - Reply SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Volpp, K (reprint author), Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. NR 3 TC 0 Z9 0 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC/NEJM 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 MAY 29 PY 2003 VL 348 IS 22 BP 2264 EP 2264 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 683EK UT WOS:000183134700038 ER PT J AU An, JB Sun, YP Sun, R Rettig, MB AF An, JB Sun, YP Sun, R Rettig, MB TI Kaposi's sarcoma-associated herpesvirus encoded vFLIP induces cellular IL-6 expression: the role of the NF-kappa B and JNK/AP1 pathways SO ONCOGENE LA English DT Article DE KSHV; vFLIP; interleukin-6; NF-kappa B; jun N-terminal kinase; AP1 ID MULTICENTRIC CASTLEMANS-DISEASE; FLICE-INHIBITORY PROTEIN; INTERLEUKIN-6 GENE-EXPRESSION; EFFUSION LYMPHOMA-CELLS; C-JUN; DNA-SEQUENCES; NUCLEAR ANTIGEN; TERMINAL KINASE; EFFECTOR DOMAIN; GROWTH-FACTOR AB The Kaposi's sarcoma-associated herpesvirus (KSHV) encodes a FADD-like interferon converting enzyme or caspase 8 (FLICE) inhibitory protein (vFLIP) that prevents death receptor-mediated apoptosis by inhibiting the recruitment and activation of FLICE. Since vFLIP physically interacts with tumor necrosis factor receptor associated factor 2 (TRAF2) and TRAF2 mediates activation of the jun NH2-terminal kinase (JNK)/activation protein 1 (AP1) pathway, we hypothesized that vFLIP might also activate this pathway. To evaluate this hypothesis, we transiently and stably transfected a vFLIP expression construct and performed several complementary assays to document that vFLIP activates the JNK/AP1 pathway and does so in a TRAF-dependent fashion. As vFLIP also activates the nuclear factor kappaB (NF-kappaB) signaling pathway and the NF-kappaB and JNK/AP1 pathways both modulate cellular interleukin-6 (cIL-6) expression, we postulated that vFLIP induces expression of this cytokine. We show that vFLIP induces cIL-6 expression and activates the cIL-6 promoter, and maximal activation of the cIL-6 promoter by vFLIP requires NF-kappaB and AP1 activation. In addition, vFLIP and latency-associated nuclear antigen (LANA), another KSHV-encoded latent protein, potentiate each other's ability to activate the cIL-6 promoter. Gene silencing experiments by RNA interference demonstrate that vFLIP in BCBL-1 endogenously infected primary effusion lymphoma (PEL) cells mediates JNK/AP1 activation and cIL-6 expression. Thus, we conclude that vFLIP, in addition to its known effects on NF-kappaB activation, also modulates the JNK/AP1 pathway and induces gene expression from the cIL-6 promoter in a JNK/AP1-dependent fashion. C1 VA Greater Los Angeles Healthcare Syst W LA, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Mol & Med Pharmacol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90095 USA. RP Rettig, MB (reprint author), VA Greater Los Angeles Healthcare Syst W LA, Dept Med, 11301 Wilshire Blvd,Bldg 304,Room E1-113, Los Angeles, CA 90073 USA. FU NCI NIH HHS [1R01CA80004-01A1] NR 46 TC 75 Z9 79 U1 0 U2 3 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0950-9232 J9 ONCOGENE JI Oncogene PD MAY 29 PY 2003 VL 22 IS 22 BP 3371 EP 3385 DI 10.1038/sj.onc.1206407 PG 15 WC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity GA 683CB UT WOS:000183128500003 PM 12776188 ER PT J AU Yaffe, K AF Yaffe, K TI Hormone therapy and the brain - Deja vu all over again? SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID CENTRAL-NERVOUS-SYSTEM; ALZHEIMERS-DISEASE; ESTROGEN REPLACEMENT; COGNITIVE IMPAIRMENT; OLDER WOMEN; RISK; DEMENTIA; POLYMORPHISMS; ONSET C1 Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94121 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. RP Yaffe, K (reprint author), Univ Calif San Francisco, Dept Psychiat, Box 181,4150 Clement St, San Francisco, CA 94121 USA. NR 25 TC 54 Z9 55 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 28 PY 2003 VL 289 IS 20 BP 2717 EP 2719 DI 10.1001/jama.289.20.2717 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 682DG UT WOS:000183075600031 PM 12771119 ER PT J AU Haidet, P Paterniti, DA AF Haidet, P Paterniti, DA TI "Building" a history rather than "Taking" one - A perspective on information sharing during the medical interview SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID PHYSICIAN-PATIENT COMMUNICATION; NARRATIVE BASED MEDICINE; PRIMARY-CARE PHYSICIANS; EXPLANATORY MODELS; SATISFACTION; SKILLS; CONSULTATIONS; RETENTION; LANGUAGE; BEHAVIOR AB Patients and physicians enter the medical encounter with unique perspectives on the illness experience. These perspectives influence the way that information is shared during the initial phase of the interview. Previous research has demonstrated that patients who are able to fully share their perspective often achieve better outcomes. However, studies of patient-physician communication have shown that the patient's perspective is often lost. Researchers and educators have responded with calls for practitioners to adopt a "narrative-based medicine" approach to the medical interview. In this article, we review the literature on narrative-based medicine with an emphasis on information sharing during the medical interview. We suggest a framework of skills and attitudes that can act as a foundation for future work in educating practitioners and researching the medical interview. C1 Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Dept Vet Affairs, Hlth Serv Res Ctr Excellence, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Univ Calif Davis, Ctr Hlth Serv Res, Dept Internal Med, Sacramento, CA 95817 USA. RP Haidet, P (reprint author), Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Dept Vet Affairs, Hlth Serv Res Ctr Excellence, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. NR 68 TC 67 Z9 68 U1 4 U2 13 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD MAY 26 PY 2003 VL 163 IS 10 BP 1134 EP 1140 DI 10.1001/archinte.163.10.1134 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 684KQ UT WOS:000183206400002 PM 12767949 ER PT J AU Samaha, FF Iqbal, N Seshadri, P Chicano, KL Daily, DA McGrory, J Williams, T Williams, M Gracely, EJ Stern, L AF Samaha, FF Iqbal, N Seshadri, P Chicano, KL Daily, DA McGrory, J Williams, T Williams, M Gracely, EJ Stern, L TI A low-carbohydrate as compared with a low-fat diet in severe obesity SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID INSULIN-RESISTANCE ATHEROSCLEROSIS; DENSITY-LIPOPROTEIN CHOLESTEROL; CORONARY HEART-DISEASE; HYPERTRIGLYCERIDEMIA AB Background: The effects of a carbohydrate-restricted diet on weight loss and risk factors for atherosclerosis have been incompletely assessed. METHODS: We randomly assigned 132 severely obese subjects (including 77 blacks and 23 women) with a mean body-mass index of 43 and a high prevalence of diabetes (39 percent) or the metabolic syndrome (43 percent) to a carbohydrate-restricted (low-carbohydrate) diet or a calorie- and fat-restricted (low-fat) diet. RESULTS: Seventy-nine subjects completed the six-month study. An analysis including all subjects, with the last observation carried forward for those who dropped out, showed that subjects on the low-carbohydrate diet lost more weight than those on the low-fat diet (mean [+/-SD], -5.8+/-8.6 kg vs. -1.9+/-4.2 kg; P=0.002) and had greater decreases in triglyceride levels (mean, -20+/-43 percent vs. -4+/-31 percent; P=0.001), irrespective of the use or nonuse of hypoglycemic or lipid-lowering medications. Insulin sensitivity, measured only in subjects without diabetes, also improved more among subjects on the low-carbohydrate diet (6+/-9 percent vs. -3+/-8 percent, P=0.01). The amount of weight lost (P<0.001) and assignment to the low-carbohydrate diet (P=0.01) were independent predictors of improvement in triglyceride levels and insulin sensitivity. CONCLUSIONS: Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost. This finding should be interpreted with caution, given the small magnitude of overall and between-group differences in weight loss in these markedly obese subjects and the short duration of the study. Future studies evaluating long-term cardiovascular outcomes are needed before a carbohydrate-restricted diet can be endorsed. C1 Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Penn, Med Ctr, Dept Med, Div Cardiol, Philadelphia, PA 19104 USA. Univ Penn, Med Ctr, Dept Med, Div Endocrinol, Philadelphia, PA 19104 USA. Drexel Univ, Coll Med, Dept Family Community & Prevent Med, Philadelphia, PA 19104 USA. RP Samaha, FF (reprint author), Cardiol 8th Fl,MC 111C,Univ & Woodland Ave, Philadelphia, PA 19104 USA. NR 21 TC 613 Z9 633 U1 11 U2 86 PU MASSACHUSETTS MEDICAL SOC/NEJM 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 MAY 22 PY 2003 VL 348 IS 21 BP 2074 EP 2081 DI 10.1056/NEJMoa022637 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 680YU UT WOS:000183008300004 PM 12761364 ER PT J AU Saxon, AJ AF Saxon, AJ TI Transporting efficacious treatments from academia to community: barriers and opportunities SO DRUG AND ALCOHOL DEPENDENCE LA English DT Editorial Material DE treatments; barriers; opportunities ID VOUCHER-BASED REINFORCEMENT; SUBSTANCE USE DISORDERS; DEPENDENCE; ABSTINENCE; THERAPIES; ADDICTION; OUTCOMES; ALCOHOL; ABUSE C1 Univ Washington, VA Puget Sound Hlth Care Syst, Ctr Excellence Substance Abuse Treatment & Educ, Dept Psychiat & Behav Sci, Seattle, WA 98108 USA. RP Saxon, AJ (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Ctr Excellence Substance Abuse Treatment & Educ, Dept Psychiat & Behav Sci, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 13 TC 2 Z9 2 U1 0 U2 0 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0376-8716 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD MAY 21 PY 2003 VL 70 IS 2 BP 127 EP 129 DI 10.1016/S0376-8716(03)00034-6 PG 3 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 686XM UT WOS:000183346300002 PM 12732404 ER PT J AU Ahmed, A AF Ahmed, A TI Use of spironolactone in heart failure patients receiving angiotensin-converting enzyme inhibitors and beta-blockers SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Letter C1 Univ Alabama, Birmingham Vet Affairs Med Ctr, Div Geriat Med, Birmingham, AL 35294 USA. Univ Alabama, Birmingham Vet Affairs Med Ctr, Geriat Heart Failure Clin, Birmingham, AL 35294 USA. RP Ahmed, A (reprint author), Univ Alabama, Birmingham Vet Affairs Med Ctr, Div Geriat Med, 1530 3rd Ave S, Birmingham, AL 35294 USA. RI Ahmed, Ali/A-2934-2008 OI Ahmed, Ali/0000-0002-6832-6424 NR 5 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAY 21 PY 2003 VL 41 IS 10 BP 1851 EP 1852 DI 10.1016/S0735-1097(03)00326-7 PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 680DK UT WOS:000182960900040 PM 12767683 ER PT J AU Spiegel, BMR Targownik, L Dulai, GS Gralnek, IM AF Spiegel, BMR Targownik, L Dulai, GS Gralnek, IM TI The cost-effectiveness of cyclooxygenase-2 selective inhibitors in the management of chronic arthritis SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; HELICOBACTER-PYLORI INFECTION; RANDOMIZED CONTROLLED TRIAL; PEPTIC-ULCER DISEASE; RHEUMATOID-ARTHRITIS; UNITED-STATES; DOUBLE-BLIND; GASTROINTESTINAL ENDOSCOPY; MYOCARDIAL-INFARCTION; UNINVESTIGATED DYSPEPSIA AB Background: Rofecoxib and celecoxib (coxibs) effectively treat chronic arthritis pain and reduce ulcer complications by 50% compared with nonselective nonsteroidal anti-inflammatory drugs (NSAIDs). However, their absolute risk reduction is small and the cost-effectiveness of treatment is uncertain. Objective: To determine whether the degree of risk reduction in gastrointestinal complications by coxibs offsets their increased cost compared with a generic nonselective NSAID. Design: Cost-utility analysis. Data Sources: Systematic review of MEDLINE and published abstracts. Target Population: Patients with osteoarthritis or rheumatoid arthritis who are not taking aspirin and who require long-term NSAID therapy for moderate to severe arthritis pain. Perspective: Third-party payer. Interventions: Naproxen, 500 mg twice daily, and coxib, once daily. Patients intolerant of naproxen were switched to a coxib. Outcome Measures: Incremental cost per quality-adjusted life-year (QALY) gained. Results of Base-Case Analysis: Using a coxib instead of a nonselective NSAID in average-risk patients cost an incremental $275 809 per year to gain 1 additional QALY. Results of Sensitivity Analysis: The incremental cost per QALY gained decreased to $55 803 when the analysis was limited to the subset of patients with a history of bleeding ulcers. The coxib strategy became dominant when the cost of coxibs was reduced by 90% of the current average wholesale price. In probabilistic sensitivity analysis, if a third-party payer was willing to pay $150 000 per QALY gained, then 4.3% of average-risk patients would fall within the budget. Conclusions: The risk reduction seen with coxibs does not offset their increased costs compared with nonselective NSAIDs in the management of average-risk patients with chronic arthritis. However, coxibs may provide an acceptable incremental cost-effectiveness ratio in the subgroup of patients with a history of bleeding ulcers. C1 Univ Calif Los Angeles, CURE Digest Dis Res Ctr,David Geffen Sch Med, Ctr Study Digest Healthcare Qual & Outcomes, Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Gralnek, IM (reprint author), Univ Calif Los Angeles, CURE Digest Dis Res Ctr,David Geffen Sch Med, Ctr Study Digest Healthcare Qual & Outcomes, Vet Adm Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 115,Room 215B, Los Angeles, CA 90073 USA. FU NCRR NIH HHS [K23 RR-16188]; NIDDK NIH HHS [DK-07180] NR 90 TC 81 Z9 81 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 J9 ANN INTERN MED JI Ann. Intern. Med. PD MAY 20 PY 2003 VL 138 IS 10 BP 795 EP 806 PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA 679KH UT WOS:000182920700003 PM 12755551 ER PT J AU Haskell, CM AF Haskell, CM TI Charter on medical professionalism: Putting the charter into practice SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Haskell, CM (reprint author), VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. NR 4 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD MAY 20 PY 2003 VL 138 IS 10 BP 852 EP 852 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 679KH UT WOS:000182920700017 PM 12755567 ER PT J AU Corvera-Tindel, T Doering, LV Machuca, K Dracup, K AF Corvera-Tindel, T Doering, LV Machuca, K Dracup, K TI Combined effects of physical training and beta blocker use on functional performance and depression in heart failure SO CIRCULATION LA English DT Meeting Abstract CT Asia Pacific Scientific Forum on New Discoveries in Cardiovascular Disease and Stroke CY JUN 08-10, 2003 CL HONOLULU, HAWAII SP World Heart Federat, Asian Pacific Soc Cardiol, Hong Kong Coll Cardiol, Japanese Circulat Soc, Chinese Soc Cardiol, Korean Soc Circulat, Japan Heart Fdn, Natl Heart, Lung, & Blood Inst C1 VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD MAY 20 PY 2003 VL 107 IS 19 MA P169 BP E174 EP E174 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 681AU UT WOS:000183014500249 ER PT J AU Wang, ZJ Corey, E Hass, GM Higano, CS True, LD Wallace, D Tisdale, MJ Vessella, RL AF Wang, ZJ Corey, E Hass, GM Higano, CS True, LD Wallace, D Tisdale, MJ Vessella, RL TI Expression of the human cachexia-associated protein (HCAP) in prostate cancer and in a prostate cancer animal model of cachexia SO INTERNATIONAL JOURNAL OF CANCER LA English DT Article DE human cachexia-associated factor; cachexia; prostate cancer (CaP); metastasis ID PROTEOLYSIS-INDUCING FACTOR; LIPID-MOBILIZING FACTOR; CACHECTIC FACTOR; IN-VITRO; MICE; ANOREXIA; MANAGEMENT; MYOBLASTS; TUMORS; VIVO AB Prostate cancer (CaP) patients with disseminated disease often suffer from severe cachexia, which contributes to mortality in advanced cancer. Human cachexia-associated protein (HCAP) was recently identified from a breast cancer library based on the available 20-amino acid sequence of proteolysis-inducing factor (PIF), which is a highly active cachectic factor isolated from mouse colon adenocarcinoma MAC16. Herein, we investigated the expression of HCAP in Cap and its potential involvement in CaP-associated cachexia. HCAP mRNA was detected in CaP cell lines, in primary CaP tissues and in its osseous metastases. In situ hybridization showed HCAP mRNA to be localized only in the epithelial cells in Cap tissues, in the metastatic foci in bone, liver and lymph node, but not in the stromal cells or in normal prostate tissues. HCAP protein was detected in 9 of 14 Cap metastases but not in normal prostate tissues from cadaveric donors or patients with organ-confined tumors. Our Western blot analysis revealed that HCAP was present in 9 of 19 urine specimens from cachectic CaP patients but not in 19 urine samples of noncachectic patients. HCAP mRNA and protein were also detected in LuCaP 35 and PC-3M xenografts from our cachectic animal models. Our results demonstrated that human CaP cells express HCAP and the expression of HCAP is associated with the progression of CaP and the development of CaP cachexia. (C) 2003 Wiley-Liss, Inc. C1 Univ Washington, Dept Urol, GU Canc Res Lab, Seattle, WA 98195 USA. Matritech, Newton, MA USA. Univ Washington, Dept Med, Div Oncol, Seattle, WA 98195 USA. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. Aston Univ, Inst Pharmaceut Sci, Birmingham B4 7ET, W Midlands, England. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Vessella, RL (reprint author), Univ Washington, Dept Urol, GU Canc Res Lab, Mail Stop 356510, Seattle, WA 98195 USA. NR 36 TC 31 Z9 31 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0020-7136 J9 INT J CANCER JI Int. J. Cancer PD MAY 20 PY 2003 VL 105 IS 1 BP 123 EP 129 DI 10.1002/ijc.11035 PG 7 WC Oncology SC Oncology GA 666EC UT WOS:000182163000021 PM 12672042 ER PT J AU Yamaguchi, DT Ma, DF AF Yamaguchi, DT Ma, DF TI Mechanism of pH regulation of connexin 43 expression in MC3T3-E1 cells SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE gap junctions; pH; connexin 43; transcription rate; mRNA stability; protein half-life ID INTERCELLULAR COMMUNICATION; TRANSCRIPTION FACTOR; OSTEOBLASTIC CELLS; GENE-EXPRESSION; AMBIENT PH AB Gap junction (GJ) expression and function allowing cell-cell communication among osteoblasts may be important in new bone formation. An alkaline milieu stimulates mineralization, while extracellular acidification leads to demineralization of bone. It was previously demonstrated that alkaline pH increases, while acid pH decreases GJ intercellular communication by an increase in steady-state GJ connexin 43 (Cx43) mRNA and protein expression. At pH 7.6, transcription of new Cx43 mRNA was significantly higher than that at pH 6.9 but not significantly different at pH 7.2, as assessed by nuclear run-on assay. Transcription of new Cx43 mRNA was higher at pH 7.2 compared to that at pH 6.9. Although Cx43 mRNA half-life tended to be longer at pH 7.6, analysis of variance did not yield a significant difference of the Cx43 mRNA half-life at any of the pHs tested. Likewise, the half-life of Cx43 protein at pHs of 6.9, 7.2, and 7.6 was not significantly different. Plasma membrane and cytosolic Cx43 fractions were proportionately similar at pH 7.2 and 6.9. Thus, the decrease in Cx43 mRNA at low pH compared to high pH is due to a decrease in the transcription rate of Cx43 but not due to an alteration of message stability. The early uncoupling of gap junctions by low pH found previously does not appear to be due to changes in the half-life nor distribution of Cx43 protein between cytosolic and plasma membrane compartments. (C) 2003 Elsevier Science (USA). All rights reserved. C1 VA Greater Los Angeles, Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. VA Greater Los Angeles, Healthcare Syst, Ctr Geriatr Res Educ & Clin, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90073 USA. RP Yamaguchi, DT (reprint author), VA Greater Los Angeles, Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. NR 14 TC 11 Z9 11 U1 1 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0006-291X J9 BIOCHEM BIOPH RES CO JI Biochem. Biophys. Res. Commun. PD MAY 16 PY 2003 VL 304 IS 4 BP 736 EP 739 DI 10.1016/S0006-291X(03)00633-8 PG 4 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 679GH UT WOS:000182912000024 PM 12727217 ER PT J AU Liu, CX Song, YL McTeague, M Vu, AW Wexler, H Finegold, SM AF Liu, CX Song, YL McTeague, M Vu, AW Wexler, H Finegold, SM TI Rapid identification of the species of the Bacteroides fragilis group by multiplex PCR assays using group- and species-specific primers SO FEMS MICROBIOLOGY LETTERS LA English DT Article DE multiplex PCR; identification; Bacteroides fragilis group ID 23S RIBOSOMAL-RNA; CLINICAL SPECIMENS; GENE; INSERTION; BACTERIA; SYSTEM; HUMANS AB We report a rapid and reliable two-step multiplex polymerase chain reaction (PCR) assay to identify the 10 Bacteroides fragilis group species - Bacteroides caccae, B. distasonis, B. eggerthii, B. fragilis, B. merdae, B. ovatus, B. stercoris, B. thetaiotaomicron, B. uniformis and B. vulgatus. These 10 species were first divided into three subgroups by multiplex PCR-G, followed by three multiplex PCR assays with three species-specific primer mixtures for identification to the species level. The primers were designed from nucleotide sequences of the 16S rRNA, the 16S-23S rRNA intergenic spacer region and part of the 23S rRNA gene. The established two-step multiplex PCR identification scheme was applied to the identification of 155 clinical isolates of the B. fragilis group that were previously identified to the species level by phenotypic tests. The new scheme was more accurate than phenotypic identification, which was accurate only 84.5% of the time. The multiplex PCR scheme established in this study is a simple, rapid and reliable method for the identification of the B. fragilis group species. This will permit more accurate assessment of the role of various B. fragilis group members in infections and of the degree of antimicrobial resistance in each of the group members. (C) 2003 Federation of European Microbiological Societies. Published by Elsevier Science B.V.. All rights reserved. C1 W Los Angeles Vet Affairs Med Ctr, Res Serv, Los Angeles, CA 90073 USA. W Los Angeles Vet Affairs Med Ctr, Clin Microbiol Lab, Los Angeles, CA 90073 USA. W Los Angeles Vet Affairs Med Ctr, Infect Dis Sect, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Microbiol Immunol & Mol Genet, Los Angeles, CA 90024 USA. RP Liu, CX (reprint author), W Los Angeles Vet Affairs Med Ctr, Res Serv, 11301 Wilshire Blvd,Room E3-237,Bldg 304, Los Angeles, CA 90073 USA. NR 29 TC 60 Z9 60 U1 1 U2 11 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0378-1097 J9 FEMS MICROBIOL LETT JI FEMS Microbiol. Lett. PD MAY 16 PY 2003 VL 222 IS 1 BP 9 EP 16 DI 10.1016/S0378-1097(03)00296-9 PG 8 WC Microbiology SC Microbiology GA 682WR UT WOS:000183115800002 PM 12757940 ER PT J AU Clarke, P Meintzer, SM Moffitt, LA Tyler, KL AF Clarke, P Meintzer, SM Moffitt, LA Tyler, KL TI Two distinct phases of virus-induced nuclear factor kappa B regulation enhance tumor necrosis factor-related apoptosis-inducing ligand-mediated apoptosis in virus-infected cells SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID REOVIRUS-INDUCED APOPTOSIS; TRAIL-INDUCED APOPTOSIS; TRANSCRIPTION FACTOR; CANCER-CELLS; FACTOR-ALPHA; TRANSFORMING PROTEIN; REQUIRES ACTIVATION; SENSITIZES CELLS; DEATH RECEPTORS; PATHWAY AB Cellular transcription factors are often utilized by infecting viruses to promote viral growth and influence cell fate. We have previously shown that nuclear factor kappaB (NF-kappaB) is activated after reovirus infection and that this activation is required for virus-induced apoptosis. In this report we identify a second phase of reovirus-induced NF-kappaB regulation. We show that at later times post-infection NF-kappaB activation is blocked in reovirus-infected cells. This results in the termination of virus-induced NF-kappaB activity and the inhibition of tumor necrosis factor alpha and etoposide-induced NF-kappaB activation in infected cells. Reovirus-induced inhibition of NF-kappaB activation occurs by a mechanism that prevents IkappaBalpha degradation and that is blocked in the presence of the viral RNA synthesis inhibitor, ribavirin. Reovirus-induced apoptosis is mediated by tumor necrosis factor-related apoptosis inducing ligand (TRAIL) in a variety of epithelial cell lines. Herein we show that ribavirin inhibits reovirus-induced apoptosis in TRAIL-resistant HEK293 cells and prevents the ability of reovirus infection to sensitize TRAIL-resistant cells to TRAIL-induced apoptosis. Furthermore, TRAIL-induced apoptosis is enhanced in HEK293 cells expressing IkappaBDeltaN2, which blocks NF-kappaB activation. These results indicate that the ability of reovirus to inhibit NF-kappaB activation sensitizes HEK293 cells to TRAIL and facilitates virus-induced apoptosis in TRAIL-resistant cells. Our findings demonstrate that two distinct phases of virus-induced NF-kappaB regulation are required to efficiently activate host cell apoptotic responses to reovirus infection. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med Microbiol & Immunol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. RP Tyler, KL (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol B 182, 4200 E 9th Ave, Denver, CO 80262 USA. OI Tyler, Kenneth/0000-0003-3294-5888 FU NIA NIH HHS [1R01AG14071] NR 62 TC 35 Z9 38 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 MAY 16 PY 2003 VL 278 IS 20 BP 18092 EP 18100 DI 10.1074/jbc.M300265200 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 677YX UT WOS:000182838300066 PM 12637521 ER PT J AU Du, LN Zhang, XP Han, YY Burke, NA Kochanek, PM Watkins, SC Graham, SH Carcillo, JA Szabo, C Clark, RSB AF Du, LN Zhang, XP Han, YY Burke, NA Kochanek, PM Watkins, SC Graham, SH Carcillo, JA Szabo, C Clark, RSB TI Intra-mitochondrial poly(ADP-ribosylation) contributes to NAD(+) depletion and cell death induced by oxidative stress SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID LONG-TERM POTENTIATION; NITRIC-OXIDE SYNTHASE; POLYMERASE INHIBITORS; DNA DAMAGE; RAT-BRAIN; APOPTOSIS; PEROXYNITRITE; SYNTHETASE; REPAIR; ACTIVATION AB Poly(ADP-ribosylation), primarily via poly(ADP-ribose) polymerase-1 (PARP-1), is a pluripotent cellular process important for maintenance of genomic integrity and RNA transcription in cells. However, during conditions of oxidative stress and energy depletion, poly(ADP-ribosylation) paradoxically contributes to mitochondrial failure and cell death. Although it has been presumed that poly(ADP-ribosylation) within the nucleus mediates this pathologic process, PARP-1 and other poly(ADP-ribosyltransferases) are also localized within mitochondria. To this end, the presence of PARP-1 and poly(ADP-ribosylation) were verified within mitochondrial fractions from primary cortical neurons and fibroblasts. Inhibition of poly(ADP-ribosylation) within the mitochondrial compartment preserved transmembrane potential (DeltaPsi(m)), NAD(+) content, and cellular respiration, prevented release of apoptosis-inducing factor, and reduced neuronal cell death triggered by oxidative stress. Treatment with liposomal NAD(+) also preserved DeltaPsi(m) and cellular respiration during oxidative stress. Furthermore, inhibition of poly(ADP-ribosylation) prevented intranuclear localization of apoptosis-inducing factor and protected neurons from excitotoxic injury; and PARP-1 null fibroblasts were protected from oxidative stress-induced cell death. Collectively these data suggest that poly(ADP-ribosylation) compartmentalized to the mitochondria can be converted from a homeostatic process to a mechanism of cell death when oxidative stress is accompanied by energy depletion. These data implicate intra-mitochondrial poly(ADP-ribosylation) as an important therapeutic target for central nervous system and other diseases associated with oxidative stress and energy failure. C1 Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Crit Care Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Cell Biol & Physiol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Pediat, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Neurol, Pittsburgh, PA 15260 USA. Vet Affairs Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA 15261 USA. Inotek Pharmaceut Corp, Beverly, MA 01915 USA. RP Clark, RSB (reprint author), Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Crit Care Med, 3434 5th Ave, Pittsburgh, PA 15260 USA. RI Kochanek, Patrick/D-2371-2015 OI Kochanek, Patrick/0000-0002-2627-913X FU NICHD NIH HHS [T32 HD 40686]; NINDS NIH HHS [P50 NS30318, R01 NS38620] NR 47 TC 213 Z9 220 U1 2 U2 9 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 MAY 16 PY 2003 VL 278 IS 20 BP 18426 EP 18433 DI 10.1074/jbc.M301295200 PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 677YX UT WOS:000182838300109 PM 12626504 ER PT J AU Gorse, GJ O'Connor, TZ Young, SL Mendelman, PM Bradley, SF Nichol, KL Strickland, JH Paulson, DM Rice, KL Foster, RA Fulambarker, AM Shigeoka, JW Kuschner, WG Goodman, RP Neuzil, KM Wittes, J Boardman, KD Peduzzi, PN AF Gorse, GJ O'Connor, TZ Young, SL Mendelman, PM Bradley, SF Nichol, KL Strickland, JH Paulson, DM Rice, KL Foster, RA Fulambarker, AM Shigeoka, JW Kuschner, WG Goodman, RP Neuzil, KM Wittes, J Boardman, KD Peduzzi, PN TI Efficacy trial of live, cold-adapted and inactivated influenza virus vaccines in older adults with chronic obstructive pulmonary disease: a VA cooperative study SO VACCINE LA English DT Article DE influenza virus; influenza vaccine; efficacy ID CHRONIC LUNG-DISEASE; ELDERLY PERSONS; REASSORTANT VIRUS; ILL ADULTS; UNDERLYING CONDITIONS; ANTIBODY-RESPONSES; HEALTHY-ADULTS; SAMPLE-SIZE; WILD-TYPE; VACCINATION AB We assessed whether trivalent live, cold-adapted influenza virus (CAIV-T) vaccine provides added protection when co-administered with trivalent inactivated influenza virus vaccine (TVV) in patients with chronic obstructive pulmonary disease (COPD). Subjects (N = 2215) were randomly assigned to receive either TVV intramuscularly (IM) and CAIV-T intranasally (TC), or TVV and placebo (TP). The vaccines were well-tolerated. Efficacy of TC compared to TP was not statistically significant and was 0.16 for any influenza virus strain (95% confidence limit (CL): -0.22, 0.43), 0.26 for A (H3N2) virus (95% CL: -0.17, 0.53), and -0.05 for type B virus (95% CL: -1.13, 0.48). However, there was a possible advantage for TC over TP in reducing respiratory consequences of an influenza season measured by pulmonary function and symptoms at end of study. Published by Elsevier Science Ltd. C1 St Louis Univ, Med Ctr, Dept Vet Affairs, St Louis, MO 63110 USA. Dept Vet Affairs, Cooperat Studies Program, Albuquerque, NM USA. Dept Vet Affairs, Cooperat Studies Program, West Haven, CT USA. Med Ctr, Dept Vet Affairs, Durham, NC USA. MedImmune Vaccines Inc, Mountain View, CA USA. Med Ctr, Dept Vet Affairs, Ann Arbor, MI USA. Med Ctr, Dept Vet Affairs, Minneapolis, MN USA. Med Ctr, Dept Vet Affairs, Birmingham, AL USA. Med Ctr, Dept Vet Affairs, Richmond, VA USA. Med Ctr, Dept Vet Affairs, Gainesville, FL USA. Med Ctr, Dept Vet Affairs, Chicago, IL USA. Med Ctr, Dept Vet Affairs, Salt Lake City, UT USA. Dept Vet Affairs, Palo Alto, CA USA. Med Ctr, Dept Vet Affairs, Boston, MA USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Stat Collaborat, Washington, DC USA. RP Gorse, GJ (reprint author), St Louis Univ, Hlth Sci Ctr, Div Infect Dis & Immunol, 3635 Vista Ave,FDT-8N, St Louis, MO 63110 USA. NR 59 TC 37 Z9 40 U1 0 U2 2 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 MAY 16 PY 2003 VL 21 IS 17-18 BP 2133 EP 2144 DI 10.1016/S0264-410X(02)00748-X PG 12 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 682PF UT WOS:000183100200042 PM 12706704 ER PT J AU Weiner, M Burman, W Vernon, A Benator, D Peloquin, CA Khan, A Weis, S King, B Shah, N Hodge, T AF Weiner, M Burman, W Vernon, A Benator, D Peloquin, CA Khan, A Weis, S King, B Shah, N Hodge, T CA Tuberculosis Trials Consortium TI Low isoniazid concentrations and outcome of tuberculosis treatment with once-weekly isoniazid and rifapentine SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE tuberculosis; isoniazid; rifapentine; treatment; pharmacokinetics ID CONTINUATION PHASE; MYCOBACTERIUM-TUBERCULOSIS; PULMONARY TUBERCULOSIS; FASTING CONDITIONS; 6-MONTH REGIMEN; RIFAMPIN; PHARMACOKINETICS; PYRAZINAMIDE; ANTACIDS; MICE AB To understand why once-weekly isoniazid/rifapentine therapy for tuberculosis was less effective than twice-weekly isoniazid/rifampin, we studied human immunodeficiency virus-seronegative patients with either failure (n = 4), relapse (n = 35), or cure (n = 94), recruited from a comparative treatment trial. In multivariate analyses that were adjusted for severity of disease, low plasma concentrations of isoniazid were associated with failure/relapse with once-weekly isoniazid/rifapentine (median isoniazid area under the concentration-time curve for 12 hours after the dose [AUCO(0-12)] was 36 mug (.) hour/ml in failure/relapse versus 56 mug - hour/ml in control cases p = 0.005), but not with twice-weekly isoniazid/rifampin. Furthermore, two patients who relapsed with Mycobacterium tuberculosis monoresistant to rifamycin had very low concentrations of isoniazid. Finally, isoniazid acetylator status determined by N-acetyltransferase type 2 genotype was associated with outcome with once-weekly isoniazid/rifapentine (p = 0.03) but not twice-weekly isoniazid/rifampin. No rifamycin pharmacokinetic parameter was consistently and significantly associated with outcome (p > 0.10). Because low isoniazid concentrations were associated with failure/ relapse, a drug with consistently greater area under the concentration-time curve than isoniazid may be needed to achieve highly active once-weekly therapy with rifapentine. C1 S Texas Vet Hlth Care Syst, Dept Med 111F, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. Univ Colorado, Denver Publ Hlth & Dept Med, Ctr Hlth Sci, Denver, CO 80202 USA. Univ Colorado, Sch Pharm, Natl Jewish Med & Res Ctr, Denver, CO 80202 USA. Univ Colorado, Sch Med, Natl Jewish Med & Res Ctr, Denver, CO 80202 USA. Ctr Dis Control & Prevent, Div TB Eliminat, Atlanta, GA USA. George Washington Univ, Med Ctr, Washington, DC 20037 USA. VAMC, Washington, DC USA. Univ N Texas, Ctr Hlth Sci, Ft Worth, TX USA. RP Weiner, M (reprint author), S Texas Vet Hlth Care Syst, Dept Med 111F, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. RI Osborne, Nicholas/N-4915-2015 OI Osborne, Nicholas/0000-0002-6700-2284 FU NCRR NIH HHS [M01-RR-00827, M01-RR-01346] NR 27 TC 120 Z9 123 U1 0 U2 5 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD MAY 15 PY 2003 VL 167 IS 10 BP 1341 EP 1347 DI 10.1164/rccm.200208-951OC PG 7 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 678HV UT WOS:000182862100012 PM 12531776 ER PT J AU Potter-Perigo, S Hull, RL Tsoi, C Braun, KR Andrikopoulos, S Teague, J Verchere, CB Kahn, SE Wight, TN AF Potter-Perigo, S Hull, RL Tsoi, C Braun, KR Andrikopoulos, S Teague, J Verchere, CB Kahn, SE Wight, TN TI Proteoglycans synthesized and secreted by pancreatic islet beta-cells bind amylin SO ARCHIVES OF BIOCHEMISTRY AND BIOPHYSICS LA English DT Article DE proteoglycans; amylin; islet amyloid polypeptide; type 2 diabetes; islet amyloid; beta-cells; islet ID HEPARAN-SULFATE PROTEOGLYCAN; SMOOTH-MUSCLE CELLS; COLONY-STIMULATING FACTOR; LOW-DENSITY LIPOPROTEINS; ALZHEIMERS-DISEASE; AMYLOID POLYPEPTIDE; FIBRIL FORMATION; GROWTH-FACTOR; A-BETA; DIFFERENTIAL EXPRESSION C1 Hope Heart Inst, Seattle, WA 98104 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Pathol, Seattle, WA 98195 USA. RP Wight, TN (reprint author), Hope Heart Inst, Seattle, WA 98104 USA. FU NHLBI NIH HHS [HL30086-19]; NIDDK NIH HHS [DK-17047, DK-50703, DK02456-42] NR 49 TC 23 Z9 25 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 0003-9861 J9 ARCH BIOCHEM BIOPHYS JI Arch. Biochem. Biophys. PD MAY 15 PY 2003 VL 413 IS 2 BP 182 EP 190 DI 10.1016/S0003-9861(03)00116-4 PG 9 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 679WC UT WOS:000182944100005 PM 12729615 ER PT J AU Wang, H Jiang, XH Yang, F Gaubatz, JW Ma, L Magera, MJ Yang, XF Berger, PB Durante, W Pownall, HJ Schafer, AI AF Wang, H Jiang, XH Yang, F Gaubatz, JW Ma, L Magera, MJ Yang, XF Berger, PB Durante, W Pownall, HJ Schafer, AI TI Hyperhomocysteinemia accelerates atherosclerosis in cystathionine beta-synthase and apolipoprotein E double knock-out mice with and without dietary perturbation SO BLOOD LA English DT Article ID LOW-DENSITY-LIPOPROTEIN; DEFICIENT MICE; ENDOTHELIAL DYSFUNCTION; FAMILIAL HYPERCHOLESTEROLEMIA; S-ADENOSYLHOMOCYSTEINE; TOTAL HOMOCYSTEINE; MURINE MODEL; CHOLESTEROL; PLASMA; MACROPHAGES AB Although hyperhomocysteinemia is an independent risk factor for cardiovascular disease, a direct role for homocysteine (Hcy) in this disease remains to be shown. Whereas diet-induced hyperhomocysteinemia promotes atherosclerosis in animal models, the effects of Hcy on atherogenesis in the absence of dietary perturbations is not known. We have generated double knock-out mice with targeted deletions of the genes for apollpoprotein E (apoE) and cystathionine p-synthase (CBS), which converts Hcy to cystathionine. ApoE(-/-)/CBS-/- mice developed aortic lesions even in the absence of dietary manipulation; lesion area and lesion cholesteryl ester (CE) and triglyceride (TG) contents increased with animal age and plasma Hcy levels. Plasma total cholesterol was significantly increased, whereas high density lipoprotein (HDL) cholesterol and TG concentrations of apoE(-/-)/CBS-/- mice were decreased. Cholesterol esterification and activities of enzymes catalyzing CE or TG formation in the vessel wall and in peritoneal macrophages were not changed by hyperhomocysteinemia. However, uptake of human acetyl-LDL, but not native low density lipoprotein (LDL), by mouse peritoneal macrophages was higher in the presence of hyperhomocysteinemia. These results suggest that isolated hyperhomocysteinemia is atherogenic and alters hepatic and macrophage lipoprotein metabolism, in part, by enhancing uptake of modified LDL. (C) 2003 by The American Society of Hematology. C1 Baylor Coll Med, VA Med Ctr, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, VA Med Ctr, Dept Pharmacol, Houston, TX 77030 USA. Baylor Coll Med, VA Med Ctr, Dept Pathol, Houston, TX 77030 USA. Mayo Clin, Rochester, MN USA. RP Wang, H (reprint author), Baylor Coll Med, VA Med Ctr, Dept Med, 2002 Holcombe Blvd 109-129, Houston, TX 77030 USA. FU NHLBI NIH HHS [HL-56865, HL-59976, HL-62467, HL-67033, HL30914] NR 41 TC 105 Z9 110 U1 1 U2 5 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD MAY 15 PY 2003 VL 101 IS 10 BP 3901 EP 3907 DI 10.1182/blood-2002-08-2606 PG 7 WC Hematology SC Hematology GA 677EB UT WOS:000182793000030 PM 12506016 ER PT J AU Lee, JS Frevert, CW Wurfel, MM Peiper, SC Wong, VA Ballman, KK Ruzinski, JT Rhim, JS Martin, TR Goodman, RB AF Lee, JS Frevert, CW Wurfel, MM Peiper, SC Wong, VA Ballman, KK Ruzinski, JT Rhim, JS Martin, TR Goodman, RB TI Duffy antigen facilitates movement of chemokine across the endothelium in vitro and promotes neutrophil transmigration in vitro and in vivo SO JOURNAL OF IMMUNOLOGY LA English DT Article ID BLOOD-GROUP ANTIGEN; RECEPTOR; CELLS; EXPRESSION; GENE; IDENTIFICATION; INDIVIDUALS; ENDOTOXIN; MIGRATION; SURFACE AB The Duffy Ag expressed on RBCs, capillaries, and postcapillary venular endothelial cells binds selective CXC and CC chemokines with high affinity. Cells transfected with the Duffy Ag internalize but do not degrade chemokine ligand. It has been proposed that Duffy Ag transports chemokines across the endothelium. We hypothesized that Duffy Ag participates in the movement of chemokines across the endothelium and, by doing so, modifies neutrophil transmigration. We found that the Duffy Ag transfected into human endothelial cells facilitates movement of the radiolabeled CXC chemokine, growth related oncogene-alpha/CXC chemokine ligand 1 (GRO-alpha/CXCL1), across an endothelial monolayer. In addition, neutrophil migration toward GRO-alpha/CXCL1 and IL-8 (IL-8/CXCL8) was enhanced across an endothelial monolayer expressing the Duffy Ag. Furthermore, GRO-alpha/CXCL1 stimulation of endothelial cells expressing the Duffy Ag did not affect gene expression by oligonucleotide microarray analysis. These in vitro observations are supported by the finding that IL-8/CXCL8-driven neutrophil recruitment into the lungs was markedly attenuated in transgenic mice lacking the Duffy Ag. We conclude that Duffy Ag has a role in enhancing leukocyte recruitment to sites of inflammation by facilitating movement of chemokines across the endothelium. C1 Vet Affairs Puget Sound Hlth Care Syst, Med Res Serv, Seattle, WA 98108 USA. Univ Washington, Sch Med, Div Pulm & Crit Care Med, Dept Med, Seattle, WA 98108 USA. Med Coll Georgia, Dept Pathol, Augusta, GA 30912 USA. Uniformed Serv Univ Hlth Sci, Dept Surg, Ctr Prostate Dis Res, Bethesda, MD 20814 USA. RP Goodman, RB (reprint author), Seattle Vet Affairs Med Ctr, S-111 Pulm,1660 S Columbian Way, Seattle, WA 98108 USA. FU NHLBI NIH HHS [F32 HL010470, F32 HL010470-02, HL30542, HL69955, HL70178, K08 HL070178, K08 HL070178-01, R01 HL069955] NR 28 TC 91 Z9 97 U1 1 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 MAY 15 PY 2003 VL 170 IS 10 BP 5244 EP 5251 PG 8 WC Immunology SC Immunology GA 676NJ UT WOS:000182758200045 PM 12734373 ER PT J AU Trail, M Nelson, ND Van, JN Appel, SH Lai, EC AF Trail, M Nelson, ND Van, JN Appel, SH Lai, EC TI A study comparing patients with amyotrophic lateral sclerosis and their caregivers on measures of quality of life, depression, and their attitudes toward treatment options SO JOURNAL OF THE NEUROLOGICAL SCIENCES LA English DT Article DE amyotrophic lateral sclerosis; quality of life; caregiver; depression; palliative care; treatment choices ID OF-LIFE; PHYSICAL FUNCTION; ALS; SURVIVAL AB Objective: To compare amyotrophic lateral sclerosis (ALS) patients and their caregivers on measures of quality of life (QOL), depression, and their attitudes toward treatment options. Methods: Over a 14-month period, we analyzed responses from 27 ALS patients and 19 ALS caregivers as they arrived at the Department of Neurology, Baylor College of Medicine, Vicki Appel MDA, ALS Clinic, and those who completed the study measures. Patients were given the Appel ALS Rating Scale (AALS), the ALS Functional Rating Scale (ALSFRS), McGill Quality of Life Questionnaire Single-Item Scale (MQOL-SIS), and the Beck Depression Inventory-II (BDI-II). An internally generated scale of 1-7 was used to measure perception of emotional support, QOL for others (i.e., the patient's perception of the caregiver's QOL and the caregiver's perception of the patient's QOL), and experience of pain. Attitudes toward treatment options were assessed by yes/ no/uncertain responses. Caregivers were administered all of the above measures except the AALS, ALSFRS, and pain scale. Percentage, mean, and standard deviation values were determined. Significance levels were also calculated. Results: Twenty-seven patients with a mean age of 57.2 (range 34-81) years and nineteen caregivers with a mean age of 56:9 (range 28-82) years completed the study. The patients were of moderate disease severity with a mean AALS total score of 76.3 (range 39-134) and a mean ALSFRS score of 28.4 (range 12-40). The mean rating of QOL for patients was 5.9 and the mean rating of QOL for caregivers was 5.7 (range 1-7). The patients reported slightly less depression (9.8) than their caregivers (10.7) (range 0-63). There was, however, no significant difference between patients and caregivers on scores of QOL and depression. Patients tended to overestimate caregivers' QOL by a small degree, whereas caregivers tended to underestimate the patients' QOL by a greater degree. Over one-half of both groups would consider percutaneous esophageal gastrostomy (PEG) placement. Patient and caregiver responses to the use of BIPAP differed. Though over half of both groups endorsed the idea of future BIPAP use, more patients (41%) than caregivers (5%) were uncertain. Only 3% of patients responded negatively compared to 32% of caregivers. Both groups were only minimally interested in future invasive ventilation. Discussion: Factors contributing to quality of life, depression, and attitudes toward treatment options need to be periodically explored with patients and caregivers throughout the course of the illness. Health care professionals should recognize that the needs and goals of the two groups might differ. For both patients and caregivers, health care professionals should provide education and opportunities for discussion centered on the issues followed by referrals and interventions appropriate to the situation. (C) 2003 Elsevier Science B.V. All rights reserved. C1 Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. VA Med Ctr, Neurol Care Line, Houston, TX USA. RP Lai, EC (reprint author), Baylor Coll Med, Dept Neurol, 6550 Fannin,Suite 1801, Houston, TX 77030 USA. NR 22 TC 84 Z9 86 U1 0 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 MAY 15 PY 2003 VL 209 IS 1-2 BP 79 EP 85 DI 10.1016/S0022-510X(03)00003-0 PG 7 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 672VN UT WOS:000182543800014 PM 12686407 ER PT J AU Kaplan-Lefko, PJ Chen, TM Ittmann, MM Barrios, RJ Ayala, GE Huss, WJ Maddison, LA Foster, BA Greenberg, NM AF Kaplan-Lefko, PJ Chen, TM Ittmann, MM Barrios, RJ Ayala, GE Huss, WJ Maddison, LA Foster, BA Greenberg, NM TI Pathobiology of autochthonous prostate cancer in a pre-clinical transgenic mouse model SO PROSTATE LA English DT Article DE TRAMP; pathology; prostate cancer; pre-clinical trials ID E-CADHERIN EXPRESSION; TRAMP MODEL; NEUROENDOCRINE DIFFERENTIATION; TUMOR-CELLS; PROGRESSION; MICE; ADENOCARCINOMA; CARCINOGENESIS; CARCINOMA; CHEMOPREVENTION AB BACKGROUND. Animal models that closely mimic clinical disease can be exploited to hasten the pace of translational research. To this end, we have defined windows of opportunity in the transgenic adenocarcinoma of the mouse prostate (TRAMP) model of prostate cancer as a paradigm for designing pre-clinical trials. METHODS. The incidence of cancer, metastasis, and distribution of pathology were examined as a function of time in TRAMP mice. The expression of various markers of differentiation were characterized. RESULTS. The TRAMP model develops progressive, multifocal, and heterogeneous disease. Each lobe of the prostate progressed at a different rate. Cytokeratin 8, E-cadherin, and androgen receptor (AR) were expressed during cancer progression but levels were reduced or absent in late stage disease. A distinct epithelial to neuroendocrine (ENT) shift was observed to be a stochastic event related to prostate cancer progression in TRAMP. CONCLUSIONS. This study will serve as the basis for the rational design of pre-clinical studies with genetically engineered mouse models. (C) 2003 Wiley-Liss, Inc. C1 Dept Mol & Cellular Biol, Houston, TX 77030 USA. Scott Dept Urol, Houston, TX USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. Houston Dept Vet Affairs Med Ctr, Houston, TX USA. Roswell Pk Canc Inst, Dept Pharmacol & Therapeut, Buffalo, NY 14263 USA. RP Greenberg, NM (reprint author), Dept Mol & Cellular Biol, 1 Baylor Plaza, Houston, TX 77030 USA. FU NCI NIH HHS [U01 CA84296] NR 48 TC 277 Z9 284 U1 0 U2 3 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0270-4137 J9 PROSTATE JI Prostate PD MAY 15 PY 2003 VL 55 IS 3 BP 219 EP 237 DI 10.1002/pros.10215 PG 19 WC Endocrinology & Metabolism; Urology & Nephrology SC Endocrinology & Metabolism; Urology & Nephrology GA 675DE UT WOS:000182677100008 PM 12692788 ER PT J AU Reeve, JR Keire, DA Coskun, T Green, GM Evans, C Ho, FJ Lee, TD Davis, MT Shively, JE Solomon, TE AF Reeve, JR Keire, DA Coskun, T Green, GM Evans, C Ho, FJ Lee, TD Davis, MT Shively, JE Solomon, TE TI Synthesis of biologically active canine CCK-58 SO REGULATORY PEPTIDES LA English DT Article DE cholecystokinin; pancreatic secretion; molecular forms; peptide synthesis; amylase secretion; pancreatic fluid secretion ID PANCREATIC DUCT CELLS; DIFFERENT CONFORMATIONS; HUMAN-PLASMA; CHOLECYSTOKININ; RATS; IMMUNOREACTIVITY; SECRETION; BINDING; ANALOGS; CALCIUM AB The carboxyl terminal octapeptide of cholecystokinin (CCK-8) has been hypothesized to account for the bioactivity of all the molecular forms of cholecystokinin. However, the physiological relevance of CCK-58 has not been rigorously examined because of the lack of sufficient amounts of the peptide and concerns about inactivation of natural peptides during their purification. Therefore, canine-sulfated CCK-58 was synthesized and conditions determined for its unblocking and purification that preserved the sulfated tyrosine. Synthetic CCK-58 was indistinguishable from natural CCK-58 by amino acid analysis and by mass spectrometry. Synthetic CCK-58 and CCK-8 have different patterns of pancreatic stimulation: both caused a dose-related increase in amylase release, while only CCK-58 stimulated bile-pancreatic output volume. Thus, CCK-58 and CCK-8 are biased agonists at the CCK-A receptor (they have distinct patterns of action mediated by the same receptor). Previous work has demonstrated that the identical carboxyl termini of CCK-8 and CCK-58 have different solution conformations. Taken together, the physiological and structural results support the hypothesis that different carboxyl terminal conformations of CCK-58 and CCK-8 alter the expression of their biological activity. (C) 2003 Elsevier Science B.V. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, Res Serv 151, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Div Digest Dis, Los Angeles, CA 90024 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78284 USA. Univ Calif Los Angeles, NPI, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. City Hope Natl Med Ctr, Beckman Res Inst, Div Immunol, Duarte, CA 91010 USA. RP Reeve, JR (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv 151, CURE Digest Dis Res Ctr, Bldg 115,Rm 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NCI NIH HHS [CA3572]; NCRR NIH HHS [R01-RR06217]; NIDDK NIH HHS [R01-DK38626, DK-41301, R01- DK33580, R01-DK37482] NR 33 TC 14 Z9 15 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-0115 J9 REGUL PEPTIDES JI Regul. Pept. PD MAY 15 PY 2003 VL 113 IS 1-3 BP 71 EP 77 DI 10.1016/S0167-0115(02)00301-4 PG 7 WC Endocrinology & Metabolism; Physiology SC Endocrinology & Metabolism; Physiology GA 674GD UT WOS:000182628300009 PM 12686463 ER PT J AU Keire, DA Wu, SV Diehl, DL Chew, P Ho, FJ Davis, MT Lee, TD Shively, JE Walsh, JH Reeve, JR AF Keire, DA Wu, SV Diehl, DL Chew, P Ho, FJ Davis, MT Lee, TD Shively, JE Walsh, JH Reeve, JR TI Rat progastrin processing yields peptides with altered potency at the CCK-B receptor SO REGULATORY PEPTIDES LA English DT Article DE gastrin-16; sulfated and nonsulfated gastrin; DPP IV; pyroglutamate ID GLYCINE-EXTENDED PROGASTRIN; GASTRIN PRECURSOR; GROWTH; CHOLECYSTOKININ; SULFATION; ACID; BRADYKININ; METABOLISM; MODULATION; RELEASE AB Details of prohormone processing patterns are revealed by purification and characterization of molecular forms stored in the tissues where the hormones are expressed. Molecular forms of rat gastrin were purified from antral extracts by gel permeation anion exchange, and reverse-phase HPLC. Amidated and glycine-extended gastrins were detected with specific antisera and their structures determined by mass spectrometry. In rats, the only form shorter than gastrin-.17 observed contained 16 amino acids. These data suggest that two enzymes process the amino terminus of gastrin-17. Pyrrolidone carboxylic acid peptidase removes the amino terminal pyrrolidone carboxylic acid (pyroGlu), forming gastrin-16. In mammals other than rat, gastrin-16 is then cleaved by dipeptidyl peptidase IV to form gastrin-14. In rat, this reaction does not take place because of proline residues PrO2-PrO3 - in gastrin-16. Gastrin-16 is found in sulfated and nonsulfated forms and comprises 28% of the total gastrin immunoreactivity. Glycine-extended forms of gastrin-16 and gastrin-17 comprises 45% of the total gastrin immunoreactivity. The sulfated forms of gastrin-16 and gastrin-17 bind to the CCK-B receptor transfected into CHO cells with 10-fold higher affinity than the nonsulfated forms of these peptides. Therefore, processing of rat progastrin may modulate the expression of gastrin biological activity. (C) 2003 Elsevier Science B.V. All rights reserved. C1 W Los Angeles Vet Affairs Med Ctr, CURE UCLA Digest Dis Res Ctr, Los Angeles, CA 90073 USA. City Hope Res Inst, Beckman Res Inst, Duarte, CA 91010 USA. RP Reeve, JR (reprint author), W Los Angeles Vet Affairs Med Ctr, CURE UCLA Digest Dis Res Ctr, Bldg 115,Room 117B,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. OI Diehl, David/0000-0003-4128-3839 FU NIDDK NIH HHS [DK17294, DK33850, DK41301] NR 36 TC 6 Z9 6 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-0115 J9 REGUL PEPTIDES JI Regul. Pept. PD MAY 15 PY 2003 VL 113 IS 1-3 BP 115 EP 124 DI 10.1016/S0167-0115(03)00005-3 PG 10 WC Endocrinology & Metabolism; Physiology SC Endocrinology & Metabolism; Physiology GA 674GD UT WOS:000182628300016 PM 12686470 ER PT J AU Chen, CY Doong, ML Rivier, JE Tache, Y AF Chen, CY Doong, ML Rivier, JE Tache, Y TI Intravenous urocortin II decreases blood pressure through CRF2 receptor in rats SO REGULATORY PEPTIDES LA English DT Article DE blood pressure; CRF2 receptor; human urocortin II; hypotension; RX-77368; urocortin; astressin(2)-B; rats ID CORTICOTROPIN-RELEASING-FACTOR; HORMONE-RECEPTOR; PEPTIDE; MICE; MECHANISMS; ARTERIES; STRESS; TYPE-2; FAMILY; ANTAGONISTS AB Urocortin II (Ucn II) is a new member of the corticotropin-releasing factor (CRF) family that binds selectively to the CRF subtype 2 receptor (CRF2). CRF or urocortin injected intravenously (iv) induced hypotension. We investigated the influence of iv human Ucn II (hUcn II) on basal mean blood pressure (MAP) and on the sympathetic mediated hypertensive response to TRH analog, RX-77368 injected intracisternally (ic) 20 min after hUcn II in urethane-anesthetized rats. Ucn II (3, 10, and 30 mug/kg, iv) significantly decreased basal MAP from baseline by - 20.9 +/- 6.5, - 21.3 +/- 5.4 and - 46.8 +/- 6.5 min Hg, respectively, after 10 min. RX-77368 (30 ng, ic) elevated MAP for over 90 min with a maximal hypertensive response at 20 min. Ucn II (3, 10, and 30 mug/kg, iv) did not alter the 20 min net rise in MAP induced by RX-77368 (35.7 +/- 7.1, 32.6 +/- 3.3 and 24.6 +/- 6.9 min Hg, respectively) compared with vehicle (33.6 +/- 4.3 min Hg). The selective CRF, antagonist, astressin(2)-B (60 mug/kg, iv) abolished hUcn II hypotensive action while having no effect on basal MAP. These data show that iv hUcn II induces hypotension through peripheral CRF2 receptor while not altering the responsiveness to sympathetic nervous system-mediated rise in MAP. (C) 2003 Elsevier Science B.V All rights reserved. C1 Univ Calif Los Angeles, Dept Med, Div Digest Dis,CURE Digest Dis Res Ctr, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Salk Inst Biol Studies, Clayton Fdn Labs Peptide Biol, San Diego, CA 92186 USA. RP Tache, Y (reprint author), Univ Calif Los Angeles, Dept Med, Div Digest Dis,CURE Digest Dis Res Ctr, Vet Affairs Greater Los Angeles Healthcare Syst, Bldg 115,Room No 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK-57238, DK-41301] NR 34 TC 28 Z9 28 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-0115 J9 REGUL PEPTIDES JI Regul. Pept. PD MAY 15 PY 2003 VL 113 IS 1-3 BP 125 EP 130 DI 10.1016/S0167-0115(03)00003-X PG 6 WC Endocrinology & Metabolism; Physiology SC Endocrinology & Metabolism; Physiology GA 674GD UT WOS:000182628300017 PM 12686471 ER PT J AU Alessi, CA Martin, JL Webber, AP AF Alessi, CA Martin, JL Webber, AP TI Randomized controlled trial of nonpharmacological interventions on sleep in nursing home residents SO SLEEP LA English DT Meeting Abstract CT 17th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 03-08, 2003 CL CHICAGO, ILLINOIS SP Assoc Prof Sleep Soc C1 GRECC, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Multicampus Program Geriatr Med & Gerontol, Los Angeles, CA 90024 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAY 15 PY 2003 VL 26 BP A158 EP A158 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 677ZY UT WOS:000182841100394 ER PT J AU Atwood, CW Shalaby, A Hartley, J Stahmann, J Ni, Q Lee, K AF Atwood, CW Shalaby, A Hartley, J Stahmann, J Ni, Q Lee, K TI Detection of sleep disordered breathing using implanted cardiac pacemakers SO SLEEP LA English DT Meeting Abstract CT 17th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 03-08, 2003 CL CHICAGO, ILLINOIS SP Assoc Prof Sleep Soc C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAY 15 PY 2003 VL 26 BP A229 EP A230 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 677ZY UT WOS:000182841100573 ER PT J AU Davis, HC Lenconi, MA Maglioni, ML Marmar, CR Neylan, TC AF Davis, HC Lenconi, MA Maglioni, ML Marmar, CR Neylan, TC TI Mood and PTSD symptom correlates with polysomnography and actigraphy SO SLEEP LA English DT Meeting Abstract CT 17th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 03-08, 2003 CL CHICAGO, ILLINOIS SP Assoc Prof Sleep Soc C1 San Francisco State Univ, San Francisco, CA USA. San Francisco Vet Adm Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAY 15 PY 2003 VL 26 BP A381 EP A381 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 677ZY UT WOS:000182841100960 ER PT J AU Gong, H Angara, C Stewart, D McGinty, D Szymusiak, R AF Gong, H Angara, C Stewart, D McGinty, D Szymusiak, R TI Projections from sleep-regulatory regions of the preoptic area to the perifornical lateral hypothalamus SO SLEEP LA English DT Meeting Abstract CT 17th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 03-08, 2003 CL CHICAGO, ILLINOIS SP Assoc Prof Sleep Soc C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAY 15 PY 2003 VL 26 BP A18 EP A19 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 677ZY UT WOS:000182841100046 ER PT J AU Hirshkowitz, M Raj, R Sharafkhaneh, A AF Hirshkowitz, M Raj, R Sharafkhaneh, A TI Improved alertness in CPAP-treated patients not meeting new medicare criteria for CPAP SO SLEEP LA English DT Meeting Abstract CT 17th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 03-08, 2003 CL CHICAGO, ILLINOIS SP Assoc Prof Sleep Soc C1 Baylor Coll Med, Houston, TX 77030 USA. Houston VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAY 15 PY 2003 VL 26 BP A215 EP A216 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 677ZY UT WOS:000182841100536 ER PT J AU Mileykovskiy, BY Kiyashchenko, LI Siegel, JM AF Mileykovskiy, BY Kiyashchenko, LI Siegel, JM TI Activity of somatosensory neurons of the inferior olive across sleep-wake (S-W) cycle SO SLEEP LA English DT Meeting Abstract CT 17th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 03-08, 2003 CL CHICAGO, ILLINOIS SP Assoc Prof Sleep Soc C1 Vet Adm Greater Los Angeles Healthcare Syst, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Sepulveda, CA 91343 USA. Russian Acad Sci, Inst Evolutionary Physiol & Biochem, St Petersburg 194223, Russia. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAY 15 PY 2003 VL 26 BP A26 EP A27 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 677ZY UT WOS:000182841100065 ER PT J AU Ross, RJ Morrison, AR Sanford, LD Jha, SK AF Ross, RJ Morrison, AR Sanford, LD Jha, SK TI Suppression of REM sleep in rats recorded in a fearful context SO SLEEP LA English DT Meeting Abstract CT 17th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 03-08, 2003 CL CHICAGO, ILLINOIS SP Assoc Prof Sleep Soc C1 Philadelphia VA Med Ctr, Philadelphia, PA USA. Univ Penn, Philadelphia, PA 19104 USA. Eastern Virginia Med Sch, Norfolk, VA 23501 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAY 15 PY 2003 VL 26 BP A443 EP A443 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 677ZY UT WOS:000182841101116 ER PT J AU Sharafkhaneh, A Richardson, P Hirshkowitz, M AF Sharafkhaneh, A Richardson, P Hirshkowitz, M TI Sleep related breathing disorders in veteran beneficiaries SO SLEEP LA English DT Meeting Abstract CT 17th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 03-08, 2003 CL CHICAGO, ILLINOIS SP Assoc Prof Sleep Soc C1 Baylor Coll Med, Houston, TX 77030 USA. Houston VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAY 15 PY 2003 VL 26 BP A236 EP A236 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 677ZY UT WOS:000182841100590 ER PT J AU Perlman, JI AF Perlman, JI TI Ophthalmology, pathology - Occular pathology SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Software Review C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. Loyola Univ, Maywood, IL 60153 USA. RP Perlman, JI (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 14 PY 2003 VL 289 IS 18 BP 2432 EP 2433 DI 10.1001/jama.289.18.2432 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 677WF UT WOS:000182831200036 ER PT J AU Howieson, DB Camicioli, R Quinn, J Silbert, LC Care, B Moore, MM Dame, A Sexton, G Kaye, JA AF Howieson, DB Camicioli, R Quinn, J Silbert, LC Care, B Moore, MM Dame, A Sexton, G Kaye, JA TI Natural history of cognitive decline in the old old SO NEUROLOGY LA English DT Article; Proceedings Paper CT 52nd Annual Meeting of the American-Academy-of-Neurology CY APR 29-MAY 06, 2000 CL SAN DIEGO, CALIFORNIA SP Amer Acad Neurol ID APOLIPOPROTEIN-E GENOTYPE; HEALTHY ELDERLY PERSONS; ALZHEIMERS-DISEASE; DEMENTIA; IMPAIRMENT; POPULATION; PROGRESSION; VALIDATION; MARKERS; SCALE AB Objective: To prospectively examine the occurrence and outcome of cognitive decline in healthy, community-dwelling elders. Methods: Ninety-five elders (mean age 84 years) who at entry had no cognitive impairment were followed for up to 13 years. Cognitive decline was defined as obtaining either a Clinical Dementia Rating (CDR) = 0.5 or Mini-Mental State Examination (MMSE) score < 24 on two examinations. Results: Three outcomes of aging were determined: intact cognition, persistent cognitive decline without progression to dementia, and dementia. Whereas 49% remained cognitively intact, 51% developed cognitive decline. Mean follow-up to first CDR 0.5 was 3.8 years and age at conversion was 90.0 years. Those who remained cognitively intact had better memory at entry and were less likely to have APOE4 than those who developed cognitive decline. Of the 48 participants with cognitive decline, 27 (56%) developed dementia (CDR &GE;1) a mean of 2.8 years later. Participants with cognitive decline who progressed to dementia had poorer confrontation naming at the time of their first CDR 0.5 than those with persistent cognitive decline who did not progress during follow-up. Conclusion: The old old are at high risk for developing cognitive decline but many will not progress to dementia in the next 2 to 3 years or even beyond. These findings are important for understanding the prognosis of cognitive decline and for the design of treatment trials for AD. APOE genotype is a risk factor for cognitive decline. C1 Oregon Hlth Sci Univ, Layton Aging & Alzheimers Dis Ctr CR131, Dept Neurol, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Med, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Publ Hlth, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. Univ Alberta, Dept Med Neurol, Edmonton, AB, Canada. RP Howieson, DB (reprint author), Oregon Hlth Sci Univ, Layton Aging & Alzheimers Dis Ctr CR131, Dept Neurol, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. OI Kaye, Jeffrey/0000-0002-9971-3478; Camicioli, Richard/0000-0003-2977-8660 FU NCRR NIH HHS [M01 RR0034]; NIA NIH HHS [P30 AG08017] NR 48 TC 59 Z9 60 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD MAY 13 PY 2003 VL 60 IS 9 BP 1489 EP 1494 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 676LT UT WOS:000182754100019 PM 12743237 ER PT J AU Garnovskaya, MN Mukhin, YV Vlasova, TM Raymond, JR AF Garnovskaya, MN Mukhin, YV Vlasova, TM Raymond, JR TI Hypertonicity activates Na+/H+ exchange through Janus kinase 2 and calmodulin SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID INSULIN-STIMULATED PHOSPHORYLATION; CELL-VOLUME REGULATION; ASCITES TUMOR-CELLS; PROTEIN-KINASE; TYROSINE PHOSPHORYLATION; 5-HT1A RECEPTOR; GROWTH-FACTOR; ISOFORM-1 NHE1; OSMOTIC SHOCK; H+ EXCHANGER AB The type 1 sodium-hydrogen exchanger (NHE-1) is a ubiquitous electroneutral membrane transporter that is activated by hypertonicity in many cells. NHE-1 may be an important pathway for Na+ entry during volume restoration, yet the molecular mechanisms underlying the osmotic regulation of NHE-1 are poorly understood. In the present study we conducted a screen for important signaling molecules that could be involved in hypertonicity-induced activation of NHE-1 in CHO-K1 cells. Hypertonicity rapidly activated NHE-1 in a concentration-dependent manner as assessed by proton microphysiometry and by measurements of intracellular pH on a FLIPR(TM) (fluorometric imaging plate reader). Inhibitors of Ca2+/calmodulin (CaM) and Janus kinase 2 (Jak2) attenuated this activation, whereas neither calcium chelation nor inhibitors of protein kinase C, the Ras-ERK1/2 pathway, Src kinase, and Ca2+/calmodulin-dependent enzymes had significant effects. Hypertonicity also resulted in the rapid tyrosine phosphorylation of Jak2 and STAT3 (the major substrate of Jak2) and CaM. Phosphorylation of Jak2 and CaM were blocked by AG490, an inhibitor of Jak2. Immunoprecipitation studies showed that hypertonicity stimulates the assembly of a signaling complex that includes CaM, Jak2, and NHE-1. Formation of the complex could be blocked by AG490. Thus, we propose that hypertonicity induces activation of NHE-1 in CHO-K1 cells in large part through the following pathway: hypertonicity 3 Jak2 phosphorylation and activation 3 tyrosine phosphorylation of CaM 3 association of CaM with NHE-1 --> NHE-1 activation. C1 Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Med Serv, Charleston, SC 29425 USA. 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,Rm 829 CSB,POB 250623, Charleston, SC 29425 USA. FU NIDDK NIH HHS [DK52448, KO1-DK02694] NR 45 TC 51 Z9 53 U1 0 U2 3 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD MAY 9 PY 2003 VL 278 IS 19 BP 16908 EP 16915 DI 10.1074/jbc.M209883200 PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 677QG UT WOS:000182818600063 PM 12626508 ER PT J AU Huse, JT Byant, D Yang, YX Pijak, DS D'Souza, I Lah, JJ Lee, VMY Doms, RW Cook, DG AF Huse, JT Byant, D Yang, YX Pijak, DS D'Souza, I Lah, JJ Lee, VMY Doms, RW Cook, DG TI Endoproteolysis of beta-secretase (beta-site amyloid precursor protein-cleaving enzyme) within its catalytic domain - A potential mechanism for regulation SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID DISEASE-ASSOCIATED PRESENILIN-1; NECROSIS-FACTOR-ALPHA; TRANS-GOLGI NETWORK; ALZHEIMERS-DISEASE; TRANSMEMBRANE ASPARTATES; PROTEOLYTIC-ENZYMES; HUMAN BRAIN; IN-VIVO; CLEAVAGE; PEPTIDE AB Sequential proteolysis of the amyloid precursor protein (APP) by beta- and gamma-secretase activities yields the amyloid beta peptide that is widely deposited in the brains of individuals with Alzheimer's disease. The membrane-anchored aspartyl protease (β) under bar- site (A) under bar PP- cleaving (e) under bar nzyme (BACE) exhibits all of the characteristics of a beta-secretase and has been shown to cleave APP at its beta-site in vitro and in vivo. We found that BACE undergoes cleavage on a surface-exposed alpha-helix between amino acid residues Leu-228 and Ala-229, generating stable N- and C-terminal fragments that remain covalently associated via a disulfide bond. The efficiency of BACE endoproteolysis was observed to depend heavily on cell and tissue type. In contrast to brain where holoprotein was predominant, BACE was found primarily as endoproteolyzed fragments in pancreas, liver, and muscle. In addition, we observed a marked up-regulation of BACE endoproteolysis in C2 myoblasts upon differentiation into multinucleated myotubes, a well established model system of muscle tissue specification. As in liver, BACE exists as endoproteolyzed fragments in the hepatic cell line, HepG2. We found that HepG2 cells are capable of generating amyloid beta peptide, suggesting that endoproteolyzed BACE retains measurable beta-secretase activity. We also found that BACE endoproteolysis occurs only after export from the endoplasmic reticulum, is enhanced in the trans-Golgi network, and is sensitive to inhibitors of vesicular acidification. The membrane-bound proteases tumor necrosis factor alpha-converting enzyme and furin were not found to be responsible for this cleavage nor was BACE observed to mediate its own endoproteolysis by an autocatalytic mechanism. Thus, we characterize a specific processing event that may serve to regulate the enzymatic activity of BACE on a post-translational level. C1 Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr 182B, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98108 USA. Univ Penn, Sch Med, Dept Microbiol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Neurodegenerat Dis Res, Philadelphia, PA 19104 USA. Emory Univ, Sch Med, Dept Neurol, Atlanta, GA 30322 USA. RP Cook, DG (reprint author), Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr 182B, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIA NIH HHS [NIA-R01 AG11762, P01 AG11542, AG05136] NR 60 TC 27 Z9 30 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD MAY 9 PY 2003 VL 278 IS 19 BP 17141 EP 17149 DI 10.1074/jbc.M213303200 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 677QG UT WOS:000182818600093 PM 12551920 ER PT J AU Grady, D AF Grady, D TI Postmenopausal hormones - Therapy for symptoms only SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material ID QUALITY-OF-LIFE; ESTROGEN/PROGESTIN REPLACEMENT; HEART; TRIAL; WOMEN C1 Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. RP Grady, D (reprint author), Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. NR 5 TC 59 Z9 62 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC/NEJM 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 MAY 8 PY 2003 VL 348 IS 19 BP 1835 EP 1837 DI 10.1056/NEJMp030038 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 675FY UT WOS:000182684100001 PM 12642636 ER PT J AU Lorenz, K Lynn, J AF Lorenz, K Lynn, J TI Moral and practical challenges of physician-assisted suicide SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID OREGON; EUTHANASIA; DEATH C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA USA. Washington Home Ctr Palliat Care Studies, Washington, DC USA. RP Lorenz, K (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. NR 17 TC 2 Z9 2 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 7 PY 2003 VL 289 IS 17 BP 2282 EP 2282 DI 10.1001/jama.289.17.2282 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 675ET UT WOS:000182680700034 PM 12734143 ER PT J AU Zile, MR AF Zile, MR TI Heart failure with preserved ejection fraction: Is this diastolic heart failure? SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Editorial Material ID VENTRICULAR SYSTOLIC FUNCTION; HYPERTROPHY; DYSFUNCTION; DIAGNOSIS C1 Med Univ S Carolina, Dept Med, Gazes Cardiac Res Inst, Div Cardiol, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC USA. RP Zile, MR (reprint author), Med Univ S Carolina, Dept Med, Gazes Cardiac Res Inst, Div Cardiol, 135 Rutledge Ave,Suite 1201,POB 250592, Charleston, SC 29425 USA. NR 15 TC 64 Z9 66 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAY 7 PY 2003 VL 41 IS 9 BP 1519 EP 1522 DI 10.1016/S0735-1097(03)00186-4 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 674HR UT WOS:000182631800016 PM 12742292 ER PT J AU Shekelle, PG Rich, MW Morton, SC Atkinson, SW Tu, WL Maglione, M Rhodes, S Barrett, M Fonarow, GC Greenberg, B Heidenreich, PA Knabel, T Konstam, MA Steimle, A Stevenson, LW AF Shekelle, PG Rich, MW Morton, SC Atkinson, SW Tu, WL Maglione, M Rhodes, S Barrett, M Fonarow, GC Greenberg, B Heidenreich, PA Knabel, T Konstam, MA Steimle, A Stevenson, LW TI Efficacy of angiotensin-converting enzyme inhibitors and beta-blockers in the management of left ventricular systolic dysfunction according to race, gender, and diabetic status - A meta-analysis of major clinical trials SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID CHRONIC HEART-FAILURE; RANDOMIZED INTERVENTION TRIAL; MYOCARDIAL-INFARCTION; MERIT-HF; METOPROLOL; CARVEDILOL; MORTALITY; MORBIDITY; CAPTOPRIL; BLOCKADE AB OBJECTIVES This study sought to assess the effect of angiotensin-converting enzyme (ACE) inhibitors and beta-blockers on all-cause mortality in patients with left ventricular (LV) systolic dysfunction according to gender, race, and the presence of diabetes. BACKGROUND Major randomized clinical trials have established that ACE inhibitors and beta-blockers have life-saving benefits in patients with LV systolic dysfunction. Most patients enrolled in these trials were Caucasian men. Whether an equal effect is achieved in women, non-Caucasians, and patients with major comorbidities has not been established. METHODS The authors performed a meta-analysis of published and individual patient data from the 12 largest randomized clinical trials of ACE inhibitors and beta-blockers to produce random effects estimates of mortality for subgroups. RESULTS Data support beneficial reductions in all-cause mortality for the use of beta-blockers in men and women, the use of ACE inhibitors and some beta-blockers in black and white patients, and the use of ACE inhibitors and beta-blockers in patients with or without diabetes. Women with symptomatic LV systolic dysfunction probably benefit from ACE inhibitors, but women with asymptomatic LV systolic dysfunction may not have reduced mortality when treated with ACE inhibitors (pooled relative risk = 0.96; 95% confidence interval: 0.75 to 1.22). The pooled estimate of three beta-blocker studies supports a beneficial effect in black patients with heart failure, but one study assessing bucindolol reported a nonsignificant increase in mortality. CONCLUSIONS Angiotensin-converting enzyme inhibitors and beta-blockers provide life-saving benefits in most of the subpopulations assessed. Women with asymptomatic LV systolic dysfunction may not achieve a mortality benefit when treated with ACE inhibitors. (C) 2003 by the American College of Cardiology Foundation. C1 RAND Hlth, So Calif Evidence Based Practice Ctr, Santa Monica, CA 90407 USA. Greater Los Angeles VA Med Ctr, Div Gen Internal Med, Los Angeles, CA USA. Washington Univ, Sch Med, Dept Internal Med, St Louis, MO 63110 USA. RAND Corp, Arroyo Ctr, Santa Monica, CA USA. USA, Dept Med, SE Reg Med Command, Athens, GA USA. Drexel Univ, Coll Med, Dept Med, Philadelphia, PA 19104 USA. Ahmanson UCLA, Cariomyopathy Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Div Cardiol, Los Angeles, CA USA. Univ Calif San Diego, Heart Failure Cardiac Transplantat Program, San Diego, CA 92103 USA. Stanford Univ, Dept Med, Stanford, CA 94305 USA. VA Palo Alto Healthcare Syst, Stanford, CA USA. Ingenix, Eden Prairie, MN USA. Tufts New England Med Ctr, Dept Med, Div Cardiol, Boston, MA USA. Tufts Univ, Sch Med, Boston, MA 02111 USA. Kaiser Permanente No Calif, Heart Failure Program, Santa Clara, CA USA. Brigham & Womens Hosp, Cardiomyopathy & Heart Failure Program, Boston, MA 02115 USA. Harvard Univ, Sch Med, Boston, MA USA. RP Shekelle, PG (reprint author), RAND Hlth, So Calif Evidence Based Practice Ctr, 1700 Main St,POB 2138, Santa Monica, CA 90407 USA. OI Heidenreich, Paul/0000-0001-7730-8490 FU PHS HHS [290-97-0000, 290-97-0001] NR 34 TC 226 Z9 235 U1 4 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 MAY 7 PY 2003 VL 41 IS 9 BP 1529 EP 1538 DI 10.1016/S0735-1097(03)00262-6 PG 10 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 674HR UT WOS:000182631800018 PM 12742294 ER PT J AU Humphrey, LL Helfand, M Chan, BKS AF Humphrey, LL Helfand, M Chan, BKS TI Screening for breast cancer - Response SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. RP Humphrey, LL (reprint author), Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. NR 3 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD MAY 6 PY 2003 VL 138 IS 9 BP 770 EP 770 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 674XA UT WOS:000182661400016 ER PT J AU Sekhon, B Sekhon, C Khan, M Patel, SJ Singh, I Singh, AK AF Sekhon, B Sekhon, C Khan, M Patel, SJ Singh, I Singh, AK TI N-Acetyl cysteine protects against injury in a rat model of focal cerebral ischemia SO BRAIN RESEARCH LA English DT Article DE focal cerebral ischemia; tumor necrosis factor; N-acetyl cysteine; nitric oxide; infarct volume ID NITRIC-OXIDE SYNTHASE; ACUTE-RENAL-FAILURE; ARTERY OCCLUSION; REPERFUSION INJURY; BRAIN INJURY; STROKE INCIDENCE; MICE LACKING; DAMAGE; INHIBITION; NECROSIS AB Ischemic cerebrovascular disease (stroke) is one of the leading causes of death and long-time disability. Ischemia/reperfusion to any organ triggers a complex series of biochemical events, which affect the structure and function of every organelle and subcellular system of the affected cells. The purpose of this study was to investigate the therapeutic efficacy of N-acetyl cysteine (NAC), a precursor of glutathione and a potent antioxidant, to attenuate ischemia/reperfusion injury to brain tissue caused by a focal cerebral ischemia model in rats. A total of 27 male Sprague-Dawley rats weighing 250-300 g were used in this study. Focal cerebral ischemia (45 min) was induced in anesthetized rats by occluding the middle cerebral artery (MCA) with an intra-luminal suture through the internal carotid artery. The rats were scored post-reperfusion for neurological deficits. They were then sacrificed after 24 h of reperfusion and infarct volume in the brain was assessed by 2,3,5-triphenyl tetrazolium chloride (TTC). Brain sections were immunostained for tumor necrosis factor (TNF-alpha) and inducible nitric oxide synthase (NOS). Animals treated with NAC showed a 49.7% (S.E.M. = 1.25) reduction in brain infarct volume and 50% (S.E.M. = 0.48) reduction in the neurological evaluation score as compared to the untreated animals. NAC treatment also blocked the ischemia/reperfusion-induced expression of tumor necrosis factor and inducible nitric oxide synthase. The data suggest that pre-administration of NAC attenuates cerebral ischemia and reperfusion injury in this brain ischemia model. This protective effect may be as a result of suppression of TNF-alpha and NOS. (C) 2003 Elsevier Science B.V. All rights reserved. C1 Med Univ S Carolina, Dept Pathol & Lab Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pediat, Div Dev Neurogenet, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Neurol Surg, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 29403 USA. RP Singh, AK (reprint author), Med Univ S Carolina, Dept Pathol & Lab Med, Rm 316 CSB,96 Jonathan Lucas St, Charleston, SC 29425 USA. FU NINDS NIH HHS [NS-22576, NS-34741, NS-37766, NS-40144, NS-40810] NR 39 TC 104 Z9 111 U1 0 U2 6 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD MAY 2 PY 2003 VL 971 IS 1 BP 1 EP 8 DI 10.1016/S0006-8993(03)002244-3 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 673NJ UT WOS:000182586800001 PM 12691831 ER PT J AU Serby, M Brickman, AM Haroutunian, V Purohit, DP Marin, D Lantz, M Mobs, RC Davis, KL AF Serby, M Brickman, AM Haroutunian, V Purohit, DP Marin, D Lantz, M Mobs, RC Davis, KL TI Cognitive burden and excess Lewy-body pathology in the Lewy-body variant of Alzheimer disease SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article ID DEMENTIA AB Authors compared the degrees of cognitive deficit among individuals with Alzheimer disease (AD), the Lewy-body variant of AD (LBV), and "pure" dementia with Lewy bodies (DLB); and compared cortical Lewy body (LB) counts in LBV versus DLB and neuritic plaque and neurofibrillary tangle severity in LBV versus AD. Methods: Authors examined brain specimens from consecutive autopsies of elderly nursing home subjects. Numbers and densities of plaques, Lewy bodies, and tangle severity were determined in multiple cortical regions, and demographic and clinical variables were compared among the three groups. Results: The three groups did not differ in demographic or clinical variables. The LBV group was significantly more impaired than the other groups. Cortical LB counts were significantly higher in LBV than in DLB. There was no evidence of increased plaque or tangle severity in LBV than in AD. Conclusion. The co-occurrence of AD and LB pathology is associated with higher numbers of LBs and more severe dementia than when classical AD or LB lesions occur alone. C1 Beth Israel Med Ctr, Dept Psychiat, New York, NY 10003 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. Mt Sinai Sch Med, Dept Pathol, New York, NY USA. Bronx Vet Affairs Med Ctr, Psychiat Serv, Bronx, NY USA. Jewish Home & Hosp, New York, NY USA. Eli Lilly & Co, Indianapolis, IN 46285 USA. RP Serby, M (reprint author), Beth Israel Med Ctr, Dept Psychiat, 1st Ave & 16th St, New York, NY 10003 USA. FU NIA NIH HHS [P01 AG 02219, P50 AG 05138] NR 10 TC 16 Z9 16 U1 0 U2 1 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD MAY-JUN PY 2003 VL 11 IS 3 BP 371 EP 374 DI 10.1176/appi.ajgp.11.3.371 PG 4 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 673DQ UT WOS:000182565300016 PM 12724118 ER PT J AU Feng, JA Perry, G Wang, DJ Oparil, S Chen, YF AF Feng, JA Perry, G Wang, DJ Oparil, S Chen, YF TI Pressure overload in the atrial natriuretic peptide deficient mouse: A novel model of heart failure SO AMERICAN JOURNAL OF HYPERTENSION LA English DT Meeting Abstract CT 18th Annual Scientific Meeting of the American-Society-of-Hypertension CY MAY 14-17, 2003 CL NEW YORK, NEW YORK SP Amer Soc Hypertens DE atrial natriuretic peptide; heart hypertrophy and failure; transgenic mouse C1 Univ Alabama, Vasc Biol & Hypertens Program, Birmingham, AL USA. Birmingham VA Med Ctr, Cardiol Sect, Birmingham, AL 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 0895-7061 J9 AM J HYPERTENS JI Am. J. Hypertens. PD MAY PY 2003 VL 16 IS 5 MA OR57 BP 26A EP 26A DI 10.1016/S0895-7061(03)00140-7 PN 2 PG 1 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 677LK UT WOS:000182809000057 ER PT J AU Eslami, P Nyby, MD Corry, DB Eggena, P Tuck, ML AF Eslami, P Nyby, MD Corry, DB Eggena, P Tuck, ML TI Insulin increases vascular smooth muscle cell cytosolic angiotensin II via an angiotensin type-1 receptor dependent mechanism SO AMERICAN JOURNAL OF HYPERTENSION LA English DT Meeting Abstract CT 18th Annual Scientific Meeting of the American-Society-of-Hypertension CY MAY 14-17, 2003 CL NEW YORK, NEW YORK SP Amer Soc Hypertens DE angiotensin II; insulin; vascular smooth muscle cells C1 Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles HEalthcare Syst, Sepulveda, CA USA. Olive View UCLA Med Ctr, Sylmar, CA 91342 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 0895-7061 J9 AM J HYPERTENS JI Am. J. Hypertens. PD MAY PY 2003 VL 16 IS 5 MA P348 BP 164A EP 164A DI 10.1016/S0895-7061(03)00513-2 PN 2 PG 1 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 677LK UT WOS:000182809000430 ER PT J AU Basile, JN AF Basile, JN TI Optimizing antihypertensive treatment in clinical practice. SO AMERICAN JOURNAL OF HYPERTENSION LA English DT Meeting Abstract CT 18th Annual Scientific Meeting of the American-Society-of-Hypertension CY MAY 14-17, 2003 CL NEW YORK, NEW YORK SP Amer Soc Hypertens DE hypertension; beta blockers; add-on therapy C1 Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-7061 J9 AM J HYPERTENS JI Am. J. Hypertens. PD MAY PY 2003 VL 16 IS 5 BP 268A EP 268A DI 10.1016/S0895-7061(03)00808-2 PN 2 PG 1 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 677LK UT WOS:000182809000716 ER PT J AU Pohland, CJ Scavnicky, SA Lasky, SS Good, CB AF Pohland, CJ Scavnicky, SA Lasky, SS Good, CB TI Lansoprazole overutilization: Methods for step-down therapy SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID PROTON PUMP INHIBITORS; BARRETTS-ESOPHAGUS; DUODENAL-ULCER; OMEPRAZOLE; RANITIDINE; OVERUSE AB Objective: To identify the documented indications for long-term therapy with lansoprazole 30 mg twice daily at the Veterans Affairs Pittsburgh Healthcare System, assess compliance with appropriate use criteria, evaluate patients eligible for step-down therapy, and recommend appropriate step-down therapy in order to improve patient care, decrease over-prescribing, and reduce medication costs. Study Design: Prospective intervention. Methods: The records of all patients with prescriptions for lansoprazole 30 mg twice daily as of June 2000 were reviewed. Patients were interviewed to assess medication compliance and symptom control and to provide education on lifestyle modifications. Interventions with the providers were completed to encourage step-down therapy in appropriate patients. Results: Two hundred forty-eight patients with active prescriptions for twice-daily lansoprazole were reviewed. Of these patients, 66% (n = 163) did not have an indication compliant with the medical center's guidelines for use of lansoprazole 30 mg twice daily. Of these, 88% (n = 143) had no documented attempt at step-down therapy and 49% (n = 80) had no documented gastrointestinal workup. Interventions for step-down therapy were recommended for 48% (n = 120) of the 248 patients. Forty-six percent (n = 60) of recommendations were accepted, resulting in a cost savings of $85 000 per year. Conclusions: A high rate of clinician noncompliance with the guidelines for appropriate use of lansoprazole 30 mg twice daily was found. These prescribing patterns resulted in significant cost concerns. Our review and interventions led to step-down therapy for almost half of the patients receiving twice-daily lansoprazole. This review of patient records and intervention with primary care providers resulted in cost reduction and offered an opportunity to educate patients on beneficial lifestyle modifications. C1 Vet Affairs Pittsburgh Healthcare Syst, Pharm SErv 132M U, Pittsburgh, PA 15240 USA. RP Scavnicky, SA (reprint author), Vet Affairs Pittsburgh Healthcare Syst, Pharm SErv 132M U, Univ Dr C, Pittsburgh, PA 15240 USA. NR 21 TC 10 Z9 12 U1 0 U2 3 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD MAY PY 2003 VL 9 IS 5 BP 353 EP 358 PG 6 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 677LA UT WOS:000182807900001 PM 12744297 ER PT J AU Villa, VM Harada, NB Washington, D Damron-Rodriguez, J AF Villa, VM Harada, NB Washington, D Damron-Rodriguez, J TI The health and functional status of US veterans aged 65+: Implications for VA health programs serving an elderly, diverse veteran population SO AMERICAN JOURNAL OF MEDICAL QUALITY LA English DT Article DE health services; health status; long-term care; race/ethnicity; veterans ID ALAMEDA COUNTY; LIFE AB As the US population is aging, so too is the US veteran population. Chief among the challenges facing the Department of Veterans Affairs (VA) is developing health programs and services that mesh with the needs of an aging veteran population and therefore improve the health status of elderly veterans. Meeting this challenge requires an understanding of the health needs of the older veteran population, including health disparities that exist across racial ethnic populations. This study examines the selfrated health and functioning of a national sample of veterans aged 65+ participating in the National Survey of Veterans. The results show that over one half of elderly veterans report difficulty in functioning and rate their health status as fair or poor. Additionally, elderly African American and Hispanic veterans report worse health than non-Hispanic white veterans across the majority of health indicators. Given the health profile of older veterans found in this study, it would seem necessary that programs serving older veterans be adept at the ongoing medical management of chronic disease and the provision of long-term care services. C1 Univ Calif Los Angeles, Sch Publ Hlth, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Policy & Social Res, Los Angeles, CA USA. RP Villa, VM (reprint author), Univ Calif Los Angeles, Sch Publ Hlth, VA Greater Los Angeles Hlth Care Syst, Bldg 115,Room 328,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 24 TC 11 Z9 11 U1 0 U2 2 PU AMER COLLEGE MEDICAL QUALITY PI BETHESDA PA 4334 MONTGOMERY AVE, 2ND FL, BETHESDA, MD 20814-4402 USA SN 1062-8606 J9 AM J MED QUAL JI Am. J. Med. Qual. PD MAY-JUN PY 2003 VL 18 IS 3 BP 108 EP 116 DI 10.1177/106286060301800304 PG 9 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 687DJ UT WOS:000183360500004 PM 12836900 ER PT J AU Grady, D AF Grady, D TI Myocardial infarction during menses: Lessons from trials and errors SO AMERICAN JOURNAL OF MEDICINE LA English DT Editorial Material ID ESTROGEN-REPLACEMENT THERAPY; CORONARY-ARTERY DISEASE; POSTMENOPAUSAL WOMEN; HEART-DISEASE; HORMONE-THERAPY C1 Univ Calif San Francisco, Womens Hlth Clin Res Ctr, San Francisco, CA 94115 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Grady, D (reprint author), Univ Calif San Francisco, Womens Hlth Clin Res Ctr, Box 0739,1635 Divisadero St,Suite 600, San Francisco, CA 94115 USA. NR 17 TC 1 Z9 1 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD MAY PY 2003 VL 114 IS 7 BP 611 EP 612 DI 10.1016/S0002-9343(03)00126-8 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 678WP UT WOS:000182889900014 PM 12753888 ER PT J AU Burns, SP Rivara, FP Johansen, JM Thompson, DC AF Burns, SP Rivara, FP Johansen, JM Thompson, DC TI Rehabilitation of traumatic injuries - Use of the Delphi method to identify topics for evidence-based review SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Article DE rehabilitation; spinal cord injuries; brain injuries; Delphi technique; evidence-based medicine AB Evidence-based reviews of research literature are useful in determining the efficacy of specific clinical practices, but the review process is frequently time-consuming and costly. The purpose of this study was to identify important research questions in rehabilitation that are appropriate for evidence-based reviews. The focus of this study was rehabilitation after traumatic injuries. Topics were identified using the Delphi method, which utilized a panel of 24 researchers and clinicians with expertise in rehabilitation of traumatic injuries. The experts identified 71 topics, predominantly in the areas of spinal cord injury and traumatic brain injury rehabilitation. The most commonly suggested intervention topics involved assessment of, pharmacologic agents, the timing or intensity of interventions, or specific nonpharmacologic therapies and exercises. Topics were ranked by mean importance score. Ten of 24 questions in the top tertile were considered to have some or a substantial amount of available research and thus may be appropriate for structured evidence-based reviews. Similar methods could be used to identify appropriate topics in other areas of rehabilitation. C1 VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv 128, Seattle, WA 98108 USA. Univ Washington, Harborview Injury Prevent & Res Ctr, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Washington, Harborview Injury Prevent & Res Ctr, Dept Pediat, Seattle, WA 98195 USA. Univ Washington, Harborview Injury Prevent & Res Ctr, Dept Epidemiol, Seattle, WA 98195 USA. RP Burns, SP (reprint author), VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv 128, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 15 TC 3 Z9 3 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 MAY PY 2003 VL 82 IS 5 BP 410 EP 414 DI 10.1097/01.PHM.0000064739.60860.A7 PG 5 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 670AY UT WOS:000182385800014 PM 12704283 ER PT J AU Yeh, CK Hymer, TK Sousa, AL Zhang, BX Lifschitz, MD Katz, MS AF Yeh, CK Hymer, TK Sousa, AL Zhang, BX Lifschitz, MD Katz, MS TI Epidermal growth factor upregulates beta-adrenergic receptor signaling in a human salivary cell line SO AMERICAN JOURNAL OF PHYSIOLOGY-CELL PHYSIOLOGY LA English DT Article DE adenylyl cyclase; G protein-coupled receptor; signal transduction; mitogen-activated protein kinase; protein kinase C ID PROTEIN-KINASE-C; OSTEOBLAST-LIKE CELLS; PAROTID ACINAR-CELLS; ADENYLATE-CYCLASE; PARATHYROID-HORMONE; BETA-2-ADRENERGIC RECEPTOR; GENE-EXPRESSION; DOWN-REGULATION; EGF RECEPTOR; GLAND AB The effects of epidermal growth factor (EGF) on the beta-adrenergic receptor-coupled adenylyl cyclase system were studied in a human salivary cell line (HSY). The beta-adrenergic agonist isoproterenol (10(-5) M) stimulated adenylyl cyclase activity by similar to2-fold, and the isoproterenol response was increased 1.8-fold after prolonged ( 48 h) exposure to EGF (5 x 10(-10) M). In contrast, enzyme activation via stimulatory prostaglandin receptors and by agents acting on nonreceptor components of the adenylyl cyclase system was not enhanced by EGF. beta-Adrenergic receptor density, assessed by binding of the beta-adrenergic receptor antagonist (-)-[I-125] iodopindolol, was increased threefold after EGF treatment. Competition binding studies with unlabeled antagonists selective for beta(1)- and beta(2)-adrenergic receptor subtypes indicated that the increase in (-)[I-25] iodopindolol binding sites induced by EGF reflected an increased number of beta(2)-adrenergic receptors. Likewise, Northern blot analysis of RNA from EGF-treated cells revealed selective induction of beta(2)-adrenergic receptor mRNA, which was blocked by the RNA synthesis inhibitor actinomycin D. The increase in beta-adrenergic receptor density produced by EGF was unaltered after phorbol ester-induced downregulation of protein kinase C (PKC). Enhancement of isoproterenol-responsive adenylyl cyclase activity and phosphorylation of mitogen-activated protein kinase ( MAPK) by EGF were both blocked by the MAPK pathway inhibitor PD-98059. The results suggest that in HSY cells EGF enhances beta-adrenergic responsiveness by upregulating beta(2)-adrenergic receptor expression at the transcriptional level. Moreover, the stimulatory effect of EGF on beta(2)-adrenergic receptor signaling appears to be mediated by the MAPK pathway and independent of PKC activation. C1 S Texas Vet Hlth Care Syst, Audie L Murphy Div, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Res Serv, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Dent Diagnost Sci, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. RP Katz, MS (reprint author), S Texas Vet Hlth Care Syst, Audie L Murphy Div, Geriatr Res Educ & Clin Ctr 182, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. FU NIDCR NIH HHS [DE-12188, DE-10756] NR 60 TC 6 Z9 6 U1 0 U2 0 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 MAY PY 2003 VL 284 IS 5 BP C1164 EP C1175 DI 10.1152/ajpcell.00343.2002 PG 12 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 663AK UT WOS:000181982400009 PM 12540376 ER PT J AU Vaughan, DJ Brogan, TV Kerr, ME Deem, S Luchtel, DL Swenson, ER AF Vaughan, DJ Brogan, TV Kerr, ME Deem, S Luchtel, DL Swenson, ER TI Contributions of nitric oxide synthase isozymes to exhaled nitric oxide and hypoxic pulmonary vasoconstriction in rabbit lungs SO AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY LA English DT Article DE nitric oxide synthase inhibitors; isolated perfused lung; 1400W; 7-nitroindazole; nitro-L-arginine methyl ester ID ENDOTHELIAL-CELLS; IN-VIVO; INHIBITION; HUMANS; AIRWAYS; CIRCULATION; EPITHELIUM; ASTHMA; MOUSE; FLOW AB We investigated the source(s) for exhaled nitric oxide (NO) in isolated, perfused rabbits lungs by using isozyme-specific nitric oxide synthase (NOS) inhibitors and antibodies. Each inhibitor was studied under normoxia and hypoxia. Only nitro-L-arginine methyl ester (L-NAME, a nonselective NOS inhibitor) reduced exhaled NO and increased hypoxic pulmonary vasoconstriction (HPV), in contrast to 1400W, an inhibitor of inducible NOS (iNOS), and 7-nitroindazole, an inhibitor of neuronal NOS (nNOS). Acetylcholine-mediated stimulation of vascular endothelial NOS (eNOS) increased exhaled NO and could only be inhibited by L-NAME. Selective inhibition of airway and alveolar epithelial NO production by nebulized L-NAME decreased exhaled NO and increased hypoxic pulmonary artery pressure. Immunohistochemistry demonstrated extensive staining for eNOS in the epithelia, vasculature, and lymphatic tissue. There was no staining for iNOS but moderate staining for nNOS in the ciliated cells of the epithelia, lymphoid tissue, and cartilage cells. Our findings show virtually all exhaled NO in the rabbit lung is produced by eNOS, which is present throughout the airways, alveoli, and vessels. Both vascular and epithelial-derived NO modulate HPV. C1 Childrens Hosp & Med Ctr, Dept Pediat, Seattle, WA 98105 USA. Univ Washington, Dept Med, Seattle, WA 98108 USA. Univ Washington, Dept Anesthesiol, Seattle, WA 98108 USA. Univ Washington, Dept Environm Hlth, Seattle, WA 98108 USA. RP Swenson, ER (reprint author), Vet Affairs Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NHLBI NIH HHS [HL-45591, HL-03796-01] NR 38 TC 33 Z9 35 U1 1 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1040-0605 J9 AM J PHYSIOL-LUNG C JI Am. J. Physiol.-Lung Cell. Mol. Physiol. PD MAY PY 2003 VL 284 IS 5 BP L834 EP L843 DI 10.1152/ajplung.00341.2002 PG 10 WC Physiology; Respiratory System SC Physiology; Respiratory System GA 662VB UT WOS:000181968600018 PM 12533440 ER PT J AU Janech, MG Fitzgibbon, WR Chen, RH Nowak, MW Miller, DH Paul, RV Ploth, DW AF Janech, MG Fitzgibbon, WR Chen, RH Nowak, MW Miller, DH Paul, RV Ploth, DW TI Molecular and functional characterization of a urea transporter from the kidney of the Atlantic stingray SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article; Proceedings Paper CT Experimental Biology 2000 Meeting CY APR 14-19, 2000 CL SAN DIEGO, CA DE euryhaline; 5 '/3 '-rapid amplification of cDNA ends; osmoregulation ID ST-JOHNS RIVER; RAT-KIDNEY; COLLECTING DUCTS; DASYATIS-SABINA; RAJA-ERINACEA; SLC14A2 GENE; CLONING; ELASMOBRANCH; OSMOREGULATION; EXPRESSION AB In general, marine elasmobranch fishes ( sharks, skates, and rays) maintain body fluid osmolality above seawater, principally by retaining large amounts of urea. Maintenance of the high urea concentration is due in large part to efficient renal urea reabsorption. Regulation of renal urea reabsorption also appears to play a role in maintenance of fluid homeostasis of elasmobranchs that move between habitats of different salinities. We identified and cloned a novel 2.7- kb cDNA from the kidney of the euryhaline Atlantic stingray Dasyatis sabina ( GenBank accession no. AF443781). This cDNA putatively encoded a 431- amino acid protein ( strUT- 1) that had a high degree of sequence identity ( 71%) to the shark kidney facilitated urea transporter ( UT). However, the predicted COOH- terminal region of strUT- 1 appears to contain an additional sequence that is unique among cloned renal UTs. Injection of strUT- 1 cRNA into Xenopus oocytes induced a 33- fold increase in [ (14)C] urea uptake that was inhibited by phloretin. Four mRNA bands were detected in kidney by Northern blot: a transcript at 2.8 kb corresponding to the expected size of strUT- 1 mRNA and bands at 3.8, 4.5, and 5.5 kb. Identification of a facilitated UT in the kidney of the Atlantic stingray provides further support for the proposal that passive mechanisms contribute to urea reabsorption by elasmobranch kidney. C1 Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Marine Biomed & Environm Sci, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pharmacol & Expt Therapeut, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29525 USA. RP Fitzgibbon, WR (reprint author), Med Univ S Carolina, Dept Med, Div Nephrol, 96 Jonathan Lucas St,POB 250623, Charleston, SC 29425 USA. EM fitzgiwr@musc.edu NR 49 TC 32 Z9 33 U1 0 U2 10 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD MAY PY 2003 VL 284 IS 5 BP F996 EP F1005 PG 10 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 663RF UT WOS:000182018200014 PM 12388386 ER PT J AU Chang, VW Christakis, NA AF Chang, VW Christakis, NA TI Self-perception of weight appropriateness in the United States SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID BODY-MASS INDEX; REPORTED WEIGHT; MARITAL-STATUS; AFRICAN-AMERICAN; SIZE PERCEPTIONS; NATIONAL-HEALTH; LOSE WEIGHT; WHITE WOMEN; OBESITY; ADULTS AB Background: The self-perception of weight appropriateness is an important component of eating and weight-loss behaviors. Self-perceived weight status, however, is not fully explained by objective weight status. Objective: To examine the influence of sociodemographic factors on Americans' perceptions of their weight appropriateness, controlling for objective weight status. Design: In the Third National Health and Nutrition Examination Survey, respondents were asked, "Do you consider yourself now to be overweight, underweight, or about the right weight?" Responses to this question were compared with how respondents (n = 15,593) would be classified by medical standards given their body mass index (BMI). A proportional odds logistic regression model was used to assess the predictive effects of various sociodemographic factors on weight self-perception. Results: Overall, 27.5% of women and 29.8% of men misclassified their own weight status by medical standards. Of particular note, 38.3% of normal weight women thought they were "overweight," while 32.8% of overweight men thought they were "about the right weight" or "underweight." Multivariate regression analysis revealed that, controlling for BMI, numerous factors-including gender, age, marital status, race, income, and education-were independently associated with the self-evaluation of weight status. Conclusions: The self-perceived appropriateness of weight status varies in highly predictable ways among population-level subgroups, likely reflecting differences in the normative evaluation of bodily weight standards. Such evaluations may assist in the explanation of discrepancies between clinical recommendations based on weight status and actual weight control behaviors, discrepancies that are socially patterned along some of the same subgroupings. C1 Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Chicago, Dept Sociol, Chicago, IL 60637 USA. Harvard Med Sch, Dept Hlth Care Policy, Cambridge, MA USA. VAMC, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. RP Chang, VW (reprint author), Univ Penn, Sch Med, Dept Med, 1233 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. RI Christakis, Nicholas/B-6690-2008; Christakis, Nicholas/C-3205-2009 FU AHRQ HHS [T32 HS 00084-04] NR 46 TC 141 Z9 142 U1 5 U2 16 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 2003 VL 24 IS 4 BP 332 EP 339 DI 10.1016/S0749-3797(03)00020-5 PG 8 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 679MV UT WOS:000182927100006 PM 12726871 ER PT J AU Religa, D Laudon, H Styczynska, M Winblad, B Naslund, J Haroutunian, V AF Religa, D Laudon, H Styczynska, M Winblad, B Naslund, J Haroutunian, V TI Amyloid beta pathology in Alzheimer's disease and schizophrenia SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID NORMAL HUMAN CORTEX; ELDERLY PATIENTS; COGNITIVE IMPAIRMENT; CYTOARCHITECTONIC DEFINITION; PREFRONTAL AREAS; SYMPTOMS; DEMENTIA; PROGRESSION; POSTMORTEM; MECHANISM AB Objective: Severe cognitive impairment is common in elderly patients with schizophrenia. Alzheimer's disease is the main cause of dementia among the elderly. Biochemical and genetic studies suggest that amyloid beta-peptide is central in Alzheimer's disease. The authors examined the possible involvement of amyloid beta-peptide in cognitive impairment in schizophrenia. Method: Specific antibodies against two major forms of amyloid beta-peptide, Abetax-40 and Abetax-42, were used in sandwich enzyme-linked immunosorbent assays to determine the levels of amyloid beta-peptide in postmortem brain samples from Alzheimer's disease patients (N=10), normal elderly comparison subjects (N=11), and schizophrenia patients with (N=7) or without (N=26) Alzheimer's disease. Results: The levels of amyloid beta-peptide were highest in the Alzheimer's disease patients, followed by the patients with schizophrenia and comparison subjects. The mean Abetax-42 level in the schizophrenia patients without Alzheimer's disease was similar to that in the comparison subjects, but the level in the schizophrenia patients with Alzheimer's disease was significantly higher than in those without Alzheimer's disease or the comparison subjects. The Abetax-42 level in the schizophrenia patients with Alzheimer's disease was significantly lower than the level in the Alzheimer's disease cohort. Conclusions: In contrast to elderly schizophrenia patients with Alzheimer's disease pathology, those without Alzheimer's disease had amyloid beta-peptide levels that were not significantly different from those of normal subjects; hence amyloid beta-peptide does not account for the cognitive deficits in this group. These results suggest that the causes of cognitive impairment in "pure" schizophrenia are different from those in Alzheimer's disease. C1 Karolinska Inst, Dept Clin Neurosci Occupat Therapy & Elderly Care, S-14186 Huddinge, Sweden. Polish Acad Sci, Med Res Ctr, Dept Neurodegenerat Disorders, Warsaw, Poland. Mt Sinai Sch Med, Dept Psychiat, Bronx, NY USA. Bronx Vet Affairs Med Ctr, Bronx, NY USA. RP Religa, D (reprint author), Karolinska Inst, Dept Clin Neurosci Occupat Therapy & Elderly Care, S-14186 Huddinge, Sweden. NR 44 TC 22 Z9 22 U1 0 U2 6 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD MAY PY 2003 VL 160 IS 5 BP 867 EP 872 DI 10.1176/appi.ajp.160.5.867 PG 6 WC Psychiatry SC Psychiatry GA 673ZC UT WOS:000182610400010 PM 12727689 ER PT J AU Schnapp, LM Matosian, M Weisman, I Welsh, CH AF Schnapp, LM Matosian, M Weisman, I Welsh, CH TI A snapshot of pulmonary medicine at the turn of the century - The American Thoracic Society membership SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE career choice; medical faculty; pulmonary disease (specialty); questionnaires ID WOMEN PHYSICIANS; UNDERSERVED POPULATIONS; ACADEMIC MEDICINE; RESPONSE RATES; CAREER; PROFESSION; RADIOLOGY; MINORITY; STUDENTS; LIFE AB To describe the characteristics of the American Thoracic Society, the Membership Committee developed a survey to assess demographics, training, professional activities, and needs of a diverse membership with a growing international segment. It also provided an opportunity to determine how the Society reflects the current state of pulmonary medicine in the United States. A self-administered survey was mailed to active members. Of responding members, 80% reside in the United States or Canada; the remainder come from 90 different countries. The majority of North American respondents (79%) were white, non-Hispanic. Seventeen percent of respondents were female. Female respondents were younger, with a mean age of 42 years, compared with 47 years for males. Sixty-five percent of respondents identified clinical practice, 20% research, and 5% teaching as their major activity. More women (33%) than men (22%) identified themselves as researchers. The majority of respondents (69%) have a medical school faculty affiliation. The American Thoracic Society represents a global organization with diverse clinical expertise and scientific interests. The majority of respondents are clinicians; however, the membership has a strong academic bent with most reporting academic affiliation, and describing teaching as a secondary activity. C1 Univ Washington, Harborview Med Ctr, Div Pulm & Crit Care Med, Seattle, WA 98104 USA. Amer Thorac Soc, Membership Serv & Mkt, New York, NY USA. William Beaumont Army Med Ctr, Dept Clin Invest, El Paso, TX 79920 USA. William Beaumont Army Med Ctr, Pulm Crit Care Serv, El Paso, TX 79920 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80202 USA. Denver Vet Affairs Med Ctr, Div Pulm, Denver, CO 80202 USA. RP Schnapp, LM (reprint author), Univ Washington, Harborview Med Ctr, Div Pulm & Crit Care Med, Box 359640,325 9Th Ave, Seattle, WA 98104 USA. NR 29 TC 6 Z9 6 U1 0 U2 1 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD MAY 1 PY 2003 VL 167 IS 9 BP 1176 EP 1180 DI 10.1164/rccm.200203-1860C PG 5 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 675NC UT WOS:000182700600006 PM 12522026 ER PT J AU Rosenheck, R Leslie, D Woody, G AF Rosenheck, R Leslie, D Woody, G TI Fiscal strain and access to opiate substitution therapy at department of Veterans Affairs Medical Centers SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article ID MENTAL-HEALTH-SERVICES; LEAST WELL; COST; SYSTEM; CARE AB This study examines the relationship between institutional fiscal strain and the availability of opiate substitution therapy (eg, methadone maintenance), an effective but relatively expensive treatment for heroin addiction. An observational design was used to examine the association of changes in funding and changes in provision for treating opiate addiction at 29 VA Medical Centers (VAMCs). We hypothesized that VAMCs experiencing greater fiscal strain would show reduced availability of opiate substitution treatment. Administrative records from each of 29 VAMCs that provided opiate substitution therapy in both Fiscal Year (FY) 1995 and FY 1999 were used to measure changes in the availability of this service, ie, the percent change in total patients treated, annual visits per patient, and total services delivered. Institutional fiscal strain was measured by the percent decline in per capita funding at four levels at each VAMC: the entire medical center, all mental health programs, all substance abuse programs (inpatient and outpatient), and outpatient substance abuse programs alone. The total number of patients receiving opiate substitution increased from 5,549 in FY 1995 to 6,884 in FY 1999 (24%), annual visits per patient decreased by 16%, and the total number of units of services increased by 4%. There were no significant relationships between changes in the delivery of opiate substitution services and changes in per capita funding at any of the four institutional levels. No new programs were started during these years. Although no new programs were started, the availability of opiate substitution therapy at VA facilities with existing programs was maintained over a five-year period regardless of local funding changes, although at somewhat reduced intensity. C1 VISN, Mental Illness Res Educ & Clin Ctr, West Haven, CT USA. Yale Univ, Dept Psychiat, New Haven, CT 06520 USA. Yale Univ, Dept Epidemiol, New Haven, CT 06520 USA. Yale Univ, Dept Publ Hlth, New Haven, CT 06520 USA. Univ Penn, Dept Psychiat, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Rosenheck, R (reprint author), 182 NE Program Evaluat Ctr, 950 Campbell Ave, West Haven, CT 06516 USA. NR 19 TC 1 Z9 1 U1 0 U2 0 PU BRUNNER-ROUTLEDGE PI PHILADELPHIA PA 325 CHESTNUT ST, 8TH FL, PHILADELPHIA, PA 19106 USA SN 1055-0496 J9 AM J ADDICTION JI Am. J. Addict. PD MAY-JUN PY 2003 VL 12 IS 3 BP 220 EP 228 DI 10.1080/10550490390202659 PG 9 WC Substance Abuse SC Substance Abuse GA 694PD UT WOS:000183782200005 PM 12851018 ER PT J AU Spyropoulos, DD Bartel, FO Higuchi, T Deguchi, T Ogawa, M Watson, DK AF Spyropoulos, DD Bartel, FO Higuchi, T Deguchi, T Ogawa, M Watson, DK TI Marker-assisted study of genetic background and gene-targeted locus modifiers in lymphopoietic phenotypes SO ANTICANCER RESEARCH LA English DT Article; Proceedings Paper CT 4th International Confrence on Gene Regulation, Oncogenesis and AIDS CY SEP 22-26, 2002 CL ATHENS, GREECE DE Ets; knockout; targeted disruption; genetic background; genetic modifiers; QTL; speed congenics ID QUANTITATIVE TRAIT LOCI; ETS-1 TRANSCRIPTION FACTOR; NK-T-CELLS; DNA-BINDING; MOUSE MUTAGENESIS; 129 SUBSTRAINS; PRACTICAL CONSEQUENCES; AUTO-INHIBITION; NATURAL-KILLER; COMPLEX TRAITS AB forward and reverse genetic approaches facilitate the molecular dissection of individual gene functions and the integration of individual gene functions into multi-gene processes in the context of the whole organism. Variations in mutant phenotypes due to genetic background differences have been well documented through the analysis of mouse mutants. Nevertheless, recommendations concerning the assessment of genetic background as it impacts on phenotype, and utilization of genetic background differences to identify and integrate gene functions have been largely, overlooked. Genetic background as it relates to immunological mutants will be discussed utilizing an Ets1-targeted allele to exemplify phenotypic variation due to background. Marker-assisted strategies for the identification of genetic modifiers', especially those linked to the targeted locus, will also be considered. C1 Med Univ S Carolina, Hollings Canc Ctr, Lab Canc Genom, Charleston, SC 29425 USA. Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Cell Biol & Anat, Charleston, SC 29425 USA. RP Spyropoulos, DD (reprint author), Med Univ S Carolina, Hollings Canc Ctr, Lab Canc Genom, Room 338,86 Jonathan Lucas St, Charleston, SC 29425 USA. FU NCI NIH HHS [P01CA78582] NR 100 TC 4 Z9 4 U1 0 U2 0 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 MAY-JUN PY 2003 VL 23 IS 3A BP 2015 EP 2026 PG 12 WC Oncology SC Oncology GA 704UN UT WOS:000184359100005 PM 12894574 ER PT J AU Doyle, PJ AF Doyle, PJ TI Preface SO APHASIOLOGY LA English DT Editorial Material C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. RP Doyle, PJ (reprint author), VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 0268-7038 J9 APHASIOLOGY JI Aphasiology PD MAY PY 2003 VL 17 IS 5 BP 421 EP 421 DI 10.1080/02687030344000201 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 669DB UT WOS:000182335700001 ER PT J AU Hula, WD McNeil, MR Doyle, PJ Rubinsky, HJ Fossett, TRD AF Hula, WD McNeil, MR Doyle, PJ Rubinsky, HJ Fossett, TRD TI The inter-rater reliability of the story retell procedure SO APHASIOLOGY LA English DT Article; Proceedings Paper CT 32nd Annual Clinical Aphasiology Conference CY JUN, 2002 CL RIDGEDALE, MISSOURI ID CONNECTED SPEECH; APHASIA; ADULTS AB Background: McNeil, Doyle, Fossett, Park, and Goda (2001) have presented the story retell procedure (SRP) as an efficient means of assessing discourse in adults with aphasia, in part because it provides reliable, valid, and sensitive indices of performance without the need for time-consuming transcription of language samples. Aims: The purpose of this study was to demonstrate that the SRP, when scored without transcription by judges with minimal training, produces a reliable measure of information transfer. Methods & Procedures: Four judges who had not used the SRP previously scored audio-recorded language samples, produced by four subjects with aphasia and eleven normal subjects, for percent information units per minute (%IU/Min). Outcomes & Results: The results demonstrate that the SRP has high inter-rater reliability. Reliability coefficients ranged from .89 to .995, and the standard error of measurement associated with inter-rater scoring error ranged from .59 to 1.42 %IU/Min. Point-to-point reliability in scoring individual information units ranged from 85-95% and averaged 91% for both subject groups. Conclusions: The SRP is a potentially useful tool for quantifying connected language behaviour, and may be particularly valuable in clinical and research settings where economy of assessment procedures is essential. C1 VA Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. RP Hula, WD (reprint author), VA Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, 7180 Highland Dr, Pittsburgh, PA 15206 USA. NR 19 TC 10 Z9 10 U1 1 U2 1 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 0268-7038 J9 APHASIOLOGY JI Aphasiology PD MAY PY 2003 VL 17 IS 5 BP 523 EP 528 DI 10.1080/02687030344000139 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 669DB UT WOS:000182335700010 ER PT J AU Davis, KL Stewart, DG Friedman, JI Buchsbaum, M Harvey, PD Hof, PR Buxbaum, J Haroutunian, V AF Davis, KL Stewart, DG Friedman, JI Buchsbaum, M Harvey, PD Hof, PR Buxbaum, J Haroutunian, V TI White matter changes in schizophrenia - Evidence for myelin-related dysfunction SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Review ID 2',3'-CYCLIC NUCLEOTIDE 3'-PHOSPHODIESTERASE; CENTRAL-NERVOUS-SYSTEM; LATE-ONSET SCHIZOPHRENIA; OLIGODENDROCYTE PRECURSOR CELLS; MAGNETIC-RESONANCE SPECTROSCOPY; ASPARTATE RECEPTOR ANTAGONISTS; ADHESION MOLECULES L1; LOCAL CIRCUIT NEURONS; MULTIPLE-SCLEROSIS; PREFRONTAL CORTEX AB Numerous lines of inquiry implicate connectivity as a central abnormality in schizophrenia. Myelination and factors that affect myelination, such. as the function of oligodendroglia, are critical processes that could profoundly affect neuronal connectivity, especially given the diffuse distribution of oligodendrocytes and the widespread distribution of brain regions that have been implicated in schizophrenia. Multiple lines of evidence now converge to implicate oligodendroglia and myelin in schizophrenia. Imaging and neurocytochemical evidence, similarities with demyelinating diseases, age-related changes in white matter, myelin-related gene abnormalities, and morphologic abnormalities in the oligodendroglia demonstrated in schizophrenic brains are all examined in light of the hypothesis that oligodendroglial dysfunction and even death, with subsequent abnormalities in myelin maintenance and repair, contribute to the schizophrenic syndrome. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY 10021 USA. Mt Sinai Sch Med, Kastor Neurobiol Aging Labs, Fishberg Res Ctr Neurobiol, New York, NY 10021 USA. Mt Sinai Sch Med, Kastor Neurobiol Aging Labs, Dept Geriatr Adult Dev, New York, NY 10021 USA. Bronx Vet Adm Med Ctr, Mental Illness Res Educ & Clin Ctr, Bronx, NY USA. Pilgrim Psychiat Ctr, Brentwood, NY USA. RP Davis, KL (reprint author), Mt Sinai Sch Med, Dept Psychiat, 1 Gustav Levy Pl, New York, NY 10021 USA. OI Buxbaum, Joseph/0000-0001-8898-8313 NR 275 TC 499 Z9 511 U1 7 U2 32 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD MAY PY 2003 VL 60 IS 5 BP 443 EP 456 DI 10.1001/archpsyc.60.5.443 PG 14 WC Psychiatry SC Psychiatry GA 676CU UT WOS:000182735000002 PM 12742865 ER PT J AU Schnurr, PP Friedman, MJ Foy, DW Shea, MT Hsieh, FY Lavori, PW Glynn, SM Wattenberg, M Bernardy, NC AF Schnurr, PP Friedman, MJ Foy, DW Shea, MT Hsieh, FY Lavori, PW Glynn, SM Wattenberg, M Bernardy, NC TI Randomized trial of trauma-focused group therapy for posttraumatic stress disorder - Results from a Department of Veterans Affairs Cooperative Study SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Annual Meeting of the International-Society-for-Traumatic-Stress-Studies CY DEC 08, 2001 CL NEW ORLEANS, LOUISIANA SP Int Soc Traumat Stress Studies ID ADMINISTERED PTSD SCALE; ASSAULT VICTIMS; CLINICAL-TRIALS; EXPOSURE; PATIENT; DESIGN; WOMEN AB Background: Department of Veterans Affairs Cooperative Study 420 is a randomized clinical trial of 2 methods of group psychotherapy for treating post-traumatic stress disorder (PTSD) in male Vietnam veterans. Methods: Vietnam veterans (360 men) were randomly assigned to receive trauma-focused group psychotherapy or a present-centered comparison treatment that avoided trauma focus. Treatment was provided weekly to groups of 6 members for 30 weeks, followed by 5 monthly booster sessions. Severity of PTSD was, the primary outcome. Additional measures were other psychiatric symptoms, functional status, quality of life, physical health, and service utilization. Follow-up assessments were conducted at the end of treatment (7 months) and at the end of the booster sessions (12 months); 325 individuals participated in 1 or both assessments. Additional follow-up for PTSD severity was performed in a subset of participants at 18 and 24 months. Results: Although posttreatment assessments of PTSD severity and other measures were significantly improved from baseline, intention-to-treat analyses found no overall differences between therapy groups on Any outcome. Analyses of data from participants who received an adequate dose of treatment suggested that trauma-focused group therapy reduced avoidance and numbing and, possibly, PTSD symptoms. Dropout from treatment was higher in trauma-focused group treatment. Average improvement was modest in both treatments, although approximately 40% of participants showed clinically significant change. Conclusions: This study did not find a treatment effect for trauma-focused group therapy. The difference between the effectiveness and adequate dose findings suggests the possible value of methods to enhance the delivery of cognitive-behavioral treatments in clinical practice settings. C1 Natl Ctr Posttraumat Stres Disorder, Dept Vet Affairs, White River Jct, VT USA. Dartmouth Coll Sch Med, Dept Psychiat, Hanover, NH USA. Dartmouth Coll Sch Med, Dept Pharmacol, Hanover, NH USA. Pepperdine Univ, Dept Psychol, Culver City, CA USA. Providence VA Med Ctr, Mental Hlth & Behav Sci Serv, Providence, RI USA. Brown Univ, Dept Psychiat, Providence, RI 02912 USA. VA Cooperat Studies Program, Menlo Pk, CA USA. Stanford Univ, Dept Hlth Res & Policy, Palo Alto, CA 94304 USA. W Los Angeles VA Med Ctr, Res Serv, Los Angeles, CA USA. VA Outpatient Clin, Boston, MA USA. Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Los Angeles, CA USA. Tufts Univ, Sch Med, Dept Psychiat, Boston, MA 02111 USA. RP Schnurr, PP (reprint author), VA Med & Reg Off Ctr, VA Natl Ctr PTSD, Mail Stop 116D, White River Jct, VT 05009 USA. NR 36 TC 191 Z9 192 U1 1 U2 19 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD MAY PY 2003 VL 60 IS 5 BP 481 EP 489 DI 10.1001/archpsyc.60.5.481 PG 9 WC Psychiatry SC Psychiatry GA 676CU UT WOS:000182735000006 PM 12742869 ER PT J AU Novis, DA Miller, KA Howanitz, PJ Renner, SW Walsh, MK AF Novis, DA Miller, KA Howanitz, PJ Renner, SW Walsh, MK TI Audit of transfusion procedures in 660 hospitals - A College of American Pathologists Q-Probes study of patient identification and vital sign monitoring frequencies in 16494 transfusions SO ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE LA English DT Article ID QUALITY-CONTROL DOCUMENTATION; NEW-YORK-STATE; PROGRAM CHARACTERISTICS; ACCURACY PERFORMANCE; 1639 HOSPITALS; UNITS; INSTITUTIONS; INDICATORS; ERRORS; ISSUES AB Context.-Hemolytic transfusion reactions are often the result of failure to follow established identification and monitoring procedures. Objective.-To measure the frequencies with which health care workers completed specific transfusion procedures required for laboratory and blood bank accreditation. Design.-In 2 separate studies, participants in the College of American Pathologists Q-Probes laboratory quality improvement program audited nonemergent red blood cell transfusions prospectively and completed questionnaires profiling their institutions' transfusion policies. Setting and Participants.-A total of 660 institutions, predominantly in the United States, at which transfusion medicine services are provided. Main Outcome Measures.-The percentages of transfusions for which participants completed 4 specific components of patient and blood unit identifications, and for which participants monitored vital signs at 3 specific intervals during transfusions. Results.-In the first study, all components of patient identification procedures were performed in 62.3%, and all required patient vital sign monitoring was performed in 81.6% of 12448 transfusions audited. The median frequencies with which institutions participating in the first study performed all patient identification and monitoring procedures were 69.0% and 90.2%, respectively. In the second study, all components of patient identification were performed in 25.4% and all patient vital sign monitoring was performed in 88.3% of 4046 transfusions audited. The median frequencies with which institutions participating in the second study performed all patient identification and monitoring procedures were 10.0% and 95.0%, respectively. Individual practices and/or institutional policies associated with greater frequencies of patient identification and/or vital sign monitoring included transporting units of blood directly to patient bedsides, having no more than I individual handle blood units in route, checking unit labels against physicians' orders, having patients wear identification tags (wristbands), reading identification information aloud when 2 or more transfusionists participated, using written checklists to guide the administration of blood, instructing health care personnel in transfusion practices, and routinely auditing the administration of transfusions. Conclusions.-In many hospitals, the functions of identification and vital sign monitoring of patients receiving blood transfusions do not meet laboratory and blood bank accreditation standards. Differences in hospital transfusion policies influence how well health care workers comply with standard practices. We would expect that efforts designed to perfect transfusion policies might also improve performance in those hospitals in which practice compliance is substandard. C1 Wentworth Douglass Hosp, Dept Pathol, Dover, NH 03820 USA. Clin Path Associates, Tempe, AZ USA. SUNY Downstate Med Ctr, Brooklyn, NY 11203 USA. VA Greater Los Angeles Healthcare Syst, Dept Pathol, Los Angeles, CA USA. Coll Amer Pathologists, Northfield, IL USA. RP Novis, DA (reprint author), Wentworth Douglass Hosp, Dept Pathol, Dover, NH 03820 USA. NR 23 TC 36 Z9 38 U1 0 U2 2 PU COLLEGE AMER PATHOLOGISTS PI NORTHFIELD PA C/O KIMBERLY GACKI, 325 WAUKEGAN RD, NORTHFIELD, IL 60093-2750 USA SN 0003-9985 J9 ARCH PATHOL LAB MED JI Arch. Pathol. Lab. Med. PD MAY PY 2003 VL 127 IS 5 BP 541 EP 548 PG 8 WC Medical Laboratory Technology; Medicine, Research & Experimental; Pathology SC Medical Laboratory Technology; Research & Experimental Medicine; Pathology GA 674XH UT WOS:000182662200002 PM 12708895 ER PT J AU Vielma-Angarita, SA Krings, G Lopes-Virella, MF Johnson, RH AF Vielma-Angarita, SA Krings, G Lopes-Virella, MF Johnson, RH TI Protein kinase c and nuclear factor-kappa B signaling pathways mediate the upregulation of intracellular adhesion molecule-1 induced by Chlamydophila pneumoniae SO ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY LA English DT Meeting Abstract CT 4th Annual Conference on Arteriosclerosis Thrombosisand Vascular Biology CY MAY 08-10, 2003 CL WASHINGTON, D.C. C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VAMC, Charleston, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1079-5642 J9 ARTERIOSCL THROM VAS JI Arterioscler. Thromb. Vasc. Biol. PD MAY PY 2003 VL 23 IS 5 MA P121 BP A22 EP A22 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 676GG UT WOS:000182742500149 ER PT J AU Gazit, A Yee, K Uecker, A Bohmer, FD Sjoblom, T Ostman, A Waltenberger, J Golomb, G Banai, S Heinrich, MC Levitzki, A AF Gazit, A Yee, K Uecker, A Bohmer, FD Sjoblom, T Ostman, A Waltenberger, J Golomb, G Banai, S Heinrich, MC Levitzki, A TI Tricyclic quinoxalines as potent kinase inhibitors of PDGFR kinase, Flt3 and Kit SO BIOORGANIC & MEDICINAL CHEMISTRY LA English DT Article ID RECEPTOR TYROSINE-KINASE; FACTOR BETA-RECEPTOR; GROWTH-FACTOR; IN-VITRO; PHOSPHORYLATION; COMPLEX; DESIGN; CELLS AB Here we report on novel quinoxalines as highly potent and selective inhibitors of the type III receptor tyrosine kinases PDGFR, FLT3, and KIT. These compounds, tricyclic quinoxalines, were generated in order to improve bioavailability over the highly hydrophobic bicyclic quinoxalines. Four of the highly active compounds were characterized in detail and are shown to inhibit PDGFR kinase activity of the isolated receptor as well as in intact cells in the sub-micromolar concentration range. We show that the most active inhibitor (compound 13, AGL 2043) is similar to 15-20 times more potent than its isomer (compound 14, AGL 2044). We therefore compared the three dimensional structures of the two compounds by X-ray crystallography. These compounds are also highly effective in blocking the kinase activity of FLT3, KIT, and the oncogenic protein Tel-PDGFR in intact cells. These compounds are potent inhibitors of the proliferation of pig heart smooth muscle cells. They fully arrest the growth of these cells and the effect is fully reversible. The chemical, biochemical and cellular properties of these compounds as well as the solubility properties make them suitable for development as anti-restenosis and anti-cancer agents. (C) 2003 Elsevier Science Ltd. All rights reserved. C1 Hebrew Univ Jerusalem, Alexander Silberman Inst Life Sci, Dept Biol Chem, IL-91904 Jerusalem, Israel. Oregon Hlth Sci Univ, Inst Canc, Dept Hematol & Med Oncol, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. Klinikum Univ Jena, Res Unit Mol Cell Biol, D-07747 Jena, Germany. Ludwig Inst Canc Res, S-75124 Uppsala, Sweden. Univ Ulm, Dept Internal Med 2, D-89081 Ulm, Germany. Hebrew Univ Jerusalem, Sch Pharm, IL-91904 Jerusalem, Israel. Bikur Holim Hosp, Dept Cardiol, IL-91004 Jerusalem, Israel. RP Levitzki, A (reprint author), Hebrew Univ Jerusalem, Alexander Silberman Inst Life Sci, Dept Biol Chem, IL-91904 Jerusalem, Israel. RI Heinrich, Michael/C-3727-2013 OI Heinrich, Michael/0000-0003-2611-6303; Waltenberger, Johannes/0000-0002-2417-9880; Golomb, Gershon/0000-0002-7369-9831 NR 23 TC 48 Z9 49 U1 0 U2 4 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0968-0896 J9 BIOORGAN MED CHEM JI Bioorg. Med. Chem. PD MAY 1 PY 2003 VL 11 IS 9 BP 2007 EP 2018 DI 10.1016/S0968-1896(03)00048-8 PG 12 WC Biochemistry & Molecular Biology; Chemistry, Medicinal; Chemistry, Organic SC Biochemistry & Molecular Biology; Pharmacology & Pharmacy; Chemistry GA 665CA UT WOS:000182101000008 PM 12670652 ER PT J AU O'Farrell, AM Abrams, TJ Yuen, HA Ngai, TJ Louie, SG Yee, KWH Wong, LM Hong, W Lee, LB Town, A Smolich, BD Manning, WC Murray, LJ Heinrich, MC Cherrington, JM AF O'Farrell, AM Abrams, TJ Yuen, HA Ngai, TJ Louie, SG Yee, KWH Wong, LM Hong, W Lee, LB Town, A Smolich, BD Manning, WC Murray, LJ Heinrich, MC Cherrington, JM TI SU11248 is a novel FLT3 tyrosine kinase inhibitor with potent activity in vitro and in vivo SO BLOOD LA English DT Article ID ACUTE MYELOID-LEUKEMIA; INTERNAL TANDEM DUPLICATION; ENDOTHELIAL GROWTH-FACTOR; ACUTE MYELOGENOUS LEUKEMIA; BONE-MARROW; CELL-GROWTH; RISK GROUP; RECEPTOR; MUTATIONS; GENE AB FLT3 (fms-related tyrosine kinase/Flk2/ Stk-2) is a receptor tyrosine kinase (RTK) primarily expressed on hematopoietic cells. In blasts from acute myelogenous leukemia (AML) patients, 2 'classes of FLT3 activating mutations have been identified: internal tandem duplication (ITD) mutations in the juxtamembrane domain (25%-30% of patients) and point mutations in the kinase domain activation loop (7%-8% of patients). FLT3-ITD mutations are the most common molecular defect identified in AML and have been shown to be an independent prognostic factor for decreased survival. FLT3-ITD is therefore an attractive molecular target for therapy. SU11248 is a recently described selective inhibitor with selectivity for split kinase domain RTKs, including platelet-derived growth factor receptors, vascular endothelial growth,factor receptors, and KIT. We show that SU11248 Aldo has potent activity against Wild-type FLT3 ( FLT3-WT), FLT3-ITD, And FLT3 activation loop FLT3-Asp835) mutants in phosphorylation Assays. SU11246 inhibits FLT3-driven phosphorylation and induces apoptosis in vitro. In addition, SU11248 inhibits FLT3-induced VEGF production. The in vivo efficacy of SU11248 was investigated in 2 FLT3-ITD models: a subcutaneous tumor xenograft model and a bone marrow engraftment model. We show that SU11248 (20 mg/kg/d) dramatically regresses FLT3-ITD tumors in the subcutaneous tumor xenograft model And prolongs survival in the bone - marrow engraftment model: Pharmacokinetic and pharmacodynamic analysis in subcutaneous tumors showed that a single administration of an efficacious drug dose potently inhibits FLT3-ITD phosphorylation for up, to 16 hours following A single dose. These results suggest that further exploration of SU11248 activity in AML patients is warranted. (C) 2003 by The American Society of Hematology. C1 SUGEN, Preclin Res & Exploratory Dev, San Francisco, CA 94080 USA. Oregon Hlth Sci Univ, Dept Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Inst Canc, Div Hematol & Med Oncol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP O'Farrell, AM (reprint author), SUGEN, Preclin Res & Exploratory Dev, 230 E Grand Ave, San Francisco, CA 94080 USA. NR 43 TC 592 Z9 608 U1 4 U2 28 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD MAY 1 PY 2003 VL 101 IS 9 BP 3597 EP 3605 DI 10.1182/blood-2002-07-2307 PG 9 WC Hematology SC Hematology GA 674EZ UT WOS:000182625600050 PM 12531805 ER PT J AU Crowley, R Casarett, D AF Crowley, R Casarett, D TI Patients' willingness to participate in symptom-related and disease-modifying research - Results of a research screening initiative in a palliative care clinic SO CANCER LA English DT Article DE palliative care; symptom management; informed consent; cancer; terminal illness ID RANDOMIZED CONTROLLED TRIAL; CANCER PAIN MANAGEMENT; GUIDELINES; ENROLLMENT; FENTANYL; PROGRAM; PLACEBO AB BACKGROUND. The growth of cancer symptom management research has been limited by challenges of slow recruitment and underenrollment. One potential solution to this problem is the use of screening questions that identify patients who are interested in participating in research. The goal of this study was to evaluate this strategy in patients with cancer. METHODS. Two screening questions (for symptom management research and disease-modifying research) were integrated into the intake process of the palliative care clinic of an urban Veteran's Administration medical center. A chart review was conducted to extract patients' reported willingness to be recruited for research, explanations for their responses, demographic data, Memorial Symptom Assessment Scale Global Distress Index (GDI) subscale scores, and Eastern Cooperative Oncology Group performance score. RESULTS. Charts were reviewed for the first 100 patients seen for a palliative care clinic visit, 86 of whom had cancer. Patients were less likely to be interested in symptom-related research than in disease-modifying research (32 of 86 [37%] vs. 46 of 86 [54%]; sign test, P = 0.009). Patients' interest in each type of research was associated moderately (kappa = 0.41; P < 0.001). Independent predictors of interest in symptom management research included younger age, white race, and a lower GDI symptom distress score. Independent predictors of interest in disease-modifying research included only younger age and white race. CONCLUSIONS. Screening questions may be useful in identifying patients who are willing to be recruited for research. However, further study is needed to evaluate this process in other populations, as well as to determine whether screening questions introduce selection bias in the recruitment process. Published 2003 by the American Cancer Society.*. C1 Univ Penn, Inst Aging, Philadelphia, PA 19104 USA. Univ Penn, Ctr Bioeth, Philadelphia, PA 19104 USA. Univ Penn, Dept Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Casarett, D (reprint author), Univ Penn, Inst Aging, 3615 Chestnut St, Philadelphia, PA 19104 USA. NR 26 TC 14 Z9 14 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER JI Cancer PD MAY 1 PY 2003 VL 97 IS 9 BP 2327 EP 2333 DI 10.1002/cncr.11329 PG 7 WC Oncology SC Oncology GA 671BT UT WOS:000182445700030 PM 12712490 ER PT J AU Khayat, RN Xie, AL Patel, AK Kaminski, A Skatrud, JB AF Khayat, RN Xie, AL Patel, AK Kaminski, A Skatrud, JB TI Cardiorespiratory effects of added dead space in patients with heart failure and central sleep apnea SO CHEST LA English DT Article DE dead space; heat failure; sleep apnea ID CHEYNE-STOKES RESPIRATION; BLOOD-PRESSURE; CARBON-DIOXIDE; HYPOXIA; CO2; HYPERVENTILATION; PATHOGENESIS; VENTILATION; OXYGEN; DOG AB Background: Inhaled CO2 has been shown to stabilize the breathing pattern of patients with central sleep apnea (CSA) with and without congestive heart failure (CHF). Added dead space (DS) as a form of supplemental CO2 was effective in eliminating idiopathic CSA. The efficacy and safety of DS has not yet been evaluated in patients with CHF and CSA. Methods: We examined the respiratory and cardiovascular effects of added DS in eight patients with CHF and CSA. The DS consisted of a facemask attached to a cylinder of adjustable volume. During wakefulness, the cardiorespiratory response to 200 to 600 mL of DS was tested. Cardiac output and stroke volume were measured using echocardiography with and without DS. During the nocturnal study, patients slept with and without DS, alternating at approximately 1-h intervals. Results: Values are expressed as the mean SE. The wakefulness study revealed a plateau in the partial pressure of end-tidal CO2 (PETCO2) and the partial pressure of end-tidal O-2 between DS amounts of 400 and 600 mL. The mean stroke volume index (33 +/- 7 vs 34 +/- 7 mL/m(2), respectively) and the mean cardiac index (1.9 +/- 0.3 vs 1.9 +/- 0.4 L/min/m(2), respectively) were not affected by DS. Neither heart rate nor BP showed a significant change in response to DS of 600 mL. During sleep, DS increased the PETCO2 (40.7 +/- 2.7 vs 38.9 +/- 2.6 mm Hg, respectively; p < 0.05), reduced apnea (1 1 vs 29 7 episodes per hour, respectively; p < 0.01) and arousal (21 +/- 8 vs 30 +/- 8 arousals per hour, respectively; p < 0.05), increased the mean arterial oxygen saturation (Sao(2)) (94.4 +/- 1.0% vs 93.5 +/- 1.1%, respectively; p < 0.01), and reduced Sao(2) oscillations (DeltaSao(2) from maximum to minimum, 1.8 +/- 0.4% vs 5.5 +/- 0.9%, respectively; p < 0.01). Conclusion: DS stabilized CSA and improved sleep quality in patients with CHIP without significant acute adverse effects on the cardiovascular function. C1 William S Middleton Mem Vet Adm Med Ctr, Pulm Physiol Lab, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Madison, WI 53706 USA. RP Xie, AL (reprint author), William S Middleton Mem Vet Adm Med Ctr, Pulm Physiol Lab, 2500 Overlook Terrace, Madison, WI 53705 USA. RI Khayat, Rami/E-3380-2011 NR 38 TC 44 Z9 46 U1 0 U2 2 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD MAY PY 2003 VL 123 IS 5 BP 1551 EP 1560 DI 10.1378/chest.123.5.1551 PG 10 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 676VJ UT WOS:000182773000037 PM 12740273 ER PT J AU Anzueto, A Niederman, MS AF Anzueto, A Niederman, MS TI Diagnosis and treatment of rhinovirus respiratory infections SO CHEST LA English DT Review DE antiviral agents; asthma; COPD; otitis media; pleconaril; rhinoviruses; sinusitis; viral respiratory infection ID TRACT INFECTIONS; PICORNAVIRUS INFECTIONS; VIRAL-INFECTIONS; COMMON COLDS; COMMUNITY; ADULTS; CARE; EXACERBATIONS; COMPLICATIONS; PHYSICIANS AB Acute upper viral respiratory infection (VRI) is the number one cause of illness for which patients seek medical care in the United States. Rhinoviruses, members of the family Picornaviridae, are the causative pathogens in more than half of VRIs, and they are associated with acute exacerbations of respiratory disease, including asthma, sinusitis, otitis media, and COPD. Owing to the lack of commercial availability of rapid and cost-effective laboratory tests to confirm the presence of VRI, the diagnosis is most commonly made empirically, based on patient history and physical examination. Currently, no antiviral agents that are active against picornaviruses are available for clinical use. Antimicrobial agents, frequently prescribed for VRIs, are not active against viruses, and their inappropriate and widespread use has contributed to an increase in antimicrobial resistance among bacteria commonly involved in respiratory tract infections. Several newer antiviral agents are being evaluated for treatment of VRIs. Although a variety of mechanisms and agents have been tested, few have shown significant clinical benefit in human trials. The most advanced antiviral agent in clinical trials is pleconaril, a novel viral capsid-binding inhibitor with potent and highly specific in vitro activity against the majority of serotypes of rhinoviruses and enteroviruses. Clinical trials of pleconaril for the treatment of VRIs have been conducted, and the role of pleconaril in patients with chronic lung disease is being evaluated. C1 Audie L Murphy Mem Vet Adm Med Ctr, Pulm Div Sect 111E, S Texas Vet Hlth Care Syst, San Antonio, TX 78284 USA. SUNY Stony Brook, Winthrop Univ Hosp, Dept Med, Mineola, NY 11501 USA. RP Anzueto, A (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, Pulm Div Sect 111E, S Texas Vet Hlth Care Syst, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. NR 40 TC 28 Z9 31 U1 0 U2 1 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD MAY PY 2003 VL 123 IS 5 BP 1664 EP 1672 DI 10.1378/chest.123.5.1664 PG 9 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 676VJ UT WOS:000182773000052 PM 12740288 ER PT J AU Feng, JA Perry, G Mori, T Hayashi, T Oparil, S Chen, YF AF Feng, JA Perry, G Mori, T Hayashi, T Oparil, S Chen, YF TI Pressure-independent enhancement of cardiac hypertrophy in atrial natriuretic peptide-deficient mice SO CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY LA English DT Article DE atrial natriuretic peptide; cardiac function; cardiac hypertrophy; echocardiography; salt depletion; transgenic mice ID RECEPTOR GENE-EXPRESSION; HYPERTENSION; MYOCYTES; ANP; HYPOXIA; FIBROBLASTS; INHIBIT; STRESS; CELLS; RATS AB 1. Homozygous deletion of the pro-atrial natriuretic peptide (Nppa) gene (ANP-/-) has been associated with both cardiac hypertrophy and salt-sensitive hypertension in mice, suggesting that cardiac hypertrophy in ANP-/- mice may be related, at least in part, to increased afterload. 2. To test the hypothesis that cardiac hypertrophy in ANP-/-mice is independent of blood pressure, male ANP-/- and wild-type ANP+/+ mice were fed a low (0.05%) or basal (0.55%) NaCl diet. Five weeks later, mean arterial pressure (MAP) was measured in conscious mice; the whole heart, atria, left and right ventricles (LV and RV, respectively), brain, lung, kidney, liver and spleen were weighed and fixed for histological analysis. Separate groups of mice were subjected to echocardiographic examination under tribromoethanol anaesthesia. 3. Mean arterial pressure and atrial, LV and RV mass were greater in ANP-/- mice than in ANP+/+ mice fed the basal salt diet. Salt depletion equalized MAP in the two genotypes, but did not alter the relative cardiac hypertrophy in ANP-/- mice. The ANP-/- mice had significant LV cardiomyocyte hypertrophy when fed either basal or low-salt diets. 4. Left ventricle chamber dimensions did not differ between genotypes, but were significantly reduced in mice fed the low-salt diet; LV posterior wall and septal thickness were greater in ANP-/- than ANP+/+ mice and were not altered by diet, indicating a concentric pattern of LV hypertrophy in ANP-/- mice. Left ventricle function (cardiac output, stroke volume, ejection fraction, circumferential wall stress and velocity of circumferential wall shortening) did not differ between strains on either diet; circumferential wall stress was reduced in the low-salt groups; other functional parameters were not altered by diet. 5. These findings indicate that ANP deletion results in cardiomyocyte hypertrophy and biventricular hypertrophy independent of blood pressure, supporting the concept that ANP has direct antihypertrophic effects in the heart. C1 Univ Alabama, UAB Stn, Dept Med, Div Cardiovasc Dis,Vasc Biol & Hypertens Program, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Cardiol Sect, Birmingham, AL USA. Osaka Med Coll, Dept Internal Med 3, Osaka, Japan. RP Chen, YF (reprint author), Univ Alabama, UAB Stn, Dept Med, Div Cardiovasc Dis,Vasc Biol & Hypertens Program, 1008 Zeigler Res Bldg, Birmingham, AL 35294 USA. FU NHLBI NIH HHS [HL-45990, HL-50147, HL-56046, HL-07457, HL-44195] NR 31 TC 33 Z9 35 U1 0 U2 0 PU BLACKWELL PUBLISHING ASIA PI CARLTON PA 54 UNIVERSITY ST, P O BOX 378, CARLTON, VICTORIA 3053, AUSTRALIA SN 0305-1870 J9 CLIN EXP PHARMACOL P JI Clin. Exp. Pharmacol. Physiol. PD MAY-JUN PY 2003 VL 30 IS 5-6 BP 343 EP 349 DI 10.1046/j.1440-1681.2003.03836.x PG 7 WC Pharmacology & Pharmacy; Physiology SC Pharmacology & Pharmacy; Physiology GA 691AE UT WOS:000183582000006 PM 12859424 ER PT J AU Huang, MX Edgar, JC Thoma, RJ Hanlon, FM Moses, SN Lee, RR Paulson, KM Weisend, MP Irwin, JG Bustillo, JR Adler, LE Miller, GA Canive, JM AF Huang, MX Edgar, JC Thoma, RJ Hanlon, FM Moses, SN Lee, RR Paulson, KM Weisend, MP Irwin, JG Bustillo, JR Adler, LE Miller, GA Canive, JM TI Predicting EEG responses using MEG sources in superior temporal gyrus reveals source asynchrony in patients with schizophrenia SO CLINICAL NEUROPHYSIOLOGY LA English DT Article DE schizophrenia; auditory; P50; M50; superior temporal gyrus ID EVOKED MAGNETIC-FIELDS; HUMAN AUDITORY-CORTEX; MIDDLE LATENCY COMPONENTS; PLANUM TEMPORALE; SOURCE LOCALIZATION; NEUROPHYSIOLOGICAL EVIDENCE; TONOTOPIC ORGANIZATION; 40-HZ OSCILLATIONS; NEURONAL-ACTIVITY; VOLUME REDUCTION AB Objective: An integrated analysis using Electroencephalography (EEG) and magnetoencephalography (MEG) is introduced to study abnormalities in early cortical responses to auditory stimuli in schizophrenia. Methods: Auditory responses were recorded simultaneously using EEG and MEG from 20 patients with schizophrenia and 19 control subjects. Bilateral superior temporal gyrus (STG) sources and their time courses were obtained using MEG for the 30-100 ms post-stimulus interval. The MEG STG source time courses were used to predict the EEG signal at electrode Cz. Results: In control subjects, the STG sources predicted the EEG Cz recording very well (97% variance explained). In schizophrenia patients, the STG sources accounted for substantially (86%) and significantly (P < 0.0002) less variance. After MEG-derived STG activity was removed from the EEG Cz signal, the residual signal was dominated by 40 Hz activity, an indication that the remaining variance in EEG is probably contributed by other brain generators, rather than by random noise. Conclusions: Integrated MEG and EEG analysis can differentiate patients and controls, and suggests a basis for a well established abnormality in the cortical auditory response in schizophrenia, implicating a disorder of functional connectivity in the relationship between STG sources and other brain generators. (C) 2003 International Federation of Clinical Neurophysiology. Published by Elsevier Science Ireland Ltd. All rights reserved. C1 Ctr Funct Brain Imaging, New Mexico VA Hlth Care Syst, Albuquerque, NM 87108 USA. Univ New Mexico, Dept Radiol, Hlth Sci Ctr, Albuquerque, NM 87131 USA. Univ Illinois, Dept Psychol, Champaign, IL 61820 USA. Univ Illinois, Beckman Inst, Champaign, IL 61820 USA. New Mexico VA Hlth Care Syst, Psychiat Serv, Albuquerque, NM 87108 USA. Univ New Mexico, Dept Psychol, Albuquerque, NM 87131 USA. Univ New Mexico, Hlth Sci Ctr, Dept Psychiat, Albuquerque, NM 87131 USA. Univ Colorado, Ctr Canc, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Dept Psychiat, Denver, CO 80262 USA. Univ Illinois, Biomed Imaging Ctr, Urbana, IL 61801 USA. Univ Illinois, Dept Psychiat, Urbana, IL 61801 USA. RP Huang, MX (reprint author), Ctr Funct Brain Imaging, New Mexico VA Hlth Care Syst, Bldg 49 114M,1501 San Pedro Dr, Albuquerque, NM 87108 USA. RI bustillo, juan/J-7067-2013 FU NIMH NIH HHS [R01-MH65304] NR 96 TC 55 Z9 55 U1 3 U2 4 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 1388-2457 J9 CLIN NEUROPHYSIOL JI Clin. Neurophysiol. PD MAY PY 2003 VL 114 IS 5 BP 835 EP 850 DI 10.1016/S1388-2457(03)00041-5 PG 16 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 683JY UT WOS:000183146000006 PM 12738429 ER PT J AU Glynn, SM AF Glynn, SM TI Psychiatric rehabilitation in schizophrenia: advances and challenges SO CLINICAL NEUROSCIENCE RESEARCH LA English DT Review DE schizophrenia; psychiatric rehabilitation; psychosocial interventions; family intervention; vocational rehabilitation; social skills training; cognitive behavioural therapy ID COGNITIVE-BEHAVIORAL THERAPY; RANDOMIZED CONTROLLED-TRIAL; FOLLOW-UP; FAMILY INTERVENTION; PSYCHOSOCIAL TREATMENT; SUPPORTED EMPLOYMENT; VOCATIONAL-REHABILITATION; EDUCATIONAL INTERVENTION; PERSISTENT SYMPTOMS; NEGATIVE SYMPTOMS AB Psychiatric rehabilitation for schizophrenia involves utilizing psychosocial interventions to assist persons with the illness to attain their highest level of independent functioning, strongest level of symptom control, and greatest level of subjective life satisfaction. The advent of newer, more well-tolerated antipsychotic medications may mean that more patients then ever are suitable for participation in concurrent psychiatric rehabilitation programs. In this article, the determinants of poor symptom control and social adjustment in schizophrenia are first discussed. Brief overviews of the procedures for the four most-well validated psychiatric rehabilitation strategies (family interventions, cognitive-behavior therapy, social skills training, and vocational rehabilitation) are then presented, with supporting data. Issues of relevance to recent-onset and older patients are then discussed. Finally, the role of individual psychotherapy in rehabilitation and opportunities for research and clinical integration of pharmacologic and psychosocial interventions are described. (C) 2003 Elsevier Science B.V. All rights reserved. C1 VA Greater Los Angeles, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90073 USA. RP Glynn, SM (reprint author), VA Greater Los Angeles, Los Angeles, CA USA. NR 101 TC 9 Z9 10 U1 6 U2 10 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1566-2772 J9 CLIN NEUROSCI RES JI Clin. Neurosci. Res. PD MAY PY 2003 VL 3 IS 1-2 BP 23 EP 33 DI 10.1016/S1566-2772(03)00016-1 PG 11 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 722GR UT WOS:000185367500004 ER PT J AU Haroutunian, V Dracheva, S Davis, KL AF Haroutunian, V Dracheva, S Davis, KL TI Neurobiology of glutamatergic abnormalities in schizophrenia SO CLINICAL NEUROSCIENCE RESEARCH LA English DT Review DE glutamate; receptors; schizophrenia; postmortem; dorsolateral prefrontal cortex; mRNA ID METHYL-D-ASPARTATE; DORSOLATERAL PREFRONTAL CORTEX; NMDA RECEPTOR SUBUNITS; MESSENGER-RNA EXPRESSION; IN-SITU HYBRIDIZATION; DOMAIN-CONTAINING PROTEIN; PURKINJE-CELL SYNAPSES; LONG-TERM POTENTIATION; AMINO-ACID TRANSPORTER; CENTRAL-NERVOUS-SYSTEM AB A variety of studies have implicated abnormalities of the glutamatergic systems in schizophrenia. Some of this evidence is based on the similarities of some of the symptoms of schizophrenia and the behavioral effects of dissociative anesthetics such as ketamine. More direct evidence has come from biological studies defining abnormalities at multiple levels of the glutamate neurotransmission cascade. These have included abnormalities in the receptor binding properties of the various classes of ionotropic glutamate receptors (AMPA, kainate, NMDA); mRNA expression levels of different subunits of each of the members of the ionotropic class of glutamate receptors; mRNA expression of glutamate receptor-specific binding and membrane anchoring proteins such as PSD-95; and alterations in the activity of the principal enzyme responsible for the synthesis of the glutamate from glutamine, phosphate activated glutaminase. Preliminary evidence from proton magnetic resonance spectroscopy studies also supports a role for increased levels of glutamate, or glutamine and glutamate, in schizophrenia. The evidence reviewed in this article, when viewed as a whole, suggests that the disruption or disregulation of glutamatergic systems contribute significantly to the pathophysiology and potentially to some of the symptoms of schizophrenia and defines a necessary role for continued investigation of this pivotal neurotransmitter system in schizophrenia. (C) 2003 Elsevier Science B.V. All rights reserved. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. Bronx Vet Adm Med Ctr, New York, NY 10029 USA. RP Haroutunian, V (reprint author), Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. NR 171 TC 9 Z9 9 U1 0 U2 0 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1566-2772 J9 CLIN NEUROSCI RES JI Clin. Neurosci. Res. PD MAY PY 2003 VL 3 IS 1-2 BP 67 EP 76 DI 10.1016/S1566-2772(03)00020-3 PG 10 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 722GR UT WOS:000185367500008 ER PT J AU Silverman, SL AF Silverman, SL TI Calcitonin SO CLINICS IN GERIATRIC MEDICINE LA English DT Article ID INTRANASAL SALMON-CALCITONIN; POSTMENOPAUSAL BONE LOSS; OSTEOPOROTIC VERTEBRAL FRACTURES; ESTABLISHED OSTEOPOROSIS; RANDOMIZED TRIAL; DOUBLE-BLIND; NASAL SPRAY; MINERAL DENSITY; DOSE-RESPONSE; THERAPY AB Calcitonin is approved by the US Food and Drug Administration for the treatment of postmenopausal osteoporosis, but not for prevention. The preferred delivery system is nasal. Nasal calcitonin is safe and well tolerated. The vertebral fracture efficacy of calcitonin in older women is similar to the two approved bisphosphonates using a post hoc stratification analysis. Calcitonin has not been demonstrated to reduce hip fracture risk, although a post hoc pooled analysis suggests potential effectiveness of nasal calcitonin. Calcitonin produces small increments in bone mass of the spine and mostly reduces bone turnover in women with osteoporosis. Calcitonin may have analgesic benefits for women with acutely painful vertebral fractures. Treatment with calcitonin should be considered for older women with osteoporosis with painful vertebral fractures, and for older women with vertebral osteoporosis that is greater than hip osteoporosis. Calcitonin also should be considered for older women who are unable to take bisphosphonates due to gastrointestinal intolerance or impaired renal function. C1 OMC Clin Res Ctr, Beverly Hills, CA 90211 USA. Univ Calif Los Angeles, Cedars Sinai Med Ctr, Greater Los Angeles VA Med Ctr, Los Angeles, CA 90048 USA. RP Silverman, SL (reprint author), OMC Clin Res Ctr, 8641 Wilshire Blvd,Suite 301, Beverly Hills, CA 90211 USA. NR 56 TC 1 Z9 1 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0749-0690 J9 CLIN GERIATR MED JI Clin. Geriatr. Med. PD MAY PY 2003 VL 19 IS 2 BP 381 EP + AR PII S0749-0690(02)00070-8 DI 10.1016/S0749-0690(02)00070-8 PG 15 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 672EM UT WOS:000182508300011 ER PT J AU Blank, RD Baldini, TH Kaufman, M Bailey, S Gupta, R Yershov, Y Boskey, AL Coppersmith, SN Demant, P Paschalis, EP AF Blank, RD Baldini, TH Kaufman, M Bailey, S Gupta, R Yershov, Y Boskey, AL Coppersmith, SN Demant, P Paschalis, EP TI Spectroscopically determined collagen Pyr/deH-DHLNL cross-link ratio and crystallinity indices differ markedly in recombinant congenic mice with divergent calculated bone tissue strength SO CONNECTIVE TISSUE RESEARCH LA English DT Article DE bone quality; collagen; crystallinity; FTIR; mouse ID FEMORAL-NECK GEOMETRY; HIP FRACTURE; OSTEOPOROTIC FRACTURES; BIOMECHANICAL PROPERTIES; MECHANICAL-PROPERTIES; TRABECULAR BONE; INFRARED-SPECTROSCOPY; MINERALIZING TISSUES; GENETIC COMPOSITION; VERTEBRAL FRACTURE AB Whole bone strength can be partitioned into structural and material components. In three-point bending tests of 6-month-old female humeri from the HcB/Dem recombinant congenic series, strains HcB/8 and HcB/23 differed markedly in calculated failure stress but not ash percentage. Fourier transform infrared spectroscopic imaging was used to determine whether differences in the ratio of pyridinoline (pyr; nonreducible) to dehydrodihydroxynorleucine (de-DHLNL; reducible) collagen cross-links (XLR), mineral crystallinity, or spatial ordering could account for the strains' differing biomechanical performance. HcB/8 had significantly higher XLR and significantly higher crystallinity than HcB/23. XLR and crystallinity were highly and similarly correlated in both strains. There were no significant differences between the strains' one-dimensional spatial correlation functions, suggesting no difference in short-range order between them. The strong correlation between XLR and crystallinity reflects the interdependence of the protein and mineral elements of bone. The data illustrate the importance of material properties in addition to mineral quantity to bone tissue strength. C1 Univ Wisconsin, Sch Med, Dept Med, Endocrinol Sect, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI USA. Hosp Special Surg, Div Res, New York, NY 10021 USA. Univ Wisconsin, Dept Phys, Madison, WI 53706 USA. Univ Virginia, Dept Phys, Charlottesville, VA 22901 USA. Netherlands Canc Inst, Dept Mol Genet, Amsterdam, Netherlands. RP Blank, RD (reprint author), Univ Wisconsin, Sch Med, Dept Med, Endocrinol Sect, H4-556 CSC 5148,600 Highland Ave, Madison, WI 53792 USA. OI Blank, Robert Daniel/0000-0003-2950-1944 FU NIAMS NIH HHS [AR043125, AR46124, AR46505] NR 60 TC 36 Z9 38 U1 0 U2 2 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 0300-8207 J9 CONNECT TISSUE RES JI Connect. Tissue Res. PD MAY-SEP PY 2003 VL 44 IS 3-4 BP 134 EP 142 DI 10.1080/03008200390223918 PG 9 WC Cell Biology; Orthopedics SC Cell Biology; Orthopedics GA 722PW UT WOS:000185386100003 PM 14504033 ER PT J AU Vallejo, J Mann, DL AF Vallejo, J Mann, DL TI Antiinflammatory therapy in myocarditis SO CURRENT OPINION IN CARDIOLOGY LA English DT Review DE viral myocarditis; inflammation; innate immunity; immune modulation; cytokine ID TUMOR-NECROSIS-FACTOR; ACUTE VIRAL MYOCARDITIS; DILATED CARDIOMYOPATHY; FACTOR-ALPHA; INNATE IMMUNITY; ENCEPHALOMYOCARDITIS VIRUS; CARDIAC MYOCYTES; TRANSGENIC MICE; MURINE MODEL; IMMUNOADSORPTION AB Acute viral myocarditis progresses through several stages, including acute viral infection, autoimmunity, and dilated cardiomyopathy. Recent studies have identified an important role for the myocardial inflammatory response during the initial phases of acute viral myocarditis. In this review, we discuss new insights into the innate host response to viral myocarditis and the various therapeutic strategies that have been attempted in managing the deleterious consequences of the myocardial inflammatory response in acute viral myocarditis. C1 Houston Vet Affairs Med Ctr, Winters Ctr Heart Failure Res, Cardiol Sect Med Care Line, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA. RP Mann, DL (reprint author), Houston Vet Affairs Med Ctr, Winters Ctr Heart Failure Res, Cardiol Sect Med Care Line, MS F524,6565 Fannin, Houston, TX 77030 USA. OI Mann, Douglas /0000-0002-2516-0145 FU NHLBI NIH HHS [HL_4225_10/10, R01 HL61543_01, P50 HL_O6H, R01 HL58081_01] NR 30 TC 6 Z9 6 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0268-4705 J9 CURR OPIN CARDIOL JI Curr. Opin. Cardiol. PD MAY PY 2003 VL 18 IS 3 BP 189 EP 193 DI 10.1097/00001573-200305000-00003 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 705EA UT WOS:000184381700003 PM 12826819 ER PT J AU Myrick, H Brady, K AF Myrick, H Brady, K TI Current review of the comorbidity of affective, anxiety, and substance use disorders SO CURRENT OPINION IN PSYCHIATRY LA English DT Editorial Material DE co-occurring disorders; mood disorders; anxiety disorders; dual diagnosis ID POSTTRAUMATIC-STRESS-DISORDER; PLACEBO-CONTROLLED TRIAL; OBSESSIVE-COMPULSIVE DISORDER; COGNITIVE-BEHAVIORAL THERAPY; PANIC DISORDER; DOUBLE-BLIND; GENERALIZED ANXIETY; ALCOHOL DEPENDENCE; SOCIAL PHOBIA; PSYCHIATRIC-DISORDERS AB Purpose of review This review will provide an update on the diagnoses treatment of co-occurring mood/anxiety and substance use disorders. Interest in co-occurring disorders is growing because of the prevalence and negative impact of comorbidity on course, treatment outcomes and prognoses of both disorders. Recent findings There have been a number of recent studies exploring psychotherapeutic and pharmacotherapeutic treatment of co-occurring disorders. In particular, serotonin reuptake inhibitors and/or buspirone have demonstrated efficacy in decreasing consumption and improving psychiatric symptons in individuals with depression, social phobia and generalized anxiety disorder. There have been promising pilot studies exploring manual-guided psychotherapeutic interventions specifically targeting individuals with co-occurring substance use and post-traumatic stress disorder, depression and bipolar disorder. Summary The co-occurrence of substance abuse and mood and anxiety disorders is common and has important treatment implications. Recent investigations of pharmacotherapeutic and psychotherapeutic strategies specifically targeting individuals with comorbidity provide cause for optimism, but much work remains to be done. C1 Ralph H Johnson VAMC, Dept Psychiat, MUSC, CTN, Charleston, SC 29401 USA. RP Brady, K (reprint author), Ralph H Johnson VAMC, Dept Psychiat, MUSC, CTN, 109 Bee St, Charleston, SC 29401 USA. NR 84 TC 32 Z9 32 U1 5 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0951-7367 J9 CURR OPIN PSYCHIATR JI Curr. Opin. Psychiatr. PD MAY PY 2003 VL 16 IS 3 BP 261 EP 270 DI 10.1097/01.yco.0000069080.26384.d8 PG 10 WC Psychiatry SC Psychiatry GA 679DR UT WOS:000182906000001 ER PT J AU Taber, KH Hurley, RA AF Taber, KH Hurley, RA TI The role for diffusion tensor imaging in neuropsychiatry SO CURRENT OPINION IN PSYCHIATRY LA English DT Article DE diffusion tensor imaging; magnetic resonance imaging; neuropsychiatry ID WHITE-MATTER TRACTS; NORMAL-APPEARING WHITE; HUMAN BRAIN; MULTIPLE-SCLEROSIS; MAGNETIZATION-TRANSFER; FIBER TRACKING; GRAY-MATTER; CORTICAL DEVELOPMENT; CORPUS-CALLOSUM; MRI AB Purpose of review Those studies published primarily since October 2001 that are relevant to psychiatric applications of diffusion tensor imaging are reviewed here. Diffusion tensor imaging is a recently developed method of magnetic resonance imaging that is sensitive to the rate and direction of water diffusion. While diffusion in gray matter is similar in all directions (isotropic), diffusion in white matter is faster along axons than across them (anisotropic). As a result, diffusion tensor imaging is extremely sensitive to the microstructure of white matter. Recent findings Although there are many technical challenges still to be conquered, diffusion tensor imaging has great potential for the study of normal brain anatomy as well as for disease- or damage-related changes. This technique is able to visualize white-matter changes and differences not seen with conventional magnetic resonance imaging. Thus it may provide a means of predicting/understanding neurological deficits related to processes or events that affect the structural integrity of white matter. Summary Diffusion tensor imaging has the potential to expand our knowledge of the brain a great deal. Currently, reports exist in the literature that demonstrate its potential use in both the acute and the chronic patient for diagnosis, prognosis, and/or treatment planning. Potential clinical applications range from developmental abnormalities (schizophrenia, congenital malformations, developmental disabilities, epilepsy) to acquired brain injury (traumatic brain injury, stroke, toxins, poisons) and degenerative conditions (Alzheimer's disease, multiple sclerosis, cancer). C1 Baylor Coll Med, Dept Radiol, Houston, TX 77030 USA. Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Herbert J Frensley Ctr Imaging Res, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Mental Hlth Care Line, Houston, TX USA. RP Taber, KH (reprint author), Baylor Coll Med, Dept Radiol, 1 Baylor Plaza, Houston, TX 77030 USA. NR 76 TC 2 Z9 2 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0951-7367 J9 CURR OPIN PSYCHIATR JI Curr. Opin. Psychiatr. PD MAY PY 2003 VL 16 IS 3 BP 341 EP 347 DI 10.1097/01.yco.0000069092.26384.ff PG 7 WC Psychiatry SC Psychiatry GA 679DR UT WOS:000182906000012 ER PT J AU Xu, Y Lu, L Greyson, C Lee, J Gen, M Kinugawa, K Long, CS Schwartz, GG AF Xu, Y Lu, L Greyson, C Lee, J Gen, M Kinugawa, K Long, CS Schwartz, GG TI Deleterious effects of acute treatment with a peroxisome proliferator-activated receptor-gamma activator in myocardial ischemia and reperfusion in pigs SO DIABETES LA English DT Article ID ATP CHANNEL ACTIVITY; PPAR-GAMMA; ISCHEMIA/REPERFUSION INJURY; INSULIN-SENSITIZERS; CALCIUM CHANNELS; SMOOTH-MUSCLE; UP-REGULATION; TROGLITAZONE; ROSIGLITAZONE; DYSFUNCTION AB Thiazolidinediones exert electrophysiologic effects in noncardiac cells in vitro, but to date there have been no reports of effects on cardiac rhythm. We previously demonstrated that chronic pretreatment with a thiazolidinedione peroxisome proliferator-activated receptor (PPAR)-gamma activator, troglitazone, improves recovery of left ventricular (LV) function and substrate metabolism after ischemia and reperfusion, without causing arrhythmias. In this study, we determined whether similar salutary effects are achieved with acute treatment with troglitazone. Anesthetized pigs underwent 90 min of regional LV ischemia and 90 min of reperfusion. Fifteen pigs were treated with troglitazone (10 mg/kg load, 5 mg (.) kg(-1) (.) h(-1) infusion i.v.) beginning 1 h before ischemia. Seven pigs received corresponding vehicle. Plasma troglitazone concentration (mean 5 mug/ml) was similar to that achieved in clinical use of this agent. Before ischemia, acute troglitazone treatment had no effect on LV function, electrocardiogram, or substrate utilization. During ischemia or reperfusion, eight pigs in the troglitazone group died of ventricular fibrillation, compared with no pigs in the vehicle group (P < 0.05). Pigs that developed ventricular fibrillation had shorter QT intervals than survivors of either group. Among survivors, neither LV function nor substrate utilization differed between groups. Acute treatment with troglitazone increases susceptibility to ventricular fibrillation during myocardial ischemia and reperfusion. Whether thiazolidinediones have proarrhythmic potential in clinical use requires further investigation. C1 Denver VA Med Ctr, Cardiol Sect 111B, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. RP Schwartz, GG (reprint author), Denver VA Med Ctr, Cardiol Sect 111B, 1055 Clermont St, Denver, CO 80220 USA. FU NHLBI NIH HHS [HL 49944, R01 HL049944, R01 HL049944-08, R56 HL049944] NR 32 TC 18 Z9 19 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD MAY PY 2003 VL 52 IS 5 BP 1187 EP 1194 DI 10.2337/diabetes.52.5.1187 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 674ED UT WOS:000182623500019 PM 12716751 ER PT J AU Jaffa, AA Durazo-Arvizu, R Zheng, DY Lackland, DT Srikanth, S Garvey, WT Schmaier, AH AF Jaffa, AA Durazo-Arvizu, R Zheng, DY Lackland, DT Srikanth, S Garvey, WT Schmaier, AH CA DCCT EDIC Study Grp TI Plasma prekallikrein - A risk marker for hypertension and nephropathy in type 1 diabetes SO DIABETES LA English DT Article ID VASCULAR SMOOTH-MUSCLE; CONVERTING-ENZYME-INHIBITION; C-FOS INDUCTION; ENDOTHELIAL-CELLS; NITRIC-OXIDE; BRADYKININ; MELLITUS; KALLIKREIN; KININ; ACTIVATION AB The relevance and significance of the plasma kallikrein/ kinin system as a risk factor for the development of vascular. complications in diabetic patients was explored in a cross-sectional study. We measured the circulating levels of plasma prekallikrein (PK) activity, factor XII, and high-molecular weight kininogen in the plasma of 636 type I diabetic patients from the Diabetes Control and Complications Trial/Epidemiology and Diabetes Intervention and Complications Study cohort. The findings demonstrated that type 1 diabetic patients with blood pressure greater than or equal to140/90 mmHg have increased PK levels compared with type I diabetic patients with blood pressure < 140/90 (1.53 +/- 0.07 vs. 1.27 +/- 0.02 units/ml; P < 0.0001). Regression analysis also determined that plasma PK levels positively and significantly correlated with diastolic (DBP) and systolic blood pressures (SBP) as continuous variables (r = 0.17 and 0.18, respectively; P < 0.0001). In multivariate regression analysis, the semipartial r(2) value for PK was 2.93% for SBP and 2.92% for DBP (P < 0.0001). A positive correlation between plasma PK levels and the urinary albumin excretion rate (AER) was also observed (r = 0.16, P < 0.0001). In categorical analysis, patients with macroalbuminuria had a significantly higher level of plasma PK than normoalbuminuric patients (1.45 +/- 0.08 vs. 1.27 +/- 0.02 units/ml; P < 0.01), whereas microalbuminuric patients had an intermediate PK value (1.38 +/- 0.05 units/ml; P = NS). Among patients in the microalbuminuric subgroup, we observed a positive and independent correlation between PK and AER in univariate and multivariate regression analysis (r = 0.27, P < 0.03; n = 63). We concluded that in type 1 diabetes, 1) PK levels are elevated in association with increased blood pressure; 2) PK levels are independently correlated with AER and are categorically elevated in patients with macroalbuminuria; and 3) although the positive correlation between PK and AER within the subgroups of patients with microalbuminuria suggest that PK could be a marker for progressive nephropathy, longitudinal studies will be necessary to address this issue. C1 Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biometry & Epidemiol, Charleston, SC 29425 USA. Univ Michigan, Med Ctr, Dept Internal Med, Ann Arbor, MI 48109 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. NDIC, EDIC, Bethesda, MD USA. RP Jaffa, AA (reprint author), Med Univ S Carolina, Dept Med, 114 Doughty St,POB 250776, Charleston, SC 29425 USA. EM jaffaa@musc.edu FU NHLBI NIH HHS [HL 52779, HL 71255, P01 HL 55782]; NIDDK NIH HHS [DK 46543] NR 46 TC 41 Z9 42 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 EI 1939-327X J9 DIABETES JI Diabetes PD MAY PY 2003 VL 52 IS 5 BP 1215 EP 1221 DI 10.2337/diabetes.52.5.1215 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 674ED UT WOS:000182623500023 PM 12716755 ER PT J AU Klein, RL Hunter, SJ Jenkins, AJ Zheng, D Semler, AJ Clore, J Garvey, WT AF Klein, RL Hunter, SJ Jenkins, AJ Zheng, D Semler, AJ Clore, J Garvey, WT CA DCCT EDIC Study Grp TI Fibrinogen is a marker for nephropathy and peripheral vascular disease in type 1 diabetes - Studies of plasma fibrinogen and fibrinogen gene polymorphism in the DCCT/EDIC cohort SO DIABETES CARE LA English DT Article ID CARDIOVASCULAR RISK-FACTORS; URINARY ALBUMIN EXCRETION; CORONARY-ARTERY-DISEASE; EDINBURGH ARTERY; MYOCARDIAL-INFARCTION; HEMOSTATIC FACTORS; GLYCEMIC CONTROL; PROMOTER REGION; HEART-DISEASE; COMPLICATIONS AB We exannined whether plasma fibrinogen levels and the beta-fibrinogen gene G(-455)-->A polymorphism Were related to microvascular or macrovascular disease in patients (n = 909) with type 1 diabetes enrolled in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC). Univariate regression showed that fibrinogen levels were correlated with BMI (r = 0.15 P < 0.0001), HbA(1c) (r = 0.11; P = 0.0014), total Cholesterol (r- = 0.17; P < 0.0001),and LDL cholesterol (r = 0.16; P < 0.0001) in all patients. In men, but not women, waist-to-hip ratio (r = 0.20, P < 0.0001) and triglycerides (r = 0.13; P = 0.0047) also became powerful predictors of fibrinogen level, in women, but not men, fibrinogen was correlated with both diastolic (r = 0.16; P = 0.0011) and systolic (r = 0.11; P = 0.0241) blood pressure. Fibrinogen was correlated with urinary albumin excretion rates in men (r = 0.13, P = 0.0033), but not in women. In both sexes, however, the development of proteinuria (albumin excretion >300 mg/24 h) was accompanied by 1.5-fold increment in plasma fibrinogen compared with patients with normal excretion or microalbuminuria. In addition, high fibrinogen levels Were associated with a lower average ankle-brachial index in women (r = -0.13, P = 0.0075), but not men. Multiple regression analyses demonstrated that plasma fibrinogen was independently correlated with high albumin excretion rate in men, and with low average ankle-brachial index in women. Fibrinogen was not correlated wit it the severity of retinopathy. Carotid artery intima-medial thickness was not correlated with fibrinogen, and the G(-455)-->A polymorphism in the 5' promoter region of the beta-fibrinogen gene did not influence circulating fibrinogen levels. However, the presence of the more common G(-455) allele was associated With greater intima-medial thickness in the internal carotid artery (ANCOVA P = 0.045). Last, hyperfibrinogenemia in type 1 diabetes is associated with components of the insulin resistance syndrome tran Cluster, and the association is influenced by sex. C1 Med Univ S Carolina, Dept Med, Div Endocrinol Metab & Med Genet, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Res Serv, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biometry & Epidemiol, Charleston, SC 29425 USA. Natl Daibet Informat Clearinghouse, Diabet Control & Complicat Trial, Bethesda, MD USA. RP Klein, RL (reprint author), Med Univ S Carolina, Dept Med, Div Endocrinol Metab & Med Genet, 114 Doughty St,POB 250770, Charleston, SC 29425 USA. EM kleinrl@musc.edu FU NHLBI NIH HHS [P01-HL55782] NR 53 TC 35 Z9 37 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 EI 1935-5548 J9 DIABETES CARE JI Diabetes Care PD MAY PY 2003 VL 26 IS 5 BP 1439 EP 1448 DI 10.2337/diacare.26.5.1439 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 724UQ UT WOS:000185505400019 PM 12716802 ER PT J AU Dackis, CA Lynch, KG Yu, E Samaha, FF Kampman, KM Cornish, JW Rowan, A Poole, S White, L O'Brien, CP AF Dackis, CA Lynch, KG Yu, E Samaha, FF Kampman, KM Cornish, JW Rowan, A Poole, S White, L O'Brien, CP TI Modafinil and cocaine: a double-blind, placebo-controlled drug interaction study SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE modafinil; cocaine; safety; drug interaction; euphoria ID HEALTHY MALE-VOLUNTEERS; VENTRAL TEGMENTAL AREA; SINGLE-DOSE PHARMACOKINETICS; NUCLEUS-ACCUMBENS; D-AMPHETAMINE; ABSTINENCE SYMPTOMATOLOGY; EXTRACELLULAR DOPAMINE; RECREATIONAL COCAINE; WITHDRAWAL SYMPTOMS; TREATMENT ATTRITION AB Modafinil is a novel compound that is approved for the treatment of narcolepsy. It is now being studied as a potential treatment for cocaine dependence. Cocaine withdrawal symptoms are associated with poor clinical outcome and are likely to be reversed by modafinil. In addition, the neurotransmitter actions of modafinil are opposite to cocaine-induced neuroadaptations affecting dopamine and glutamate reward circuits. Since cocaine-dependent subjects might use cocaine during a clinical trial with modafinil, this study tested the safety of intravenous cocaine (30 mg) in combination with modafinil. Each of seven subjects received a baseline (open-label) cocaine infusion. Three subsequent cocaine infusions were administered after subjects received 4 days of low dose modafinil (200 mg/day), high dose modafinil (400 mg/day), or placebo in randomized double-blind sequences. One subject received placebo prior to all infusions. Our results indicate that co-administering modafinil and a single dose of intravenous cocaine is not associated with medical risk in terms of blood pressure, pulse, temperature, or electrocardiogram measures. Furthermore, pretreatment with modafinil did not intensify cocaine euphoria or cocaine-induced craving. In fact, cocaine euphoria was significantly blunted (P=0.02) in one of our subjective measures. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved. C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Dept Psychiat, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Dept Cardiol, Philadelphia, PA 19104 USA. RP Dackis, CA (reprint author), Univ Penn, Dept Psychiat, 3900 Chestnut St, Philadelphia, PA 19104 USA. FU NIDA NIH HHS [DA30012-02, DA P50-12756, DA P60-05186] NR 80 TC 118 Z9 118 U1 3 U2 7 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0376-8716 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD MAY 1 PY 2003 VL 70 IS 1 BP 29 EP 37 AR PII S0376-8716(02)00335-6 DI 10.1016/S0376-8716(02)00335-6 PG 9 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 676VN UT WOS:000182773400004 PM 12681523 ER PT J AU Ahuja, SS Zhao, SJ Bellido, T Plotkin, LI Jimenez, F Bonewald, LF AF Ahuja, SS Zhao, SJ Bellido, T Plotkin, LI Jimenez, F Bonewald, LF TI CD40 ligand blocks apoptosis induced by tumor necrosis factor alpha, glucocorticoids, and etoposide in osteoblasts and the osteocyte-like cell line murine long bone osteocyte-Y4 SO ENDOCRINOLOGY LA English DT Article ID TNF RECEPTOR SUPERFAMILY; FACTOR FAMILY MEMBER; DENDRITIC CELLS; OSTEOPROTEGERIN LIGAND; B-LYMPHOCYTES; IFN-GAMMA; T-CELLS; DEATH; ESTROGEN; TRANCE AB During characterization of the osteocyte-like murine long bone osteocyte-Y4 (MLO-Y4) cell line, comparison was made with antigen-presenting cells of the immune system known as dendritic cells. It was observed that the MLO-Y4 osteocyte-like cells express CD40 antigen and MHC class I antigen, but they are negative for a series of other dendritic cells markers (DEC-205, CD11b, CD11c, CD86, and MHC class II) and immune cell markers [ CD45, CD3, CD4, B220, Gr-1, and CD40 ligand (CD40L)]. RT-PCR results showed expression of CD40 mRNA and lack of CD40L mRNA expression. Like MLO-Y4 osteocyte cells, both primary osteoblasts and the osteoblast-like cell lines MC3T3, OCT-1, and 2T3 were shown to express CD40 antigen by fluorescence-activated cell sorting. Because CD40L has been shown to function as an antiapoptotic factor in dendritic cells, it was reasoned that this molecule may have a similar function in bone cells. In three different assays for apoptosis, including trypan blue exclusion, changes in nuclear morphology, and fluorescence-activated cell sorting staining for annexin V/propidium iodide, CD40L significantly inhibited apoptosis of MLO-Y4 cells induced by dexamethasone, TNFalpha, or etoposide. CD40L also inhibited dexamethasone and TNFalpha-induced apoptosis in the osteoblast cell lines, OCT1 and MC3T3-E1. These data support the hypothesis that CD40L preserves viability of osteoblasts and osteocytes against a wide variety of apoptotic factors independent of signaling or transcriptional mechanisms. Because osteocyte cell death appears to result in bone loss, these studies have important implications for the treatment of bone loss due to glucocorticoid excess and/or to osteoporosis in general. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Biochem, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78284 USA. Univ Arkansas Med Sci, Div Endocrinol & Metab, Little Rock, AR 72205 USA. Univ Arkansas Med Sci, Ctr Osteoporosis & Metab Bone Dis, Little Rock, AR 72205 USA. RP Bonewald, LF (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. FU NIAID NIH HHS [AI-48644]; NIAMS NIH HHS [KO2-AR-02127, AR-46798] NR 54 TC 58 Z9 61 U1 2 U2 6 PU ENDOCRINE SOC PI BETHESDA PA 4350 EAST WEST HIGHWAY SUITE 500, BETHESDA, MD 20814-4110 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD MAY PY 2003 VL 144 IS 5 BP 1761 EP 1769 DI 10.1210/en.2002-221136 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 668BE UT WOS:000182269800015 PM 12697681 ER PT J AU Liu, XM Chapman, GB Peyton, KJ Schafer, AI Durante, W AF Liu, XM Chapman, GB Peyton, KJ Schafer, AI Durante, W TI Antiapoptotic action of carbon monoxide on cultured vascular smooth muscle cells SO EXPERIMENTAL BIOLOGY AND MEDICINE LA English DT Article DE cell death; circulation; cell cycle ID HEME OXYGENASE; GUANYLYL CYCLASE; APOPTOSIS; EXPRESSION; ATHEROSCLEROSIS; INHIBITOR; GROWTH; ENZYME AB Vascular smooth muscle cells (SMCs) generate carbon monoxide (CO) from the degradation of heme by the enzyme heme oxygenase. Because recent studies indicate that CO influences the properties of vascular SMCs, we examined whether this diatomic gas regulates apoptosis in vascular SMCs. Treatment of cultured rat aortic SMCs with a cytokine cocktail consisting of interleukin-1beta (5 ng/ml), tumor necrosis factor-alpha (20 ng/ml), and interferon-gamma (200 U/mI) for 48 hr stimulated apoptosis, as demonstrated by DNA laddering, caspase-3 activation, and annexin V staining. However, the exogenous addition of CO (200 ppm) completely blocked cytokine-mediated apoptosis. The antiapoptotic action of CO was partially reversed by the soluble guanylate cyclase inhibitor, H-[1,2,4]oxadiazolo[4,3a]quinoxalin-1-one (10 muM). In contrast, the p38 mitogen-activated protein kinase inhibitor, SB203580 (10 muM), had no effect on SMC apoptosis. These findings indicate that CO is a potent inhibitor of vascular SMC apoptosis and that it blocks apoptosis, in part, by activating the cGMP signaling pathway. The ability of CO to inhibit vascular SMC apoptosis may play a critical role in attenuating lesion formation at sites of arterial damage. C1 Baylor Coll Med, Houston VA Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Pharmacol, Houston, TX 77030 USA. RP Durante, W (reprint author), VA Med Ctr Bldg 109,Room 130,2002 Holcombe Blvd, Houston, TX 77030 USA. EM wdurante@bcm.tmc.edu FU NHLBI NIH HHS [HL62467, HL36045, HL59976] NR 26 TC 31 Z9 34 U1 0 U2 2 PU SOC EXPERIMENTAL BIOLOGY MEDICINE PI MAYWOOD PA 195 WEST SPRING VALLEY AVE, MAYWOOD, NJ 07607-1727 USA SN 1535-3702 J9 EXP BIOL MED JI Exp. Biol. Med. PD MAY PY 2003 VL 228 IS 5 BP 572 EP 575 PG 4 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 833ER UT WOS:000222319700025 PM 12709589 ER PT J AU Zhang, XP Graham, SH Kochanek, PM Marion, DW Nathaniel, PD Watkins, SC Clark, RSB AF Zhang, XP Graham, SH Kochanek, PM Marion, DW Nathaniel, PD Watkins, SC Clark, RSB TI Caspase-8 expression and proteolysis in human brain after severe head injury SO FASEB JOURNAL LA English DT Article DE apoptosis; cysteine protease; Fas; programmed cell death; traumatic brain injury ID TUMOR-NECROSIS-FACTOR; CEREBROSPINAL-FLUID; NEURONAL APOPTOSIS; FAS LIGAND; CELL-DEATH; SIGNALING COMPLEX; ACTIVATION; MICE; CONTUSIONS; INDUCTION AB Programmed cell death involves a complex and interrelated cascade of cysteine proteases termed caspases that are synthesized as inactive zymogens, which are proteolytically processed to active enzymes. Caspase-8 is an initiator caspase that becomes activated when Fas death receptor-Fas ligand (FasL) coupling on the cell surface leads to coalescence of a "death complex" perpetuating the programmed cell death cascade. In this study, brain tissue samples removed from adult patients during the surgical management of severe intracranial hypertension after traumatic brain injury (TBI; n=17) were compared with postmortem control brain tissue samples (n=6). Caspase-8 mRNA was measured by semiquantitative reverse transcription and polymerase chain reaction, and caspase-8 protein was examined by Western blot and immunocytochemistry. Fas and FasL were also examined using Western blot. Caspase-8 mRNA and protein were increased in TBI patients vs. controls, and caspase-8 protein was predominately expressed in neurons. Proteolysis of caspase-8 to 20-kDa fragments was seen only in TBI patients. Fas was also increased after TBI vs. control and was associated with relative levels of caspase-8, supporting formation of a death complex. These data identify additional steps in the programmed cell death cascade involving Fas death receptors and caspase-8 after TBI in humans. C1 Safar Ctr Resuscitat Res, Dept Crit Care Med, Pittsburgh, PA 15260 USA. Safar Ctr Resuscitat Res, Dept Neurol, Pittsburgh, PA USA. Safar Ctr Resuscitat Res, Dept Pediat, Pittsburgh, PA USA. Safar Ctr Resuscitat Res, Dept Neurol Surg, Pittsburgh, PA USA. Safar Ctr Resuscitat Res, Dept Cell Biol & Physiol, Pittsburgh, PA USA. Univ Pittsburgh, Brain Trauma Res Ctr, Pittsburgh, PA USA. VA Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Clark, RSB (reprint author), Safar Ctr Resuscitat Res, Dept Crit Care Med, 3434 5th Ave, Pittsburgh, PA 15260 USA. EM clarkrs@ccm.upmc.edu RI Kochanek, Patrick/D-2371-2015 OI Kochanek, Patrick/0000-0002-2627-913X NR 33 TC 33 Z9 37 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 MAY PY 2003 VL 17 IS 8 BP 1367 EP + DI 10.1096/fj.02-1067fje PG 17 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 683TE UT WOS:000183165000027 PM 12738800 ER PT J AU Cummings, DE Foster, KE AF Cummings, DE Foster, KE TI Ghrelin-leptin tango in body-weight regulation SO GASTROENTEROLOGY LA English DT Editorial Material ID INSULIN-INDUCED HYPOGLYCEMIA; FOOD-INTAKE; SECRETION; STOMACH; ADIPOSITY; PEPTIDE; RODENTS; OBESITY C1 Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. RP Cummings, DE (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, 1660 S Columbian Way,S-111-Endo, Seattle, WA 98108 USA. NR 26 TC 104 Z9 107 U1 0 U2 4 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD MAY PY 2003 VL 124 IS 5 BP 1532 EP 1535 DI 10.1016/S0016-5085(03)00350-0 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 673GF UT WOS:000182571800038 PM 12730891 ER PT J AU Datto, CJ Thompson, R Horowitz, D Disbot, M Oslin, DW AF Datto, CJ Thompson, R Horowitz, D Disbot, M Oslin, DW TI The pilot study of a telephone disease management program for depression SO GENERAL HOSPITAL PSYCHIATRY LA English DT Article DE depression; disease management; primary care; treatment algorithm; treatment adherence ID PRIMARY-CARE; PRACTICE GUIDELINES; RANDOMIZED TRIAL; HEALTH; DISORDERS; SYSTEM AB Most depressed patients are seen and treated exclusively by primary care clinicians. However, primary care patients with depression are often not adequately treated. The aims of this pilot study were to measure the impact of a telephone disease management program on patient outcome and clinician adherence to practice guidelines, measure the relationship of clinician adherence to patient outcome, and explore the measurement of patient adherence to clinician recommendations and its impact on patient outcomes. Thirty-five primary care practices in the University of Pennsylvania Health System were randomized to telephone disease management (TDM) or "usual care" (UC). All patients received a baseline and a 16-week follow-up clinical evaluation performed over the telephone. Those from TDM practices also received follow-up contact at least every 3 weeks, with formal evaluations at weeks 6 and 12. These interval contacts were designed to facilitate patient and clinician adherence to a treatment algorithm based on the Agency for Health Research and Quality (AHRQ) practice guidelines. Depressive symptoms evaluated with the Community Epidemiologic Survey of Depression (CES-D) scale as well as guideline adherence were the primary outcome measures. Sixty-one patients were enrolled in this pilot project. The overall effect for CES-D scores over time was significant, (P < .001), indicating that those participating in the trial (both TDM and UC groups) showed significant improvement. The interaction between intervention condition and time was also significant (P < .05), indicating that TDM patients improved significantly more over time than did UC patients. A greater proportion of TDM patients had CES-D scores <16 by Week 16 (66.7 versus 33.3%; chi(2), p < .05). The improvement in depression outcome for the TDM group was related to its impact on improving clinician adherence to depression treatment algorithms. The TDM pilot did not show a statistically significant effect on improving patient adherence to clinician recommendations, however. This preliminary data suggests that TDM for depression improves both clinician guideline adherence and patient outcomes in the acute phase of depression. The effect on patient outcome is at least partially explained by the effect of TDM on clinician adherence to depression treatment algorithms. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Penn, Hlth Syst, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. RP Oslin, DW (reprint author), Univ Penn, Hlth Syst, Philadelphia, PA 19104 USA. RI Thompson, Richard/G-5408-2011 OI Thompson, Richard/0000-0003-0127-513X FU PHS HHS [P30 52129] NR 23 TC 31 Z9 32 U1 0 U2 0 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 MAY-JUN PY 2003 VL 25 IS 3 BP 169 EP 177 DI 10.1016/S0163-8343(03)00019-7 PG 9 WC Psychiatry SC Psychiatry GA 679YT UT WOS:000182950100004 PM 12748029 ER PT J AU DeVito, C Morgan, RO Duque, M Abdel-Moty, E Virnig, BA AF DeVito, C Morgan, RO Duque, M Abdel-Moty, E Virnig, BA TI Physical performance effects of low-intensity exercise among clinically defined high-risk elders SO GERONTOLOGY LA English DT Article DE high-risk elders; equilibrium; exercise; gait; muscle strength ID RANDOMIZED CONTROLLED TRIAL; OLDER ADULTS; MUSCLE STRENGTH; FALLS; BALANCE; WOMEN; GAIT; MOBILITY; MEN; FRAILTY AB Background: Falls are among the leading causes of injuries and deaths. Results from a number of studies have suggested that a community-based exercise program may be effective in improving lower body strength, although some have shown only limited improvements. However, the impact of these programs on gait and balance are equivocal. Further, studies that have specifically targeted deconditioned elderly individuals, rather than individuals drawn from the general community, either showed limited or no improvements in gait and balance. Objective: This study examined the effectiveness of a community-based, short-term, low-intensity exercise intervention strategy on measures of mobility skills, gait and balance, and muscle strength for a clinically targeted group of elderly individuals at high risk of falls. Methods: 245 men and women aged 60 years or older were randomized into either an intervention or control group and received a baseline (T1) assessment. Subjects in the intervention group received up to 24 sessions (45 min long) of low-intensity standard exercise modalities tailored to the individual patient over an 8- to 10-week period. At the conclusion of the program, the participants in the intervention group were instructed to continue performing the exercises at home until 1 year after T1. Measures of physical function and performance were collected for all subjects at three different points of study enrollment. Results: Of the subjects assessed at baseline, 138 (56%) also had a postintervention assessment (T2), 128 (52%) had a 6-month follow-up assessment (T3), and 105 subjects had assessments at all time points. Primary analyses were based on the 105 subjects who had assessments at all time points. Intervention and control subjects did not differ in any of the physical function or performance measures at baseline. Between T1 and T2, the intervention subjects showed significantly greater improvement than the control subjects on all outcomes, with improvements plateauing for most measures between T2 and T3. Gait and balance scores continued to improve throughout the study period for both groups of subjects. Conclusions: This easily implemented, low-intensity exercise program may lead to improvements in physical functioning that are retained over the long term and effectively targets a clinically defined population of deconditioned elders at high risk of falling and sustaining serious injury. Copyright (C) 2003 S. Karger AG, Basel. C1 Dept Vet Affairs Med Ctr, Res Serv 151, Hlth Serv Res & Dev Ctr, GRECC, Miami, FL 33125 USA. Univ Miami, Sch Med, Dept Psychiat & Behav Sci, Miami, FL USA. Houston VAMC, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Univ Miami, Sch Educ, Dept Exercise & Sport Sci, Coral Gables, FL 33124 USA. Univ Miami, Coll Engn, Dept Ind Engn, Coral Gables, FL 33124 USA. Univ Miami, Sch Med, Miami Beach, FL USA. Univ Miami, S Shore Hosp & Med Ctr, Comprehens Pain & Rehabil Ctr, Miami Beach, FL USA. Univ Minnesota, Sch Publ Hlth, Div Hlth Serv Res & Policy, Minneapolis, MN 55455 USA. RP DeVito, C (reprint author), Dept Vet Affairs Med Ctr, Res Serv 151, Hlth Serv Res & Dev Ctr, GRECC, 1201 NW 16th St, Miami, FL 33125 USA. RI Morgan, Robert/A-8577-2009 NR 46 TC 25 Z9 27 U1 1 U2 4 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0304-324X J9 GERONTOLOGY JI Gerontology PD MAY-JUN PY 2003 VL 49 IS 3 BP 146 EP 154 DI 10.1159/000069168 PG 9 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 671QD UT WOS:000182474800002 PM 12679604 ER PT J AU Cullen, PA Haake, DA Bulach, DM Zuerner, RL Adler, B AF Cullen, PA Haake, DA Bulach, DM Zuerner, RL Adler, B TI LipL21 is a novel surface-exposed lipoprotein of pathogenic Leptospira species SO INFECTION AND IMMUNITY LA English DT Article ID OUTER-MEMBRANE PROTEIN; LPS BIOSYNTHETIC LOCI; TREPONEMA-PALLIDUM; SEROVAR HARDJO; BORRELIA-BURGDORFERI; SUBTYPE HARDJOBOVIS; MAMMALIAN INFECTION; MOLECULAR-CLONING; SEQUENCE-ANALYSIS; ESCHERICHIA-COLI AB Leptospira is the etiologic agent of leptospirosis, a bacterial zoonosis distributed worldwide. Leptospiral lipopolysaccharide is a protective immunogen, but the extensive serological diversity of leptospires has inspired a search for conserved outer membrane proteins (OMPs) that may stimulate heterologous immunity. Previously, a global analysis of leptospiral OMPs (P. A. Cullen, S. J. Cordwell, D. M. Bulach, D. A. Haake, and B. Adler, Infect. Immun. 70:2311-2318, 2002) identified pL21, a novel 21-kDa protein that is the second most abundant constituent of the Leptospira interrogans serovar Lai outer membrane proteome. In this study, we identified the gene encoding pL21 and found it to encode a putative lipoprotein; accordingly, the protein was renamed LipL21. Southern hybridization analysis revealed the presence of lipL21 in all of the pathogenic species but in none of the saprophytic species examined. Alignment of the LipL21 sequence from six strains of Leptospira revealed 96 to 100% identity. When specific polyclonal antisera to recombinant LipL21 were used, LipL21 was isolated together with other known leptospiral OMPs by both Triton X-114 extraction and sucrose density. gradient membrane fractionation. All nine strains of pathogenic leptospires investigated by Western blotting, whether culture attenuated or virulent, were found to express LipL21. In contrast, the expression of LipL21 or an antigenically related protein could not be detected in nonpathogenic L. biflexa. Infected hamster sera and two of eight human leptospirosis sera tested were found to react with recombinant LipL21. Native LipL21 was found to incorporate tritiated palmitic acid, consistent with the prediction of a lipoprotein signal peptidase cleavage site. Biotinylation of the leptospiral surface resulted in selective labeling of LipL21 and the previously known OMPs LipL32 and LipL41. These findings show that LipL21 is a surface-exposed, abundant outer membrane lipoprotein that is expressed during infection and conserved among pathogenic Leptospira species. C1 Monash Univ, Dept Microbiol, Bacterial Pathogenesis Res Grp, Melbourne, Vic 3800, Australia. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA 90073 USA. USDA ARS, Natl Anim Dis Ctr, Bacterial Dis Livestock Res Unit, Ames, IA 50010 USA. RP Adler, B (reprint author), Monash Univ, Dept Microbiol, Bacterial Pathogenesis Res Grp, Melbourne, Vic 3800, Australia. RI Bulach, Dieter/D-5793-2011 OI Bulach, Dieter/0000-0001-9823-6078 FU NIAID NIH HHS [R01 AI034431, AI-34431, R01 AI034431-06A2, R21 AI034431, R29 AI034431] NR 43 TC 62 Z9 81 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0019-9567 J9 INFECT IMMUN JI Infect. Immun. PD MAY PY 2003 VL 71 IS 5 BP 2414 EP 2421 DI 10.1128/IAI.71.5.2414-2421.2003 PG 8 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 672BT UT WOS:000182501500014 PM 12704111 ER PT J AU Bull, TM Keith, RL Kraft, M Dempsy, EC Miller, YE AF Bull, TM Keith, RL Kraft, M Dempsy, EC Miller, YE TI Mycobacterium tuberculosis presenting as an infected pulmonary bulla SO INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE LA English DT Letter C1 Univ Colorado, Ctr Hlth Sci, Boulder, CO 80309 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Bull, TM (reprint author), Univ Colorado, Ctr Hlth Sci, Boulder, CO 80309 USA. NR 3 TC 0 Z9 0 U1 0 U2 1 PU INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D) PI PARIS PA 68 BOULEVARD SAINT-MICHEL,, 75006 PARIS, FRANCE SN 1027-3719 J9 INT J TUBERC LUNG D JI Int. J. Tuberc. Lung Dis. PD MAY PY 2003 VL 7 IS 5 BP 504 EP 504 PG 1 WC Infectious Diseases; Respiratory System SC Infectious Diseases; Respiratory System GA 678LT UT WOS:000182869200021 PM 12757057 ER PT J AU Woody, TE Gallop, R Luborsky, L Blaine, J Frank, I Salloum, IM Gastfriend, B Crits-Christoph, P AF Woody, TE Gallop, R Luborsky, L Blaine, J Frank, I Salloum, IM Gastfriend, B Crits-Christoph, P CA Cocaine Psychotherapy Study Grp TI HIV risk reduction in the National Institute on Drug Abuse Cocaine Collaborative Treatment Study SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE cocaine dependence; HIV risk ID ANTISOCIAL PERSONALITY-DISORDER; DEPENDENCE AB HIV risk was evaluated among 487 cocaine-dependent patients recruited from five treatment programs in a trial that examined the efficacy of four outpatient-based psychosocial treatments. Treatments were offered two to three times per week for 6 months and consisted of group drug counseling (GDC) or group counseling plus individual drug counseling (IDC), cognitive therapy (CT), or supportive-expressive therapy (SE). The average patient had used cocaine for 7 years, with 10 days of use in the last month. Crack smoking was the main route in 79%, and HIV risk was mainly due to multiple partners and unprotected sex. Treatment was associated with a decrease in cocaine use from an average of 10 days per month at baseline to 1 day per month at 6 months. Reduction in cocaine use was associated with an average 40% decrease in HIV risk across all treatment, gender, and ethnic groups, mainly as a result of fewer sexual partners and less unprotected sex. The combination of IDC and GDC was associated with an equal or even greater reduction in HIV risk than the other treatment conditions and thus shows promise as an effective HIV prevention strategy, at least for some patients. C1 Univ Penn, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. NIDA, Bethesda, MD 20892 USA. Brookside Hosp, Nashua, NH USA. Harvard Univ, Boston, MA 02115 USA. Univ Pittsburgh, Pittsburgh, PA USA. RP Woody, TE (reprint author), Treatment Res Inst, 600 Publ Ledger Bldg,150 S Independence Mall W, Philadelphia, PA 19106 USA. NR 19 TC 0 Z9 0 U1 3 U2 4 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 MAY 1 PY 2003 VL 33 IS 1 BP 82 EP 87 PG 6 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 677KD UT WOS:000182805400012 ER PT J AU Moriarty, PJ Harvey, PD Mitropoulou, V Granholm, E Silverman, JM Siever, LJ AF Moriarty, PJ Harvey, PD Mitropoulou, V Granholm, E Silverman, JM Siever, LJ TI Reduced processing resource availability in schizotypal personality disorder: Evidence from a dual-task CPT study SO JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY LA English DT Article ID VISUOSPATIAL WORKING-MEMORY; SCHIZOPHRENIC-PATIENTS; NONPSYCHOTIC RELATIVES; PERFORMANCE; RESPONSES; MARKER AB Performance on a dual-task information processing task was investigated in 23 schizotypal personality disorder patients (SPD), 29 patients with other noncluster A personality disorders (ORD) and 8 nonpsychiatric healthy controls (NC). All participants were assessed using a computer-based visual continuous performance test (CPT) and an auditory CPT individually, and administered again simultaneously in a dual-task condition. The SPD group showed a greater increase in the number of errors of omission than the OPD group or normal controls on the CPT tasks in the dual-task conditions. Performance operating characteristics indicated that the SPD patients did not allocate their attention in a manner different from the healthy controls, suggesting that poorer performance was due to resource limitations in the dual task condition and not strategic failures. These results are similar to previous studies of patients with schizophrenia, where performance deficits on information processing tests have been shown to be related to resource limitations more than failures in effective allocation of attention. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Hofstra Univ, Dept Psychol, Hempstead, NY 11550 USA. Bronx Vet Adm Med Ctr, Dept Psychiat, Bronx, NY USA. VA San Diego Healthcare Syst, Psychiat Serv, San Diego, CA USA. Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. RP Harvey, PD (reprint author), Mt Sinai Sch Med, Dept Psychiat, Box 1229, New York, NY 10029 USA. RI Granholm, Eric/P-7680-2014 FU NIMH NIH HHS [MH56140] NR 32 TC 17 Z9 17 U1 0 U2 0 PU SWETS ZEITLINGER PUBLISHERS PI LISSE PA P O BOX 825, 2160 SZ LISSE, NETHERLANDS SN 1380-3395 J9 J CLIN EXP NEUROPSYC JI J. Clin. Exp. Neuropsychol. PD MAY PY 2003 VL 25 IS 3 BP 335 EP 347 PG 13 WC Psychology, Clinical; Clinical Neurology; Psychology SC Psychology; Neurosciences & Neurology GA 683GX UT WOS:000183141200004 PM 12916647 ER PT J AU Corbie-Smith, G St George, DMM Moody-Ayers, S Ransohoff, DF AF Corbie-Smith, G St George, DMM Moody-Ayers, S Ransohoff, DF TI Adequacy of reporting race/ethnicity in clinical trials in areas of health disparities SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE clinical research; inclusion of minorities; randomized clinical trials; health disparities ID RANDOMIZED CONTROLLED TRIALS; CANCER-TREATMENT TRIALS; WOMEN; REPRESENTATION; PARTICIPATION; MINORITIES; INCLUSION; INSTITUTE; RACE AB Although federal initiatives have mandated broader inclusion of minorities in clinical research on diseases that have disparities in health by race and ethnicity, it is not clear whether these initiatives have affected reporting of trial results. The objective of,this-study was to examine the reporting of race/ethnicity in clinical trials reports in areas of known disparities in health (i.e., diabetes, cardiovascular disease, HIV/AIDS, and cancer) and to determine what factors were associated with reporting of race/ethnicity in,results. We,performed a Medline search covering the period January 1989 to Oct 2000 to identify clinical trials of diabetes, cardiovascular disease, HIV/AIDS, and cancer published in the Annals of Internal Medicine, JAMA, and New England Journal of Medicine. The main outcome measure, was the reporting of participation and of results by race/ethnicity of trial participants. Of 253 : eligible trials, 40% (n = 102) were non race-focused yet did not report. race, while 2% (n = 4) were non gender-focused and did not report gender. Forty-six percent of trials' that reported the race/ethnicity of the sample reported only one or two racial/ethnic categories, and in 43% of these trials the total number of individuals reported in each race/ethnicity category, did not equal the total reported sample size. Analysis of results by race/ethnicity was reported in only two trials, and by gender in only three trials. In diseases With known racial and,ethnic disparities, many clinical trials do not report the race/ethnicity of the study participants, and almost none report analyses by race/ethnicity. Although federal initiatives mandate inclusion of minority groups in research, that inclusion has not translated to reporting of results that might. guide therapeutic decisions. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ N Carolina, Dept Social Med, Chapel Hill, NC 27599 USA. Walden Univ, Sch Hlth & Human Sci, Minneapolis, MN 55401 USA. San Francisco Vet Affairs Med Ctr, Dept Med, Div Geriatr, San Francisco, CA 94121 USA. Univ N Carolina, Dept Med, Chapel Hill, NC 27599 USA. RP Corbie-Smith, G (reprint author), Univ N Carolina, Dept Social Med, CB 7240, Chapel Hill, NC 27599 USA. FU NHLBI NIH HHS [HL04039] NR 24 TC 52 Z9 52 U1 0 U2 5 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 MAY PY 2003 VL 56 IS 5 BP 416 EP 420 DI 10.1016/S0895-4356(03)00031-3 PG 5 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 691DH UT WOS:000183589200003 PM 12812814 ER PT J AU Zirwas, MJ Abell, E Ruben, A Silverman, AR Wolff, J Deng, JS AF Zirwas, MJ Abell, E Ruben, A Silverman, AR Wolff, J Deng, JS TI Immunofluorescence findings in granuloma faciale: report of two cases SO JOURNAL OF CUTANEOUS PATHOLOGY LA English DT Article AB Background: Immunofluorescence findings in granuloma faciale have been infrequently described. Reported findings include granular IgA, IgG, IgM, and C3 deposits in the dermoepidermal junction, in blood vessel walls, and on connective tissue fibers; IgG in the basement membrane zone, and IgG around blood vessels. Observations: We report two cases of granuloma faciale in which biopsy specimens were sent for routine pathology as well as immunofluorescence. Additional work-up included serologic testing for markers of lupus erythematosus (LE). Immunofluorescence in both cases revealed granular IgA, IgG, IgM, C3, and C5-9 deposits along the dermoepidermal junction only. Blood vessel walls and connective tissue fibers were spared. Serologic studies for markers of LE were negative. Conclusion: Immunofluorescence findings were essentially identical to those which would be expected in cutaneous LE; however, the combination of negative serologic studies for LE, histopathologic findings typical of granuloma faciale, and clinical findings most consistent with granuloma faciale allowed the diagnosis of granuloma faciale to be rendered with certainty. Interpretation of results of direct immunofluorescence of skin should be correlated with clinical presentation, histopathological findings and other laboratory results in order to render final diagnosis of a given patient. C1 VA Pittsburgh Healthcare Syst, Serv Dermatol, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Dermatol, Pittsburgh, PA 15261 USA. Dermatopathol Lab, Pittsburgh, PA USA. Westmorland Dermatol Assoc, Greensburg, PA USA. RP Deng, JS (reprint author), VA Pittsburgh Healthcare Syst, Serv Dermatol, Univ Dr, Pittsburgh, PA 15240 USA. NR 14 TC 10 Z9 10 U1 0 U2 0 PU BLACKWELL MUNKSGAARD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 0303-6987 J9 J CUTAN PATHOL JI J. Cutan. Pathol. PD MAY PY 2003 VL 30 IS 5 BP 314 EP 317 DI 10.1034/j.1600-0560.2003.00051.x PG 4 WC Dermatology; Pathology SC Dermatology; Pathology GA 680ZQ UT WOS:000183010300005 PM 12753171 ER PT J AU Streja, D Cressey, P Rabkin, SW AF Streja, D Cressey, P Rabkin, SW TI Associations between inflammatory markers, traditional risk factors, and complications in patients with type 2 diabetes mellitus SO JOURNAL OF DIABETES AND ITS COMPLICATIONS LA English DT Article DE diabetes mellitus; non-insulin-dependent; body mass index; C reactive protein; fibrinogen; microalbuminuria; hemoglobin A, C; hydroxymethylglutoryl Co A reductase inhibitor; post menopousal hormone replacement therapy ID C-REACTIVE PROTEIN; CORONARY-ARTERY DISEASE; INSULIN-RESISTANCE ATHEROSCLEROSIS; BEAM COMPUTED-TOMOGRAPHY; PLASMA-FIBRINOGEN; PRIMARY HYPERCHOLESTEROLEMIA; CAROTID ATHEROSCLEROSIS; ENDOTHELIAL DYSFUNCTION; CARDIOVASCULAR-DISEASE; POSTMENOPAUSAL WOMEN AB Objective: Inflammatory markers predict cardiovascular events in a wide range of patients. Two factors, fibrinogen (FIB) and high-sensitivity C reactive protein (CRP), are currently entering clinical practice as cardiovascular risk predictors. In patients with type 2 diabetes mellitus, we sought to examine the relationship between macrovascular disease, urinary albumin/creatinine ratio (ACR), and FIB or CRP, as well as the relationship of FIB and CRP with traditional risk predictors of these complications of diabetes. Methods: In 202 consecutive patients with type 2 diabetes mellitus from a diabetes clinic, clinical and biochemical data were obtained and a cross-sectional analysis was performed. Results: Patients with macrovascular disease had higher FIB (P = .02) but not higher CRP. They were older, more likely to have retinopathy or elevated serum creatinine, had higher ACR and lower HDL cholesterol. They were more likely to be treated with statins, beta-blockers, and ASA. Adjustment for statin therapy did not result in significant differences in CRP levels according to macrovascular disease status. Both FIB (P = .01) and CRP (P = .02) were significantly higher in patients with ACR whose values were in the proteinuria range. In multivariate analysis, both FIB (P = .001) and CRP (P = .03) were positively correlated with ACR, but no association was seen between CRP and ACR when FIB was entered in the model. Other factors positively associated with ACR were age, diastolic blood pressure, retinopathy, and hemoglobin A1c (HbA1c). FIB and CRP were strongly correlated (R = .49, P < .001) and this effect was independent of statin therapy. CRP was positively associated with body mass index (BMI), serum triglycerides, and sulfonylurea therapy and negatively associated with metformin therapy. Patients on statin therapy had significantly higher FIB and lower CRP. Women on hormone replacement therapy (HRT) had significantly lower FIB and higher CRP. Conclusions: In patients with diabetes: (1) the two markers, FIB and CRP, are interrelated; (2) FIB is significantly associated with presence of microvascular disease, independent of CRP; (3) CRP is strongly associated with metabolic factors but not with complications of diabetes, independently of FIB; (4) statins and HRT were divergently associated with CRP and FIB as HRT was associated with lower FIB and higher CRP, while statins showed the reverse association; and (5) CRP and FIB provide different information about the characteristics and consequences of diabetes mellitus because of divergent associations with biological indicators and therapeutic agents. (C) 2003 Elsevier Science Inc. All rights reserved. C1 Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ British Columbia, Dept Med, Vancouver, BC, Canada. RP Streja, D (reprint author), W Los Angeles Vet Affairs Med Ctr, Endocrinol Sect, 7345 Med Ctr Dr, Canoga Pk, CA 91307 USA. NR 53 TC 40 Z9 47 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1056-8727 J9 J DIABETES COMPLICAT JI J. Diabetes Complications PD MAY-JUN PY 2003 VL 17 IS 3 BP 120 EP 127 DI 10.1016/S1056-8727(02)00204-0 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 679LQ UT WOS:000182924200002 PM 12738395 ER PT J AU Stelzner, M Hoagland, VD Woolman, JD AF Stelzner, M Hoagland, VD Woolman, JD TI Identification of optimal harvest sites of ileal stem cells for treatment of bile acid malabsorption in a dog model SO JOURNAL OF GASTROINTESTINAL SURGERY LA English DT Article; Proceedings Paper CT 43rd Annual Meeting of the Society-for-Surgery-of-the-Alimentary-Tract CY MAY 19-22, 2002 CL SAN FRANCISCO, CALIFORNIA SP Soc Surg Alimentary Tract DE ileum; absorption; bile acid; dog ID MUCOSAL NUTRIENT TRANSPORT; ABSORPTION; ILEUM; EXPRESSION; MEMBRANE; RABBIT AB Ileal mucosal stein cells expressing the sodium-dependent ileal bile acid transporter (IBAT) have been successfully transplanted into the jejunum of rodents in projects aimed at creating a "neoileum" to treat bile acid malabsorption. To find optimal harvest sites for a dog model of stem cell transplantation, the ex,act location of peak IBAT expression in the donor ileum needs to be known. We therefore mapped MAT function, IBAT mRNA, and IBAT protein in the ileum of Beagle dogs (N = 3). Mucosal samples were taken every 5 cm in the ileum and every 20 cm in the jejunum of each dog. Sodium-dependent (active) and sodium-independent (passive) taurocholate uptake rates were measured using a standardized everted sleeve technique. IBAT mRNA concentrations were determined by semiquantitative reverse transcriptase-polymerase chain reaction and IBAT protein concentrations by fluorometric immunohistochemical analysis. The small bowel measured 208 +/- 17 cm (mean +/- standard error of the mean). Active and passive uptake rates were found to follow distinct distribution curves. Significant active uptake was seen only at the terminal 50 cm and peaked at 479 +/- 176 pM/mm(2). Depending on location, active uptake accounted for approximately half of the total uptake. IBAT in RNA and protein distributions corroborated uptake curves. The terminal 10 to 50 cm of ileum has the highest bile acid uptake capacity. This short segment appears to be the most promising donor site for ileal stem cell transplants to create a "neoileum" in dogs. (C) 2003 The Society for Surgery of the Alimentary Tract, Inc. C1 Univ Washington, Dept Surg, VAPSHCS Surg Serv 112, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Stelzner, M (reprint author), Univ Washington, Dept Surg, VAPSHCS Surg Serv 112, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 20 TC 4 Z9 5 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1091-255X J9 J GASTROINTEST SURG JI J. Gastrointest. Surg. PD MAY-JUN PY 2003 VL 7 IS 4 BP 516 EP 522 DI 10.1016/S1091-255X(03)00027-1 PG 7 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 684LP UT WOS:000183209100016 PM 12763409 ER PT J AU Ito, A Matejuk, A Hopke, C Drought, H Dwyer, J Zamora, A Subramanian, S Vandenbark, AA Offner, H AF Ito, A Matejuk, A Hopke, C Drought, H Dwyer, J Zamora, A Subramanian, S Vandenbark, AA Offner, H TI Transfer of severe experimental autoimmune encephalomyelitis by IL-12- and IL-18-potentiated T cells is estrogen sensitive SO JOURNAL OF IMMUNOLOGY LA English DT Article ID GAMMA-INDUCING FACTOR; CHEMOKINE RECEPTOR EXPRESSION; CENTRAL-NERVOUS-SYSTEM; TNF-ALPHA PRODUCTION; IFN-GAMMA; INTERFERON-GAMMA; DENDRITIC CELLS; B-CELLS; MULTIPLE-SCLEROSIS; TH1 DEVELOPMENT AB The aim of this study was to evaluate the roles of IL-18 and IL-12 in potentiating the encephalitogenic activity of T cell lines specific for myelin oligodendrocyte glycoprotein (MOG(35-55)) MOG-specific T cells stimulated with anti-CD3 and anti-CD28 in the presence of IL-12 or IL-18 alone transferred only mild experimental autoimmune encephalomyelitis (EAE) into a low percentage of recipients. However, T cells cocultured with both cytokines transferred aggressive clinical and histological EAE into all recipients. Coculture of T cells with IL-12 enhanced the secretion of IFN-gamma, but not TNF-alpha, whereas coculture with IL-18 enhanced the secretion of TNF-alpha, but not INF-gamma. However, coculture with both IL-18 and IL-12 induced high levels of both TNF-alpha and IFN-gamma. Additionally, IL-12 selectively enhanced mRNA expression of CCR5, whereas IL-18 selectively enhanced the expression of CCR4 and CCR7, and CCR4 and CCR5 were coexpressed on the surface of T cells cocultured with IL-12 and IL-18. Finally, estrogen treatment, previously found to inhibit both TNF-alpha and IFN-gamma production, completely abrogated all signs of passive EAE. These data demonstrate that optimal potentiation of encephalitogenic activity can be achieved by conditioning MOG-specific T cells with the combination of IL-12 and IL-18, which, respectively, induce the secretion of IFN-gamma/CCR5 and TNF-alpha/CCR4/CCR7, and that estrogen treatment, which is known to inhibit both proinflammatory cytokines, can completely ablate this aggressive form of passive EAE. C1 Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. Kyoto Univ, Inst Med Sci, Dept Expt Pathol, Kyoto, Japan. Polish Acad Sci, L Hirszfeld Inst Immunol & Expt Therapy, Wroclaw, Poland. Oregon Hlth & Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR 97201 USA. RP Offner, H (reprint author), Portland Vet Affairs Med Ctr, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. FU NIAID NIH HHS [AI42376]; NINDS NIH HHS [NS23444, NS23221] NR 52 TC 32 Z9 32 U1 0 U2 1 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD MAY 1 PY 2003 VL 170 IS 9 BP 4802 EP 4809 PG 8 WC Immunology SC Immunology GA 672NX UT WOS:000182528100049 PM 12707362 ER PT J AU McConnell, KA Bohning, DE Nahas, Z Shastri, A Teneback, C Lorberbaum, JP Lomarev, MP Vincent, DJ George, MS AF McConnell, KA Bohning, DE Nahas, Z Shastri, A Teneback, C Lorberbaum, JP Lomarev, MP Vincent, DJ George, MS TI BOLD fMRI response to direct stimulation (transcranial magnetic stimulation) of the motor cortex shows no decline with age SO JOURNAL OF NEURAL TRANSMISSION LA English DT Article DE transcranial magnetic stimulation; motor cortex; fMRI; blood flow; imaging; aging ID CEREBRAL BLOOD-FLOW; POSITRON EMISSION TOMOGRAPHY; HEMODYNAMIC-RESPONSE; NEURAL ACTIVITY; FUNCTIONAL MRI; BRAIN; METABOLISM; OXYGEN; TMS; PET AB Previous studies using BOLD fMRI to examine age-related changes in cortical activation used tasks that relied on peripheral systems to activate the brain. They were unable to distinguish between alterations due to age-related changes in the periphery and actual changes in cortical physiology. Transcranial magnetic stimulation (TMS), which allows direct, non-invasive stimulation of cortical neurons, was interleaved with BOLD fMRI to study 6 young and 5 old subjects. Three different tasks were compared: direct stimulation by TMS, indirect active stimulation produced by a motor task, and indirect passive stimulation produced by hearing the TMS coil discharge. Direct neuronal stimulation by TMS produced similar fMRI signal increases in both groups, suggesting that cortical physiology itself may not necessarily decline with age. C1 Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Psychiat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Neurobiol, Ctr Adv Imaging Res, Charleston, SC 29425 USA. Med Univ S Carolina, Brain Stimulat Lab, Charleston, SC 29425 USA. Ralph H Johnson Vet Hosp, Charleston, SC USA. RP George, MS (reprint author), Med Univ S Carolina, Dept Radiol, 171 Ashley Ave, Charleston, SC 29425 USA. FU NIAAA NIH HHS [AA10761-03] NR 39 TC 9 Z9 10 U1 0 U2 1 PU SPRINGER-VERLAG WIEN PI VIENNA PA SACHSENPLATZ 4-6, PO BOX 89, A-1201 VIENNA, AUSTRIA SN 0300-9564 J9 J NEURAL TRANSM JI J. Neural Transm. PD MAY PY 2003 VL 110 IS 5 BP 495 EP 507 DI 10.1007/s00702-002-0804-6 PG 13 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 675UW UT WOS:000182715400005 PM 12721811 ER PT J AU Bakalkin, G Yakovleva, T Usynin, I Pasikova, N Marinova, Z Cebers, G Gileva, I Matskevich, A Nikoshkov, A Haroutunian, V Hauser, KF Hurd, YL Terenius, L AF Bakalkin, G Yakovleva, T Usynin, I Pasikova, N Marinova, Z Cebers, G Gileva, I Matskevich, A Nikoshkov, A Haroutunian, V Hauser, KF Hurd, YL Terenius, L TI Biogenesis and secretion of dynorphins are regulated by the Ubiquitin Proteasome system: implications for Alzheimer's disease SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 34th Annual Meeting of the American-Society-for-Neurochemistry CY MAY 03-07, 2003 CL NEWPORT BEACH, CALIFORNIA SP Amer Soc Neurochem C1 Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden. Bronx Vet Adm Med Ctr, Bronx, NY USA. Univ Kentucky, Dept Anat, Lexington, KY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD MAY PY 2003 VL 85 SU 1 BP 61 EP 61 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 677VJ UT WOS:000182828800217 ER PT J AU Rajendran, JG Meyer, J Schwartz, DL Kinahan, PE Cheng, PM Hummell, SM Phillips, M Krohn, KA AF Rajendran, JG Meyer, J Schwartz, DL Kinahan, PE Cheng, PM Hummell, SM Phillips, M Krohn, KA TI PET imaging with [F-18]FMISO permits hypoxia directed radiotherapy dose escalation in head and neck cancer. SO JOURNAL OF NUCLEAR MEDICINE LA English DT Meeting Abstract CT 50th Annual Meeting of the Society-of-Nuclear-Medicine CY JUN 21-25, 2003 CL NEW ORLEANS, LOUISIANA SP Soc Nucl Med C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 2 Z9 2 U1 0 U2 0 PU SOC NUCLEAR MEDICINE INC PI RESTON PA 1850 SAMUEL MORSE DR, RESTON, VA 20190-5316 USA SN 0161-5505 J9 J NUCL MED JI J. Nucl. Med. PD MAY PY 2003 VL 44 IS 5 SU S MA 415 BP 127P EP 128P PG 2 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 676AK UT WOS:000182729600416 ER PT J AU Smith, CJ Sieckman, GL Owen, NK Atkinson, LA Volkert, WA Hoffman, TJ AF Smith, CJ Sieckman, GL Owen, NK Atkinson, LA Volkert, WA Hoffman, TJ TI Design and development of Tc-99m-carbonyl-Bombesin analogs: A structure activity relationship study. SO JOURNAL OF NUCLEAR MEDICINE LA English DT Meeting Abstract CT 50th Annual Meeting of the Society-of-Nuclear-Medicine CY JUN 21-25, 2003 CL NEW ORLEANS, LOUISIANA SP Soc Nucl Med C1 Univ Missouri, Columbia, MO 65211 USA. US Dept Vet Affairs, Columbia, MO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SOC NUCLEAR MEDICINE INC PI RESTON PA 1850 SAMUEL MORSE DR, RESTON, VA 20190-5316 USA SN 0161-5505 J9 J NUCL MED JI J. Nucl. Med. PD MAY PY 2003 VL 44 IS 5 SU S MA 1066 BP 298P EP 298P PG 1 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 676AK UT WOS:000182729600983 ER PT J AU Rajendran, JG Ng, P Peterson, LM Schwartz, DL Scharnhorst, J Conrad, EU Grierson, JR Krohn, KA AF Rajendran, JG Ng, P Peterson, LM Schwartz, DL Scharnhorst, J Conrad, EU Grierson, JR Krohn, KA TI F-18 FMISO PET tumor hypoxia imaging: Investigating the tumor volume-hypoxia connection. SO JOURNAL OF NUCLEAR MEDICINE LA English DT Meeting Abstract CT 50th Annual Meeting of the Society-of-Nuclear-Medicine CY JUN 21-25, 2003 CL NEW ORLEANS, LOUISIANA SP Soc Nucl Med C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Orthoped, Seattle, WA 98195 USA. NR 0 TC 2 Z9 2 U1 0 U2 0 PU SOC NUCLEAR MEDICINE INC PI RESTON PA 1850 SAMUEL MORSE DR, RESTON, VA 20190-5316 USA SN 0161-5505 J9 J NUCL MED JI J. Nucl. Med. PD MAY PY 2003 VL 44 IS 5 SU S MA 1340 BP 376P EP 376P PG 1 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 676AK UT WOS:000182729601257 ER PT J AU Gerard, SK AF Gerard, SK TI Whole-body thyroid tumor I-123 scintigraphy SO JOURNAL OF NUCLEAR MEDICINE LA English DT Letter ID CANCER C1 San Francisco VA Med Ctr, San Francisco, CA USA. RP Gerard, SK (reprint author), San Francisco VA Med Ctr, San Francisco, CA USA. NR 5 TC 2 Z9 2 U1 0 U2 0 PU SOC NUCLEAR MEDICINE INC PI RESTON PA 1850 SAMUEL MORSE DR, RESTON, VA 20190-5316 USA SN 0161-5505 J9 J NUCL MED JI J. Nucl. Med. PD MAY PY 2003 VL 44 IS 5 BP 852 EP 852 PG 1 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 675XZ UT WOS:000182724000031 PM 12732689 ER PT J AU Sundgren, NC Giraud, GD Stork, PJS Maylie, JG Thornburg, KL AF Sundgren, NC Giraud, GD Stork, PJS Maylie, JG Thornburg, KL TI Angiotensin II stimulates hyperplasia but not hypertrophy in immature ovine cardiomyocytes SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Article ID LEFT-VENTRICULAR HYPERTROPHY; CONVERTING ENZYME-INHIBITION; MYOCARDIAL-CELL HYPERTROPHY; INDUCED CARDIAC-HYPERTROPHY; EXPERIMENTAL HEART-FAILURE; ACTIVATED PROTEIN-KINASES; INDUCED GROWTH-RESPONSES; ADULT-RAT HEARTS; IN-VITRO; NEONATAL RAT AB Rat and sheep cardiac myocytes become binucleate as they complete the 'terminal differentiation' process soon after birth and are not able to divide thereafter. Angiotensin II (Ang II) is known to stimulate hypertrophic changes in rodent cardiomyocytes under both in vivo and in vitro conditions via the AT, receptor and intracellular extracellular regulated kinase (ERK) signalling cascade. We sought to develop culture methods for immature sheep cardiomyocytes in order to test the hypothesis that Ang II is a hypertrophic agent in the immature myocardium of the sheep. We isolated fetal sheep cardiomyocytes and cultured them for 96 h, added Ang II and phenylephrine (PE) for 48 h, and measured footprint area and proliferation (5-bromo-2'-deoxyuridine (BrdU) uptake) separately in mono- vs. binucleate myocytes. We found that neither Ang II nor PE changed the footprint area of mononucleated cells. PE stimulated an increase in footprint area of binucleate cells but Ang II did not. Ang II increased myocyte BrdU uptake compared to serum free conditions, but PE did not affect BrdU uptake. The MAP kinase kinase (MEK) inhibitor UO126 prevented BrdU uptake in Ang II-stimulated cells and prevented cell hypertrophy in PE-stimulated cells. This paper establishes culture methods for immature sheep cardiomyocytes and reports that: (1) Ang II is not a hypertrophic agent; (2) Ang II stimulates hyperplastic growth among mononucleate myocytes; (3) PE is a hypertrophic agent in binucleate myocytes; and (4) the ERK cascade is required for the proliferation effect of Ang H and the hypertrophic effect of PE. C1 Oregon Hlth Sci Univ, Sch Med, Heart Res Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Sch Med, Dept Physiol Pharmacol, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Sch Med, Dept Med Cardiol, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Sch Med, Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Sch Med, Vollum Inst Adv Biomed Res, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Sch Med, Dept Obstet & Gynecol, Portland, OR 97239 USA. RP Thornburg, KL (reprint author), Oregon Hlth Sci Univ, Sch Med, Heart Res Ctr, L464, Portland, OR 97239 USA. FU NICHD NIH HHS [P01 HD034430, 2P01 HD34430] NR 67 TC 56 Z9 59 U1 0 U2 1 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD MAY 1 PY 2003 VL 548 IS 3 BP 881 EP 891 DI 10.1113/jphysiol.2003.038778 PG 11 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 690VR UT WOS:000183571600024 PM 12626668 ER PT J AU Taub, E Uswatte, G AF Taub, E Uswatte, G TI Constraint-induced movement therapy: Bridging from the primate laboratory to the stroke rehabilitation laboratory SO JOURNAL OF REHABILITATION MEDICINE LA English DT Article DE rehabilitation; physical therapy; cortical reorganization; learned nonuse; stroke; neurological injury ID MYOGRAPHIC BIOFEEDBACK APPLICATIONS; MOTOR CORTEX PLASTICITY; UPPER EXTREMITY; CORTICAL REORGANIZATION; FORCED-USE; PHYSICAL REHABILITATION; CEREBRAL-PALSY; OWL MONKEYS; RECOVERY; ARM AB In this laboratory we have developed a set of techniques that randomized controlled studies indicate can substantially reduce the motor deficit of patients with mild to moderately severe chronic strokes. The techniques, termed Constraint-Induced Movement therapy (CI therapy), involve motor restriction of the less-affected arm while at the same time intensively training the more-affected arm. The intervention was derived directly from basic research with monkeys. The primary difference between Cl therapy and conventional physical therapy is in the duration and intensity of the treatment. The greatly improved extremity function produced in the laboratory transfers to the activities of daily living outside the clinic. Treatment gains persisted for the two years tested. Converging data from seven experiments has shown that CI therapy produces massive alterations in brain organization and function correlated with the large improvements in motor ability that it produces. C1 Univ Alabama, Dept Psychol, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Taub, E (reprint author), Univ Alabama, Dept Psychol, CPM 712,1530 3rd Ave S, Birmingham, AL 35294 USA. EM Etaub@uab.edu RI Uswatte, Gitendra/C-4913-2009 NR 71 TC 3 Z9 5 U1 0 U2 1 PU FOUNDATION REHABILITATION INFORMATION PI UPPSALA PA TRADGARDSGATAN 14, UPPSALA, SE-753 09, SWEDEN SN 1650-1977 J9 J REHABIL MED JI J. Rehabil. Med. PD MAY PY 2003 VL 35 SU 41 BP 34 EP 40 DI 10.1080/16501960310010124 PG 7 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 686TD UT WOS:000183336300007 ER PT J AU Hatzakis, M Haselkorn, J Williams, R Turner, A Nichol, P AF Hatzakis, M Haselkorn, J Williams, R Turner, A Nichol, P TI Telemedicine and the delivery of health services to veterans with multiple sclerosis SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE cost-benefit analysis; health services; MS; multiple sclerosis; review; telemedicine; translation; veterans ID COLUMBIA-UNIVERSITY INFORMATICS; SPINAL-CORD INJURY; PARKINSONS-DISEASE; DIABETES EDUCATION; IDEATEL PROJECT; DEPRESSION; PRESSURE; PATIENT; TELEDERMATOLOGY; CONSULTATIONS AB Telemedicine involves the provision of health care and sharing of medical knowledge using telecommunications technologies. Preventive, diagnostic, and therapeutic services, as well as patient education and assistance with self-management of health, can be provided via telemedicine. The Veterans Health Administration (VHA) has a wide range of telemedicine capabilities. Given limitations on studying its effectiveness, telemedicine is often applied to new patient populations without explicit evaluation of efficacy. Evaluating the potential use of telemedicine services through supporting literature from other disorders may be possible. This paper discusses applying telemedicine to the care of individuals with multiple sclerosis (MS) when few published evaluations exist in MS. In this paper, we (1) provide a background on the use of telemedicine in the private sector and in the VHA, (2) discuss the use of current telemedicine literature to management of individuals with MS, and (3) review the strengths and limitations of telemedicine as a care delivery vehicle. C1 VA Puget Sound Hlth Care Syst, Seattle Div, Rehabil Care Serv, Seattle, WA 98108 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Washington, Dept Internal Med, Seattle, WA 98195 USA. RP Hatzakis, M (reprint author), VA Puget Sound Hlth Care Syst, Seattle Div, Rehabil Care Serv, S-117-RCS,1660 S Columbian Way, Seattle, WA 98108 USA. OI Turner, Aaron/0000-0001-6897-8003 NR 56 TC 20 Z9 20 U1 2 U2 3 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PD MAY-JUN PY 2003 VL 40 IS 3 BP 265 EP 282 PG 18 WC Rehabilitation SC Rehabilitation GA 687KE UT WOS:000183374800008 PM 14582530 ER PT J AU Lindenberger, EC Landefeld, CS Sands, LP Counsell, SR Fortinsky, RH Palmer, RM Kresevic, DM Covinsky, KE AF Lindenberger, EC Landefeld, CS Sands, LP Counsell, SR Fortinsky, RH Palmer, RM Kresevic, DM Covinsky, KE TI Unsteadiness reported by older hospitalized patients predicts functional decline SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Geriatrics-Society CY MAY, 2002 CL WASHINGTON, D.C. SP Amer Geriatr Soc DE aged; hospitalization; activities of daily living; equilibrium; physical fitness ID ACUTE MEDICAL ILLNESS; PHYSICAL PERFORMANCE; ADULTS; RISK; OUTCOMES; VALIDATION; DEPENDENCE; MORBIDITY; ADMISSION; DISCHARGE AB OBJECTIVES: To determine whether a simple question about steadiness at admission predicts in-hospital functional decline and whether unsteadiness at admission predicts failure of in-hospital functional recovery of patients who have declined immediately before hospitalization. DESIGN: Prospective cohort study. SETTING: One university hospital and one community teaching hospital. PARTICIPANTS: One thousand five hundred fifty-seven hospitalized medical patients aged 70 and older. MEASUREMENTS: On admission, patients reported their steadiness with walking and whether they could perform independently each of five basic activities of daily living (ADLs) at admission and 2 weeks before admission (baseline). For the primary analysis, the outcome was decline in ADL function between admission and discharge. For the secondary analysis, the outcome was in-hospital recovery to baseline ADL function in patients who experienced ADL decline in the 2 weeks before admission. RESULTS: In the primary cohort (n = 1,557), 25% of patients were very unsteady at admission; 22% of very unsteady patients declined during hospitalization, compared with 17%, 18%, and 10% for slightly unsteady, slightly steady, and very steady patients, respectively (P for trend = .001). After adjusting for age; medical comorbidities; Acute Physiology, Age, and Chronic Health Evaluation II score; and admission ADL, unsteadiness remained significantly associated with ADL decline (odds for decline for very unsteady compared with very steady = 2.6, 95% confidence interval = 1.5-4.5). In the secondary analysis, predicting ADL recovery in patients who declined before hospitalization (n = 563), 46% of patients were very unsteady at admission. In this cohort, 44% of very unsteady patients failed to recover, compared with 35%, 36%, and 33% for each successively higher level of steadiness, respectively (P for trend = 0.06). After multivariate adjustment, greater unsteadiness independently predicted failure of recovery (P for trend = 0.02). CONCLUSION: A simple question about steadiness identified patients at increased risk for in-hospital ADL decline and, in patients who lost ADL function immediately before admission, failure to recover. C1 San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. Indiana Univ, Sch Med, Ctr Aging Res, Div Gen Internal Med & Geriatr, Indianapolis, IN USA. Univ Connecticut, Ctr Hlth, Ctr Aging, Farmington, CT USA. Univ Connecticut, Ctr Hlth, Div Geriatr, Farmington, CT USA. Cleveland Clin Fdn, Geriatr Med Sect, Cleveland, OH 44195 USA. Univ Hosp Cleveland, Cleveland, OH 44106 USA. RP Lindenberger, EC (reprint author), San Francisco VA Med Ctr, Div Geriatr, 4150 Clement St,Box 181G, San Francisco, CA 94121 USA. RI Sands, Laura/E-8919-2015 OI Sands, Laura/0000-0003-2446-4486 FU AHRQ HHS [K02HS00006-01]; PHS HHS [T-32] NR 27 TC 15 Z9 17 U1 2 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD MAY PY 2003 VL 51 IS 5 BP 621 EP 626 DI 10.1034/j.1600-0579.2003.00205.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 673JU UT WOS:000182577900005 PM 12752836 ER PT J AU Roman, GC AF Roman, GC TI Vascular dementia: Distinguishing characteristics, treatment, and prevention SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE vascular dementia; poststroke dementia; multi-infarct dementia; strategic stroke dementia; subcortical ischemia dementia ID EXECUTIVE COGNITIVE IMPAIRMENT; CENTRAL-NERVOUS-SYSTEM; WHITE-MATTER LESIONS; BASE-LINE FREQUENCY; ALZHEIMERS-DISEASE; POSTSTROKE DEMENTIA; ANTIHYPERTENSIVE TREATMENT; MULTIINFARCT DEMENTIA; PHYSICAL-DISABILITY; RISK-FACTORS AB Vascular dementia (VaD) is the second-most-common cause of dementia in the elderly, after Alzheimer's disease (AD). VaD is defined as loss of cognitive function resulting from ischemic, hypoperfusive, or hemorrhagic brain lesions due to cerebrovascular disease or cardiovascular pathology. Diagnosis requires the following criteria: cognitive loss, often predominantly subcortical; vascular brain lesions demonstrated by imaging; a temporal link between stroke and dementia; and exclusion of other causes of dementia. Poststroke VaD may be caused by large-vessel disease with multiple strokes (multiinfarct dementia) or by a single stroke (strategic stroke VaD). A common form is sub. cortical ischemic VaD caused by small-vessel occlusions with multiple lacunas and by hypoperfusive lesions resulting from stenosis of medullary arterioles, as in Binswanger's disease. Unlike with AD, in VaD, executive dysfunction is commonly seen, but memory impairment is mild or may not even be present. The cholinesterase inhibitors used for AD are also useful in VaD. Prevention strategies should focus on reduction of stroke and cardiovascular disease, with attention to control of risk factors such as hypertension, diabetes mellitus, hypercholesterolemia, and hyperhomocysteinemia. C1 Univ Texas, Hlth Sci Ctr, Sch Med, Dept Med,Div Neurol, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78229 USA. RP Roman, GC (reprint author), Univ Texas, Hlth Sci Ctr, Sch Med, Dept Med,Div Neurol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 70 TC 82 Z9 85 U1 1 U2 11 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD MAY PY 2003 VL 51 IS 5 SU 2 BP S296 EP S304 DI 10.1046/j.1532-5415.5155.x PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 675WG UT WOS:000182720100003 PM 12801386 ER PT J AU Penson, DF Litwin, MS Aaronson, NK AF Penson, DF Litwin, MS Aaronson, NK TI Health related quality of life in men with prostate cancer SO JOURNAL OF UROLOGY LA English DT Review DE prostatic neoplasms; quality of life; research; follow-up studies; patient satisfaction ID EXTERNAL-BEAM RADIATION; OF-LIFE; RADICAL PROSTATECTOMY; FUNCTIONAL ASSESSMENT; PATIENT PREFERENCES; CAPSURE DATABASE; THERAPY; OUTCOMES; RADIOTHERAPY; INSTRUMENT AB Purpose: Quality of life is of great concern to patients considering treatment options for prostate cancer. In the absence of clinical trial data clearly demonstrating that a particular treatment is superior to another for localized prostate cancer, in terms of cause specific survival, patients may value quality of life as much as quantity of life. The goal of this review is to familiarize the reader with the methodology of quality of life research and to review the recent literature on quality of life outcomes in prostate cancer. Materials and Methods: A structured MEDLINE review of literature on health related quality of life in prostate cancer for the years 1995 to 2001 was performed, and was augmented with highly relevant articles from additional selected journals. Results: In the case of advanced or metastatic disease, where the goal of treatment is palliation and symptom-free survival, quality of life often becomes the primary desired outcome. In localized disease all treatments affect health related quality of life, although the impact of each therapy on sexual, urinary and bowel function is unique. Conclusions: Although a highly personal and subjective entity, health related quality of life can be assessed using rigorous and scientifically stringent methods from the field of psychometric test theory. A substantial amount of literature exists regarding the use of established and validated instruments for assessing the impact of prostate cancer and its treatment on health related quality of life. This information is of critical importance when counseling men with newly diagnosed prostate cancer regarding treatment choices and is also helpful in setting appropriate expectations for men with metastatic disease. C1 VA Puget Sound Hlth Care Syst, Urol Sect, Seattle, WA 98108 USA. Univ Washington, Sch Med, Seattle, WA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Urol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Netherlands Canc Inst, Div Psychosocial Res & Epidemiol, Amsterdam, Netherlands. RP Penson, DF (reprint author), VA Puget Sound Hlth Care Syst, Urol Sect, Seattle, WA 98108 USA. NR 68 TC 108 Z9 110 U1 3 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD MAY PY 2003 VL 169 IS 5 BP 1653 EP 1661 DI 10.1097/01.ju.0000061964.49961.55 PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 667WM UT WOS:000182257600003 PM 12686803 ER PT J AU Beer, TM Garzotto, M Eilers, KM Lemmon, D AF Beer, TM Garzotto, M Eilers, KM Lemmon, D TI Phase II study of abarelix depot for androgen independent prostate cancer progression during gonadotropin-releasing hormone agonist therapy SO JOURNAL OF UROLOGY LA English DT Article DE prostatic neoplasms; gonadorelin; hormone antagonists ID FOLLICLE-STIMULATING-HORMONE; LUTEINIZING-HORMONE; ANTAGONIST CETRORELIX; CLINICAL-TRIALS; GNRH AGONIST; OPEN-LABEL; TESTOSTERONE; LEUPROLIDE; CARCINOMA; RECEPTOR AB Purpose: We determine the clinical efficacy of the gonadotropin-releasing hormone (Gn-RH) antagonist abarelix in patients with androgen independent prostate cancer, and measure its effect on serum follicle-stimulating hormone (FSH) and testosterone. Materials and Methods: A total of 20 patients with prostate cancer progression during Gn-RH agonist therapy received 100 mg. abarelix depot by intramuscular injection on days 1, 15 and 29, and then every 28 days for up to 24 weeks. Gn-RH agonist therapy was not continued. Patients who met criteria for prostate specific antigen (PSA) response after 24 weeks of therapy could receive treatment for up to 52 weeks. PSA response was the primary end point and was defined as a 50% decrease confirmed 4 weeks later. Secondary end points of this study were the effect of therapy on serum FSH and testosterone. Results: No patient met the criteria for PSA response. At the end of the 6 cycles of therapy 2 patients remained stable without PSA progression or other signs of disease progression. Median time to progression was 8 weeks (95% CI 5.7-10.3). Mean serum FSH decreased by more than 50% from a baseline of 5.7 IU/l. (95% Cl 4.2-7.1) and remained suppressed throughout the observation period. Mean serum testosterone did not change after 4 and 8 weeks of therapy and remained in the anorchid range. Treatment was well tolerated with no grade 3 or higher toxicity. Conclusions: Treatment of androgen independent prostate cancer with abarelix decreases circulating FSH. and maintains anorchid testosterone but does not result in clinical responses. C1 Oregon Hlth & Sci Univ, Div Hematol, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Div Med Oncol, Portland, OR USA. Portland VA Med Ctr, Div Urol, Portland, OR USA. RP Beer, TM (reprint author), Oregon Hlth & Sci Univ, Div Hematol, Portland, OR 97201 USA. FU NCRR NIH HHS [5M01 RR 00334-33S2] NR 20 TC 20 Z9 20 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD MAY PY 2003 VL 169 IS 5 BP 1738 EP 1741 DI 10.1097/01.ju.0000059584.47272.9d PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 667WM UT WOS:000182257600021 PM 12686821 ER PT J AU Bean-Mayberry, B AF Bean-Mayberry, B TI Influences on primary care achievement among women veterans SO JOURNAL OF WOMENS HEALTH & GENDER-BASED MEDICINE LA English DT Meeting Abstract C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1524-6094 J9 J WOMEN HEALTH GEN-B JI J. WOMENS HEALTH GENDER-BASED MED. PD MAY PY 2003 VL 12 IS 4 MA P16 BP 426 EP 426 PG 1 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 683JN UT WOS:000183145100058 ER PT J AU Ibrahim, SA Burant, CJ Mercer, MB Siminoff, LA Kwoh, CK AF Ibrahim, SA Burant, CJ Mercer, MB Siminoff, LA Kwoh, CK TI Older patients' perceptions of quality of chronic knee or hip pain: Differences by ethnicity and relationship to clinical variables SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID OF-LIFE; RHEUMATOID-ARTHRITIS; HEALTH-STATUS; OSTEO-ARTHRITIS; OSTEOARTHRITIS; ARTHROPLASTY; DETERMINANTS; VALIDATION; SEVERITY; WOMAC AB Background. There is marked ethnic or racial disparity in the utilization of joint replacement for osteoarthritis. The reasons are not known. Pain is the reason most patients with osteoarthritis seek care. Cultural and psychosocial factors influence how patients experience and express pain. We examined whether patient descriptions of chronic pain vary by ethnicity and if they correlate with important clinical measures used in arthritis care. Methods. Sample consisted of 300 male veterans who were greater than or equal to50 years of age with moderate to severe symptomatic knee or hip osteoarthritis. Structured surveys were used to assess patient descriptions of pain and to collect important demographic, clinical, and psychosocial variables. Factor analysis was used to assess patterns of pain description in a comparison of African-American and Caucasian patients. Pearson correlations were used to examine relationships between pain descriptions and clinical variables. Results. The two groups were similar with respect to age and other baseline clinical characteristics. A confirmatory factor analysis on quality of pain description showed that a four-factor model converged for Caucasian patients (chi square = 39.6, comparative fit index = 0.95, Tucker Lewis index = 0.93, and root mean square error of approximation = 0.047), but a three-factor model was supported by the data for African-American patients (chi square = 25.4, comparative fit index = 1.00, Tucker Lewis index = 1.05, and root mean square error of approximation less than or equal to 0.001). Chronic pain quality descriptions correlate significantly with Western Ontario and McMaster Universities Arthritis Index scores but not with radiologic stage of disease. Conclusions. African-American and Caucasian elderly patients with chronic knee or hip symptomatic osteoarthritis describe the quality of their pain differently. Patient descriptions of quality of chronic knee or hip pain do not correlate with radiologic stage of disease. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA 15240 USA. Case Western Reserve Univ, Sch Med, Dept Bioeth, Cleveland, OH USA. RP Ibrahim, SA (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Univ Dr C,11 East 130 A-U, Pittsburgh, PA 15240 USA. RI Siminoff, Laura /H-6277-2012 NR 40 TC 24 Z9 24 U1 1 U2 1 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD MAY PY 2003 VL 58 IS 5 BP 472 EP 477 PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 675BP UT WOS:000182673400015 ER PT J AU Al-Nimri, MA Komers, R Oyama, TT Subramanya, AR Lindsley, JN Anderson, S AF Al-Nimri, MA Komers, R Oyama, TT Subramanya, AR Lindsley, JN Anderson, S TI Endothelial-derived vasoactive mediators in polycystic kidney disease SO KIDNEY INTERNATIONAL LA English DT Article DE polycystic kidney; nitric oxide; endothelin; cystic disease; glomerular filtration rate; proteinuria ID NITRIC-OXIDE SYNTHASE; RENAL HEMODYNAMIC-CHANGES; DEPENDENT RELAXATION; SYMPATHETIC ACTIVITY; VASCULAR-RESPONSES; RESISTANCE VESSELS; CONVERTING ENZYME; FAMILY MEMBERS; RATS; HYPERTENSION AB Background. Autosomal dominant polycystic kidney disease (ADPKD) is characterized by hypertension and renal vasoconstriction. Mediators of these hemodynamic changes are not well understood, but evidence suggests that endothelial-derived mediators may participate. Methods. Baseline measurements of blood pressure, proteinuria, and urinary nitrite/nitrate excretion were performed in control and cystic male Han:SPRD rats (6 weeks of age). They were then treated with the nitric oxide (NO), nitric oxide synthase (NOS) inhibitor, N-G-nitro-L-arginine methyl ester (L-NAME), or vehicle, for 6 weeks. After repeat systemic measurements, renal function was determined using inulin and para-aminohippurate (PAH) clearances. Levels of renal endothelin-1 (ET-1) and renal endothelial NOS (eNOS) proteins were determined, and immunohistochemistry localized renal eNOS and neuronal NOS (nNOS). Results. Administration of L-NAME aggravated systemic hypertension and renal vasoconstriction in the cystic rats, but did not affect the progression of proteinuria or cystic expansion. Cystic rats demonstrated marked increases in renal ET-1 and eNOS levels. L-NAME reduced eNOS expression in the membrane compartment, but increased eNOS in the cytosol. Localization studies indicated that renal eNOS was abundant in nonvascular compartments, but not in renal vascular and glomerular structures, whereas renal nNOS was diffusely diminished. Conclusion. These alterations of endothelial-derived mediators (up-regulation of ET-1, and dysfunction of the NO system) contribute to vasoconstriction, and thereby are likely to contribute to the progressive loss of renal function in polycystic kidney disease (PKD). C1 Oregon Hlth Sci Univ, Dept Hypertens & Nephrol, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. RP Anderson, S (reprint author), Oregon Hlth Sci Univ, Div Nephrol, PP262,3314 SW,US Vet Hosp Rd, Portland, OR 97201 USA. FU NIA NIH HHS [AG 14699] NR 42 TC 23 Z9 25 U1 1 U2 3 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD MAY PY 2003 VL 63 IS 5 BP 1776 EP 1784 DI 10.1046/j.1523-1755.2003.00913.x PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 664BG UT WOS:000182041400018 PM 12675853 ER PT J AU Folmer, RL Griest, SE AF Folmer, RL Griest, SE TI Chronic tinnitus resulting from head or neck injuries SO LARYNGOSCOPE LA English DT Article DE tinnitus; head-neck trauma; severity; whiplash; brain injury ID PERILYMPHATIC FISTULA; WHIPLASH; LITIGATION; SEVERITY; TRAUMA AB Objectives: The main objectives were 1) to determine the percentage of cases of chronic tinnitus in a specialized clinic that resulted from head or neck injuries; 2) to describe the characteristics of this population; and 3) to compare patients with head or neck trauma with patients whose tinnitus onset was not associated with head or neck injuries. Study Design: Retrospective analysis of tinnitus clinic patient data. Methods: Detailed questionnaires were mailed to 2400 patients before their initial appointment at the Oregon Health and Science University Tinnitus Clinic (Portland, OR). All of the patients experienced and received treatment for chronic tinnitus. Patient data were entered into a database and later analyzed. Results: Two hundred ninety-seven patients (214 male and 83 female patients) reported that their chronic tinnitus started as a result of head or neck injuries. Compared with patients whose tinnitus onset was not associated with trauma, patients with tinnitus associated with head or neck trauma were younger; had better hearing thresholds; experienced headaches more frequently, reported greater difficulties with concentration, memory, and thinking clearly; were more likely to experience current depression, but not lifetime depression; rated their tinnitus as louder on a 1-to-10 scale; matched their tinnitus to louder sounds on the right side; and had higher Tinnitus Severity Index scores. Conclusions: Tinnitus is a significant symptom that commonly occurs as a result of head or neck trauma. The fact that tinnitus resulting from head or neck injuries tends to be more severe (and is often accompanied by a greater number of co-symptoms) than tinnitus resulting from other causes should be taken into account by clinicians treating these patients. C1 Oregon Hlth Sci Univ, Oregon Hlth & Sci Univ Tinnitus Clin, Dept Otolaryngol, Oregon Hearing Res Ctr, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Natl Ctr Rehabilitat Auditory Res, Portland, OR USA. RP Folmer, RL (reprint author), Oregon Hlth Sci Univ, Oregon Hlth & Sci Univ Tinnitus Clin, Dept Otolaryngol, Oregon Hearing Res Ctr, 3181 SW Sam Jackson Pk Rd,Mail Code NRC04, Portland, OR 97239 USA. RI Folmer, Robert/E-3105-2010 NR 24 TC 27 Z9 29 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0023-852X J9 LARYNGOSCOPE JI Laryngoscope PD MAY PY 2003 VL 113 IS 5 BP 821 EP 827 DI 10.1097/00005537-200305000-00010 PG 7 WC Medicine, Research & Experimental; Otorhinolaryngology SC Research & Experimental Medicine; Otorhinolaryngology GA 676AF UT WOS:000182729200010 PM 12792317 ER PT J AU Ishikawa, F Livingston, AG Minamiguchi, H Wingard, JR Ogawa, M AF Ishikawa, F Livingston, AG Minamiguchi, H Wingard, JR Ogawa, M TI Human cord blood long-term engrafting cells are CD34(+) CD38(-) SO LEUKEMIA LA English DT Article DE umbilical cord blood; hematopoietic stem cells; CD34; CD38; xenotransplantation ID HEMATOPOIETIC STEM-CELLS; REPOPULATING ACTIVITY; EXPRESSION; MICE; GENERATION AB There have been controversies about CD34 and CD38 expression by human cord blood (CB) stem cells. Using the newborn NOD/SCID/beta2-microglobulin-null mouse assay that we recently developed, we examined the in vivo engrafting capability of human CB cells. Almost all of the 4-5 months engrafting cells were found in CD34(+) population. The capability of secondary reconstitution was found only in the CD34(+) cells. When the CD34(+) CB cells were separated into CD38(-) and CD38(+) subpopulations and tested for engraftment, the majority of the engrafting cells were detected in the CD38(-) subpopulation. These findings are consistent with the results from studies of murine stem cells and strongly indicate that the phenotype of human CB stem cells is CD34(+) CD38(-). C1 Med Univ S Carolina, Dept Med, Dept Vet Affairs Med Ctr, Charleston, SC 29425 USA. Univ Florida, Div Hematol Oncol, Gainesville, FL USA. RP Ogawa, M (reprint author), Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29401 USA. RI 石川, 文彦/L-4488-2014 FU NCI NIH HHS [P01-CA78582]; NIDDK NIH HHS [R01-DK54197] NR 17 TC 36 Z9 44 U1 0 U2 2 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0887-6924 J9 LEUKEMIA JI Leukemia PD MAY PY 2003 VL 17 IS 5 BP 960 EP 964 DI 10.1038/sj.leu.2402878 PG 5 WC Oncology; Hematology SC Oncology; Hematology GA 679FN UT WOS:000182910200019 PM 12750710 ER PT J AU Saab, S Wang, V Ibrahim, AB Durazo, F Han, S Farmer, DG Yersiz, H Morrisey, M Goldstein, LI Ghobrial, RM Busuttil, RW AF Saab, S Wang, V Ibrahim, AB Durazo, F Han, S Farmer, DG Yersiz, H Morrisey, M Goldstein, LI Ghobrial, RM Busuttil, RW TI MELD score predicts 1-year patient survival post-orthotopic liver transplantation SO LIVER TRANSPLANTATION LA English DT Article ID PUGH SCORE; MODEL; ALLOCATION; SEVERITY; DISEASE AB The Model for End-Stage Liver Disease (MELD) is an important predictor in patients awaiting orthotopic liver transplantation (OLT). However, the model's association with posttransplant patient survival is unclear. We studied 1-year patient survival in 404 adult patients who underwent OLT at the University of California Los Angeles. The hazard rates of patient survival according to the MELD strata and United Network for Organ Sharing (UNOS) statuses were assessed by Proportional Hazard Cox regression analysis. The difference in survival for MELD strata and UNOS status were compared using the Cox model. There was a significant difference in 1-year patient (P =.0006) survival using different MELD strata, whereas there was a trend according to UNOS status (P =.051). Increased rate of death was observed in recipients of OLT with higher MELD scores (> 36, hazard ratio 3.9; 95% CI 1.55, 10.27) and more urgent UNOS status (2A, hazard ratio, 1.99; 95% CI 1.07, 3.7). The MELD stratum is better associated with 1-year patient survival in liver transplant recipients than UNOS statuses. Patient survival was worse with higher MELD scores. C1 Univ Calif Los Angeles, Ctr Med, Div Digest Dis, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dumont Liver Transplant Ctr, Los Angeles, CA 90095 USA. W Los Angeles Vet Adm Med Ctr, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Biostat, Los Angeles, CA 90024 USA. RP Saab, S (reprint author), Univ Calif Los Angeles, Ctr Med, Div Digest Dis, 44-138 CHS,MC 168417,10833 Le Conte Ave, Los Angeles, CA 90095 USA. NR 15 TC 125 Z9 136 U1 0 U2 5 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1527-6465 J9 LIVER TRANSPLANT JI Liver Transplant. PD MAY PY 2003 VL 9 IS 5 BP 473 EP 476 DI 10.1053/jlts.2003.50090 PG 4 WC Gastroenterology & Hepatology; Surgery; Transplantation SC Gastroenterology & Hepatology; Surgery; Transplantation GA 674MQ UT WOS:000182640900004 PM 12740789 ER PT J AU McGlynn, EA Kerr, EA Adams, J Keesey, J Asch, SM AF McGlynn, EA Kerr, EA Adams, J Keesey, J Asch, SM TI Quality of health care for women - A demonstration of the quality assessment tools system SO MEDICAL CARE LA English DT Article DE quality; women's health; quality measurement; managed care ID ARTERY BYPASS-SURGERY; DIABETES-MELLITUS; PERFORMANCE; CRITERIA; OUTCOMES; CONSUMERS; UNDERUSE; STATE AB BACKGROUND. Consumers, purchasers, and regulators are seeking information on quality for a variety of purposes. To address these demands, methods are required that are flexible in meeting the information needs of different audiences. OBJECTIVES. To test a new clinically detailed, comprehensive approach to quality measurement called Quality Assessment (QA) Tools. DESIGN. Quality measures were developed for women ages 18 to 50 years for preventive care and 17 clinical areas that included chronic and acute health problems. A stratified random sample of women enrolled in 1 of 2 health plans in 1996 to 1997 was drawn and data abstracted from the medical records of all their providers for a 2-year period. FINDINGS. We evaluated quality for 758 women in 2 managed care plans. Quality of care varied substantially depending on the dimension being examined. For example, acute care was significantly better than chronic or preventive care. Quality was highest for follow-up care and lowest for treatment in both plans. Quality by modality ranged from approximately 90% for referral or admission to 16% for education and counseling. We found significant differences between the plans in the quality of care for 7 of the 17 conditions studied. CONCLUSION. The QA Tools system offers an alternative approach to evaluating health system performance. Potential advantages include the richness of the information produced by the system, the ability to create summary scores for consumers and purchasers, and the system-level performance information for use in quality improvement activities. C1 RAND Hlth, Santa Monica, CA 90401 USA. Vet Affairs Ctr Practice Management & Outcomes Re, VA Ann Arbor Hlth Care Syst, Ann Arbor, MI USA. Univ Michigan, Dept Med, Ann Arbor, MI 48109 USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RP McGlynn, EA (reprint author), RAND Hlth, 1700 Main St, Santa Monica, CA 90401 USA. NR 47 TC 15 Z9 15 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 MAY PY 2003 VL 41 IS 5 BP 616 EP 625 DI 10.1097/00005650-200305000-00009 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 675LH UT WOS:000182695900010 PM 12719686 ER PT J AU King, JT Styn, MA Tsevat, J Roberts, MS AF King, JT Styn, MA Tsevat, J Roberts, MS TI "Perfect health" versus "disease free": The impact of anchor point choice on the measurement of preferences and the calculation of disease-specific disutilities SO MEDICAL DECISION MAKING LA English DT Article DE measurement; preferences; standard gamble; time tradeoff; utility; visual analogue scale; willingness to pay AB Background. During preference testing, some investigators use "perfect health " as the upper anchor point of their measurement scale ("Q scale "), whereas others use "disease free " ("q scale"), which can confound the interpretation and comparison of study results. Methods. We measured current health preferences among 74 patients with cervical spondyloticmyelopathy(CSM) on both the Q and q scales using the visual analogue scale (VAS), standard gamble (SG), time tradeoff (TTO), and willingness to pay (WTP). Results. There were significant differences in mean Q and q scale values for the VAS, SG, and WTP (for all, P < 0.011); there were no significant differences for mean TTO values (P = 0.592). CSM accounted for 63% to 82% of total disutility, whereas other comorbidities accounted for 28% to 37%. Conclusions. Preferences for CSM differ when measured on the Q and q scales. Caution should be used when comparing and interpreting health values measured on scales with different upper anchors. Key words: measurement; preferences; standard gamble; time tradeoff; utility; visual analogue scale; willingness to pay. (Med Decis Making 2003;23:212-225). C1 VA Pittsburgh Healthcare Syst, Neurosurg Sect, Surg Serv Line, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Dept Neurol Surg, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sect Decis Sci & Clin Syst Modeling, Div Gen Internal Med, Dept Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Div Gen Internal Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA 15260 USA. Univ Cincinnati, Med Ctr, Dept Internal Med, Div Gen Internal Med,Sect Outcomes Res, Cincinnati, OH 45267 USA. Univ Cincinnati, Med Ctr, Ctr Clin Effectiveness, Inst Hlth Policy & Hlth Serv Res, Cincinnati, OH 45267 USA. Vet Affairs Med Ctr, Cincinnati, OH 45267 USA. RP King, JT (reprint author), VA Connecticut Healthcare Syst, Surg Serv 112, 950 Campbell Ave, West Haven, CT 06516 USA. FU NINDS NIH HHS [1K23 NS02169-01] NR 13 TC 18 Z9 18 U1 0 U2 0 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0272-989X J9 MED DECIS MAKING JI Med. Decis. Mak. PD MAY-JUN PY 2003 VL 23 IS 3 BP 212 EP 225 DI 10.1177/0272989X03253652 PG 14 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA 681UA UT WOS:000183052700002 PM 12809319 ER PT J AU Kahn, T AF Kahn, T TI Reset osmostat and salt and water retention in the course of severe hyponatremia SO MEDICINE LA English DT Article ID INTOXICATION; POLYDIPSIA; HUMANS AB To evaluate whether a reset osmostat and salt and water retention may be features of the course of some patients with hyponatremia, we present the long-term course of 6 selected patients. Three patients had spinal cord injury, 3 had marked psychiatric problems, and 3 had alcoholism. Five developed severe hyponatremia superimposed on chronic hyponatremia consequent to a reset osmostat. In 5 patients marked salt and water retention of unclear etiology occurred during therapy on 11 occasions. In 4 of these 11 episodes hypernatremia developed. Knowledge of a patient's past history and the possibility of developing salt and water overload should influence therapy. C1 Bronx Vet Adm Med Ctr, Renal Sect, Bronx, NY 10468 USA. CUNY Mt Sinai Sch Med, New York, NY 10029 USA. RP Kahn, T (reprint author), Bronx Vet Adm Med Ctr, Renal Sect, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. NR 19 TC 9 Z9 10 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7974 J9 MEDICINE JI Medicine (Baltimore) PD MAY PY 2003 VL 82 IS 3 BP 170 EP 176 DI 10.1097/00005792-200305000-00003 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 679EC UT WOS:000182907000003 PM 12792303 ER PT J AU Goss, JR Tubio, AT Fetterolf, CM Mata, M Glorioso, JC Fink, DJ AF Goss, JR Tubio, AT Fetterolf, CM Mata, M Glorioso, JC Fink, DJ TI A non-replicating HSV vector expressing interleukin-4 reduces pain-related behavior in a mouse model of bone cancer pain SO MOLECULAR THERAPY LA English DT Meeting Abstract CT 6th Annual Meeting of the American-Society-of-Gene-Therapy CY JUN 04-08, 2003 CL WASHINGTON, D.C. SP Amer Soc Gene Therapy C1 Univ Pittsburgh, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, GRECC, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 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 1525-0016 J9 MOL THER JI Mol. Ther. PD MAY PY 2003 VL 7 IS 5 MA 635 BP S248 EP S248 PN 2 PG 1 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Medicine, Research & Experimental SC Biotechnology & Applied Microbiology; Genetics & Heredity; Research & Experimental Medicine GA 676FH UT WOS:000182740300634 ER PT J AU Mountz, JD Yang, PA Wu, Q Hsu, HC Zhang, HG AF Mountz, JD Yang, PA Wu, Q Hsu, HC Zhang, HG TI Identification of multiple genetic loci that regulate clearance of adenovirus gene therapy SO MOLECULAR THERAPY LA English DT Meeting Abstract CT 6th Annual Meeting of the American-Society-of-Gene-Therapy CY JUN 04-08, 2003 CL WASHINGTON, D.C. SP Amer Soc Gene Therapy C1 Univ Alabama, Birmingham, AL USA. Birmingham VAMC, Birmingham, AL USA. NR 0 TC 0 Z9 0 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 1525-0016 J9 MOL THER JI Mol. Ther. PD MAY PY 2003 VL 7 IS 5 MA 16 BP S7 EP S7 PN 2 PG 1 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Medicine, Research & Experimental SC Biotechnology & Applied Microbiology; Genetics & Heredity; Research & Experimental Medicine GA 676FH UT WOS:000182740300017 ER PT J AU Zhang, HG Hyde, K Page, GP Brand, JPL Hsu, HC Allison, DB Mountz, JD AF Zhang, HG Hyde, K Page, GP Brand, JPL Hsu, HC Allison, DB Mountz, JD TI AdlkB-DN specifically blocks a TNF-alpha-induced anti-apoptosis signaling resulting in significant downregulation of 350 genes that normally enhance adhesion or inflammation in RASF SO MOLECULAR THERAPY LA English DT Meeting Abstract CT 6th Annual Meeting of the American-Society-of-Gene-Therapy CY JUN 04-08, 2003 CL WASHINGTON, D.C. SP Amer Soc Gene Therapy C1 Univ Alabama, Sect Stat Genet, Dept Stat, Birmingham, AL USA. Birmingham VAMC, Birmingham, AL USA. NR 0 TC 0 Z9 0 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 1525-0016 J9 MOL THER JI Mol. Ther. PD MAY PY 2003 VL 7 IS 5 MA 1048 BP S404 EP S404 PN 2 PG 1 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Medicine, Research & Experimental SC Biotechnology & Applied Microbiology; Genetics & Heredity; Research & Experimental Medicine GA 676FH UT WOS:000182740301047 ER PT J AU Zhang, HG Mountz, JM Wu, Q Yang, P Hsu, HC Mountz, JD AF Zhang, HG Mountz, JM Wu, Q Yang, P Hsu, HC Mountz, JD TI T cells transfected with Ad-hSSTR2 into T cells from hCARxTg71xGFP triple transgenic mice can be used to determine T-cell activation and AICD in vitro and in vivo SO MOLECULAR THERAPY LA English DT Meeting Abstract CT 6th Annual Meeting of the American-Society-of-Gene-Therapy CY JUN 04-08, 2003 CL WASHINGTON, D.C. SP Amer Soc Gene Therapy C1 Univ Alabama, Birmingham, AL USA. Birmingham VAMC, Birmingham, AL USA. NR 0 TC 0 Z9 0 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 1525-0016 J9 MOL THER JI Mol. Ther. PD MAY PY 2003 VL 7 IS 5 MA 282 BP S111 EP S112 PN 2 PG 2 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Medicine, Research & Experimental SC Biotechnology & Applied Microbiology; Genetics & Heredity; Research & Experimental Medicine GA 676FH UT WOS:000182740300283 ER PT J AU Anzai, Y Yueh, B AF Anzai, Y Yueh, B TI Imaging evaluation of sinusitis: diagnostic performance and impact on health outcome SO NEUROIMAGING CLINICS OF NORTH AMERICA LA English DT Article ID COMPUTED TOMOGRAPHIC FINDINGS; HIV-INFECTED PATIENTS; PARANASAL SINUSES; ENDOSCOPIC SURGERY; FRONTAL SINUSITIS; COCAINE ABUSE; CT FINDINGS; CORONAL CT; RHINOSINUSITIS; CHILDREN AB Sinusitis is a highly prevalent disease, with a significant impact on the health care economy. Sinus CT is the primary imaging modality for evaluation of acute and chronic sinusitis. The roles of CT for patients with sinusitis are to assist clinical diagnosis, to evaluate the extent of disease, and to provide detailed anatomy necessary for treatment planning. Although sinus CT has been criticized for lack of specificity and correlation with patients' clinical symptoms, sinus CT may provide pivotal objective information that affects treatment decisions for acute and chronic sinusitis. This article provides a clinical overview and reviews the role of imaging studies in diagnosis and treatment of sinusitis. C1 Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98108 USA. RP Anzai, Y (reprint author), Univ Washington, Dept Radiol, 1959 NE Pacific St,Box 357115, Seattle, WA 98195 USA. EM anzai@u.washington.edu OI Yueh, Bevan/0000-0003-1380-1053 NR 63 TC 6 Z9 6 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 1052-5149 J9 NEUROIMAG CLIN N AM JI Neuroimaging Clin. N. Am. PD MAY PY 2003 VL 13 IS 2 BP 251 EP + DI 10.1016/S1052-5149(03)00017-0 PG 14 WC Neurosciences; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging GA 694RY UT WOS:000183789100009 PM 13677805 ER PT J AU Zile, MR Gaasch, WH AF Zile, MR Gaasch, WH TI Heart failure in aortic stenosis - Improving diagnosis and treatment SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material C1 Med Univ S Carolina, Gazes Cardiac Res Inst, Dept Med, Div Cardiol, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC USA. Lahey Clin Fdn, Dept Cardiovasc Med, Burlington, MA USA. RP Zile, MR (reprint author), Med Univ S Carolina, Gazes Cardiac Res Inst, Dept Med, Div Cardiol, Charleston, SC 29425 USA. NR 0 TC 13 Z9 13 U1 0 U2 2 PU MASSACHUSETTS MEDICAL SOC/NEJM 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 MAY 1 PY 2003 VL 348 IS 18 BP 1735 EP 1736 DI 10.1056/NEJMp030035 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 672VK UT WOS:000182543500001 PM 12724478 ER PT J AU Jackson, LA Neuzil, KM Yu, OC Benson, P Barlow, WE Adams, AL Hanson, CA Mahoney, LD Shay, DK Thompson, WW AF Jackson, LA Neuzil, KM Yu, OC Benson, P Barlow, WE Adams, AL Hanson, CA Mahoney, LD Shay, DK Thompson, WW CA Vaccine Safety Datalink TI Effectiveness of pneumococcal polysaccharide vaccine in older adults SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID COMMUNITY-ACQUIRED PNEUMONIA; STREPTOCOCCUS-PNEUMONIAE; REQUIRING HOSPITALIZATION; ELDERLY PEOPLE; UNITED-STATES; EFFICACY; DISEASE; TRIAL; INFECTION; METAANALYSIS AB BACKGROUND: Streptococcus pneumoniae is the chief cause of pneumonia in older adults, but it remains unclear whether use of the pneumococcal polysaccharide vaccine alters the overall risk of community-acquired pneumonia. In a large population of older adults, we assessed the effectiveness of the pneumococcal vaccine. METHODS: In this retrospective cohort study, 47,365 Group Health Cooperative members 65 years of age or older were assessed over a three-year period. The primary outcomes were hospitalization because of community-acquired pneumonia (validated by chart review), pneumonia in patients who were not hospitalized (``outpatient pneumonia,'' determined from administrative data sources), and pneumococcal bacteremia. The association between pneumococcal vaccination and the risk of each outcome was evaluated by means of multivariate Cox proportional-hazards models, with adjustment for age, sex, nursing-home residence or nonresidence, smoking status, medical conditions, and receipt or nonreceipt of influenza vaccine. RESULTS: During the study period, 1428 cohort members were hospitalized with community-acquired pneumonia, 3061 were assigned a diagnosis of outpatient pneumonia, and 61 had pneumococcal bacteremia. Receipt of the pneumococcal vaccine was associated with a significant reduction in the risk of pneumococcal bacteremia (hazard ratio, 0.56; 95 percent confidence interval, 0.33 to 0.93) but a slightly increased risk of hospitalization for pneumonia (hazard ratio, 1.14; 95 percent confidence interval, 1.02 to 1.28). Pneumococcal vaccination did not alter the risk of outpatient pneumonia (hazard ratio, 1.04; 95 percent confidence interval, 0.96 to 1.13) or of any case of community-acquired pneumonia, whether or not it required hospitalization (hazard ratio, 1.07; 95 percent confidence interval, 0.99 to 1.14). CONCLUSIONS: These findings support the effectiveness of the pneumococcal polysaccharide vaccine for the prevention of bacteremia, but they suggest that alternative strategies are needed to prevent nonbacteremic pneumonia, which is a more common manifestation of pneumococcal infection in elderly persons. C1 Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Ctr Dis Control & Prevent, Natl Immunizat Program, Atlanta, GA USA. RP Jackson, LA (reprint author), Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, 1730 Minor Ave,Suite 1600, Seattle, WA 98101 USA. OI Shay, David/0000-0001-9619-4820 NR 39 TC 322 Z9 333 U1 1 U2 13 PU MASSACHUSETTS MEDICAL SOC/NEJM 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 MAY 1 PY 2003 VL 348 IS 18 BP 1747 EP 1755 DI 10.1056/NEJMoa022678 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 672VK UT WOS:000182543500003 PM 12724480 ER PT J AU Sarraf, D Schwartz, SD AF Sarraf, D Schwartz, SD TI Bilateral choroidal folds and optic neuropathy: a variant of the crowded disk syndrome.? SO OPHTHALMOLOGY LA English DT Article ID ACQUIRED HYPEROPIA; INTRACRANIAL HYPERTENSION; CHORIORETINAL FOLDS; RISK-FACTORS; PAPILLEDEMA; EYE AB Purpose: To describe the clinical features of the syndrome that includes bilateral choroidal folds and optic neuropathy and to propose a novel etiology to explain this presentation. Design: Observational small case series. Participants: Three patients. Methods: Three patients received an extensive clinical work-up including complete ocular examination, A and B scan ultrasonography, Humphrey visual field analysis, and imaging of the brain and orbit. Neurological consultation was obtained in each patient two of whom underwent lumbar puncture. The findings of this detailed investigation are reported. Results: Each patient demonstrated bilateral choroidal folds with optic disk congestion and leakage in one eye and optic atrophy in the fellow eye. Extensive ocular and extraocular investigation failed to uncover a specific etiology. Pseudotumor cerebri, a well-documented cause of papilledema and choroidal folds, was ruled out in each case. Each patient did demonstrate variable degrees of hyperopia and shortened axial lengths. Conclusions: The syndrome of bilateral choroidal folds and optic neuropathy may have various etiologies. Pseudotumor cerebri needs to be definitively ruled out. Normal neuro-ophthalmological investigation including lumbar puncture may indicate an alternative cause. Idiopathic acquired hyperopia in middle-aged patients who are hyperopic with shortened axial lengths may be associated with choroidal folds and a constricted scleral canal causing optic disk congestion and complicated by nonarteritic anterior ischemic optic neuropathy due to a crowded disk. C1 Univ Calif Los Angeles, Jules Stein Eye Inst, Sch Med, Dept Ophthalmol, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Dept Ophthalmol, Los Angeles, CA USA. Martin L King Hosp, Dept Ophthalmol, Charles R Drew Sch Med, Los Angeles, CA USA. Kaiser Permanente, Dept Ophthalmol, Woodland Hills, CA USA. RP Sarraf, D (reprint author), Univ Calif Los Angeles, Jules Stein Eye Inst, Sch Med, Dept Ophthalmol, 100 Stein Plaza, Los Angeles, CA 90095 USA. NR 36 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 0161-6420 J9 OPHTHALMOLOGY JI Ophthalmology PD MAY PY 2003 VL 110 IS 5 BP 1047 EP 1052 DI 10.1016/S0161-6420(03)00082-4 PG 6 WC Ophthalmology SC Ophthalmology GA 676LY UT WOS:000182754600043 PM 12750112 ER PT J AU Netscher, DT AF Netscher, DT TI The benefit of transverse carpal ligament reconstruction following open carpal tunnel release SO PLASTIC AND RECONSTRUCTIVE SURGERY LA English DT Editorial Material ID FLEXOR TENDON EXCURSION; DIVISION C1 Baylor Coll Med, Div Plast Surg, Houston, TX 77030 USA. Dept Vet Affairs Med Ctr, Plast Surg Serv, Houston, TX USA. RP Netscher, DT (reprint author), 6560 Fannin,Suite 800, Houston, TX 77030 USA. NR 19 TC 7 Z9 7 U1 0 U2 0 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 MAY PY 2003 VL 111 IS 6 BP 2020 EP 2022 DI 10.1097/01.PRS.0000056836.14559.09 PG 3 WC Surgery SC Surgery GA 674AM UT WOS:000182614200031 PM 12711966 ER PT J AU Liu, CF Hedrick, SC Caheny, EF Heagerty, P Felker, B Hasenberg, N Fihn, S Katon, W AF Liu, CF Hedrick, SC Caheny, EF Heagerty, P Felker, B Hasenberg, N Fihn, S Katon, W TI Cost-effectiveness of collaborative care for depression in a primary care veteran population SO PSYCHIATRIC SERVICES LA English DT Article; Proceedings Paper CT Annual Meeting of the VA-Health-Services-Research-and-Development-Service CY FEB 14-16, 2001 CL Washington, DC SP VA Hlth Serv Res Dev Serv ID RANDOMIZED CONTROLLED-TRIAL; TREATING MAJOR DEPRESSION; CHRONIC DISEASE SCORE; QUALITY IMPROVEMENT; MEDICAL PATIENTS; HIGH UTILIZERS; HEALTH-STATUS; OLDER-ADULTS; MANAGEMENT; SYMPTOMS AB Objective: This study examined the incremental cost-effectiveness of a Collaborative care intervention for depression compared with consult-liaison care. Methods: A total of 354 patients in a Department of Veterans Affairs (VA) primary care clinic who met the criteria for major depression or dysthymia were randomly assigned to one of the two care models. Under the collaborative care model, a mental health team provided a treatment plan to primary care providers, telephoned patients to encourage adherence, reviewed treatment results, and suggested modifications. Outcomes were assessed at three and nine months by telephone interviews. Health care greater number of use and costs were also assessed. Results: A significantly collaborative care patients were treated for depression and given prescriptions for antidepressants. The collaborative care patients experienced an average of 14.6 additional depression-free days over the nine months. The mean incremental Cost of the intervention per patient Was $237 for depression treatment and $519 for total outpatient costs. A majority of the additional expenditures were accounted for by the intervention. The incrementa-l cost-effectiveness ratio was $24 per depression-free day for depression treatment costs and $33 for total outpatient cost. Conclusions: Better coordination and communication under collaborative care was associated with a greater number of patients being treated for depression and with moderate increase's in days free of depression and in treatment cost. Additional resources are needed for effective collaborative care models for depression treatment in primary care. C1 VA Puget Sound Hlth Care Syst, Hlth Serv Res, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Dev Ctr Excellence, Seattle, WA 98108 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Mental Hlth Serv, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. RP Liu, CF (reprint author), VA Puget Sound Hlth Care Syst, Hlth Serv Res, HSRD 152,1660 S Columbian Way, Seattle, WA 98108 USA. EM chuan-fen.liu@med.va.gov NR 58 TC 62 Z9 62 U1 1 U2 3 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD MAY PY 2003 VL 54 IS 5 BP 698 EP 704 DI 10.1176/appi.ps.54.5.698 PG 7 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 839BK UT WOS:000222758100013 PM 12719501 ER PT J AU Yehuda, R Bierer, L Halligan, S AF Yehuda, R Bierer, L Halligan, S TI Urinary free cortisol levels in PTSD offspring - Response SO PSYCHONEUROENDOCRINOLOGY LA English DT Letter ID POSTTRAUMATIC-STRESS-DISORDER C1 Bronx Vet Affairs Med Ctr, Bronx, NY 10468 USA. RP Yehuda, R (reprint author), Bronx Vet Affairs Med Ctr, 130 W Kingsbridge Rd,Psychiat 116-A, Bronx, NY 10468 USA. NR 6 TC 0 Z9 0 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4530 J9 PSYCHONEUROENDOCRINO JI Psychoneuroendocrinology PD MAY PY 2003 VL 28 IS 4 BP 595 EP 596 DI 10.1016/S0306-4530(02)00042-2 PG 2 WC Endocrinology & Metabolism; Neurosciences; Psychiatry SC Endocrinology & Metabolism; Neurosciences & Neurology; Psychiatry GA 678JP UT WOS:000182864000010 ER PT J AU Herndon, B Asch, SM Kilbourne, AM Wang, MM Lee, M Wenzel, SL Andersen, R Gelberg, L AF Herndon, B Asch, SM Kilbourne, AM Wang, MM Lee, M Wenzel, SL Andersen, R Gelberg, L TI Prevalence and predictors of HIV testing among a probability sample of homeless women in Los Angeles county SO PUBLIC HEALTH REPORTS LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; SEXUALLY-TRANSMITTED DISEASES; NEW-YORK-CITY; UNITED-STATES; MEDICAL-CARE; RISK BEHAVIORS; DRUG-USE; INFECTION; ADULTS; AIDS AB Objectives. To describe the prevalence and predictors of HIV testing in a probability cluster sample of urban homeless women. Methods. Analysis of data from the University of California Los Angeles-RAND Access to Health Care for Homeless Women of Reproductive Age Study, a survey conducted in six waves from January 1997 through November 1997 at shelters and soup kitchens in Los Angeles (LA) County, California. The sampling unit consists of homeless woman-visits, and data were collected using structured face-to-face interviews for which respondents were paid $10. Each sampling unit was weighted to take into account the frequency with which the respondent used shelters or meal programs. The main outcome measure was receipt of HIV test in the past year. Results. The response rate was 83%, and the final sample size was N=970. Sixty-eight percent of our sample reported receiving an HIV test in the past year, and 1.6% reported ever being diagnosed with HIV. HIV testing in the past year was most strongly associated with pregnancy in the past year (OR 2.99; p<.001) and having a regular source of care (OR 2.13; p<.001). Approximately 25% of homeless women with indications for HIV testing had not been tested in the past year. Conclusions. The reported HIV seroprevalence of greater than 1% suggests that providers should offer and encourage HIV testing for all homeless women in LA County. Our data, which show a high rate of testing and few statistically significant independent predictors, indicate that this may be what is happening in practice. C1 Dartmouth Coll, Hitchcock Med Ctr, Sect Gen Internal Med, Lebanon, NH 03756 USA. Vet Affairs Greater Los Angeles, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Pittsburgh, Vet Affairs Pittsburgh Ctr Hlth Equity Res & Prom, Pittsburgh, PA USA. Univ Pittsburgh, Dept Med, Pittsburgh, PA USA. Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Family Med, Los Angeles, CA USA. RP Herndon, B (reprint author), Dartmouth Coll, Hitchcock Med Ctr, Sect Gen Internal Med, 1 Med Ctr Dr, Lebanon, NH 03756 USA. FU AHRQ HHS [HS08323]; NIAAA NIH HHS [1R21AA13398]; NIDA NIH HHS [1R01 DA14835] NR 54 TC 16 Z9 16 U1 2 U2 3 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD MAY-JUN PY 2003 VL 118 IS 3 BP 261 EP 269 DI 10.1016/S0033-3549(04)50246-7 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 754AJ UT WOS:000187280300012 PM 12766220 ER PT J AU Dirks, SJ Paunovich, ED Terezhalmy, GT Chiodo, LK AF Dirks, SJ Paunovich, ED Terezhalmy, GT Chiodo, LK TI The patient with Parkinson's disease SO QUINTESSENCE INTERNATIONAL LA English DT Article ID ENDOGENOUS DOPAMINERGIC NEUROTOXIN; ALPHA-SYNUCLEIN; 1-METHYL-4-PHENYL-1,2,3,6-TETRAHYDROPYRIDINE MPTP; ULTRASONIC TOOTHBRUSH; CLINICAL-EVALUATION; SURGICAL-TREATMENT; UNITED-STATES; PLAQUE; MORTALITY; GENE AB Parkinson's disease is an idiopathic, slowly progressive disorder of the central nervous system characterized by resting tremor, muscular rigidity, slow and decreased movement (bradykinesia), and postural instability. In the United States, Parkinson's disease is the fourth most common neurodegenerative disorder in the elderly, affecting an estimated half a million people. Oral health care providers can expect to be called upon to care for patients with this progressively debilitating disease. To provide competent care to patients with Parkinson's disease, clinicians must understand the disease, its treatment, and its impact on the patient's ability to undergo and respond to dental care. C1 Univ Texas, Hlth Sci Ctr, Dept Dent Diagnost Sci, Div Oral Med,Dent Sch, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Geriatr Oral Hlth Clin Program, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. RP Terezhalmy, GT (reprint author), Univ Texas, Hlth Sci Ctr, Dept Dent Diagnost Sci, Div Oral Med,Dent Sch, Mail Code 7919,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 78 TC 9 Z9 11 U1 0 U2 3 PU QUINTESSENCE PUBL CO INC PI CAROL STREAM PA 551 NORTH KIMBERLY DR, CAROL STREAM, IL 60188-1881 USA SN 0033-6572 J9 QUINTESSENCE INT JI Quintessence Int. PD MAY PY 2003 VL 34 IS 5 BP 379 EP 393 PG 15 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 688UJ UT WOS:000183454700009 PM 12795358 ER PT J AU Seliger, SL Stehman-Breen, CO AF Seliger, SL Stehman-Breen, CO TI Are HMG-CoA reductase inhibitors underutilized in dialysis patients? SO SEMINARS IN DIALYSIS LA English DT Editorial Material ID CORONARY-ARTERY DISEASE; CHRONIC-RENAL-FAILURE; CARDIOVASCULAR-DISEASE; HEMODIALYSIS-PATIENTS; DENSITY LIPOPROTEINS; FOLLOW-UP; CHOLESTEROL; MEN; PREVENTION; EVENTS AB Patients with end-stage renal disease (ESRD) treated with dialysis have a dramatically elevated rate of cardiovascular disease (CVD) compared to the general population. Lipid-lowering therapy with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors ("statins") has been shown to markedly reduce cardiovascular risk in patients without renal failure, but their effect has not been fully studied in the dialysis population. In this article we will first discuss the known benefits of statin therapy in the general population and summarize the current guidelines for such therapy. We will then examine the evidence linking dyslipidemia and cardiac disease in the dialysis population and discuss possible pathophysiologic mechanisms by which statins could prevent cardiac disease in these patients. We will also review prior clinical studies of the effects of statins in patients on dialysis, with particular attention to the safety and efficacy of these drugs in this population. Finally, we will review how statins are currently being used in the care of dialysis patients and suggest whether an expanded utilization of these drugs could help reduce the enormously high rates of cardiac disease in this patient population. C1 VA Puget Sound Hlth Care Syst, Div Nephrol, Seattle, WA 98108 USA. Univ Washington, Dept Med, Div Nephrol, Seattle, WA 98195 USA. RP Stehman-Breen, CO (reprint author), VA Puget Sound Hlth Care Syst, Div Nephrol, Mailstop 111A,1650 S Columbian Way, Seattle, WA 98108 USA. NR 81 TC 11 Z9 11 U1 0 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0894-0959 J9 SEMIN DIALYSIS JI Semin. Dial. PD MAY-JUN PY 2003 VL 16 IS 3 BP 179 EP 185 DI 10.1046/j.1525-139X.2003.16036.x PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 677AM UT WOS:000182784800001 PM 12753674 ER PT J AU Ancoli-Israel, S Cole, R Alessi, C Chambers, M Moorcroft, W Pollak, CP AF Ancoli-Israel, S Cole, R Alessi, C Chambers, M Moorcroft, W Pollak, CP TI The role of actigraphy in the study of sleep and circadian rhythms SO SLEEP LA English DT Review ID NURSING-HOME PATIENTS; REST-ACTIVITY RHYTHM; DEFICIT-HYPERACTIVITY DISORDER; DATA-ANALYSIS SOFTWARE; SCHOOL-AGE-CHILDREN; POSTTRAUMATIC-STRESS-DISORDER; AMBULATORY BLOOD-PRESSURE; STIMULATION TENS IMPROVES; PHYSICAL-ACTIVITY LEVEL; ARTERY BYPASS-SURGERY C1 VASDHS, Dept Psychiat, San Diego, CA 92161 USA. Univ Calif San Diego, Dept Psychiat, La Jolla, CA 92093 USA. Synchrony Appl Hlth Sci, Del Mar, CA 92014 USA. VA Greater Los Angles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Multicampus Program Geriatr Med & Gerontol, Los Angeles, CA 90024 USA. Colorado State Univ, Ft Collins, CO 80523 USA. Ohio State Univ, Dept Neurol, Columbus, OH 43210 USA. RP Ancoli-Israel, S (reprint author), VASDHS, Dept Psychiat, 3350 La Jolla Village Dr, San Diego, CA 92161 USA. FU NCI NIH HHS [CA85264]; NIA NIH HHS [AG08415, AG13885] NR 224 TC 911 Z9 919 U1 22 U2 118 PU AMER ACAD SLEEP MEDICINE PI ROCHESTER PA 6301 BANDEL RD, STE 101, ROCHESTER, MN 55901 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAY 1 PY 2003 VL 26 IS 3 BP 342 EP 392 PG 51 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 670ZC UT WOS:000182439100020 PM 12749557 ER PT J AU Orces, CH Casas, C Lee, S Garcia-Cavazos, R White, W AF Orces, CH Casas, C Lee, S Garcia-Cavazos, R White, W TI Determinants of osteoporosis prevention in low-income Mexican-American women SO SOUTHERN MEDICAL JOURNAL LA English DT Article ID HORMONE REPLACEMENT THERAPY; BONE-MINERAL DENSITY; POSTMENOPAUSAL WOMEN; ESTROGEN REPLACEMENT; CALCIUM; HEALTH; EXERCISE; MANAGEMENT; PHYSICIANS; NUTRITION AB Background: Prevention is the most cost-effective means of managing osteoporosis. However, little is known about osteoporosis-related preventive practices in Mexican-American women. We examined factors that might influence women's decision to start preventive measures for osteoporosis. Methods: Information was gathered through a cross-sectional survey of low-income Mexican-American women who were seen at two clinics in southern Texas. Results: Of the 270 participants, 37% reported calcium supplementation, and 41% reported regular weight-bearing exercise to prevent osteoporosis. Fifty (41%) of the postmenopausal women were currently using hormone replacement therapy. Only 15% of the premenopausal and 13% of the postmenopausal women recalled that their health care provider had counseled them about prevention. Multivariate analysis showed that public education, bone densitometry evaluation, knowledge of osteoporosis, and counseling were determinants of prevention. Conclusion: Although osteoporosis is a preventable condition, our findings suggest that the majority of Mexican-American women do not receive adequate preventive measures or counseling about osteoporosis. Furthermore, we found that their health care provider's counseling about osteoporosis was a major determinant of osteoporosis prevention in these women. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. Gateway Community Hlth Ctr, Laredo, Spain. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Orces, CH (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 35 TC 19 Z9 22 U1 2 U2 2 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 MAY PY 2003 VL 96 IS 5 BP 458 EP 464 DI 10.1097/01.SMJ.0000051905.38128.B4 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 681XP UT WOS:000183061100009 PM 12911184 ER PT J AU Berger, DH O'Mahony, CA Sheng, HM Shao, JY Albo, D DuBois, RN Beauchamp, RD AF Berger, DH O'Mahony, CA Sheng, HM Shao, JY Albo, D DuBois, RN Beauchamp, RD TI Intestinal transformation results in transforming growth factor-beta-dependent alteration in tumor cell-cell matrix interactions SO SURGERY LA English DT Article ID PLASMINOGEN-ACTIVATOR INHIBITOR-1; PRIMARY BREAST-CANCER; HUMAN-LUNG FIBROBLASTS; HUMAN COLON-CANCER; TGF-BETA; COLORECTAL-CANCER; DISEASE PROGRESSION; UROKINASE-RECEPTOR; MESSENGER-RNA; ENDOTHELIAL-CELLS AB Background. An alteration in the expression of and response to transforming growth fa(tor-beta I (TGF-beta1) appears to be an important event during colorectal carcinogenesis. However, the precise role of TGF-beta1 in colorectal carcinogenesis is not clear. We have previously described in detail the changes in cell proliferation and differentiation caused by chronic exposure to TGF-beta1. In this study we sought to better characterize, the changes in tumor cell-cell matrix interactions seen during TGF-beta1-mediated intestinal transformation. Methods. Rat intestinal epithelial cells (RIE) and RIE cells transformed by chroinic exposure to TGF-beta1 (RIE-Tr) were treated with TGF-beta1 and production of components of the plasmin/plasminogen system measured by ELISA and Western blotting. TGF-beta1 effects on invasion and adhesion were determined in vitro. The role of urokinase on TGF-beta1-mediated invasion and adhesion were determined using immunoneutralization. The role of COX-2 was determined suing a specific COS-2 inhibitor. Results. TGF-beta1 had no effect on RIE-1 adhesion to collagen types I and IV, fibronectin, and laminin, or invasion through collagen types I and IV However, 5 ng/mL TGF-beta1 significantly increased the invasiveness and decreased the adhesiveness of RIE-Tr. This effect of TGF-beta1 on RIE-Tr was associated with a significant increase in plasmin activity secondary to increased expression of muPA. TGF-beta1 had no effect on either uPA receptor or PAI-1 in this system. Antibodies to uPA completely blocked the TGF-beta1-mediated invasiveness of the RIE-Tr cells and returned their adhesiveness to basement membrane proteins to baseline. Addition of the selective Cox-2, inhibitor SG58125 resulted in a dose-dependent decrease in TGF-beta1-mediated invasion and uPA expression. Conclusion. This study provides additional evidence for TGF-beta1 as a tumor promoter during intestinal carcinogenesis and a possible new mechanism for Cox-2-related colon carcinogenesis. C1 Baylor Coll Med, Dept Surg, Houston, TX 77030 USA. Vet Affairs Med Ctr, Houston, TX 77030 USA. Drexel Univ, Sch Med, Dept Surg, Philadelphia, PA 19104 USA. Vanderbilt Univ, Ctr Med, Vanderbilt Ingram Canc Ctr, Dept Surg, Nashville, TN USA. Vanderbilt Univ, Med Ctr, Vanderbilt Ingram Canc Ctr, Dept Med, Nashville, TN USA. Vet Affairs Med Ctr, Nashville, TN 37212 USA. RP Berger, DH (reprint author), Houston Vet Adm Med Ctr, Surg Serv 112, 2002 Holcombe Blvd, Houston, TX 77030 USA. OI Beauchamp, Robert Daniel/0000-0002-8446-4114 FU NCI NIH HHS [CA69457, P01-CA 77839, CA68485]; NIDDK NIH HHS [DK47297, DK-52334]; NIEHS NIH HHS [ES00267] NR 57 TC 5 Z9 6 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0039-6060 J9 SURGERY JI Surgery PD MAY PY 2003 VL 133 IS 5 BP 568 EP 579 DI 10.1067/msy.2003.125 PG 12 WC Surgery SC Surgery GA 686RL UT WOS:000183334700014 PM 12773985 ER PT J AU Chandrasekar, B Colston, JT de la Rosa, SD Rao, PP Freeman, GL AF Chandrasekar, B Colston, JT de la Rosa, SD Rao, PP Freeman, GL TI TNF-alpha and H2O2 induce IL-18 and IL-18R beta expression in cardiomyocytes via NF-kappa B activation SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE proinflammatory cytokines; oxidative stress; reperfusion injury; cardiomyocytes; NF-kappa B; PDTC ID TUMOR-NECROSIS-FACTOR; CXC CHEMOKINE; PROINFLAMMATORY CYTOKINE; INTERLEUKIN-18; CELLS; DYSFUNCTION; FAMILY; BRAIN AB Myocardial ischemia/reperfusion is characterized by oxidative stress and induction of proinflammatory cytokines. Interleukin (IL)-18, a member of the IL-1 family, acts as a proinflammatory cytokine, and is induced during various immune and inflammatory disorders. Therefore, in the present study we investigated whether IL-18 expression is regulated by cytokines and oxidative stress in cardiomyocytes. TNF-alpha induced rapid and sustained activation of NF-kappaB whereas H2O2 induced delayed and transient activation. Both TNF-alpha and H2O2 induced IL-18 mRNA and precursor protein in cardiornyocytes, and IL-18 release into culture supernatants. However, only TNF-alpha led to sustained expression. Expression of IL-18Rbeta, but not alpha, was induced by both agonists. TNF-alpha and H2O2 induced delayed expression of IL-18 BP. Pretreatment with PDTC attenuated TNF-alpha and H2O2 induced IL-18 and IL-18Rbeta, but not basal expression of IL-18Ralpha. These results indicate that adult cardiomyocytes express IL-18 and its receptors, and proinflammatory cytokines and oxidative stress regulate their expression via activation of NF-kappaB. Presence of both ligand and receptors suggests IL-18 impacts myocardial biology through an autocrine pathway. (C) 2003 Elsevier Science (USA). All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Med Cardiol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78229 USA. RP Chandrasekar, B (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med Cardiol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM chandraseka@uthscsa.edu FU NHLBI NIH HHS [HL68020] NR 28 TC 62 Z9 74 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 0006-291X J9 BIOCHEM BIOPH RES CO JI Biochem. Biophys. Res. Commun. PD APR 18 PY 2003 VL 303 IS 4 BP 1152 EP 1158 DI 10.1016/S0006-291X(03)00496-0 PG 7 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 672MN UT WOS:000182524600027 PM 12684057 ER PT J AU Yueh, B Shapiro, N MacLean, CH Shekelle, PG AF Yueh, B Shapiro, N MacLean, CH Shekelle, PG TI Screening and management of adult hearing loss in primary care - Scientific review SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Review ID QUALITY-OF-LIFE; OLDER ADULTS; COST-UTILITY; COCHLEAR IMPLANT; OTITIS-MEDIA; COGNITIVE DYSFUNCTION; SYSTEMIC STEROIDS; RANDOMIZED TRIAL; ELDERLY PATIENTS; IMPAIRMENT AB Context Hearing loss is the third most prevalent chronic condition in older adults and has important effects on their physical and mental health. Despite these effects, most older patients are not assessed or treated for hearing loss. Objective To review the evidence on screening and management of hearing loss of older adults in the primary care setting. Data Sources and Study Selection We performed a search from 1985 to 2001 using MEDLINE, HealthSTAR, EMBASE, Ageline, and the National Guideline Clearinghouse for articles and practice guidelines about screening and management of hearing loss in older adults, as well as reviewed references in these articles and those suggested by experts in hearing impairment. Data Extraction We reviewed articles for the most clinically important information, emphasizing randomized clinical trials, where available, and identified 1595 articles. Data Synthesis Screening tests that reliably detect hearing loss are use of an audioscope, a hand-held combination otoscope and audiometer, and a self-administered questionnaire, the Hearing Handicap Inventory for the Elderly-Screening version. The value of routine screening for improving patient outcomes has not been evaluated in a randomized clinical trial. Screening is endorsed by most professional organizations, including the US Preventive Services Task Force. While most hearing loss in older adults is sensorineural and due to presbycusis, cerumen impaction and chronic otitis media may be present in up to 30% of elderly patients with hearing loss and can be treated by the primary care clinician. In randomized trials, hearing aids have been demonstrated to improve outcomes for patients with sensorineural hearing loss. Nonadherence to use of hearing aids is high. Prompt recognition of potentially reversible causes of hearing loss, such as sudden sensorineural hearing loss, is important to maximize the possibility of functional recovery. Conclusion While untested in a clinical trial, older adults can be screened for hearing loss using simple methods, and effective treatments exist and are available for many forms of hearing loss. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98108 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Hlth Serv, Seattle, WA 98108 USA. RAND Hlth, Santa Monica, CA USA. Univ Calif Los Angeles, Div Head & Neck Surg, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Div Rheumatol, Los Angeles, CA 90024 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RP Yueh, B (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Otolaryngol Head & Neck Surg, 1660 S Columbian Way,Surg Sect 112OTO, Seattle, WA 98108 USA. OI Yueh, Bevan/0000-0003-1380-1053 NR 88 TC 141 Z9 155 U1 6 U2 32 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 16 PY 2003 VL 289 IS 15 BP 1976 EP 1985 DI 10.1001/jama.289.15.1976 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 667VC UT WOS:000182253900031 PM 12697801 ER PT J AU Bogardus, ST Yueh, B Shekelle, PG AF Bogardus, ST Yueh, B Shekelle, PG TI Screening and management of adult hearing loss in primary care - Clinical applications SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Review ID QUALITY-OF-LIFE; OLDER ADULTS; ELDERLY PEOPLE; COGNITIVE DYSFUNCTION; RANDOMIZED TRIAL; IMPAIRMENT; PREVALENCE; AIDS; AMPLIFICATION; EPIDEMIOLOGY AB Hearing loss is one of the most common chronic health conditions and has important implications for patient quality of life. However, hearing loss is substantially underdetected and undertreated. We present clinical cases to illustrate common situations in which primary care physicians may be called on to identify or to manage hearing loss. With the data reported in the companion scientific review as a guide, we present potential answers to important questions pertaining to hearing loss and suggest ways in which primary care physicians can improve the detection, evaluation, and treatment of hearing loss. The cases focus on screening for chronic hearing loss, evaluation of hearing loss, and treatment of patients with presbycusis. C1 Yale Univ, Sch Med, Dept Med, New Haven, CT 06504 USA. Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res Serv, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Dev Serv, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Surg Serv, Seattle, WA USA. Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. Univ Washington, Hlth Serv, Seattle, WA 98195 USA. RAND Hlth, Los Angeles, CA USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RP Bogardus, ST (reprint author), Yale Univ, Sch Med, Dept Med, 20 York St,Tompkins 15, New Haven, CT 06504 USA. OI Yueh, Bevan/0000-0003-1380-1053 NR 41 TC 39 Z9 42 U1 5 U2 9 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 16 PY 2003 VL 289 IS 15 BP 1986 EP 1990 DI 10.1001/jama.289.15.1986 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 667VC UT WOS:000182253900032 PM 12697802 ER PT J AU Fried, LF Shlipak, MG Crump, C Bleyer, AJ Gottdiener, JS Kronmal, RA Kuller, LH Newman, AB AF Fried, LF Shlipak, MG Crump, C Bleyer, AJ Gottdiener, JS Kronmal, RA Kuller, LH Newman, AB TI Renal insufficiency as a predictor of cardiovascular outcomes and mortality in elderly individuals SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID C-REACTIVE PROTEIN; CONGESTIVE-HEART-FAILURE; METABOLIC SYNDROME; RISK-FACTORS; CREATININE CLEARANCE; SERUM CREATININE; UNITED-STATES; DISEASE; HEALTH; INTERLEUKIN-6 AB OBJECTIVES This study was designed to evaluate the relationship between elevated creatinine levels and cardiovascular events. BACKGROUND End-stage renal disease is associated with high cardiovascular morbidity and mortality. The association of mild to moderate renal insufficiency with cardiovascular outcomes remains unclear. METHODS We analyzed data from the Cardiovascular Health Study, a prospective population-based study of subjects, aged >65 years, who had a serum creatinine measured at baseline (n = 5,808) and were followed for a median of 7.3 years. Proportional hazards models were used to examine the association of creatinine to all-cause mortality and incident cardiovascular mortality and morbidity. Renal insufficiency was defined as a creatinine level greater than or equal to1.5 mg/dl in men or greater than or equal to1.3 mg/dl in women. RESULTS An elevated creatinine level was present in 648 (11.2%) participants. Subjects with elevated creatinine had higher overall (76.7 vs. 29.5/1,000 years, p < 0.001) and cardiovascular (35.8 vs. 13.0/1,000 years, p < 0.001) mortality than those with normal creatinine levels. They were more likely to develop cardiovascular disease (54.0 vs. 31.8/1,000 years, p < 0.001), stroke (21.1 vs. 11.9/1,000 years, p < 0.001), congestive heart failure (38.7 vs. 17/1,000 years, p < 0.001), and symptomatic peripheral vascular disease (10.6 vs. 3.5/1,000 years, p < 0.001). After adjusting for cardiovascular risk factors and subclinical disease measures, elevated creatinine remained a significant predictor of all-cause and cardiovascular mortality, total cardiovascular disease (CVD), claudication, and congestive heart failure (CHF). A linear increase in risk was observed with increasing creatinine. CONCLUSIONS Elevated creatinine levels are common in older adults and are associated with increased risk of mortality, CVD, and CHF. The increased risk is apparent early in renal disease. (C) 2003 by the American College of Cardiology Foundation. C1 VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Renal Electrolyte Div, Pittsburgh, PA 15260 USA. Vet Affairs Med Ctr, Med Serv, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Biostat, San Francisco, CA 94143 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Wake Forest Univ, Sch Med, Nephrol Sect, Winston Salem, NC 27109 USA. St Francis Hosp, Div Cardiol, Roslyn, NY USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Div Geriatr Med, Pittsburgh, PA 15260 USA. RP Fried, LF (reprint author), VA Pittsburgh Healthcare Syst, Renal Sect, 111F-U,Univ Dr C, Pittsburgh, PA 15240 USA. OI Newman, Anne B./0000-0002-0106-1150 FU NHLBI NIH HHS [N01-HC-15103, N01-HC-35129, N01-HC-85079, N01-HC-85086] NR 45 TC 327 Z9 340 U1 0 U2 9 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 APR 16 PY 2003 VL 41 IS 8 BP 1364 EP 1372 DI 10.1016/S0735-1097(03)00163-3 PG 9 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 666KW UT WOS:000182177300019 PM 12706933 ER PT J AU Pond, KK Martin, GV Every, N Lehmann, KG Anderson, R Caldwell, JH Kapadia, SR AF Pond, KK Martin, GV Every, N Lehmann, KG Anderson, R Caldwell, JH Kapadia, SR TI Predictors of progression of native coronary narrowing to total occlusion after coronary artery bypass grafting SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID STENOSIS C1 VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Div Cardiol, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Div Cardiothorac Surg, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. RP Kapadia, SR (reprint author), VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. NR 9 TC 4 Z9 4 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD APR 15 PY 2003 VL 91 IS 8 BP 971 EP 974 DI 10.1016/S0002-9149(03)00115-2 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 667DH UT WOS:000182215300011 PM 12686339 ER PT J AU Ho, PM Maynard, C Starks, H Sun, H Sloan, K Sales, A AF Ho, PM Maynard, C Starks, H Sun, H Sloan, K Sales, A TI Outcomes in patients with coronary heart disease who do not undergo lipid testing SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID ARTERY DISEASE; GUIDELINES; SECONDARY C1 VAMC, Cardiol & Hlth Serv Res, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80202 USA. VA Puget Sound Hlth Care Syst, IHD QUERI, Hlth Serv Res & Dev, Seattle, WA USA. RP Ho, PM (reprint author), 1055 Clermont St,111B, Denver, CO 80220 USA. RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814; Sales, Anne/0000-0001-9360-3334 NR 8 TC 2 Z9 2 U1 0 U2 1 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD APR 15 PY 2003 VL 91 IS 8 BP 986 EP 988 DI 10.1016/S0002-9149(03)00120-6 PG 3 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 667DH UT WOS:000182215300016 PM 12686344 ER PT J AU Morrison, ED Brandhagen, DJ Phatak, PD Barton, JC Krawitt, EL El-Serag, HB Gordon, SC Galan, MV Tung, BY Ioannou, GN Kowdley, KV AF Morrison, ED Brandhagen, DJ Phatak, PD Barton, JC Krawitt, EL El-Serag, HB Gordon, SC Galan, MV Tung, BY Ioannou, GN Kowdley, KV TI Serum ferritin level predicts advanced hepatic fibrosis among US patients with phenotypic hemochromatosis SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID HEREDITARY HEMOCHROMATOSIS; HOMOZYGOUS HEMOCHROMATOSIS; DIAGNOSIS; SURVIVAL AB Background: DNA-based HFE gene testing can confirm hereditary hemochromatosis in most people of Northern European descent. However, liver biopsy is important to detect cirrhosis. Objective: To develop noninvasive criteria to predict the presence or absence of advanced hepatic fibrosis or cirrhosis in Americans with hemochromatosis. Design: Cross-sectional study. Setting: Six tertiary care referral clinics. Patients: 182 patients with phenotypically defined hemochromatosis. Measurements: Liver histopathology and serum ferritin, aspartate arninotransferase, and alanine arninotransferase levels. Multivariate logistic regression analysis was used to examine factors associated with cirrhosis (defined as bridging fibrosis or unequivocal cirrhosis on biopsy). Results: Cirrhosis was present in 40 of 182 (22%) patients in the overall group and in 35 of 147 (24%) of C282Y homozygotes. Only 1 of 93 patients with a serum ferritin level less than 1000 mug/L had cirrhosis compared with 39 of 89 patients with serum ferritin levels greater than 1000 mug/L (P < 0.001). No C282Y homozygotes or C282Y/H63D compound heterozygotes with serum ferritin levels less than 1000 mug/L had cirrhosis. Elevated serum aminotransferase levels (P = 0.001) and serum ferritin levels greater than 1000 mug/L (P = 0.001), but not age older than 40 years (P = 0.2), were independently associated with cirrhosis. In a multivariate model, the probability of cirrhosis was 7.4% among patients with serum ferritin levels less than 1000 mug/L compared with 72% among patients with serum ferritin levels greater than 1000 mug/L after adjustment for age and elevated serum liver enzyme levels. Conclusions: Patients with hemochromatosis and serum ferritin levels less than 1000 mug/L are unlikely to have cirrhosis. Liver biopsy to screen for cirrhosis may be unnecessary in such patients, regardless of age or serum liver enzyme levels. C1 Univ Washington, Div Gastroenterol Hepatol, Seattle, WA 98195 USA. William Beaumont Hosp, Royal Oak, MI 48072 USA. Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Seattle, WA USA. Baylor Coll Med, Vet Adm Med Ctr, Houston, TX 77030 USA. Univ Vermont, Burlington, VT USA. So Iron Disorders Ctr, Birmingham, AL USA. Univ Rochester, Rochester, NY USA. Rochester Gen Hosp, Rochester, NY 14621 USA. Mayo Clin, Rochester, MN USA. RP Kowdley, KV (reprint author), Univ Washington, Div Gastroenterol Hepatol, 1959 NE Pacific St,Box 356174, Seattle, WA 98195 USA. FU NIDDK NIH HHS [DK02957, DK 38215] NR 12 TC 111 Z9 114 U1 1 U2 1 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD APR 15 PY 2003 VL 138 IS 8 BP 627 EP 633 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 666JH UT WOS:000182173800003 PM 12693884 ER PT J AU Humphrey, LL Chan, BK Sox, HC AF Humphrey, LL Chan, BK Sox, HC TI Postmenopausal hormone replacement therapy - Response SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. Amer Coll Physicians, Philadelphia, PA 19106 USA. RP Humphrey, LL (reprint author), Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD APR 15 PY 2003 VL 138 IS 8 BP 688 EP 689 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 666JH UT WOS:000182173800023 ER PT J AU Del Rincon, I Battafarano, DF Arroyo, RA Murphy, FT Fischbach, M Escalante, A AF Del Rincon, I Battafarano, DF Arroyo, RA Murphy, FT Fischbach, M Escalante, A TI Ethnic variation in the clinical manifestations of rheumatoid arthritis: Role of HLA-DRB1 Alleles SO ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH LA English DT Article DE rheumatoid arthritis; African Americans; Hispanic Americans; ethnic groups; HLA-DRB1; shared epitope ID SHARED-EPITOPE HYPOTHESIS; AMERICAN PATIENTS; DISEASE SEVERITY; SUSCEPTIBILITY; ASSOCIATION; RA; EXPRESSION; DISABILITY; REVEALS; INDIANS AB Objective. To assess the extent of ethnic variation in the clinical expression of rheumatoid arthritis (RA) and the role of HLA-DRB1 alleles in this variation. Methods. We assessed consecutive RA patients for joint findings, subcutaneous nodules, laboratory and radiographic findings, and treatment. We typed HLA-DRB1 alleles to identify those that contain the shared epitope (SE). We adjusted ethnic comparisons for age and sex, and tested for ethnic heterogeneity in the effect of the SE. Results. We studied 777 RA patients, 498 of whom were women (64%), 432 were Hispanic (56%), 2 72 were non-Hispanic white (NHW; 35%), 53 were African American (AA; 7%), and 20 were Asian (3%). Compared with NHW, Hispanics had significantly more tender joints (17 versus 11), more swollen joints (8 versus 7), more frequent rheumatoid factor (RF) positivity (93% versus 84%), higher erythrocyte sedimentation rate (ESR; 45 versus 36 mm/hr), and a lower number of lifetime disease-modifying antirheumatic drugs (1.9 versus 2.5). AA were older at onset (46 versus 44 years), had less frequent subcutaneous nodules (18% versus 28%). and higher ESR (42 versus 36 mm/hour) than did NHW. Hispanics and AA were more likely than NHW to be null for the SE (odds ratio, [OR] = 4.59 for AA; and OR = 1.61 for Hispanics), and less likely to have 2 SE-carrying alleles (OR = 0.59 for Hispanics and OR = 0.25 for AA). The number of SE copies was associated with subcutaneous nodules, ESR, RF, and radiographic changes. Ethnic heterogeneity in the effect of the SE was modest. Conclusions. There is ethnic variation in the clinical expression of RA and in both the frequency and types of SE-carrying HLA-DRB1 alleles. Some ethnic variation in clinical findings is associated with differences in SE frequency. However, we found that the effect of the SE on the clinical features of RA varies little between ethnic groups. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. Brooke Army Med Ctr, San Antonio, TX USA. Wilford Hall USAF Med Ctr, San Antonio, TX 78236 USA. S Texas Vet Adm Hlth Syst, San Antonio, TX USA. RP Escalante, A (reprint author), Univ Texas, Hlth Sci Ctr, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NCRR NIH HHS [M01-RR1346]; NHLBI NIH HHS [K23-HL004481]; NIAMS NIH HHS [K24-AR47530]; NICHD NIH HHS [R01-HD37151] NR 37 TC 35 Z9 35 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0004-3591 J9 ARTHRIT RHEUM-ARTHR JI Arthritis Rheum-Arthritis Care Res. PD APR 15 PY 2003 VL 49 IS 2 BP 200 EP 208 DI 10.1002/art.11000 PG 9 WC Rheumatology SC Rheumatology GA 666HM UT WOS:000182171700009 PM 12687511 ER PT J AU Wirshing, DA Smith, RA Wirshing, WC Pierre, JM Kisicki, MD AF Wirshing, DA Smith, RA Wirshing, WC Pierre, JM Kisicki, MD TI The metabolic syndrome and schizophrenia SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Greater Los Angeles VA Healthcare Syst, Dept Psychiat, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 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 APR 15 PY 2003 VL 53 IS 8 SU S MA 82 BP 29S EP 30S PG 2 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000079 ER PT J AU Wirshing, WC Wirshing, DA Champion, KM Pierre, JM Erhart, SM Kisicki, MD AF Wirshing, WC Wirshing, DA Champion, KM Pierre, JM Erhart, SM Kisicki, MD TI Switchover from clozapine to quetiapine: Mixed results SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Greater Los Angeles VA Healthcare Syst, Dept Psychiat, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 83 BP 30S EP 30S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000080 ER PT J AU Casada, JH Roache, JD AF Casada, JH Roache, JD TI The stop-signal task in PTSD: Behavioral and physiological responses SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78284 USA. Audie L Murphy Mem Vet Hosp Div, S Texas Vet Hlth Care Syst, Psychiat Serv, San Antonio, TX 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 108 BP 38S EP 39S PG 2 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000105 ER PT J AU Albers, L Ozdemir, V Aravagiri, M Marder, S Raggi, M Reist, C AF Albers, L Ozdemir, V Aravagiri, M Marder, S Raggi, M Reist, C TI A prospective dose-controlled interaction between olanzapine and fluvoxamine: Application to pharmacoeconomic optimization of olanzapine treatment in schizophrenia SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 VA Long Beach Healthcare Syst, Mental Healthcare Grp, Long Beach, CA USA. Univ Calif Irvine, Long Beach, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Toronto, Toronto, ON, Canada. Univ Bologna, Bologna, Italy. NR 0 TC 0 Z9 0 U1 1 U2 1 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 APR 15 PY 2003 VL 53 IS 8 SU S MA 133 BP 47S EP 48S PG 2 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000130 ER PT J AU Koenigsberg, HW Buchsbaum, M Harvey, PD Tang, C New, AS Goodman, M Siever, LJ AF Koenigsberg, HW Buchsbaum, M Harvey, PD Tang, C New, AS Goodman, M Siever, LJ TI Fmri in schizotypal personality disorder patients during a visuospatial working memory task SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. Bronx Vet Affairs Med Ctr, Dept Psychiat, Bronx, NY 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 157 BP 56S EP 56S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000154 ER PT J AU Yamanaka, K Nahas, Z Mu, Q Mishory, A Hill, SA Horner, MD Bedwell, JS Bohning, DE George, MS AF Yamanaka, K Nahas, Z Mu, Q Mishory, A Hill, SA Horner, MD Bedwell, JS Bohning, DE George, MS TI The effect of sleep deprivation on functional circuits involved in working memory SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Med Univ S Carolina, Brain Stimulat Lab, Charleston, SC 29425 USA. Med Univ S Carolina, Ctr Adv Imaging Res, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 160 BP 57S EP 57S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000157 ER PT J AU Yao, JK Magan, SJ Thomas, EA Gurklis, JA Sanders, R Sonel, AF Reddy, RD AF Yao, JK Magan, SJ Thomas, EA Gurklis, JA Sanders, R Sonel, AF Reddy, RD TI Biochemical and treatment effects of ethyl eicosapentaenoate supplementation in neuroleptic-treated schizophrenic patients with a high risk for coronary artery disease SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 VA Pittsburgh Healthcare Syst, Med Res Serv, Pittsburgh, PA USA. Univ Pittsburgh, Med Ctr, Dept Psychiat, Pittsburgh, PA USA. Univ Pittsburgh, Sch Pharm, Dept Pharmaceut Sci, Pittsburgh, PA USA. Univ Pittsburgh, Sch Nursing, Hlth & Community Syst, Pittsburgh, PA USA. Scripps Res Inst, Dept Biol Mol, La Jolla, CA USA. VA Med Ctr, Dept Psychiat, Dayton, OH 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 185 BP 65S EP 66S PG 2 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000182 ER PT J AU Leverenz, JB Tsuang, DW AF Leverenz, JB Tsuang, DW TI Psychosis in dementia - Biology to treatment SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Univ Washington, Clin & Educ Ctr, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 280 BP 99S EP 100S PG 2 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000272 ER PT J AU New, AS Hazlett, EA Buchsbaum, MS Goodman, M Koenigsberg, HW Iskander, L Lo, J Mitropoulou, V Siever, LJ AF New, AS Hazlett, EA Buchsbaum, MS Goodman, M Koenigsberg, HW Iskander, L Lo, J Mitropoulou, V Siever, LJ TI M-CPP PET and impulsive aggression in borderline personality disorder SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Mt Sinai Sch Med, New York, NY USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. NR 0 TC 4 Z9 4 U1 1 U2 1 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 APR 15 PY 2003 VL 53 IS 8 SU S MA 292 BP 104S EP 104S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000284 ER PT J AU Siever, LJ Frankle, WG Laruelle, M New, AS Buchsbaum, M Hazlett, E Goodman, M O'Flynn, K Miller, K Abi-Dargham, A AF Siever, LJ Frankle, WG Laruelle, M New, AS Buchsbaum, M Hazlett, E Goodman, M O'Flynn, K Miller, K Abi-Dargham, A TI The serotonergic system in personality disordered patients with impulsive aggression SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Mt Sinai Sch Med, New York, NY USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. Columbia Univ, New York State Psychiat Inst, New York, NY 10027 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 306 BP 108S EP 109S PG 2 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000298 ER PT J AU Kennedy, A Wood, AE Tapp, A AF Kennedy, A Wood, AE Tapp, A TI Poverty of speech and verbal memory in patients with schizophrenia SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. MIRECC, VA Puget Sound Hlth Care Syst, Amer Lake Div, Tacoma, WA 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 335 BP 119S EP 119S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000327 ER PT J AU Pekary, AE Faull, KF Sattin, A AF Pekary, AE Faull, KF Sattin, A TI A novel peptide, pyroglutamyltyrosylproline amide, in rat brain, structurally related to thyrotropin-releasing hormone SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Psychiat Serv, Los Angeles, CA USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90024 USA. NR 0 TC 2 Z9 2 U1 0 U2 0 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 APR 15 PY 2003 VL 53 IS 8 SU S MA 374 BP 132S EP 132S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000366 ER PT J AU Bartzokis, G Freeman, T Roca, V Kimbrell, T Brown, SJ Lu, PH Turner, J Mintz, J Saunders, S AF Bartzokis, G Freeman, T Roca, V Kimbrell, T Brown, SJ Lu, PH Turner, J Mintz, J Saunders, S TI Risperidone in the treatment of chronic combat-related posttraumatic stress disorder SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Univ Calif Los Angeles, Los Angeles, CA USA. Cent Arkansas Vet Heath Care Syst, Little Rock, AR USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. Univ Arkansas Med Sci, Little Rock, AR 72205 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RI Bartzokis, George/K-2409-2013; Mintz, Jim/N-7385-2014 OI Mintz, Jim/0000-0002-8299-5851 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 384 BP 135S EP 135S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000376 ER PT J AU Mishory, A Yamanaka, K Nahas, Z Mu, Q Hill, S Horner, MD Li, X Bohning, D George, MS AF Mishory, A Yamanaka, K Nahas, Z Mu, Q Hill, S Horner, MD Li, X Bohning, D George, MS TI Can within-individual image-guided repetitive transcranial magnetic stimulation (rTMS) improve cognitive performance in sleep deprived men? SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Med Univ S Carolina, Brain Stimulat Lab, CAIR, Dept Psychiat Radiol & Neurol, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs, Med Ctr, Charleston, SC USA. NR 2 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 414 BP 146S EP 146S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000406 ER PT J AU Kose, S Lorberbaum, JP Horwitz, AR Dubno, JR Newman, JD Lester, BM Hamner, MB George, MS AF Kose, S Lorberbaum, JP Horwitz, AR Dubno, JR Newman, JD Lester, BM Hamner, MB George, MS TI A method of inducing an infant cry that parents can easily identify as their own infant's cry SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Med Univ S Carolina, Dept Psychiat, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. Med Univ S Carolina, Dept Otolaryngol, Charleston, SC 29425 USA. NICHHD, Comparat Ethol Lab, Poolesville, MD USA. Brown Univ, Infant Dev Ctr, Providence, RI 02912 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 439 BP 155S EP 156S PG 2 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000431 ER PT J AU Goodman, M Frankle, WG Laurelle, A New, A Koenigsberg, H Miller, K Iskander, E Abi-Dargham, A Siever, L AF Goodman, M Frankle, WG Laurelle, A New, A Koenigsberg, H Miller, K Iskander, E Abi-Dargham, A Siever, L TI Pet imaging of 5-HT 2A and 5-HT transporter receptors in personality disordered subjects with impulsive aggression SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Mt Sinai Sch Med, New York, NY USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. New York State Psychiat Inst Columbia, New York, NY USA. NR 0 TC 0 Z9 0 U1 1 U2 1 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 APR 15 PY 2003 VL 53 IS 8 SU S MA 440 BP 156S EP 156S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000432 ER PT J AU Green, MF Marder, SR Fenton, W Davis, KL AF Green, MF Marder, SR Fenton, W Davis, KL TI Overcoming obstacles in treating cognitive deficits in schizophrenia SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Psychiat Serv, Los Angeles, CA USA. NIMH, NIH, Bethesda, MD 20892 USA. Mt Sinai Sch Med, New York, NY 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 449 BP 158S EP 158S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000436 ER PT J AU Pierre, JM Wirshing, DA Cannell, J Marks, J Sheppard, K Saunders, D Wirshing, WC AF Pierre, JM Wirshing, DA Cannell, J Marks, J Sheppard, K Saunders, D Wirshing, WC TI High dose quetiapine in treatment refractory schizophrenia SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. W Los Angeles VA Healthcare Ctr, Dept Psychiat, Los Angeles, CA USA. Atascadero State Hosp, Dept Psychiat, Atascadero, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 532 BP 188S EP 188S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000519 ER PT J AU Li, X Nahas, Z Anderson, B Kozel, AF Yamanaka, K Bohning, DE George, MS AF Li, X Nahas, Z Anderson, B Kozel, AF Yamanaka, K Bohning, DE George, MS TI Transcranial magnetic stimulation delivered over the left prefrontal cortex of depressed patients increases local cortical activity as well as in the right orbitofrontal cortex, hippocampus, insula and thalamus SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Med Univ S Carolina, Brain Stimulat Lab, Charleston, SC 29425 USA. Med Univ S Carolina, Ctr Adv Imaging Res, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Mental Hlth Serv, Charleston, SC USA. NR 0 TC 0 Z9 0 U1 1 U2 1 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 APR 15 PY 2003 VL 53 IS 8 SU S MA 541 BP 191S EP 192S PG 2 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000528 ER PT J AU Martin, LF Olincy, A Hall, MH Freedman, R AF Martin, LF Olincy, A Hall, MH Freedman, R TI Abnormalities of antisaccade task performance in schizophrenia and bipolar illness SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Denver Vet Affairs Med Ctr, Denver, CO 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 554 BP 197S EP 197S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000541 ER PT J AU Lorberbaum, JP Kose, S Hamner, MB George, MS AF Lorberbaum, JP Kose, S Hamner, MB George, MS TI Women prefer cradling infants on the left side in late pregnancy and the early postpartum period SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract CT 58th Annual Convention and Scientific Program of the Society-of-Biological-Psychiatry CY MAY 15-17, 2003 CL SAN FRANCISCO, CALIFORNIA SP Soc Bio Psychiatry C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Mental Hlth Serv, Charleston, SC 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 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 15 PY 2003 VL 53 IS 8 SU S MA 607 BP 215S EP 215S PG 1 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 670XU UT WOS:000182436000593 ER PT J AU Hu, LP Shi, YJ Hsu, JH Gera, J Van Ness, B Lichtenstein, A AF Hu, LP Shi, YJ Hsu, JH Gera, J Van Ness, B Lichtenstein, A TI Downstream effectors of oncogenic ras in multiple myeloma cells SO BLOOD LA English DT Article ID NF-KAPPA-B; P70 S6 KINASE; K-RAS; FARNESYLTRANSFERASE INHIBITORS; TRANSCRIPTIONAL ACTIVITY; ACTIVATING MUTATIONS; PROTEIN-KINASES; TUMOR-CELLS; LINE ANBL6; AKT KINASE AB Ectopic expression of mutated K-ras or N-ras in the interleukin 6 (IL-6)-dependent ANBL6 multiple myeloma cell line induces cytokine-independent growth. To investigate the signaling pathways activated by oncogenic ras that may stimulate IL-6-independent growth, we compared ANBL6. cells stably transfected with mutated K or N-ras genes with wild-type ras-expressing control cells identically transfected with an empty vector. Upon depletion of IL-6, both mutated rascontaining myeloma lines demonstrated constitutive activation of mitogen-activated extracellular kinase 2(MEK)/extracellular signal-regulated kinase (ERK), phosphatidylinositol-3 kinase (PI3-kinase)/AKT, mammalian target of rapamycin (mTOR)/p70S6-kinase, and nuclear factor kippaB (NF-kB) pathways. In contrast, signal transducer and activator of transcription-3 (STAT-3) was not constitutively tyrosine phosphorylated in mutant ras-expressing cells. We used several maneuvers in attempts to selectively target these constitutively active pathways. The mTOR inhibitors rapamycin and CCI-779, the PI3-kinase inhibitor LY294002, and the MEK inhibitor PD98059 all significantly curtailed growth of mutant. rascontaining cells. Farnesyl transferase inhibitors, used to target ras itself, had modest effects only against mutant N-ras-containing cells. Growth of mutant N-ras-containing myeloma cells was also inhibited by acute expression of the IKB superrepressor gene, which abrogated NF-kB activation. These results indicate that several pathways contributing to stimulation of cytokine-independent growth are activated downstream of oncogenic ras in myeloma cells. They also suggest that therapeutic strategies that target these pathways may be particularly efficacious in patients whose myeloma clones contain ras mutations. (C) 2003 by The American Society of Hematology. C1 Univ Calif Berkeley, Ctr Med, Hematol Oncol Div, W Los Angeles Vet Adm, Los Angeles, CA USA. Univ Minnesota, Dept Lab Med & Pathol, Minneapolis, MN 55455 USA. RP Lichtenstein, A (reprint author), VA W LA Med Ctr, W111H,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NCI NIH HHS [CA 62242, CA 96920] NR 46 TC 101 Z9 106 U1 0 U2 4 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD APR 15 PY 2003 VL 101 IS 8 BP 3126 EP 3135 DI 10.1182/blood-2002-08-2640 PG 10 WC Hematology SC Hematology GA 665CE UT WOS:000182101400040 PM 12515720 ER PT J AU Miller, SM Beattie, MM Butt, AA AF Miller, SM Beattie, MM Butt, AA TI Personal digital assistant infectious diseases applications for health care professionals SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID PRACTICE GUIDELINES; INTERVENTIONS AB Personal digital assistants (PDAs; also known as "handheld computers," "pocket personal computers," and Palm Pilots) provide immediate access to vital and clinically relevant infectious diseases information at the point of care. Several infectious diseases applications are available that provide information on pathogens, diagnosis, medication, and treatment. In this article, 4 infectious diseases PDA applications are reviewed: ePocrates ID (part of ePocrates Rx Pro), the Johns Hopkins Division of Infectious Diseases Antibiotic Guide, the 2002 Sanford Guide to Antimicrobial Therapy, and Infectious Diseases and Antimicrobials Notes. Drug information, including clinical pharmacology, dosing in patients with renal insufficiency, adverse reactions, and drug interactions, is evaluated for completeness and accuracy by comparison of each application with the package insert. Treatment recommendations for 6 diseases are compared with current practice guidelines. Each PDA infectious diseases application reviewed has unique advantages and disadvantages. This critical review will help health care professionals select the infectious diseases PDA application best tailored to meet their individual information needs. C1 Univ Missouri, Sch Med, Clin Pharmacol Sect, Kansas City, MO 64108 USA. Univ Missouri, Hlth Sci Lib, Kansas City, MO 64110 USA. Univ Pittsburgh, Ctr Hlth Equity Res & Promot, Pittsburgh, PA 15260 USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Miller, SM (reprint author), Univ Missouri, Sch Med, Clin Pharmacol Sect, M4-207 Med Sch,2411 Holmes St, Kansas City, MO 64108 USA. NR 22 TC 24 Z9 24 U1 0 U2 6 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD APR 15 PY 2003 VL 36 IS 8 BP 1018 EP 1029 DI 10.1086/368198 PG 12 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 665MK UT WOS:000182124700014 PM 12684915 ER PT J AU Fultz, SL Justice, AC Butt, AA Rabeneck, L Weissman, S Rodriguez-Barradas, M AF Fultz, SL Justice, AC Butt, AA Rabeneck, L Weissman, S Rodriguez-Barradas, M CA VACS-3 Project Team TI Testing, referral, and treatment patterns for hepatitis C virus coinfection in a cohort of veterans with human immunodeficiency virus infection SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID ACTIVE ANTIRETROVIRAL THERAPY; RISK; HEPATOTOXICITY; HCV AB We examined testing, referral, and treatment of patients with hepatitis C among HIV-infected patients in the Veterans Aging 3-Site Cohort Study by using patient- and provider-completed surveys and laboratory, pharmacy, and administrative records from the Department of Veterans Affairs electronic medical record. Of 881 human immunodeficiency virus-positive patients, 43% were coinfected with hepatitis C virus. Of these, 88 (30%) reported current alcohol consumption. Only one-third were counseled to reduce or stop alcohol consumption. Coinfected patients with indications for hepatitis C treatment had a high rate of contraindications, including both medical and psychiatric comorbidities. Of the 65 patients with indications for hepatitis C therapy and free of contraindications for treatment, only 18% underwent liver biopsy and 3% received IFN. Although treatment indications are common in this population, contraindications are also common. Health care providers are often unaware of alcohol consumption that may accelerate the course of hepatitis C, increase the risk of hepatocellular carcinoma, and reduce treatment efficacy. C1 Univ Pittsburgh, Sch Med, Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Div Gen Internal Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Div Infect Dis, Pittsburgh, PA USA. Baylor Coll Med, Houston, TX 77030 USA. Vet Affairs Med Ctr, Houston, TX 77030 USA. Vet Affairs Ctr Excellence, Houston, TX USA. Hosp St Raphael, New Haven, CT USA. RP Justice, AC (reprint author), Univ Pittsburgh, Sch Med, Vet Affairs Pittsburgh Healthcare Syst, Univ Dr C,11 E 124 130-U, Pittsburgh, PA 15240 USA. FU NIA NIH HHS [AG-00826]; NIAAA NIH HHS [AA-13566]; NIDDK NIH HHS [DK-59318] NR 21 TC 62 Z9 63 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD APR 15 PY 2003 VL 36 IS 8 BP 1039 EP 1046 DI 10.1086/374049 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 665MK UT WOS:000182124700016 PM 12684917 ER PT J AU John, J Wu, MF Kodama, T Siegel, JM AF John, J Wu, MF Kodama, T Siegel, JM TI Intravenously administered hypocretin-1 alters brain amino acid release: an in vivo microdialysis study in rats SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Article ID OREXIN-A; LOCUS-COERULEUS; GABA RELEASE; SPINAL-CORD; NEURONS; NARCOLEPSY; GLUTAMATE; SLEEP; STIMULATION; EXPRESSION AB We have reported that intravenous administration of hypocretin (Hcrt or orexin) reverses the symptoms of narcolepsy in genetically narcoleptic dogs. We have also reported that the onset of symptoms in canine genetic narcolepsy is accompanied by degenerative changes in forebrain regions, particularly the septal nucleus and amygdala. In the present in vivo microdialysis study we have investigated the effect of intravenous administration of Hcrt-1 (orexin-A) to anaesthetized rats on glutamate and GABA release in the amygdala, a region with moderate Hcrt innervation, and in the cerebellar cortex, a region with sparse or no Hcrt innervation. We found that intravenous Hcrt administration caused a marked (> 60%) and sustained (> 50 min) increase in glutamate release within the amygdala, but no change in release in the cerebellar cortex. We did not detect a significant change in GABA release. When calcium-free artificial cerebrospinal fluid was used as the microdialysis perfusate, Hcrt-1 no longer produced an increase in glutamate release. Hcrt may act via the calcium-dependent regulation of glutamate release in certain nuclei of the central nervous system. C1 Vet Affairs Greater Los Angeles Hlth Care Syst, North Hills, CA 91343 USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 91020 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 91020 USA. RP Siegel, JM (reprint author), Univ Calif Los Angeles, Sepulveda VAMC, Neurobiol Res 151A3,16111 Plummer St, North Hills, CA 91343 USA. FU NHLBI NIH HHS [R01 HL041370, R37 HL041370, HL41370, P50 HL060296, HL60296]; NINDS NIH HHS [NS14610, R01 NS014610, R37 NS014610] NR 36 TC 32 Z9 33 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD APR 15 PY 2003 VL 548 IS 2 BP 557 EP 562 DI 10.1113/jphysiol.2002.038729 PG 6 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 690VL UT WOS:000183571100025 PM 12626669 ER PT J AU Bradley, KA Bush, KR Epler, AJ Dobie, DJ Davis, TM Sporleder, JL Maynard, C Burman, ML Kivlahan, DR AF Bradley, KA Bush, KR Epler, AJ Dobie, DJ Davis, TM Sporleder, JL Maynard, C Burman, ML Kivlahan, DR TI Two brief alcohol-screening tests from the Alcohol Use Disorders Identification Test (AUDIT) - Validation in a female veterans affairs patient population SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID BRIEF PHYSICIAN ADVICE; RANDOMIZED CONTROLLED TRIAL; PRIMARY-CARE; PROBLEM DRINKING; BINGE-DRINKING; PROBLEM DRINKERS; LIKELIHOOD RATIOS; DIAGNOSTIC-TEST; DRUG MODULES; AUDADIS-ADR AB Background: Primary care physicians need a brief alcohol questionnaire that identifies hazardous drinking and alcohol use disorders. The Alcohol Use Disorders identification Test (AUDIT) questions 1 through 3 (AUDIT-C), and AUDIT question 3 alone are effective alcohol-screening tests in male Veterans Affairs (VA) patients, but have not been validated in women. Methods: Female VA patients (n = 393) completed self-administered questionnaires, including the 10-item AUDIT and a previously proposed modification to AUDIT question 3 with a sex-specific threshold for binge drinking (greater than or equal to 4 drinks/occasion), and in-person interviews with the Alcohol Use Disorder and Associated Disabilities Interview Schedule. The AUDIT-C, AUDIT question 3 alone, and the 10-item AUDIT were each evaluated with and without the sex-specific binge question and compared with past-year hazardous drinking (> 7 drinks/week or :4 drinks/occasion) and/or active Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition alcohol abuse or dependence, based on interviews. Results: Eighty-nine women (22.6%) met interview criteria for past-year hazardous drinking and/or active alcohol abuse or dependence. Standard and sex-specific AUDIT-Cs were sensitive (0.81 and 0.84, respectively) and specific (0.86 and 0.85, respectively). Their areas under the receiver operating characteristic curves were equivalent (0.91, and 0.92, respectively) and slightly higher than for the standard 10-item AUDIT (0.87). A single, sex-specific question about binge drinking (modified AUDIT question 3) had a sensitivity of 0.69 and specificity of 0.94, whereas the standard AUDIT question 3 was specific (0.96) but relatively insensitive (0.45). Conclusions: The standard and sex-specific AUDIT-Cs are effective screening tests for past-year hazardous drinking and/or active alcohol abuse or dependence in female patients in a VA study. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv,Vet Hlth Adm, Dept Vet Affairs,Vet Womens Alcohol Problems Stud, Seattle, WA 98108 USA. Univ Washington, Primary & Specialty Med Care Serv, Seattle, WA 98108 USA. Univ Washington, Ctr Excellence Subst Abuse Treatment & Educ, Seattle, WA 98108 USA. Univ Washington, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98108 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98108 USA. RP Bradley, KA (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv,Vet Hlth Adm, Dept Vet Affairs,Vet Womens Alcohol Problems Stud, Mail Stop 152,1660 S Columbian Way, Seattle, WA 98108 USA. RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 FU NIAAA NIH HHS [K23 AA00313] NR 59 TC 261 Z9 263 U1 4 U2 13 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD APR 14 PY 2003 VL 163 IS 7 BP 821 EP 829 DI 10.1001/archinte.163.7.821 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 669EZ UT WOS:000182340100008 PM 12695273 ER PT J AU Montfort, MJ Bouwer, HGA Hinrichs, DJ AF Montfort, MJ Bouwer, HGA Hinrichs, DJ TI CD40 deficiency impacts the quality of memory CD8 T cells generated in response to infection with Listeria monocytogenes SO FASEB JOURNAL LA English DT Meeting Abstract CT 90th Annual Meeting of the American-Association-for-Immunologists CY MAY 06-10, 2003 CL DENVER, COLORADO SP American Assoc Immunologists C1 Oregon Hlth Sci Univ, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 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 APR 14 PY 2003 VL 17 IS 7 SU S BP C257 EP C258 PG 2 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 669TR UT WOS:000182367001200 ER PT J AU Wang, XH Yang, PA Wu, Q Zhou, JL Li, LN Powell, JK Zhang, HG Mountz, JD Hsu, HC AF Wang, XH Yang, PA Wu, Q Zhou, JL Li, LN Powell, JK Zhang, HG Mountz, JD Hsu, HC TI Defective activation-induced cell death (AICD) in T cells from aged mice is associated with altered PI-3 kinase/Akt signaling pathway SO FASEB JOURNAL LA English DT Meeting Abstract CT 90th Annual Meeting of the American-Association-for-Immunologists CY MAY 06-10, 2003 CL DENVER, COLORADO SP American Assoc Immunologists C1 Univ Alabama, Birmingham, AL 35294 USA. Birmingham VAMC, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 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 APR 14 PY 2003 VL 17 IS 7 SU S BP C225 EP C225 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 669TR UT WOS:000182367001045 ER PT J AU Zhang, HG Liu, ZY Hsu, HC Grizzle, WE Yang, PA Wu, Q Mountz, JD AF Zhang, HG Liu, ZY Hsu, HC Grizzle, WE Yang, PA Wu, Q Mountz, JD TI Establishment of a novel tumor cell line (2299) derived from a tumor in IRF-1(-/-) and CD95LP-Luc transgene mouse SO FASEB JOURNAL LA English DT Meeting Abstract CT 90th Annual Meeting of the American-Association-for-Immunologists CY MAY 06-10, 2003 CL DENVER, COLORADO SP American Assoc Immunologists C1 Univ Alabama, Birmingham, AL 35294 USA. Birmingham VAMC, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 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 APR 14 PY 2003 VL 17 IS 7 SU S BP C76 EP C76 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 669TR UT WOS:000182367000350 ER PT J AU Ho, A Lievore, A Patierno, S Kohlmeier, SE Tonini, M Sternini, C AF Ho, A Lievore, A Patierno, S Kohlmeier, SE Tonini, M Sternini, C TI Neurochemically distinct classes of myenteric neurons express the mu-opioid receptor in the guinea pig ileum SO JOURNAL OF COMPARATIVE NEUROLOGY LA English DT Article DE ascending excitatory neurons; interneurons; descending neurons; motor neurons; interstitial cells of Cajal ID PRIMARY AFFERENT NEURONS; SMALL-INTESTINE; INTERSTITIAL-CELLS; GASTROINTESTINAL-TRACT; ENDOGENOUS OPIOIDS; MOLECULAR-BIOLOGY; ENTERIC NEURONS; CAJAL; MOTILITY; PEPTIDES AB The mu-opioid receptor ( LOR), which mediates many of the opioid effects in the nervous system, is expressed by enteric neurons. The aims of this study were to determine whether 1) different classes of myenteric neurons in the guinea pig ileum contain muOR immunoreactivity by using double- and triple-labeling immunofluorescence and confocal microscopy, 2) muOR immunoreactivity is localized to enteric neurons immunoreactive for the endogenous opioid enkephalin, and 3) muOR immunoreactivity is localized to interstitial cells of Cajal visualized by c-kit. In the myenteric plexus, 50% of muOR-immunoreactive neurons contained choline acetyltransferase (ChAT) immunoreactivity, whereas about 43% of ChAT-immunoreactive neurons were LOR immunoreactive. Approximately 46% of muOR myenteric neurons were immunoreactive for vasoactive intestinal polypeptide (VIP), and about 31% were immunoreactive for nitric oxide synthase (NOS). muOR immunoreactivity was found in about 68% of VIP-containing neurons and 60% of NOS-immunoreactive neurons. Triple labeling showed that about 32% of muOR neurons contained VIP and ChAT immunoreactivities. The endogenous opioid enkephalin (ENK) was observed in about 30% of muOR neurons; conversely, 48% of ENK neurons contained muOR immunoreactivity. muOR was not detected in neurons containing calbindin, nor in interstitial cells of Cajal. muOR-immunoreactive fibers formed a dense network around interstitial cells of Cajal in the deep muscular plexus. This study demonstrates that muOR is expressed by neurochemically distinct classes of myenteric neurons that are likely to differ functionally, is colocalized with the endogenous opioid ENK, and is not expressed by interstitial cells of Cajal. (C) 2003 Wiley-Liss, Inc. C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Pavia, Inst Pharmacol, I-27100 Pavia, Italy. Univ Calif Los Angeles, Dept Neurobiol, Los Angeles, CA 90095 USA. CURE Digest Dis Res Ctr, Div Digest Dis, Los Angeles, CA 90073 USA. RP Sternini, C (reprint author), CURE Digest Dis Res Ctr, Div Digest Dis, Bldg 115,Room 224,11301 Wilshire Blvd,VAGLAHS, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK 41301, DK 35740, DK 54155] NR 58 TC 25 Z9 25 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0021-9967 J9 J COMP NEUROL JI J. Comp. Neurol. PD APR 14 PY 2003 VL 458 IS 4 BP 404 EP 411 DI 10.1002/cne.10606 PG 8 WC Neurosciences; Zoology SC Neurosciences & Neurology; Zoology GA 657BF UT WOS:000181645000008 PM 12619074 ER PT J AU Wolkowitz, OM Kramer, JH Reus, VI Costa, MM Yaffe, K Walton, P Raskind, M Peskind, E Newhouse, P Sack, D De Souza, E Sadowsky, C Roberts, E AF Wolkowitz, OM Kramer, JH Reus, VI Costa, MM Yaffe, K Walton, P Raskind, M Peskind, E Newhouse, P Sack, D De Souza, E Sadowsky, C Roberts, E CA DHEA-Alzheimer's Dis Collborative TI DHEA treatment of Alzheimer's disease - A randomized, double-blind, placebo-controlled study SO NEUROLOGY LA English DT Article ID DEHYDROEPIANDROSTERONE DHEA; SENILE DEMENTIA; SULFATE DHEAS; DIFFERENTIATION; ASSOCIATION; WOMEN AB Objective: To compare the efficacy and tolerability of dehydroepiandrosterone (DHEA) vs placebo in AD. Method: Fifty-eight subjects with AD were randomized to 6 month's treatment with DHEA (50 mg per os twice a day; n 28) or placebo (n = 30) in a multi-site, double-blind pilot trial. Primary efficacy measures assessed cognitive functioning (the AD Assessment Scale-Cognitive [ADAS-Cog]) and observer-based ratings of overall changes in severity (the Clinician's Interview-Based Impression of Change with Caregiver Input [CIBIC-Plus]). At baseline, 3 months, and 6 months, the ADAS-Cog was administered, and at 3 and 6 months, the CIBIC-Plus was administered. The 6-month time point was the primary endpoint. Results: Nineteen DHEA-treated subjects and 14 placebo-treated subjects completed the trial. DHEA was relatively well-tolerated. DHEA treatment, relative to placebo, was not associated with improvement in ADAS-Cog scores at month 6 (last observation carried forward; p = 0.10); transient improvement was noted at month 3 (p = 0.014; cutoff for Bonferroni significance = 0.0125). No difference between treatments was seen on the CIBIC-Plus at either the 6-month or the 3-month time points. Conclusions: DHEA did not significantly improve cognitive performance or overall ratings of change in severity in this small-scale pilot study. A transient effect on cognitive performance may have been seen at month 3, but narrowly missed significance. C1 Univ Calif San Francisco, Sch Med, Dept Psychiat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Sch Med, Dept Neurol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Sch Med, Ctr Neurobiol & Psychiat, San Francisco, CA 94143 USA. Univ Washington, Sch Med, Alzheimers Dis Res Ctr, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Vermont, Coll Med, Dept Psychiat, Burlington, VT 05405 USA. Inst Psychopharmacol Res, Cerritos, CA USA. Neurocrine Biosci Inc, San Diego, CA USA. Premier Res Inst, W Palm Beach, FL USA. City Hope Natl Med Ctr, Beckman Res Inst, Dept Neurobiochem, Duarte, CA 91010 USA. Clin Studies Ltd, Ft Myers, FL USA. Clin Studies Ltd, Boynton Beach, FL USA. So New Jersey Med Inst, Stratford, NJ USA. RP Wolkowitz, OM (reprint author), 401 Parnassus Ave,Box F-0984, San Francisco, CA 94143 USA. RI Wolkowitz, Owen/J-6649-2013; Newhouse, Paul/J-4597-2014; reus, victor/I-7923-2015 OI Wolkowitz, Owen/0000-0003-0655-5042; reus, victor/0000-0002-8193-5697 FU NIA NIH HHS [1R4 1AG NS13334-01] NR 29 TC 61 Z9 63 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD APR 8 PY 2003 VL 60 IS 7 BP 1071 EP 1076 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 675EP UT WOS:000182680300004 PM 12682308 ER PT J AU Knopp, RH Retzlaff, B Aikawa, K Kahn, SE AF Knopp, RH Retzlaff, B Aikawa, K Kahn, SE TI Management of patients with diabetic hyperlipidemia SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article; Proceedings Paper CT Symposium on High-Density Lipoprotein Cholesterol esterol CY OCT 11-12, 2001 CL NEW YORK, NEW YORK ID CORONARY HEART-DISEASE; INSULIN-RESISTANCE; CHOLESTEROL CONCENTRATIONS; ARTERY DISEASE; RISK-FACTORS; LIPOPROTEIN; TRIGLYCERIDE; HYPERTRIGLYCERIDEMIA; ATHEROSCLEROSIS; FRAMINGHAM AB Hyperlipidemia is commonly observed in patients with type 2 diabetes and is also characteristic of the metabolic syndrome. We discuss the lipoprotein abnormalities in type 2 diabetes and the relation of triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol to insulin resistance and diabetes. We also present a case study of a diabetic woman with hyperlipidemia and coronary artery disease. (C) 2003 by Excerpta Medica, Inc. C1 Univ Washington, Sch Med, NW Lipid Res Clin, Seattle, WA 98104 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98104 USA. Vet Affairs Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Seattle, WA USA. Univ Washington, Sch Med, Div Cardiol, Seattle, WA 98104 USA. RP Knopp, RH (reprint author), Univ Washington, Sch Med, NW Lipid Res Clin, 325 9th Ave,UW Box 359720, Seattle, WA 98104 USA. OI Kahn, Steven/0000-0001-7307-9002 FU NCRR NIH HHS [RR37 DK 358616]; NIDDK NIH HHS [K24 DK 02654] NR 32 TC 12 Z9 14 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD APR 3 PY 2003 VL 91 IS 7A SU S BP 24E EP 28E DI 10.1016/S0002-9149(02)03385-4 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 664TT UT WOS:000182077800005 PM 12679200 ER PT J AU Doong, ML Yang, H AF Doong, ML Yang, H TI Intravenous glucose infusion decreases intracisternal thyrotropin-releasing hormone induced vagal stimulation of gastric acid secretion in anesthetized rats SO NEUROSCIENCE LETTERS LA English DT Article DE autonomic disorders; diabetes; glucose; medullary vagal regulation ID TRH ANALOG; CONSCIOUS RATS; VAGUS NERVE; COMPLEX; NEURONS; HYPERGLYCEMIA; NUCLEUS; LOCALIZATION; EXPRESSION; MOTILITY AB Gastroparesis is a common complication of diabetes attributed to autonomic neuropathy. This study investigated whether acute hyperglycemia influences central thyrotropin-releasing hormone (TRH), a well-established brain medullary vagal stimulus, induced gastric acid secretion in overnight fasted, urethane-anesthetized rats. Intravenous infusion of D-glucose (20%, 30% and 40%) dose dependently reduced intracisternal TRH-induced gastric acid secretion (71 +/- 28 mumol/90,min) by 39%, 90% and 100% respectively. Pretreatment with cholecystokinin(A) (CCKA) receptor antagonist devazepide (1 mg/kg) did not influence the inhibitory effect of intravenous glucose (30%). These results indicate that hyperglycemia may have a central effect to antagonize medullary TRH stimulation of vagal outflow to the stomach. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved. C1 Univ Calif Los Angeles, CURE Digest Dis Res Ctr, VA Great Los Angeles Healthcare Syst, Dept Med,Div Digest Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. RP Yang, H (reprint author), Univ Calif Los Angeles, CURE Digest Dis Res Ctr, VA Great Los Angeles Healthcare Syst, Dept Med,Div Digest Dis, W Los Angeles Campus,Bldg 115,Room 203,11301 Wils, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK-41301, DK-50255] NR 20 TC 9 Z9 10 U1 0 U2 0 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0304-3940 J9 NEUROSCI LETT JI Neurosci. Lett. PD APR 3 PY 2003 VL 340 IS 1 BP 49 EP 52 DI 10.1016/S0304-3940(03)00068-5 PG 4 WC Neurosciences SC Neurosciences & Neurology GA 661QR UT WOS:000181901700013 PM 12648756 ER PT J AU Mozaffarian, D Kumanyika, SK Lemaitre, RN Olson, JL Burke, GL Siscovick, DS AF Mozaffarian, D Kumanyika, SK Lemaitre, RN Olson, JL Burke, GL Siscovick, DS TI Cereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Heart-Associations-Epidemiology-Council CY APR 24, 2002 CL HONOLULU, HAWAII SP Amer Heart Assoc Epidemiol Council ID CORONARY HEART-DISEASE; FOOD FREQUENCY QUESTIONNAIRE; DIETARY FIBER; HEALTH; MEN; MORTALITY; WOMEN; CANCER; REDUCE; DEATH AB Context People older than 65 years are the fastest-growing segment of the population and account for the majority of cardiovascular disease (CVD) morbidity, mortality, and health care expenditures. Additionally, the influence of dietary habits on risk may be less pronounced in elderly persons, when atherosclerosis is more advanced. However, few data address the influence of diet on CVD risk in this population. Objective To determine whether fiber consumption from fruit, vegetable, and cereal sources (including whole grains and bran) is associated with incident CVD in elderly persons. Design Prospective cohort study conducted from 1989 to June 2000. Setting and Participants Population-based, multicenter study among 3588 men and women aged 65 years or older and free of known CVD at baseline in 1989-1990. Usual dietary fiber consumption was assessed at baseline (mean participant age, 72 years) using a 99-item food frequency questionnaire. Main Outcome Measure Incident CVD (combined stroke, ischemic heart disease death, and nonfatal myocardial infarction). Results During 8.6 years mean follow-up, there were 811 incident CVD events. After adjustment for age, sex, education, diabetes, ever smoking, pack-years of smoking, daily physical activity, exercise intensity, alcohol intake, and fruit and vegetable fiber consumption, cereal fiber consumption was inversely associated with incident CVD (P for trend=.02), with 21% lower risk (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.62-0.99) in the highest quintile of intake, compared with the lowest quintile. In similar analyses, neither fruit fiber intake (P for trend=.98) nor vegetable fiber intake (P for trend=.95) were associated with incident CVD. When CVD events were separately evaluated, higher cereal fiber intake was associated with lower risk of total stroke and ischemic stroke and a trend toward lower risk of ischemic heart disease death. In a post hoc analysis, dark breads such as wheat, rye, or pumpernickel were associated with a lower risk of incident CVD (HR, 0.76; 95% CI, 0.64-0.90) rather than cereal fiber from other sources. Conclusions Cereal fiber consumption late in life is associated with lower risk of incident CVD, supporting recommendations for elderly individuals to increase consumption of dietary cereal fiber. C1 Univ Washington, Dept Med, Cardiovasc Hlth Res Unit, Seattle, WA 98101 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98101 USA. Univ Washington, Div Cardiol, Seattle, WA 98101 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. NHLBI, Div Epidemiol & Clin Applicat, NIH, Bethesda, MD 20892 USA. Wake Forest Univ, Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27109 USA. RP Mozaffarian, D (reprint author), Univ Washington, Dept Med, Cardiovasc Hlth Res Unit, 1730 Minor Ave,Suite 1360, Seattle, WA 98101 USA. EM darymd@hotmail.com RI Mozaffarian, Dariush/B-2276-2008 FU NHLBI NIH HHS [N01-HC-85079, N01-HC-15103, N01-HC-35129, N01-HC-85086] NR 39 TC 155 Z9 172 U1 1 U2 14 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 2 PY 2003 VL 289 IS 13 BP 1659 EP 1666 DI 10.1001/jama.289.13.1659 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 662JX UT WOS:000181944500029 PM 12672734 ER PT J AU Kampman, K Majewska, MD Tourian, K Dackis, C Cornish, J Poole, S O'Brien, C AF Kampman, K Majewska, MD Tourian, K Dackis, C Cornish, J Poole, S O'Brien, C TI A pilot trial of piracetam and ginkgo biloba for the treatment of cocaine dependence SO ADDICTIVE BEHAVIORS LA English DT Article DE cocaine; piracetam; ginkgo biloba; clinical trial ID NEUROPSYCHOLOGICAL DEFICITS; CEREBRAL PERFUSION; MEMORY IMPAIRMENT; DOUBLE-BLIND; EXTRACT; ABUSERS; DEMENTIA; ABNORMALITIES; OUTPATIENTS; VOLUNTEERS AB Background: Chronic cocaine use is associated with cognitive deficits that may reduce the effectiveness of psychosocial treatment and promote relapse in newly abstinent cocaine-dependent patients. Nootropic agents, such as piracetam. and ginkgo biloba, may improve cognitive function and reduce the incidence of relapse in these patients. Methods: This was a 10-week, double-blind, placebo-controlled pilot trial involving 44 cocaine-dependent subjects. Subjects received either piracetam (4.8 g/day), ginkgo biloba (120 mg/day), or placebo. Subjects were required to attain abstinence from cocaine during a 2-week baseline phase demonstrated by providing at least one benzoylecgonine (BE)-negative urine toxicology screen. Outcome measures included treatment retention, urine toxicology screens, Clinical Global Impression (CGI) scores, and results from the Addiction Severity Index (ASI). Results: Ginkgo biloba was not superior to placebo in any outcome measure. Piracetam was associated with more cocaine use and lower CGI scores compared to placebo. Conclusions: Neither piracetam nor ginkgo biloba appears to be a promising medication for the treatment of cocaine dependence. (C) 2002 Elsevier Science Ltd. All rights reserved. C1 Univ Penn, Treatment Res Ctr, Dept Psychiat, Sch Med, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Natl Inst Drug Abuse, Bethesda, MD USA. Belmont Ctr, Philadelphia, PA USA. RP Kampman, K (reprint author), Univ Penn, Treatment Res Ctr, Dept Psychiat, Sch Med, 2900 Chestnut St, Philadelphia, PA 19104 USA. EM kampman_k@mail.trc.upenn.edu FU NIDA NIH HHS [K20 DA00238, YO1 DA30012] NR 42 TC 12 Z9 12 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4603 J9 ADDICT BEHAV JI Addict. Behav. PD APR PY 2003 VL 28 IS 3 BP 437 EP 448 DI 10.1016/S0306-4603(02)00226-5 PG 12 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 658DK UT WOS:000181706200003 PM 12628617 ER PT J AU Schutzer, WE Mader, SL AF Schutzer, WE Mader, SL TI Age-related changes in vascular adrenergic signaling: clinical and mechanistic implications SO AGEING RESEARCH REVIEWS LA English DT Review DE aging; aorta; beta-adrenergic receptors; blood pressure; cyclic AMP; G proteins; G protein receptor kinase; hypertension; isoproterenol; vascular smooth muscle cell; vasorelaxation ID DEPENDENT PROTEIN-KINASE; COUPLED RECEPTOR KINASES; SMOOTH-MUSCLE-CELLS; AGONIST-INDUCED DESENSITIZATION; CYCLIC-AMP METABOLISM; BETA-GAMMA-SUBUNITS; RAT ISOLATED AORTA; ADENYLYL-CYCLASE; BETA(2)-ADRENERGIC RECEPTOR; ANGIOTENSIN-II AB A large and growing segment of the general population are age 65 or older, and this percentage will continue to rise. Primary care of this population has, and is becoming a priority for clinicians. Hypertension, orthostatic hypotension, arterial insufficiency, and atherosclerosis are common disorders in the elderly that lead to significant morbidity and mortality. One common factor to these conditions is an age-related decline in beta-adrenergic receptor (beta-AR)-mediated function and subsequent cAMP generation. Presently, there is no single cellular factor that can explain this age-related decline, and thus the primary cause of this homeostatic imbalance is yet to be identified. However, the etiology is clearly associated with an age-related change in the ability of beta-AR receptor to respond to agonist at the cellular level. This article will review what is presently understood regarding the molecular and biochemical basis of age-impaired beta-AR receptor-mediated signaling. A fundamental understanding of why beta-AR-mediated vasorelaxation is impaired with age will provide new insights and innovative strategies for the management of the multiple clinical disorders that effect older people. (C) 2002 Published by Elsevier Science Ireland Ltd. C1 Oregon Hlth Sci Univ, Portland VA Med Ctr, Res Serv, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Sch Med, Portland, OR 97201 USA. RP Mader, SL (reprint author), Oregon Hlth Sci Univ, Portland VA Med Ctr, Res Serv, POB 1034, Portland, OR 97201 USA. NR 146 TC 26 Z9 28 U1 1 U2 1 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 1568-1637 J9 AGEING RES REV JI Ageing Res. Rev. PD APR PY 2003 VL 2 IS 2 BP 169 EP 190 AR PII S1568-1637(02)00063-6 DI 10.1016/S1568-1637(02)00063-6 PG 22 WC Cell Biology; Geriatrics & Gerontology SC Cell Biology; Geriatrics & Gerontology GA 691HG UT WOS:000183599600004 PM 12605959 ER PT J AU Barton, C Miller, B Yaffe, K AF Barton, C Miller, B Yaffe, K TI Evaluation of the diagnosis and management of cognitive impairment in long-term care SO ALZHEIMER DISEASE & ASSOCIATED DISORDERS LA English DT Article DE dementia; long-term care ID MINIMUM DATA SET; QUALITY STANDARDS SUBCOMMITTEE; NURSING-HOME PLACEMENT; ACADEMY-OF-NEUROLOGY; ALZHEIMERS-DISEASE; DOUBLE-BLIND; INTERNATIONAL WORKSHOP; RESIDENT ASSESSMENT; PRACTICE PARAMETER; MENTAL-STATE AB The objective was to determine the prevalence of screening for cognitive impairment and its effect on diagnosis and management of cognitive impairment in a long-term care setting, especially in comparison to depressive and behavioral symptoms. The study was a prospective cohort study of medical records of 60 patients admitted to the 120 bed Veterans Administration Nursing Home in San Francisco. Screening was determined by documented results on the Mini-Mental Status Examination, Geriatric Depression Scale, and Minimum Data Set. Diagnosis and management were determined by review of medical records for provider documentation. Strategies for management were broad, including interventions such as pharmacological therapy, education, behavioral strategies, or caregiver interventions. Screening was conducted routinely for cognitive impairment (95%), depressive symptoms (95%), and behavioral symptoms (85%). Cognitive status was uncertain in 8 patients; 23 (44%) met criteria for cognitive impairment. Twelve (52%) had a differential diagnosis of cognitive impairment and 11 (48%) had evidence of strategies for management. Depressive and behavioral symptoms were equally or almost as common as cognitive impairment (44% and 25%, respectively), but evidence of a management plan was more frequently present (80% and 100%; p = 0.002 vs. with cognitive impairment). Although depressive and behavioral symptoms were frequently diagnosed and interventions initiated, the diagnosis and management of cognitive impairment were often imprecise or absent. Further research is needed to identify barriers to diagnosis and management so that greater numbers of patients can benefit from recommended strategies. C1 Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Barton, C (reprint author), Univ Calif San Francisco, Dept Neurol, Box 111G,4150 Clement St, San Francisco, CA 94121 USA. FU NIA NIH HHS [K23-AG00888, P50 AG023501] NR 33 TC 6 Z9 6 U1 1 U2 1 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 APR-JUN PY 2003 VL 17 IS 2 BP 72 EP 76 DI 10.1097/00002093-200304000-00004 PG 5 WC Clinical Neurology; Pathology SC Neurosciences & Neurology; Pathology GA 693QP UT WOS:000183730100004 PM 12794383 ER PT J AU Raitt, MH Klein, RC Wyse, DG Wilkoff, BL Beckman, K Epstein, AE Coromilas, J Friedman, PL Martins, J Ledingham, RB Greene, HL AF Raitt, MH Klein, RC Wyse, DG Wilkoff, BL Beckman, K Epstein, AE Coromilas, J Friedman, PL Martins, J Ledingham, RB Greene, HL CA AVID Invest TI Comparison of arrhythmia recurrence in patients presenting with ventricular fibrillation versus ventricular tachycardia in the antiarrhythmics versus implantable defibrillators (AVID) trial SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID CARDIAC-ARREST; SURVIVORS AB Because many episodes of ventricular fibrillation (VF) are believed to be triggered by ventricular tachycardia (VT), patients who present with VT or VF are usually grouped together in discussions of natural history and treatment. However, there are significant differences in the clinical profiles of these 2 patient groups, and some studies have suggested differences in their response to therapy. We examined arrhythmias occurring spontaneously in 449 patients assigned to implantable cardioverter-defibrillator (ICD) therapy in the Antiarrhythmics Versus Implantable Defibrillators (AVID) trial to determine whether patients who receive an ICD after VT have arrhythmias during follow-up that are different from patients who present with VF. ICD printouts were analyzed both by a committee blinded to the patients' original presenting arrhythmia and by the local investigator, During 31 +/- 14 months of follow-up, 2,673 therapies were reported. Patients who were enrolled in the AVID trial after an episode of VT were more likely to have an episode of VT (73.5% vs 30.1%, p <0.001), and were less likely to have an episode of VF (18.3% vs 28.0%, p = 0.013) than patients enrolled after an episode of VF. Adjustment for differences in ejection fraction, previous infarction, and β-blocker and antiarrhythmic therapy did not appreciably c hange the results. Ventricular arrhythmia recurrence during follow-up is different in patients who originally present with VT than in those who originally present with VF. These findings suggest there are important differences in the electrophysiologic characteristics of these 2 patient populations. (C) 2003 by Excerpta Medica, Inc. C1 Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR USA. Univ Utah, Salt Lake City, UT USA. Univ Calgary, Calgary, AB, Canada. Cleveland Clin, Cleveland, OH 44106 USA. Univ Oklahoma, Oklahoma City, OK USA. Univ Alabama, Birmingham, AL USA. Columbia Univ, New York, NY USA. Brigham & Womens Hosp, Boston, MA 02115 USA. Univ Iowa, Iowa City, IA USA. Univ Washington, Seattle, WA 98195 USA. RP Raitt, MH (reprint author), AVID Clin Trial Ctr, 1107 NE 45th St,Room 505, Seattle, WA 98105 USA. OI Raitt, Merritt/0000-0001-5638-7732; Wilkoff, Bruce/0000-0001-8905-9233 FU NHLBI NIH HHS [N01-HC-25117] NR 10 TC 20 Z9 21 U1 0 U2 2 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD APR 1 PY 2003 VL 91 IS 7 BP 812 EP 816 DI 10.1016/S0002-9149(03)00015-8 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 663EY UT WOS:000181994300006 PM 12667566 ER PT J AU Saab, S DeRosa, V Nieto, J Durazo, F Han, S Roth, B AF Saab, S DeRosa, V Nieto, J Durazo, F Han, S Roth, B TI Costs and clinical outcomes of primary prophylaxis of variceal bleeding in patients with hepatic cirrhosis: A decision analytic model SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID RANDOMIZED CONTROLLED TRIAL; ESOPHAGEAL-VARICES; COMPENSATED CIRRHOSIS; PROGNOSTIC INDICATORS; PORTAL-HYPERTENSION; NATURAL-HISTORY; LIVER-DISEASE; PROPRANOLOL; PREVENTION; HEMORRHAGE AB OBJECTIVE: Current guidelines recommend upper endoscopic screening for patients with hepatic cirrhosis and primary prophylaxis with a nonselective beta-blocker for those with large varices. However, only 25% of cirrhotics develop large varices. Thus. the aim of this study is to evaluate the most cost-effective approach for primary prophylaxis of variceal hemorrhage. METHODS: Using a Markov model, we compared the costs and clinical outcomes of three strategies for primary prophylaxis of variceal bleeding. In the first strategy, patients were given a beta-blocker without undergoing upper endoscopy. In the second strategy, patients underwent upper endoscopic screening: those found to have large varices were treated with a beta-blocker. In the third strategy, no prophylaxis was used. Selected sensitivity analyses were performed to Validate outcomes. RESULTS: Our results show screening prophylaxis was associated with a cost of $37,300 and 5.72 quality-adjusted life yr (QALYs). Universal prophylaxis was associated with a cost of $34.100 and 6.65 QALYs. The no prophylaxis strategy was associated with a cost of $36,600 and 4.84 QALYs. The incremental cost-effectiveness ratio was $800/QALY for the endoscopic strategy relative to the no prophylaxis strategy. Screening endoscopy was cost saving when the compliance, bleed risk without beta-blocker, and variceal bleed costs were increased, and when the discount rate. bleed risk on beta-blockers, and cost of upper endoscopy were decreased. In contrast, the universal prophylaxis strategy was persistently cost saving relative to the no prophylaxis strategy. In comparing the strategies, sensitivity analysis on the death rates from variceal hemorrhage did not alter outcomes. CONCLUSIONS: Our results provide economic and clinical support for primary prophylaxis of esophageal variceal bleeding in patients with hepatic cirrhosis. Universal prophylaxis with beta-blocker is preferred because it is consistently associated with the lowest costs and highest QALYs. C1 Dumont UCLA Liver Transplant Ctr, Dept Med, Div Digest Dis, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Dept Med, Los Angeles, CA 90073 USA. RP Saab, S (reprint author), Univ Calif Los Angeles, Med Ctr, Div Digest Dis, 44-138 CHS,MC 168417,10833 Le Conte Ave, Los Angeles, CA 90095 USA. NR 55 TC 45 Z9 45 U1 2 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD APR PY 2003 VL 98 IS 4 BP 763 EP 770 DI 10.1016/S0002-9270(03)00056-X PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 676LW UT WOS:000182754400010 PM 12738453 ER PT J AU Chen, DH Brkanac, Z Verlinde, CLMJ Tan, XJ Bylenok, L Nochlin, D Matsushita, M Lipe, H Wolff, J Fernandez, M Cimino, PJ Bird, TD Raskind, WH AF Chen, DH Brkanac, Z Verlinde, CLMJ Tan, XJ Bylenok, L Nochlin, D Matsushita, M Lipe, H Wolff, J Fernandez, M Cimino, PJ Bird, TD Raskind, WH TI Missense mutations in the regulatory domain of PKC gamma: A new mechanism for dominant nonepisodic cerebellar ataxia SO AMERICAN JOURNAL OF HUMAN GENETICS LA English DT Article ID PROTEIN-KINASE-C; SCA1 TRANSGENIC MICE; PHORBOL ESTER BINDING; CHROMOSOME 19Q13.4-QTER; MOLECULAR-DYNAMICS; PURKINJE-CELLS; MUTANT MICE; FAMILIES; MULTIPLE; SPINOCEREBELLAR AB We report a nonepisodic autosomal dominant (AD) spinocerebellar ataxia (SCA) not caused by a nucleotide repeat expansion that is, to our knowledge, the first such SCA. The AD SCAs currently comprise a group of greater than or equal to16 genetically distinct neurodegenerative conditions, all characterized by progressive incoordination of gait and limbs and by speech and eye-movement disturbances. Six of the nine SCAs for which the genes are known result from CAG expansions that encode polyglutamine tracts. Noncoding CAG, CTG, and ATTCT expansions are responsible for three other SCAs. Approximately 30% of families with SCA do not have linkage to the known loci. We recently mapped the locus for an AD SCA in a family (AT08) to chromosome 19q13.4-qter. A particularly compelling candidate gene, PRKCG, encodes protein kinase C gamma (PKCgamma), a member of a family of serine/threonine kinases. The entire coding region of PRKCG was sequenced in an affected member of family AT08 and in a group of 39 unrelated patients with ataxia not attributable to trinucleotide expansions. Three different nonconservative missense mutations in highly conserved residues in C1, the cysteine-rich region of the protein, were found in family AT08, another familial case, and a sporadic case. The mutations cosegregated with disease in both families. Structural modeling predicts that two of these amino acid substitutions would severely abrogate the zinc-binding or phorbol ester-binding capabilities of the protein. Immunohistochemical studies on cerebellar tissue from an affected member of family AT08 demonstrated reduced staining for both PKCg and ataxin 1 in Purkinje cells, whereas staining for calbindin was preserved. These results strongly support a new mechanism for neuronal cell dysfunction and death in hereditary ataxias and suggest that there may be a common pathway for PKCgamma-related and polyglutamine-related neurodegeneration. C1 Univ Washington, Dept Med, Sch Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Biochem, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Biol Struct, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Pathol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res, Educ & Clin Ctr, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, VISN 20 Mental Illness Res, Educ & Clin Ctr, Seattle, WA USA. Ohio State Univ, Dept Med, Columbus, OH 43210 USA. RP Raskind, WH (reprint author), Univ Washington, Dept Med, Sch Med, Box 35-7720, Seattle, WA 98195 USA. RI VERLINDE, CHRISTOPHE/J-5796-2013 FU NIEHS NIH HHS [P30 ES007033, P30ES07033] NR 33 TC 138 Z9 146 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0002-9297 J9 AM J HUM GENET JI Am. J. Hum. Genet. PD APR PY 2003 VL 72 IS 4 BP 839 EP 849 DI 10.1086/373883 PG 11 WC Genetics & Heredity SC Genetics & Heredity GA 662WT UT WOS:000181972600006 PM 12644968 ER PT J AU Arar, N Lee, S Chun, C Plaetke, R Abboud, H AF Arar, N Lee, S Chun, C Plaetke, R Abboud, H TI Gender differences in progression to end stage renal disease among diabetic Mexican-Americans SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Meeting Abstract CT Annual Clinical Meeting of the National-Kidney-Foundation CY APR 02-06, 2003 CL DALLAS, TEXAS SP Natl Kidney Fdn C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD APR PY 2003 VL 41 IS 4 MA 8 BP A13 EP A13 PG 1 WC Urology & Nephrology SC Urology & Nephrology GA 675EG UT WOS:000182679600038 ER PT J AU Skol, AD Young, KA Tsuang, DW Faraone, SV Haverstock, SL Bingham, S Prabhudesai, S Mena, F Menon, AS Yu, CE Rudell, P Pepple, J Sauter, F Baldwin, C Weiss, D Collins, J Keith, T Boehnke, M Schellenberg, GD Tsuang, MT AF Skol, AD Young, KA Tsuang, DW Faraone, SV Haverstock, SL Bingham, S Prabhudesai, S Mena, F Menon, AS Yu, CE Rudell, P Pepple, J Sauter, F Baldwin, C Weiss, D Collins, J Keith, T Boehnke, M Schellenberg, GD Tsuang, MT TI Modest evidence for linkage and possible confirmation of association between NOTCH4 and schizophrenia in a large veterans affairs cooperative study sample SO AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS LA English DT Article DE NOTCH4; chromosome 6; schizophrenia; association; linkage; genetics ID PEDIGREE DISEQUILIBRIUM TEST; SIB-PAIR LINKAGE; CHROMOSOME 6P; SUSCEPTIBILITY LOCUS; DIAGNOSTIC INTERVIEW; GENETIC-LINKAGE; POLYMORPHISM; FAMILIES; SUPPORT; PROGRAM AB Wei and Hemmings [2000: Nat Genet 25:376-377], using 80 British parent-offspring trios, identified a number of NOTCH4 variants and haplotypes that showed statistically significant evidence of association to schizophrenia. Specifically, the 10 repeat allele of a (CTG)(n) marker and the 8 repeat allele of a (TAA)(n) marker demonstrated excess transmission to affected individuals; SNP2(1) and haplotypes SNP2-(CTG) and SNP1(2)-SNP2-(CTG)(n) also showed significant associations. In an attempt to replicate these findings, we tested for linkage and association between the same five markers used by Wei and Hemmings in 166 families collected from a multi-center study conducted by the Department of Veterans Affairs (DVA) Cooperative Study Program (CSP). The families include 392 affected subjects (schizophrenia or schizoaffective disorder, depressed) and 216 affected sibling pairs. The families represent a mix of European Americans (n=62, 37%), African Americans (n=60, 36%), and racially mixed or other races (n=44, 27%). We identified moderate evidence for linkage in the pooled race sample (LOD=1.25) and found excess transmission of the 8 (P=0.06) and 13 (P=0.04) repeat alleles of the (TAA)(n) marker to African American schizophrenic subjects. The 8 and 13 repeat alleles were previously identified to be positively associated with schizophrenia by Wei and Hemmings [2000: Nat Genet 25:376-377] and Sklar et al. [2001: Nat Genet 28:126-128], respectively. (C) 2003 Wiley-Liss, Inc. C1 VAPSHCS, GRECC 182, Seattle, WA 98108 USA. Univ Michigan, Dept Biostat, Ann Arbor, MI 48109 USA. Univ Michigan, Ctr Stat Genet, Ann Arbor, MI 48109 USA. Vet Affairs Med Ctr, Waco, TX USA. Vet Affairs Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Brockton W Roxbury Vet Affairs Med Ctr, Brockton, MA USA. Harvard Univ, Sch Med, Massachusetts Mental Hlth Ctr, Dept Psychiat, Cambridge, MA 02138 USA. Harvard Univ, Inst Psychiat Epidemiol & Genet, Boston, MA 02115 USA. Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA. Vet Affairs Med Ctr, Augusta, GA USA. Vet Affairs Med Ctr, Cooperat Studies Program Coordinating Ctr, Perry Point, MD USA. Vet Affairs Med Ctr, Danville, IL USA. Vet Affairs Med Ctr, Tuskegee, AL USA. Univ Washington, Dept Gerontol, Seattle, WA 98195 USA. Univ Washington, Dept Geriatr Med, Seattle, WA 98195 USA. Vet Affairs Med Ctr, New Orleans, LA USA. Vet Affairs Med Ctr, Northport, NY USA. RP Schellenberg, GD (reprint author), VAPSHCS, GRECC 182, 1660 S Columbian Way, Seattle, WA 98108 USA. RI Tsuang, Debby/L-7234-2016 OI Tsuang, Debby/0000-0002-4716-1894; Faraone, Stephen/0000-0002-9217-3982 NR 42 TC 26 Z9 27 U1 1 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0148-7299 J9 AM J MED GENET B JI Am. J. Med. Genet. B PD APR 1 PY 2003 VL 118B IS 1 BP 8 EP 15 DI 10.1002/ajmg.b.10055 PG 8 WC Genetics & Heredity; Psychiatry SC Genetics & Heredity; Psychiatry GA 670HQ UT WOS:000182401800002 PM 12627457 ER PT J AU Cornia, PB Amory, JK Fraser, S Saint, S Lipsky, BA AF Cornia, PB Amory, JK Fraser, S Saint, S Lipsky, BA TI Computer-based order entry decreases duration of indwelling urinary catheterization in hospitalized patients SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID DECISION-SUPPORT SYSTEMS; PREVENTIVE CARE; TRACT INFECTION; RISK-FACTORS; BACTERIURIA; PERFORMANCE; PHYSICIANS C1 Univ Washington, Sch Med, Primary & Specialty Med Serv, Seattle, WA 98195 USA. Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Ann Arbor VA Med Ctr, Ann Arbor, MI USA. Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA. Univ Michigan, Patient Safety Enhancement Program, Ann Arbor, MI 48109 USA. RP Cornia, PB (reprint author), Gen Internal Med Clin, S-111,1660 S Columbian Way, Seattle, WA 98108 USA. OI Lipsky, Benjamin A./0000-0001-9886-5114 FU AHRQ HHS [P20-HS11540] NR 20 TC 67 Z9 68 U1 0 U2 2 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD APR 1 PY 2003 VL 114 IS 5 BP 404 EP 407 DI 10.1016/S0002-9343(02)01568-1 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 670XY UT WOS:000182436400010 PM 12714131 ER PT J AU Clow, KA Giraud, GD Ogden, BE Brooks, VL AF Clow, KA Giraud, GD Ogden, BE Brooks, VL TI Pregnancy alters hemodynamic responses to hemorrhage in conscious rabbits SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE cardiac output; stroke volume; total peripheral resistance; mean arterial pressure; femoral conductance ID PRESSURE AB Pregnant animals are less able to maintain mean arterial pressure (MAP) during hemorrhage compared with nonpregnant animals, but the hemodynamic basis of this difference is unknown. The hypothesis that pregnancy attenuates responses of cardiac output, as well as total peripheral resistance (TPR) and femoral conductance, to hemorrhage was tested in conscious rabbits in both the pregnant and nonpregnant state (n = 10). During continuous slow blood loss (2% of the initial blood volume per minute), MAP was maintained initially in both groups. However, MAP then abruptly decreased to <45 mmHg in all animals after a smaller percentage of the initial blood volume was removed in pregnant compared with nonpregnant rabbits (43.6 +/- 1.7%, nonpregnant; 29.6 +/- 2.2%, pregnant; P < 0.005). The more rapid transition to hypotension exhibited by pregnant rabbits was associated with greater initial falls in cardiac output (-56 +/- 10 ml/min, nonpregnant; -216 +/- 33 ml/min, pregnant; P < 0.005) and stroke volume (0.8 +/- 0.1 ml/beat, nonpregnant; -1.3 +/- 0.1 ml/beat, pregnant; P < 0.05). In addition, the increase in TPR as a function of the decrease in cardiac output was markedly attenuated (P < 0.0001) during pregnancy. Whereas femoral conductance decreased in nonpregnant rabbits, it did not change significantly in pregnant animals. In conclusion, the lesser ability of conscious pregnant rabbits to maintain MAP during hemorrhage is due largely to a greater decrease in cardiac output but also to inadequate reflex increases in TPR, possibly in part in the femoral vascular bed. C1 Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Comparat Med, Portland, OR 97239 USA. Portland VA Med Ctr, Dept Med, Div Cardiol, Portland, OR 97207 USA. RP Brooks, VL (reprint author), Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, L-334,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM brooksv@ohsu.edu FU NHLBI NIH HHS [HL-35872, HL-39923] NR 21 TC 7 Z9 7 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 EI 1522-1539 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD APR PY 2003 VL 284 IS 4 BP H1110 EP H1118 DI 10.1152/ajpheart.00626.2002 PG 9 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 653GB UT WOS:000181425900010 PM 12595295 ER PT J AU Figlewicz, DP AF Figlewicz, DP TI Adiposity signals and food reward: expanding the CNS roles of insulin and leptin SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Review DE central nervous system; dopamine; food intake ID BLOOD-BRAIN-BARRIER; CENTRAL-NERVOUS-SYSTEM; OBESE ZUCKER RATS; CONDITIONED PLACE PREFERENCE; CULTURED FETAL NEURONS; BODY-WEIGHT; ENERGY-BALANCE; INTRAVENTRICULAR INSULIN; NUCLEUS-ACCUMBENS; GENE-EXPRESSION AB The hormones insulin and leptin have been proposed to act in the central nervous system (CNS) as adiposity signals as part of a theoretical negative feedback loop that senses the caloric stores of an animal and orchestrates adjustments in energy balance and food intake. Much research has provided support for both the existence of such a feedback loop and the specific roles that insulin and leptin may play. Most studies have focused on hypothalamic sites, which historically are implicated in the regulation of energy balance, and on the brain stem, which is a target for neural and humoral signals relating to ingestive acts. More recent lines of research, including studies from our lab, suggest that in addition to these CNS sites, brain reward circuitry may be a target for insulin and leptin action. These studies are reviewed together here with the goals of providing a historical overview of the findings that have substantiated the originally hypothesized negative feedback model and of opening up new lines of investigation that will build on these findings and allow further refinement of the model of adiposity signal/CNS feedback loop. The understanding of how motivational circuitry and its endocrine or neuroendocrine modulation contributes to normal energy balance regulation should expand possibilities for future therapeutic approaches to obesity and may lead to important insights into mental illnesses such as substance abuse or eating disorders. C1 VA Puget Sound Hlth Care Syst, Seattle Div, Seattle, WA 98108 USA. Univ Washington, Dept Psychol, Seattle, WA 98195 USA. RP Figlewicz, DP (reprint author), VA Puget Sound Hlth Care Syst, Seattle Div, 1660 So Columbian Way, Seattle, WA 98108 USA. EM latte@u.washington.edu FU NIDDK NIH HHS [DK-40963] NR 132 TC 132 Z9 137 U1 2 U2 9 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6119 EI 1522-1490 J9 AM J PHYSIOL-REG I JI Am. J. Physiol.-Regul. Integr. Comp. Physiol. PD APR PY 2003 VL 284 IS 4 BP R882 EP R892 DI 10.1152/ajpregu.00602.2002 PG 11 WC Physiology SC Physiology GA 653GA UT WOS:000181425800002 PM 12626355 ER PT J AU Wallace, A Ratcliffe, M AF Wallace, A Ratcliffe, M TI Ventricular energetics in endoventricular circular patch plasty for dyskinetic anterior left ventricular aneurysm - Invited commentary SO ANNALS OF THORACIC SURGERY LA English DT Editorial Material C1 San Francisco Vet Affairs Med Ctr, VAMC Surg 112D, San Francisco, CA 94121 USA. RP Wallace, A (reprint author), San Francisco Vet Affairs Med Ctr, VAMC Surg 112D, 4150 Clement St, San Francisco, CA 94121 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 0003-4975 J9 ANN THORAC SURG JI Ann. Thorac. Surg. PD APR PY 2003 VL 75 IS 4 BP 1208 EP 1209 AR PII S0003-4975(03)00122-X DI 10.1016/S0003-4975(03)00122-X PG 2 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 662KX UT WOS:000181946800030 ER PT J AU Andes, D Marchillo, K Lowther, J Bryskier, A Stamstad, T Conklin, R AF Andes, D Marchillo, K Lowther, J Bryskier, A Stamstad, T Conklin, R TI In vivo pharmacodynamics of HMR 3270, a glucan synthase inhibitor, in a murine candidiasis model SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID BLOOD-STREAM INFECTIONS; ANTIFUNGAL AGENTS; STREPTOCOCCUS-PNEUMONIAE; UNITED-STATES; MOUSE MODELS; OTITIS-MEDIA; ECHINOCANDIN; ALBICANS; FLUCONAZOLE; ASPERGILLOSIS AB In vivo pharmacokinetic/pharmacodynamic characterization for numerous antibacterial compounds has had a significant impact upon optimal dosing regimen design and the development of in vivo susceptibility breakpoints. More recently, similar characterization has been undertaken for antifungal drug classes. Very little is known of these pharmacodynamic relationships for the new echinocandin class of compounds. We utilized a neutropenic murine model of disseminated candidiasis to describe the time course antifungal activity of HMR 3270, a new glucan synthase inhibitor. Single-dose in vivo time kill studies with four 16-fold escalating doses demonstrated concentration-dependent killing when drug levels in serum were more than four times the MIC. Postantifungal effects were dose dependent, ranging from 8 to 80 h duration. Multiple dosing regimen studies utilized six total doses, four dosing intervals, and a treatment duration of 6 days. Shortening the dosing interval from every 144 h (q144h) to q36h resulted in a fourfold rise in the dose necessary to achieve a net fungistatic effect. The peak/MIC ratio most strongly correlated with treatment outcomes (peak/MIC ratio, R 2 = 98%; ratio of the area under the concentration-time curve from 0 to 24 h to the MIC, R-2 = 79%, percentage of time above the MIC, R-2 = 61%). Studies were also conducted with five additional Candida albicans isolates to determine if a similar peak/MIC ratio was associated with efficacy. In vivo concentration-dependent killing was similarly observed in studies with each of the additional isolates. The peak/MIC ratio necessary to produce efficacy was relatively similar among the strains studied (P = 0.42). The peak/MIC ratio (mean standard deviation) necessary to achieve a fungistatic effect was 3.72 +/- 1.84, and the ratio necessary to achieve maximal killing was near 10. C1 Univ Wisconsin, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. Aventis Pharmaceut, Romainville, France. RP Andes, D (reprint author), Univ Wisconsin, 600 Highland Ave,Room H4-572, Madison, WI 53792 USA. NR 31 TC 68 Z9 76 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD APR PY 2003 VL 47 IS 4 BP 1187 EP 1192 DI 10.1128/AAC.47.4.1187-1192.2003 PG 6 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 660PR UT WOS:000181842000002 PM 12654645 ER PT J AU Andes, D Marchillo, K Stamstad, T Conklin, R AF Andes, D Marchillo, K Stamstad, T Conklin, R TI In vivo pharmacodynamics of a new triazole, ravulconazole, in a murine candidiasis model SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID IN-VITRO; STREPTOCOCCUS-PNEUMONIAE; ANTIFUNGAL AGENTS; PROTEIN-BINDING; AMPHOTERICIN-B; OTITIS-MEDIA; FLUCONAZOLE; ALBICANS; ITRACONAZOLE; INFECTIONS AB In vivo studies have characterized the pharmacodynamic characteristics of the triazole fluconazole. These investigations demonstrated that the ratio of the area under the concentration-time curve from 0 to 24 h to the MIC (24-h AUC/MIC ratio) is the critical pharmacokinetic/pharmacodynamic (PK/PD) parameter associated with treatment efficacy. Further analysis demonstrated that a fluconazole 24-h AUC/MIC ratio of 20 to 25 was predictive of treatment success in both experimental models and clinical trials. We used a neutropenic murine model of disseminated Candida albicans infection to similarly characterize the time course activity of the new triazole ravuconazole. The PK/PD parameters (percent time above the MIC, AUC/MIC ratio, and peak level in serum/MIC ratio) were correlated with in vivo efficacy, as measured by organism number in kidney cultures after 24 and 72 h of therapy. Ravuconazole kinetics and protein binding were performed in neutropenic infected mice. Peak/dose and AUC/dose values ranged from 0.03 to 0.04 and 0.30 to 0.34, respectively. Serum elimination half-life ranged from 3.9 to 4.8 h. Protein binding was 95.8%. Single-dose postantifungal effect studies demonstrated prolonged suppression of organism regrowth after serum ravuconazole levels had fallen below the MIC. Treatment efficacies with the five dosing intervals studied were similar, supporting the argument for the AUC/MIC ratio as the PK/PD parameter predictive of efficacy. Nonlinear regression analysis also suggested that the AUC/MIC ratio was strongly predictive of treatment outcomes (AUC/MIC ratio, R-2 = 91%; peak/MIC ratio, R-2 = 85%; percent time above the MIC, R-2 = 47 to 65%). Similar studies were conducted with seven additional C. albicans isolates with various ravuconazole susceptibilities (MIC, 0.016 to 0.12 mug/ml) to determine if a similar 24-h AUC/MIC ratio was associated with efficacy. The ravuconazole free-drug AUC/MIC ration were similar for all of the organisms studied (10 to 36; mean +/- SD = 20.3 +/- 8.2; P = 0.43). These free-drug AUC/MIC ratios are similar to those observed for fluconazole in this model. C1 Univ Wisconsin, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. RP Andes, D (reprint author), Univ Wisconsin, 600 Highland Ave,Room H4-572, Madison, WI 53792 USA. NR 30 TC 67 Z9 70 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD APR PY 2003 VL 47 IS 4 BP 1193 EP 1199 DI 10.1128/AAC.47.4.1193-1199.2003 PG 7 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 660PR UT WOS:000181842000003 PM 12654646 ER PT J AU Gonzalez, GM Tijerina, R Najvar, LK Bocanegra, R Rinaldi, MG Loebenberg, D Graybill, JR AF Gonzalez, GM Tijerina, R Najvar, LK Bocanegra, R Rinaldi, MG Loebenberg, D Graybill, JR TI Activity of posaconazole against Pseudallescheria boydii: In vitro and in vivo assays SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID INFECTION; SCH56592; MODEL AB Thirty isolates of Pseudallescheria boydii were tested to compare the in vitro activity of posaconazole with those of fluconazole and itraconazole, using NCCLS methods. Posaconazole was evaluated in an immunosuppressed mouse model of disseminated pseudallescheriasis. Posaconazole was more effective than itraconazole and as effective as fluconazole in preventing death and significantly reducing the CFU of P. boydii from tissues. C1 Univ Autonoma Nuevo Leon, Dept Microbiol, Fac Med, Monterrey 64460, Nuevo Leon, Mexico. Univ Texas, Hlth Sci Ctr, Div Infect Dis 7881, Dept Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78229 USA. Schering Plough Corp, Inst Res, Kenilworth, NJ 07033 USA. RP Gonzalez, GM (reprint author), Univ Autonoma Nuevo Leon, Dept Microbiol, Fac Med, Madero & Dr Eduardo A Pequeno S-N,Colonia Mitras, Monterrey 64460, Nuevo Leon, Mexico. NR 14 TC 31 Z9 33 U1 0 U2 2 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD APR PY 2003 VL 47 IS 4 BP 1436 EP 1438 DI 10.1128/AAC.47.4.1436-1438.2003 PG 3 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 660PR UT WOS:000181842000044 PM 12654687 ER PT J AU Baer, JS Sampson, PD Barr, HM Connor, PD Streissguth, AP AF Baer, JS Sampson, PD Barr, HM Connor, PD Streissguth, AP TI A 21-year longitudinal analysis of the effects of prenatal alcohol exposure on young adult drinking SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Annual Meeting of the Research-Society-on-Alcoholism CY JUN 23-28, 2001 CL MONTREAL, CANADA SP Res Soc Alcoholism ID MATERNAL SMOKING; PREGNANCY; RATS; ETHANOL; DRUG; RESPONSIVENESS; DEPENDENCE; DISORDER; INUTERO; SENSITIVITY AB Background: Prenatal alcohol exposure may be a risk factor for the development of alcohol problems in humans. Methods: We use data beginning with interviews of women in prenatal care at midpregnancy to predict alcohol use and alcohol-related problems in their offspring now aged 21 years. Maternal drinking during pregnancy was assessed from November 4, 1974, through October 2, 1975, along with measures of maternal smoking, use of caffeine and other drugs, and demographic factors. Family history of alcohol problems was assessed from interviews with parents when offspring were 14 years of age and updated when offspring were 21 years of age. Measures of parental use of alcohol and other drugs and many aspects of the family environment were assessed at 7 different ages, prenatally through 21 years. Young adult offspring (age, 21 years [N = 433]) provided self-reports of drinking quantity and frequency and completed the Alcohol Dependence Scale as a measure of alcohol-related problems and dependence. Results: Univariate, partial least squares, and regression analyses indicate that prenatal alcohol exposure is significantly associated with alcohol problems at 21 years of age. The relationship persists independent of the effects of family history of alcohol problems, nicotine exposure, other prenatal exposures, and postnatal environmental factors including parental use of other drugs. Prenatal nicotine exposure was not associated with alcohol problems by offspring at 21 years of age. Conclusions: Prenatal alcohol exposure is a risk factor for the development of drinking problems in humans. Potential mechanisms for the role of fetal exposure and the development of alcohol problems deserve study. C1 Univ Washington, Dept Psychol, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Stat, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. RP Streissguth, AP (reprint author), Fetal Alcohol & Drug Unit, 180 Nickerson St, Seattle, WA 98109 USA. FU PHS HHS [R3701455-01-25] NR 48 TC 165 Z9 169 U1 2 U2 12 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD APR PY 2003 VL 60 IS 4 BP 377 EP 385 DI 10.1001/archpsyc.60.4.377 PG 9 WC Psychiatry SC Psychiatry GA 664ZW UT WOS:000182096000007 PM 12695315 ER PT J AU Graham, SH Hickey, RW AF Graham, SH Hickey, RW TI Cyclooxygenases in central nervous system diseases - A special role for cyclooxygenase 2 in neuronal cell death SO ARCHIVES OF NEUROLOGY LA English DT Article ID ACTIVATED RECEPTOR-GAMMA; MITOGEN-INDUCIBLE CYCLOOXYGENASE; 15-DEOXY-DELTA(12,14)-PROSTAGLANDIN J(2); ALZHEIMERS-DISEASE; PPAR-GAMMA; BRAIN; EXPRESSION; LIGAND; DIFFERENTIATION; CONTRIBUTES C1 Vet Affairs Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Pediat, Pittsburgh, PA 15261 USA. RP Graham, SH (reprint author), Vet Affairs Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Univ Dr C, Pittsburgh, PA 15240 USA. FU NICHD NIH HHS [K08 HD040848, K08 HD40848]; NINDS NIH HHS [R01 NS37459, R01 NS037459, R01 NS037459-06] NR 24 TC 30 Z9 33 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD APR PY 2003 VL 60 IS 4 BP 628 EP 630 DI 10.1001/archneur.60.4.628 PG 3 WC Clinical Neurology SC Neurosciences & Neurology GA 667CV UT WOS:000182214000024 PM 12707081 ER PT J AU Yueh, B Piccirillo, JF AF Yueh, B Piccirillo, JF TI On equivalence trials and alternative medicine SO ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY LA English DT Editorial Material ID SURGERY; ISSUES C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Yueh, B (reprint author), VA Puget Sound Hlth Care Syst, 112OTO,1660 S Columbian Way, Seattle, WA 98108 USA. OI Yueh, Bevan/0000-0003-1380-1053 NR 11 TC 3 Z9 4 U1 2 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0886-4470 J9 ARCH OTOLARYNGOL JI Arch. Otolaryngol. Head Neck Surg. PD APR PY 2003 VL 129 IS 4 BP 403 EP 404 DI 10.1001/archotol.129.4.403 PG 2 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 665TK UT WOS:000182137200002 PM 12707185 ER PT J AU Davis, GE Murphy, MP Yueh, B Weymuller, EA AF Davis, GE Murphy, MP Yueh, B Weymuller, EA TI A complication from neurocranial restructuring - Nasal septum fracture SO ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY LA English DT Article AB We report a case of nasal septum fracture after a complementary and alternative medicine procedure called neurocranial restructuring (NCR) that was used to treat a patient with chronic sinusitis. We initially evaluated this patient, obtained a computed tomographic scan, and recommended frontal sinus obliteration. The patient opted to see an alternative medicine practitioner, who performed NCR. This treatment involves the expansion of endonasal balloons in the nasopharynx that are used to "alter the skeletal structure." During the NCR procedure, the patient experienced severe midface pain and a crunching sound. Because of persisting pain, she presented to the emergency department, at which time another computed tomographic scan showed new septal fractures. The patient ultimately received a frontal sinus obliteration, bilateral revision antrostomies, and repositioning of her nasal septum. To our knowledge, this is the first published case report of a complication from NCR. C1 Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. Univ Washington, Hlth Serv, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA USA. RP Davis, GE (reprint author), Univ Washington, Dept Otolaryngol Head & Neck Surg, Box 356515, Seattle, WA 98195 USA. OI Yueh, Bevan/0000-0003-1380-1053 FU NIDCD NIH HHS [DC-00018] NR 7 TC 2 Z9 2 U1 1 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0886-4470 J9 ARCH OTOLARYNGOL JI Arch. Otolaryngol. Head Neck Surg. PD APR PY 2003 VL 129 IS 4 BP 472 EP 474 DI 10.1001/archotol.129.4.472 PG 3 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 665TK UT WOS:000182137200014 PM 12707197 ER PT J AU Covin, R O'Brien, M Grunwald, G Brimhall, B Sethi, G Walczak, S Reiquam, W Rajagopalan, C Shroyer, AL AF Covin, R O'Brien, M Grunwald, G Brimhall, B Sethi, G Walczak, S Reiquam, W Rajagopalan, C Shroyer, AL TI Factors affecting transfusion of fresh frozen plasma, platelets, and red blood cells during elective coronary artery bypass graft surgery SO ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE LA English DT Article ID MULTIVARIATE-ANALYSIS; CONSERVATION; ASPIRIN; REQUIREMENTS; DETERMINANTS; VARIABILITY; OPERATIONS; REDUCTION; PRODUCTS; MODEL AB Context.-The ability to predict the use of blood components during surgery will improve the blood bank's ability to provide. efficient service. Objective.-Develop prediction models using preoperative risk factors to assess blood component usage during elective coronary artery bypass graft surgery (CABG). Design.-Eighty-three preoperative, multidimensional risk variables were evaluated for patients undergoing elective CARG-only surgery. Main Outcome Measures.-The study endpoints included transfusion of fresh frozen plasma (FFP), platelets, and red blood cells (RBC). Multivariate logistic regression models were built to assess the predictors related to each of these endpoints. Setting.-Department of Veterans Affairs (VA) health care system. Patients.-Records for 3034 patients undergoing elective CARG-only procedures; 1033 patients received a blood component transfusion during CABG. Results.-Previous heart surgery and decreased ejection fraction were significant predictors of transfusion for all blood components. Platelet count was predictive of platelet transfusion and FFP utilization. Baseline hemoglobin was a predictive factor for more than 2 units of RBC. Some significant hospital variation was noted beyond that predicted by patient risk factors alone. Conclusions.-Prediction models based on preoperative variables may facilitate blood component management for patients undergoing elective CABG. Algorithms are available to predict transfusion resources to assist blood banks in improving responsiveness to clinical needs. Predictors for use of each blood component may be identified prior to elective CABG for VA patients. C1 Denver Vet Affairs Med Ctr, Dept Cardiac Res, Denver, CO 80220 USA. Denver Vet Affairs Med Ctr, Dept Pathol, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Sch Med, Dept Pathol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Sch Med, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Sch Med, Dept Prevent Med & Biometr, Denver, CO 80262 USA. Univ Arizona, Hlth Sci Ctr, Dept Cardiothorac Surg, Tucson, AZ USA. Tucson Vet Affairs Med Ctr, Tucson, AZ USA. Univ Colorado, Coll Business & Adm, Denver, CO 80202 USA. RP Shroyer, AL (reprint author), Denver Vet Affairs Med Ctr, Dept Cardiac Res, 1055 Clermont St, Denver, CO 80220 USA. RI Shroyer, Annie Laurie/B-8836-2016 OI Shroyer, Annie Laurie/0000-0001-6461-0623 NR 32 TC 33 Z9 33 U1 0 U2 0 PU COLLEGE AMER PATHOLOGISTS PI NORTHFIELD PA C/O KIMBERLY GACKI, 325 WAUKEGAN RD, NORTHFIELD, IL 60093-2750 USA SN 0003-9985 J9 ARCH PATHOL LAB MED JI Arch. Pathol. Lab. Med. PD APR PY 2003 VL 127 IS 4 BP 415 EP 423 PG 9 WC Medical Laboratory Technology; Medicine, Research & Experimental; Pathology SC Medical Laboratory Technology; Research & Experimental Medicine; Pathology GA 667YE UT WOS:000182261800008 PM 12683868 ER PT J AU Hastings, JD Fanucchi, ER Burns, SP AF Hastings, JD Fanucchi, ER Burns, SP TI Wheelchair configuration and postural alignment in persons with spinal cord injury SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Spinal-Injury-Association CY MAY 18, 2001 CL LONG BEACH, CALIFORNIA SP Amer Spinal Injury Assoc DE rehabilitation; shoulder; spinal cord injuries; spine; wheelchairs ID BALANCE CONTROL; INDIVIDUALS; PAIN; TETRAPLEGIA; POSITION; PRESSURE AB Objective: To determine whether postural alignment and shoulder flexion range differ for persons with spinal cord injury (SCI) seated in wheelchairs with standard configurations versus wheelchairs with posterior seat inclination and a low backrest set perpendicular to the floor. Design: Prospective repeated-measures study. Setting: Outpatient SCI clinic. Participants: Fourteen subjects with C6-T10 motor-complete SCI. Interventions: Subjects sat in 3 manual wheelchairs: standard setup E&J Premier (S1), standard setup Quickie Breezy (S2), and test configuration Quickie TNT (T) with posterior seat inclination and a low backrest set perpendicular to the floor. Main Outcome Measures: Shoulder and neck alignment and pelvic tilt were determined from sagittal plane digital photographs at rest and with maximal vertical reach. Results: At rest, T produced less shoulder protraction than either standard configuration (difference between the mean values, S1: 1.6cm, P=.048; S2: 1.2cm, P=.013). SI and S2 showed a greater head-forward position than T (differences between the mean values, S1: 6.5degrees, P=.008; S2: 6.3degrees, P=.013). T allowed greater humeral flexion than S2 (difference between the mean values: 3.7degrees, P=.036) and greater vertical reach above the seat plane than either conventional configuration (differences between the mean values, S1: 4.7cm, P=.005; S2: 4.1cm, P=.002). The indirect pelvic tilt measurement showed a trend (P=.06) toward greater posterior pelvic tilt with S1 and S2. Conclusion: The alternate configuration produces more vertical postural alignment and greater reach ability versus the standard factory setup wheelchairs. C1 Univ Puget Sound, Phys Therapy Dept, Tacoma, WA 98416 USA. Vet Affairs Puget Sound Hlth Care Syst, Spinal Cord Injury Serv, Seattle, WA USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Hastings, JD (reprint author), Univ Puget Sound, Phys Therapy Dept, 1500 N Warner, Tacoma, WA 98416 USA. NR 24 TC 20 Z9 21 U1 0 U2 3 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD APR PY 2003 VL 84 IS 4 BP 528 EP 534 DI 10.1053/apmr.2003.50036 PG 7 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 664QL UT WOS:000182071700010 PM 12690591 ER PT J AU Livingston, EH Fink, AS AF Livingston, EH Fink, AS TI Quality of life - Cost and future of bariatric surgery SO ARCHIVES OF SURGERY LA English DT Article; Proceedings Paper CT Annual Meeting of the New-England-Surgical-Society CY SEP 27-29, 2002 CL DIXVILLE NOTCH, NEW HAMPSHIRE SP New England Surg Soc ID GASTRIC BYPASS-SURGERY; MORBIDLY OBESE PATIENTS; INDUCED WEIGHT-LOSS; HEALTH-CARE COSTS; BODY-MASS INDEX; OF-LIFE; UNITED-STATES; US ADULTS; OVERWEIGHT; MORTALITY AB Obesity is increasing in epidemic proportions internationally.(1) Health care costs for the teatment of obesity and its complications have also increased. Recent estimates are about $70 billion or 9.4% of all health care costs are attributable to treating obesity and obesity-related complications.(2,3) As the population's weight has become heavier,(46) the prevalence of morbid obesity has dramatically increased.(7) Morbid obesity is associated with significant medical complications such as sleep apnea, hypertension, osteoarthritis, diabetes mellitus, and other degenerative conditions.(8-18) Although these disorders respond to weight loss, individuals who have morbid obesity rarely achieve long-term weight loss with dietary interventions.(19) Bariatric surgery remains the only method that culminates in sustained weight loss with. subsequent control of obesity-related complications.(20) Bariatric surgery effectively treats obesity-induced diabetes mellitus,(21,22) hypertension,(23-26) hyperlipidemia.(27-32) osteoarthritis, pulmonary hypertension,(33) and sleep apnea.(34-36) The effects of obesity on health and, similarly, the effectiveness of bariatric surgery in treating obesity-related comorbid conditions is well documented. C1 Vet Affairs Greater Los Angeles Hlth Care Syst, Dept Surg, Los Angeles, CA USA. Emory Univ, Atlanta, GA 30322 USA. Vet Affairs Med Ctr, Atlanta, GA 30033 USA. RP Livingston, EH (reprint author), Univ Texas, SW Med Ctr, Dept Gastrointestinal & Endocrine Surg, 5323 Harry Hines Blvd,Room E7-126, Dallas, TX 75390 USA. NR 62 TC 34 Z9 35 U1 2 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD APR PY 2003 VL 138 IS 4 BP 383 EP 388 DI 10.1001/archsurg.138.4.383 PG 6 WC Surgery SC Surgery GA 663WV UT WOS:000182030500006 PM 12686524 ER PT J AU Cummings, DE Shannon, MH AF Cummings, DE Shannon, MH TI Roles for ghrelin in the regulation of appetite and body weight SO ARCHIVES OF SURGERY LA English DT Article; Proceedings Paper CT Annual Meeting of the New-England-Surgical-Society CY SEP 27-29, 2002 CL DIXVILLE NOTCH, NEW HAMPSHIRE SP New England Surg Soc ID VERTICAL BANDED GASTROPLASTY; GROWTH-HORMONE SECRETAGOGUE; QUALITY-OF-LIFE; ROUX-EN-Y; AGOUTI-RELATED PROTEIN; PRADER-WILLI-SYNDROME; FOOD-INTAKE; GASTRIC BYPASS; MORBID-OBESITY; MESSENGER-RNA AB Obesity is a global epidemic that has proven daunting to prevent and treat. The prevalences of obesity (body mass index [BMI] > 30) and morbid obesity (BMI > 40) among American adults are about 30% and 5%, respectively.(1) Obesity is so strongly associated with medical comorbidities and mortality that it has begun to overtake infectious diseases as the most significant contributor to ill health worldwide.(2,3) Overweight persons are also frequently stigmatized and consequently suffer from low self-esteem. Their motivation to achieve and maintain weight loss is often Herculean. In 1 study of 47 patients who had durably lost 45 kg or more after bariatric surgery, 100% preferred to be deaf, dyslexic, diabetic, or have heart disease rather than be obese again; leg amputation and blindness were preferred by 91.5% and 89.4%, respectively.(4) The traditional treatment paradigm of diet, exercise, and medication generally achieves no more than a 5% to 10% reduction in body weight,5,6 and recidivism after such weight loss exceeds 90% within 5 years. 1,8 This failure arises because a robust homeostatic system of body weight regulation compensates for weight loss with increased hunger and decreased energy expenditure.(9-11) The molecular mediators of these compensatory responses to weight loss are potential targets for antiobesity treatments. Ghrelin is a potent orexigenic (appetite-stimulating) peptide that seems to participate in the adaptive response to weight loss. Therefore, ghrelin holds promise as a target for both medical and surgical approaches to obesity. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. RP Cummings, DE (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, 1660 S Columbian Way,S-111 Endo, Seattle, WA 98108 USA. NR 111 TC 155 Z9 165 U1 3 U2 9 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD APR PY 2003 VL 138 IS 4 BP 389 EP 396 DI 10.1001/archsurg.138.4.389 PG 8 WC Surgery SC Surgery GA 663WV UT WOS:000182030500007 PM 12686525 ER PT J AU Lefler, D Mukhin, YV Pettus, T Leeb-Lundberg, LMF Garnovskaya, MN Raymond, JR AF Lefler, D Mukhin, YV Pettus, T Leeb-Lundberg, LMF Garnovskaya, MN Raymond, JR TI Jak2 and Ca2+/calmodulin are key intermediates for bradykinin B-2 receptor-mediated activation of Na+/H+ exchange in KNRK and CHO cells SO ASSAY AND DRUG DEVELOPMENT TECHNOLOGIES LA English DT Article ID SMOOTH-MUSCLE-CELLS; PROTEIN-KINASE; ISOFORM-1 NHE1; PHOSPHORYLATION; CALCIUM; TRANSDUCTION; INHIBITION; EXPRESSION; P90(RSK) AB Na+/H+ exchangers are ubiquitous in mammalian cells, carrying out key functions, such as cell volume defense, acid-base homeostasis, and regulation of the cytoskeleton. We used two screening technologies (FLIPR and microphysiometry) to characterize the signal transduction pathway used by the bradykinin beta(2) receptor to activate Na+/H+ exchange in two cell lines, KNRK and CHO. In both cell types, beta(2) receptor activation resulted in rapid increases in the rate of proton extrusion that were sodium-dependent and could be blocked by the Na+/H+ exchange inhibitors EIPA and MIA or by replacing extracellular sodium with TMA. Activation of Na+/H+ exchange by bradykinin was concentration-dependent and could be blocked by the selective beta(2) receptor antagonist HOE140, but not by the beta(1) receptor antagonist des-Arg(10)-HOE140. Inhibitors of Jak2 tyrosine kinase (genistein and AG490) and of CAM (W-7 and calmidazolium) attenuated bradykinin-induced activation of Na+/H+ exchange. Bradykinin induced formation of a complex between CAM and Jak2, supporting a regulatory role for Jak2 and CAM in the activation of Na+/H+ exchange in KNRK and CHO cells. We propose that this pathway (beta(2) receptor --> Jak2 --> CAM --> Na+/H+ exchanger) is a fundamental regulator of Na+/H+ exchange activity. C1 Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pharmacol, Charleston, SC 29425 USA. Ralph H Johnson Vet Adm Med Ctr, Med Serv, Charleston, SC USA. Ralph H Johnson Vet Adm Med Ctr, Res Serv, Charleston, SC USA. Lund Univ, Wallenberg Neurosci Ctr, Div Mol Neurobiol, S-22100 Lund, Sweden. RP Raymond, JR (reprint author), Med Univ S Carolina, Dept Med, Div Nephrol, Room 200,Adm Bldg,POB 250002,171 Ashley Ave, Charleston, SC 29425 USA. RI Pettus, Thomas/B-4352-2008 FU NCRR NIH HHS [S10RR13656]; NIDDK NIH HHS [DK02694, DK52448] NR 34 TC 7 Z9 7 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1540-658X J9 ASSAY DRUG DEV TECHN JI ASSAY DRUG DEV. TECHNOL. PD APR PY 2003 VL 1 IS 2 BP 281 EP 289 DI 10.1089/15406580360545099 PG 9 WC Biochemical Research Methods; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Pharmacology & Pharmacy GA 738WK UT WOS:000186310700007 PM 15090193 ER PT J AU Feinstein, LC Sandmaier, BM Maloney, DG Maris, MB Gooley, TA Chauncey, TR Hegenbart, U McSweeney, PA Stuart, MJ Forman, SJ Agura, EA Pulsipher, MA Blume, KG Niedervieser, DW Storb, RF AF Feinstein, LC Sandmaier, BM Maloney, DG Maris, MB Gooley, TA Chauncey, TR Hegenbart, U McSweeney, PA Stuart, MJ Forman, SJ Agura, EA Pulsipher, MA Blume, KG Niedervieser, DW Storb, RF TI Allografting after nonmyeloablative conditioning as a treatment after a failed conventional hematopoietic cell transplant SO BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION LA English DT Article DE second hematopoietic cell allografts nonmyeloablative conditioning ID BONE-MARROW TRANSPLANTATION; GRAFT-VERSUS-LEUKEMIA; NON-HODGKINS-LYMPHOMA; ALLOGENEIC TRANSPLANTATION; AUTOLOGOUS TRANSPLANTATION; HEMATOLOGIC MALIGNANCIES; 2ND AUTOGRAFT; DOUBLE-BLIND; BLOOD; FLUDARABINE AB Outcomes with conventional allogeneic hematopoietic cell transplantation (HCT) after failed HCT are typically poor. To reduce transplantation-related mortality (TRM), 55 patients (median age, 43 years; range, 18-69 years) who had failed conventional autologous (n = 49), allogeneic (n = 4), or syngeneic (n = 2) HCT received human leukocyte antigen-matched related (n 31) or unrelated (n = 24) donor allografts after nomnyeloablative conditioning with 2 Gy of total body irradiation or 2 Gy of total body irradiation and 90 mg/m(2) of fludarabine. Postgrafting inununosuppression consisted of cyclosporine and mycophenolate mofetil. One rejection occurred. Thirty-three patients died a median of 127 days (range, 7-834 days) after HCT: 21 of relapse, 11 of TRM, and 1 of suicide. The TRM rate on day 100 was 11 % with an estimated 1-year TRM rate of 20% (95% confidence interval [CI], 9% to 3 1 %). The median follow-up among the 22 survivors is 368 days (range, 173-796 days). Seventeen of 22 survivors are progression-free. One-year estimates of overall and progression-free survival rates are 49% (95% CI, 35% to 62%) and 28% (95% CI, 16% to 41%), respectively. Untreated disease at the time of allografting after nomnyeloablative conditioning increased the risk of death (hazard ratio = 2.4; P = .04). Although the length of follow-up is still short, it appears that encouraging outcomes can be achieved with nomnyeloablative conditioning in patients expected to have poor outcomes with conventional allografting. (C) 2003 American Society for Blood and Marrow Transplantation. C1 Fred Hutchinson Canc Res Ctr, Seattle, WA 98109 USA. Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Leipzig, Leipzig, Germany. Univ Colorado, Denver, CO 80202 USA. Stanford Univ, Stanford, CA 94305 USA. City Hope Natl Med Ctr, Duarte, CA 91010 USA. Baylor Univ, Dallas, TX USA. Univ Utah, Salt Lake City, UT USA. RP Storb, RF (reprint author), Fred Hutchinson Canc Res Ctr, 1100 Fairview Ave N,D1-100,POB 19024, Seattle, WA 98109 USA. EM rstorb@fhcrc.org FU NCI NIH HHS [K23CA92058, CA78902, P01 CA078902, CA15704, CA18221]; NHLBI NIH HHS [HL36444] NR 34 TC 20 Z9 20 U1 0 U2 0 PU CARDEN JENNINGS PUBL CO LTD PI CHARLOTTESVILLE PA BLAKE CTR, STE 200, 1224 W MAIN ST, CHARLOTTESVILLE, VA 22903 USA SN 1083-8791 J9 BIOL BLOOD MARROW TR JI Biol. Blood Marrow Transplant. PD APR PY 2003 VL 9 IS 4 BP 266 EP 272 DI 10.1053/bbmt.2003.50014 PG 7 WC Hematology; Immunology; Transplantation SC Hematology; Immunology; Transplantation GA 675GZ UT WOS:000182686800005 PM 12720219 ER PT J AU Nemeth, E Valore, EV Territo, M Schiller, G Lichtenstein, A Ganz, T AF Nemeth, E Valore, EV Territo, M Schiller, G Lichtenstein, A Ganz, T TI Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein SO BLOOD LA English DT Article ID HEREDITARY HEMOCHROMATOSIS; ANTIMICROBIAL ACTIVITY; PEPTIDE HEPCIDIN; IRON OVERLOAD; LIVER; GENE; HORMONE; DISEASE; MICE AB Hepcidin is a liver-made peptide proposed to be a central regulator of intestinal iron absorption and iron recycling by macrophages. In animal models, hepcidin is induced by inflammation and iron loading, but its regulation in humans has not been studied. We report that urinary excretion of hepcidin was greatly increased in patients with iron overload, infections, or inflammatory diseases. Hepcidin excretion correlated well with serum ferritin levels, which are regulated by similar pathologic stimuli. In vitro iron loading of primary human hepatocytes, however, unexpectedly down-regulated hepcidin mRNA, suggesting that in vivo regulation of hepcidin expression by iron stores involves complex indirect effects. Hepcidin mRNA was dramatically induced by interleukin-6 (IL-6) in vitro, but not by IL-1 or tumor necrosis factor a (TNF-alpha), demonstrating that human hepcidin is a type II acute-phase reactant. The linkage of hepcidin induction to inflammation in humans supports its proposed role as a key mediator of anemia of inflammation. C1 Univ Calif Los Angeles, Dept Med, David Gelfen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Pathol, David Gelfen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, W Los Angeles Vet Adm Hosp, Los Angeles, CA 90095 USA. RP Ganz, T (reprint author), Univ Calif Los Angeles, Dept Med, David Gelfen Sch Med, 37-055 CHS, Los Angeles, CA 90095 USA. NR 13 TC 782 Z9 830 U1 8 U2 30 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD APR 1 PY 2003 VL 101 IS 7 BP 2461 EP 2463 DI 10.1182/blood-2002-10-3235 PG 3 WC Hematology SC Hematology GA 660FR UT WOS:000181823600010 PM 12433676 ER PT J AU Wright, K Popli, S Gandhi, VC Lentino, JR Reyes, CV Leehey, DJ AF Wright, K Popli, S Gandhi, VC Lentino, JR Reyes, CV Leehey, DJ TI Paecilomyces peritonitis: case report and review of the literature SO CLINICAL NEPHROLOGY LA English DT Review DE paecilomyces; fungal peritonitis; peritoneal dialysis ID VARIOTII PERITONITIS; DIALYSIS; PATIENT AB While filamentous fungi are a rare cause of peritonitis in peritoneal dialysis patients, there is increasing recognition of Paecilomyces species as pathogens in such patients. We herein report a case of fungal peritonitis secondary to the filamentous Paecilomyces variotii species. The patient had a long and ultimately fatal course of illness despite catheter removal, discontinuation of peritoneal dialysis, recurrent intra-abdominal abscess drainage, and prolonged courses of antifungal therapy. Our experience with this case and a review of the literature suggests that infection with this fungus can cause substantial morbidity and is probably best treated with prompt catheter removal, aggressive antifungal therapy and vigilant observation for complications. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Maywood, IL 60153 USA. RP Leehey, DJ (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, 111-L,Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. NR 14 TC 11 Z9 13 U1 2 U2 3 PU DUSTRI-VERLAG DR KARL FEISTLE PI OBERHACHING PA BAJUWARENRING 4, D-82041 OBERHACHING, GERMANY SN 0301-0430 J9 CLIN NEPHROL JI Clin. Nephrol. PD APR PY 2003 VL 59 IS 4 BP 305 EP 310 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 661EL UT WOS:000181878200011 PM 12708573 ER PT J AU Shulman, DG Amdahl, L Washington, C Graves, A AF Shulman, DG Amdahl, L Washington, C Graves, A TI A combined analysis of two studies assessing the ocular comfort of antiallergy ophthalmic agents SO CLINICAL THERAPEUTICS LA English DT Article DE seasonal allergic conjunctivitis; pemirolast; cromolyn; ketorolac; nedocromil; comfort ID SEASONAL ALLERGIC CONJUNCTIVITIS; PEMIROLAST; TILAVIST; EFFICACY; SAFETY; SODIUM AB Background: Many topical agents with similar efficacies are available for the treatment of ocular allergies. In addition to efficacy, comfort is an important criterion because it affects overall patient satisfaction, compliance, and in turn efficacy. Objective: The goal of this study was to compare the comfort profiles of pemirolast, ketorolac, cromolyn, and nedocromil ophthalmic solutions using combined results from 2 separate clinical trials. Methods: Two clinical trials were conducted. Adults with asymptomatic eyes were included in the first study. In this single-center, 7-day, prospective, double-blind, single-dose, crossover, parallel-group study, subjects were randomized to be bilaterally dosed with pemirolast, cromolyn, or ketorolac at each of 3 visits. Study 2 was a single-center, I-day, prospective, randomized, double-blind, single-dose, contralateral, active-control study in which subjects received pemirolast in I eye and nedocromil in the contralateral eye. In both studies, subjects completed a pre- and postinstillation ocular comfort questionnaire: the primary variable was overall ocular discomfort, measured on a 4-point scale original to these studies (0 = absent, I = mild, 2 = moderate, 3 = severe). Half-increments were permitted. Secondary variables included burning/stinging, foreign-body sensation, tearing, and photophobia. Results: Forty-five subjects (29 women, 16 men; mean [SD] age, 35.9 [12.6] years) were enrolled in study 1; 48 subjects (30 women, 18 men; mean [SD] age, 33.6 [10.2] years) were enrolled in study 2. In study 1, overall discomfort was significantly lower with pemirolast than with cromolyn (P = 0.001) or ketorolac (P < 0.001). In terms of overall discomfort, the number of subjects with a clinically significant increase (greater than or equal to1 unit) in score was significantly lower with pemirolast compared with ketorolac (P = 0.021). Burning/stinging and tearing were also significantly lower with pemirolast than with cromolyn (P < 0. 00 1 and P = 0. 0 14, respectively). Mean changes in score compared with preinstillation were consistently lower with pemirolast than with cromolyn for both burning/stinging (P < 0.001) and tearing (P = 0.014). In study 2, overall discomfort was significantly lower with pemirolast than with nedocromil (P < 0.001). The number of subjects with a clinically significant increase in overall discomfort score was significantly lower with pemirolast than with nedocromil (P = 0.007). No changes in ocular tolerability parameters were reported in either study Conclusion: In these single-dose studies, pemirolast was found to be significantly more comfortable than cromolyn, ketorolac, or nedocromil. Copyright (C) 2003 Excerpta Medica, Inc. C1 Univ Texas, Hlth Sci Ctr, Audie Murphy Vet Adm Hosp, San Antonio, TX USA. Santen Inc, Napa, CA USA. RP Shulman, DG (reprint author), 999 E Basse Rd,Suite 127, San Antonio, TX 78209 USA. NR 21 TC 12 Z9 12 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0149-2918 J9 CLIN THER JI Clin. Ther. PD APR PY 2003 VL 25 IS 4 BP 1096 EP 1106 DI 10.1016/S0149-2918(03)80069-3 PG 11 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 674GC UT WOS:000182628200004 PM 12809959 ER PT J AU Martin, TR Nakamura, M Matute-Bello, G AF Martin, TR Nakamura, M Matute-Bello, G TI The role of apoptosis in acute lung injury SO CRITICAL CARE MEDICINE LA English DT Article; Proceedings Paper CT Margaux Conference on Critical Illness CY NOV 13-17, 2002 CL SINTRA, PORTUGAL DE acute lung injury; acute respiratory distress syndrome; apoptosis; Fas ligand; inflammation; neutrophils ID RESPIRATORY-DISTRESS SYNDROME; EPITHELIAL-CELL APOPTOSIS; FAS LIGAND; NEUTROPHIL APOPTOSIS; PULMONARY FIBROSIS; II PNEUMOCYTES; SOLUBLE FORM; TGF-BETA; IN-VIVO; INFLAMMATION AB Objective: To discuss current aspects of our understanding of the role of apoptosis in lung injury. Data Sources: Review of English language literature. Data Summary: Apoptosis is a process that produces timely death in senescent cells. Apoptosis is important in developmental biology and in remodeling of tissues during repair. Many apoptosis pathways converge in intracellular protease cascades that lead to DNA cleavage and cell death. Apoptosis pathways can be triggered by surface receptors, which interact with soluble proteins or membrane-bound proteins, such as Fas ligand. Fas ligand accumulates in soluble form at sites of tissue inflammation and has the potential to initiate apoptosis of leukocytes, epithelial cells, and other parenchymal cells. Dysregulation of apoptosis pathways could contribute to the epithelial injury that is characteristic of acute lung injury in humans. The effects of Fas ligand are modulated by factors in lung fluids, such as cytokines (e.g., transforming growth factor-beta, surfactant protein A, and angiotensin II) and a specific Fas ligand decoy receptor (DcR3). Conclusion. Strategies to block apoptosis pathways could be useful in limiting some forms of acute lung injury in humans. C1 VA Puget Sound Hlth Care Syst, Med Res Serv, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Div Pulm & Crit Care Med, Seattle, WA 98195 USA. RP Martin, TR (reprint author), VA Puget Sound Hlth Care Syst, Med Res Serv, Seattle, WA 98108 USA. FU NHLBI NIH HHS [HL30542, HL65892, HL70840] NR 55 TC 100 Z9 112 U1 1 U2 8 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 APR PY 2003 VL 31 IS 4 SU S BP S184 EP S188 DI 10.1097/01.CCM.0000057841.33876.B1 PG 5 WC Critical Care Medicine SC General & Internal Medicine GA 672HG UT WOS:000182514700002 PM 12682438 ER PT J AU Penson, DF Latini, DM Lubeck, DP Wallace, KL Henning, JM Lue, TF AF Penson, DF Latini, DM Lubeck, DP Wallace, KL Henning, JM Lue, TF TI Do impotent men with diabetes have more severe erectile dysfunction and worse quality of life than the general population of impotent patients? Results from the Exploratory Comprehensive Evaluation of Erectile Dysfunction (ExCEED) database SO DIABETES CARE LA English DT Article ID SILDENAFIL; TYPE-1 AB Objective-Little is known regarding how diabetic men with erectile dysfunction (ED) differ from the general population of impotent men. The primary objective of this study was to compare disease-specific health-related quality of life (HRQOL) and severity of ED in impotent men with and without diabetes. Research Design and Methods-Validated functional and HRQOL questionnaires (including the International Index of Erectile Function, the Sexual Self-Efficacy Scale, and the Psychological Impact of Erectile Dysfunction scales) were administered to patients in an ED disease registry. Men with ED and a history of diabetes (n=20) were compared with men with ED and no history of diabetes (n=90) at baseline and at the 12-month follow-up. Results-Diabetic impotent men reported worse erectile function and intercourse satisfaction at baseline, and ED had a greater impact on their emotional life-Diabetic men with ED had significantly different trends over time in the Erectile Function (P<0.001.), Intercourse Satisfaction (P<0.013), Sexual Desire (P<0.016), Overall Satisfaction (P<0.023), and the. Sexual Experience-Psychological Impact domains (P<0.002). In addition, there was a trend toward a difference over time in the Emotional Life-Psychological impact domain (P<0.0067). Conclusions-impotent men with diabetes present with worse ED than nondiabetic men with ED, resulting in worse disease-specific HRQOL in the diabetic men. Although diabetic patients initially respond well to ED treatment, responses do not appear to be durable over time. Therefore, clinicians must provide longer-term follow-up when treating ED in diabetic patients. C1 Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Urol Sect, Seattle, WA 98108 USA. Univ Washington, Dept Urol, Seattle, WA 98195 USA. Univ Calif San Francisco, Dept Urol, San Francisco, CA 94143 USA. TAP Pharmaceut Prod Inc, Lake Forest, IL USA. RP Penson, DF (reprint author), Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Urol Sect, 112-UR,1660 S Columbian Way, Seattle, WA 98108 USA. OI Latini, David/0000-0002-6161-4861 NR 16 TC 95 Z9 105 U1 1 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD APR PY 2003 VL 26 IS 4 BP 1093 EP 1099 DI 10.2337/diacare.26.4.1093 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 724UP UT WOS:000185505300021 PM 12663579 ER PT J AU Li, N Sioutas, C Cho, A Schmitz, D Misra, C Sempf, J Wang, MY Oberley, T Froines, J Nel, A AF Li, N Sioutas, C Cho, A Schmitz, D Misra, C Sempf, J Wang, MY Oberley, T Froines, J Nel, A TI Ultrafine particulate pollutants induce oxidative stress and mitochondrial damage SO ENVIRONMENTAL HEALTH PERSPECTIVES LA English DT Article DE concentrated ambient particles; dithiothreitol assay; heme oxygenase-1; mitochondrial damage; oxidative stress; polycyclic aromatic hydrocarbon; ultrafine particles ID DIESEL EXHAUST PARTICLES; BRONCHIAL EPITHELIAL-CELLS; HEME OXYGENASE-1; AIR-POLLUTION; CYTOCHROME-P450 1A1; URBAN AIR; INFLAMMATION; EXPRESSION; MACROPHAGES; CHEMICALS AB The objectives of this study were to determine whether differences in the size and composition of coarse (2.5-10 mum), fire (<2.5 μm), and ultrafine (<0.1 mum) particulate matter (PM) are related to their uptake in macrophages and epithelial cells and their ability to induce oxidative stress. The premise for this study is the increasing awareness that various PM components induce pulmonary inflammation through the generation of oxidative stress. Coarse, fine, and ultrafine particles (UFPs) were collected by ambient particle concentrators in the Los Angeles basin in California and used to study their chemical composition in parallel with assays for generation of reactive oxygen species (ROS) and ability to induce oxidative stress in macrophages and epithelial cells. UFPs were most potent toward inducing cellular heme oxygenase-1 (HO-1) expression and depleting intracellular glutathione. HO-1 expression, a sensitive marker for oxidative stress, is directly correlated with the high organic carbon and polycyclic aromatic hydrocarbon (PAH) content of UFPS. The dithiothreitol (DTT) assay, a quantitative measure of in vitro ROS formation, was correlated with PAH content and HO-1 expression. UFPs also had the highest ROS activity in the DTT assay. Because the small size of UFPs allows better tissue penetration, we used electron microscopy to study subcellular localization. UFPs and, to a lesser extent, fine particles, localize in mitochondrial where they induce major structural damage. This may contribute to oxidative stress. Our studies demonstrate that the increased biological potency of UFPs is related to the content of redox cycling organic chemicals and their ability to damage mitochondria. C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. So Calif Particle Ctr & Supersite, Los Angeles, CA USA. Univ So Calif, Dept Civil & Environm Engn, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Mol & Med Pharmacol, Los Angeles, CA USA. William S Middleton Mem Vet Adm Med Ctr, Pathol Serv, Madison, WI 53705 USA. Univ Wisconsin, Dept Pathol & Lab Med, Madison, WI USA. Univ Calif Los Angeles, Ctr Environm & Occupat Hlth, Los Angeles, CA USA. RP Nel, A (reprint author), Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RI Nel, Andre/J-2808-2012 FU NIEHS NIH HHS [R01-ES10553] NR 37 TC 980 Z9 1026 U1 47 U2 293 PU US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE PI RES TRIANGLE PK PA NATL INST HEALTH, NATL INST ENVIRONMENTAL HEALTH SCIENCES, PO BOX 12233, RES TRIANGLE PK, NC 27709-2233 USA SN 0091-6765 J9 ENVIRON HEALTH PERSP JI Environ. Health Perspect. PD APR PY 2003 VL 111 IS 4 BP 455 EP 460 DI 10.1289/ehp.6000 PG 6 WC Environmental Sciences; Public, Environmental & Occupational Health; Toxicology SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Toxicology GA 665WM UT WOS:000182144300030 PM 12676598 ER PT J AU Hussein, MR Haemel, AK Wood, GS AF Hussein, MR Haemel, AK Wood, GS TI p53-related pathways and the molecular pathogenesis of melanoma SO EUROPEAN JOURNAL OF CANCER PREVENTION LA English DT Review DE cutaneous malignant melanoma; p53; ultraviolet radiation; UV ID TUMOR-SUPPRESSOR GENE; CUTANEOUS MALIGNANT-MELANOMA; CELL NUCLEAR ANTIGEN; DNA MISMATCH REPAIR; P53 GENE; PROTEIN EXPRESSION; MICROSATELLITE INSTABILITY; P53-MEDIATED APOPTOSIS; FAMILY PROTEINS; DYSPLASTIC NEVI AB Cutaneous malignant melanoma (CMM) is a life-threatening cancer that can have a poor prognosis with high metastatic potential. Its incidence is rapidly increasing worldwide. Its molecular alterations involve multiple pathways, including those related to p53. Since 1981, more than 380 papers containing the terms 'p53 and melanoma' as key words in the Abstract have been published in the literature. However, in spite of these extensive investigations, a review of p53 and associated genes in CMM is still lacking. To remedy this issue, this review seeks to provide a brief overview of p53 and discuss the genes targeted along its related pathways. (C) 2003 Lippincott Williams Wilkins. C1 Dept Dermatol, Madison, WI 53705 USA. Assiut Univ, Fac Med, Dept Pathol, Assiut, Egypt. Univ Wisconsin, William S Middleton Mem Vet Hosp, Madison, WI 53705 USA. RP Wood, GS (reprint author), Dept Dermatol, Madison, WI 53705 USA. FU NIAMS NIH HHS [AR02136] NR 108 TC 48 Z9 53 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0959-8278 J9 EUR J CANCER PREV JI Eur. J. Cancer Prev. PD APR PY 2003 VL 12 IS 2 BP 93 EP 100 DI 10.1097/01.cej.0000062797.86004.35 PG 8 WC Oncology SC Oncology GA 677DW UT WOS:000182792500002 PM 12671532 ER PT J AU Kanwal, F Dulai, G Jensen, DM Gralnek, IM Kovacs, TOG Machicado, GA Jutabha, R AF Kanwal, F Dulai, G Jensen, DM Gralnek, IM Kovacs, TOG Machicado, GA Jutabha, R TI Major stigmata of recent hemorrhage on rectal ulcers in patients with severe hematochezia: endoscopic diagnosis, treatment, and outcomes SO GASTROINTESTINAL ENDOSCOPY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Society-for-Gastrointestinal-Endoscopy CY MAY 20-23, 2002 CL SAN FRANCISCO, CALIFORNIA SP Amer Soc Gastrointestinal Endoscopy ID MASSIVE HEMORRHAGE; URGENT COLONOSCOPY; STERCORAL ULCER; DISEASE; THERAPY AB Background. Endoscopic diagnosis and treatment of hematochezia caused by rectal ulcers is poorly described. Methods: Consecutive patients hospitalized with severe hematochezia underwent urgent colonoscopy after purge. Those with rectal ulcers were divided into 2 groups based on the absence or presence of major stigmata of recent hemorrhage: active bleeding, visible vessel, or adherent clot. Major stigmata were treated with epinephrine injection and coagulation with a bipolar probe. The primary outcome endpoint was recurrent bleeding within 4 weeks of diagnosis. Results: Rectal ulcers were identified in 23 of 285 (8%) patients. Twelve of 23 patients had major stigmata; these patients had an arithmetically greater decrease in hematocrit and required more blood transfusions than patients without major stigmata. Initial hemostasis was achieved in all, but bleeding recurred in 5 with stigmata. Four patients died of comorbid conditions. There was no recurrent bleeding or death in those without stigmata. Conclusions: Patients with rectal ulcers harboring major stigmata are at high risk for severe bleeding, recurrent bleeding, and death. For ulcers with major stigmata, endoscopic hemostasis is feasible but rates of recurrent bleeding are high. C1 VA Greater Los Angeles Healthcare Syst, CURE, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Div Digest Dis, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Div Gastroenterol, Los Angeles, CA 90073 USA. RP Jensen, DM (reprint author), VA Greater Los Angeles Healthcare Syst, CURE, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. FU NCRR NIH HHS [1K23 RR16188]; NIDDK NIH HHS [DK41301, 1K24 DK02650] NR 19 TC 18 Z9 18 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD APR PY 2003 VL 57 IS 4 BP 462 EP 468 DI 10.1067/mge.2003.147 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 663KH UT WOS:000182004400005 PM 12665754 ER PT J AU Hunt, GC Rader, AE Faigel, DO AF Hunt, GC Rader, AE Faigel, DO TI A comparison of EUS features between CD-117 positive GI stromal tumors and CD-117 negative GI spindle cell tumors SO GASTROINTESTINAL ENDOSCOPY LA English DT Article; Proceedings Paper CT Digestive Disease Week Meeting/Annual Meeting of the American-Gastroenterology-Association CY MAY 19-23, 2002 CL SAN FRANCISCO, CALIFORNIA SP Amer Gastroenterol Assoc ID FINE-NEEDLE ASPIRATION; C-KIT; SUBMUCOSAL TUMORS; DIFFERENTIAL-DIAGNOSIS; INTERSTITIAL-CELLS; LEIOMYOSARCOMAS; LEIOMYOMAS; MUTATIONS; BENIGN; TRACT AB Background. GI stromal tumors are spindle cell tumors that stain positive for immunohistochemical CD-117 (c-kit). Prognostic factors for malignancy include size ( A cm), mitotic index (5 mitotic figures/50 high-powered fields), and ulcerated, cystic, or necrotic areas within the tumor. The purpose of this study was to compare these features in c-kit positive vs. c-kit negative tumors. Methods: All patients referred for EUS of submucosal lesions were identified, and histopathology, including immunohistochemical staining, was reviewed to determine all diagnoses of GI stromal tumors. Size, echo pattern, and presence, of cystic spaces and ulceration were recorded as diagnosed by EUS. Histopathologic diagnoses were made by FNA or endoscopic submucosal-mucosal resection. If surgical resection followed, the surgical diagnosis, staining pattern, mitotic index, and presence of ulceration, necrosis, and nuclear atypia were recorded. Results: Forty patients (21 men, 19 women; 38 white, 2 African American; mean age 58 +/- 2.6 years) had 46 EUS procedures performed for evaluation of spindle cell tumors. Seventeen stained positive for c-kit (mean age, 59 +/- 3.6 years; range 19 to 80 years) and 12 negative (mean age, 57 +/- 3.8 years; range 31 to 76 years); 11 were not stained for c-kit (excluded from analysis). On EUS, 7 were ulcerated, 3 cystic, and 6 were larger than 4 cm. This group of findings was observed in 12 patients, 11 of whom had c-kit positive tumors (11/17 vs. 1/12; p = 0.006). Tumors positive for c-kit were larger (42.4 +/- 5.5 mm vs. 19.0 +/- 5.9 mm; p = 0.005). There were 13 c-kit positive tumors in the stomach, 2 in the duodenum, and 1 each in the esophagus and at the gastroesophageal junction. Of the 12 c-kit negative tumors, 8 were located in the esophagus and 1 at the gastroesophageal junction (9/12 vs. 2/17; p < 0.01). Surgical resection was performed on 13 patients, 12 of whom had c-kit positive tumors, and 3 of these 12 tumors had greater than 5 mitoses per 50 high-powered field. Conclusions: If a GI stromal tumor is suspected, EUS-FNA with immunohistochemical staining should be performed for CD-117 (c-kit). C-kit tumors are more likely to have malignant features and should be resected or subjected to close clinical follow-up. C1 Oregon Hlth & Sci Univ, Portland Vet Affairs Med Ctr, Dept Med, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Portland Vet Affairs Med Ctr, Dept Pathol, Portland, OR 97201 USA. RP Faigel, DO (reprint author), Oregon Hlth & Sci Univ, Portland Vet Affairs Med Ctr, Dept Med, P3GI, Portland, OR 97201 USA. NR 27 TC 40 Z9 42 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD APR PY 2003 VL 57 IS 4 BP 469 EP 474 DI 10.1067/mge.2003.146 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 663KH UT WOS:000182004400006 PM 12665755 ER PT J AU Volpp, KGM Williams, SV Waldfogel, J Silber, JH Schwartz, JS Pauly, MV AF Volpp, KGM Williams, SV Waldfogel, J Silber, JH Schwartz, JS Pauly, MV TI Market reform in New Jersey and the effect on mortality from acute myocardial infarction SO HEALTH SERVICES RESEARCH LA English DT Article DE quality of health care; health care reform; economics; financing; economics/hospital ID NEW-YORK-STATE; HOSPITAL COMPETITION; CARE; OUTCOMES; SURGERY; COST; CALIFORNIA; DISEASE; PROGRAM; LENGTH AB Objective. To determine whether mortality rates for patients with acute myocardial infarction (AMI) changed in New Jersey after implementation of the Health Care Reform Act, which reduced subsidies for hospital care for the uninsured and changed hospital payment to price competition from a rate-setting system based on hospital cost. Data Sources/Study Setting. Patient discharge data from hospitals in New Jersey and New York from 1990 through 1996 and the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS). Study Design. A comparison between states over time of unadjusted and risk-adjusted mortality and cardiac procedure rates. Data Collection. Discharge data were obtained for 286,640 patients with the primary diagnosis of AMI admitted to hospitals in NewJersey or New York from 1990 through 1996. Records of 364,273 NIS patients were used to corroborate time trends. Principal Findings. There were no significant differences in AMI mortality among insured patients in New Jersey relative to New York or the NIS. However, there was a relative increase in mortality of 41 to 57 percent among uninsured NewJersey patients post-reform, and their rates of expensive cardiac procedures decreased concomitantly. Conclusions. The introduction of hospital price competition and reductions in subsidies for hospital care of the uninsured were associated with an increased mortality rate among uninsured NewJersey AMI patients. A relative decrease in the use of cardiac procedures in NewJersey may partly explain this finding. Additional studies should be done to identify whether other market reforms have been associated with changes in the quality of care. C1 Univ Penn, Sch Med, Wharton Sch, Philadelphia, PA 19104 USA. Philadelphia Vet Hosp, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Gen Internal Med Sect, Philadelphia, PA 19104 USA. Natl Bur Econ Res, Cambridge, MA 02138 USA. Univ Penn, Sch Med, Wharton Sch, Hlth Care Syst Dept, Philadelphia, PA 19104 USA. RP Volpp, KGM (reprint author), Univ Penn, Sch Med, Wharton Sch, 1232 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. RI Waldfogel, Joel/A-1047-2007; Waldfogel, Joel/A-4916-2015 OI Waldfogel, Joel/0000-0002-8040-7227 FU AHRQ HHS [R03 HS09325-01]; NIGMS NIH HHS [T32 GM007170, 5-T32-GM-07170] NR 32 TC 43 Z9 43 U1 2 U2 4 PU BLACKWELL PUBL LTD PI OXFORD PA 108 COWLEY RD, OXFORD OX4 1JF, OXON, ENGLAND SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD APR PY 2003 VL 38 IS 2 BP 515 EP 533 DI 10.1111/1475-6773.00131 PG 19 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 677EF UT WOS:000182793400004 PM 12785559 ER PT J AU Whitcomb, DC Pogue-Geile, K AF Whitcomb, DC Pogue-Geile, K TI Pancreatitis as a risk for pancreatic cancer (Reprinted from Gastroenterology Clinics of North America, vol 31, pg 663, 2002) SO HEMATOLOGY-ONCOLOGY CLINICS OF NORTH AMERICA LA English DT Reprint ID COMPARATIVE GENOMIC HYBRIDIZATION; CATIONIC TRYPSINOGEN GENE; RAS ONCOGENE MUTATIONS; HEREDITARY PANCREATITIS; CYSTIC-FIBROSIS; INTRAEPITHELIAL NEOPLASIA; TROPICAL PANCREATITIS; DUCTAL HYPERPLASIA; EXOCRINE PANCREAS; SOMATIC MUTATIONS AB Pancreatic cancer remains one of the most recalcitrant of all cancers. As current treatment regimens for pancreatic cancer are inadequate, a major focus of research is to understand the pathways important for pancreatic cancer development, and to identify factors that can be modified to retard the development of pancreatic cancer. Smoking is the strongest risk factor amenable to modification. Other major risk factors include chronic pancreatitis and germ line genetic mutations. Epidemiologic studies of patients with chronic pancreatitis, cystic fibrosis, tropical pancreatitis, and hereditary pancreatitis prove that all forms of pancreatitis increase the risk of pancreatic cancer. Recent studies also demonstrate gene-gene and gene-environmental interactions that increase the risk of pancreatic cancer in the setting of chronic pancreatitis. Finally, the article outlines new guidelines that address the problem of whether or not patients with chronic pancreatitis should be screened for pancreatic cancer. C1 Univ Pittsburgh, UPMC Presbyterian, Dept Med, Pittsburgh, PA 15213 USA. Univ Pittsburgh, UPMC Presbyterian, Dept Cell Biol & Physiol & Human Genet, Pittsburgh, PA 15213 USA. VA Pittsburgh Hlth Care Syst, Pittsburgh, PA 15240 USA. RP Whitcomb, DC (reprint author), Univ Pittsburgh, UPMC Presbyterian, Dept Med, Mezzanine Level,C Wing,200 Lothrop St, Pittsburgh, PA 15213 USA. NR 102 TC 0 Z9 0 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0889-8588 J9 HEMATOL ONCOL CLIN N JI Hematol. Oncol. Clin. North Am. PD APR PY 2003 VL 17 IS 2 BP 647 EP + DI 10.1016/s0889-8588(03)00017-0 PG 17 WC Oncology; Hematology SC Oncology; Hematology GA 675JF UT WOS:000182690100018 ER PT J AU Ioannou, GN Dominitz, JA Weiss, NS Heagerty, PJ Kowdley, KV AF Ioannou, GN Dominitz, JA Weiss, NS Heagerty, PJ Kowdley, KV TI Racial differences in the relationship between hepatitis C infection and iron stores SO HEPATOLOGY LA English DT Article ID CHRONIC VIRAL-HEPATITIS; INTERFERON THERAPY; CONTROLLED TRIAL; UNITED-STATES; LIPID-PEROXIDATION; AFRICAN-AMERICANS; ALPHA-INTERFERON; VIRUS-INFECTION; PLUS RIBAVIRIN; CIRRHOSIS AB Black race and increased hepatic iron stores predict poor response to interferon treatment for chronic hepatitis C virus (HCV) infection. We tested the hypothesis that these 2 observations are linked by investigating whether HCV-infected African-Americans have increased iron stores relative to uninfected persons. Using data from the third National Health and Nutrition Examination Survey (NHANES III), we determined the risk of having increased iron stores, defined as elevation of both serum ferritin and transferrin-iron saturation (TS), in HCV-RNA-positive blacks (n = 100) and nonblacks (n = 126) relative to HCV-RNA-negative blacks (n = 4,002) and nonblacks (n = 10,943). HCV-positive blacks were 5.4 times (95% CI, 1.2 to 24) more likely to have increased iron stores than HCV-positive nonblacks. The proportion of HCV-positive blacks who had increased iron stores was 16.4% among those with abnormal liver enzymes and 2.8% among those with normal liver enzymes, compared with only 0.6% among HCV-negative blacks. After adjustment for age, alcohol intake, gender, menopausal status, education, body mass index, and poverty index, HCV-positive blacks with abnormal liver enzymes had an elevated risk of having increased iron stores (odds ratio, 17.8; 95% CI, 5.1 to 63). In contrast, among persons of other races, there was a much smaller difference in the proportion of persons with increased iron stores between HCV-positive persons with (3.4%) or without (1.4%) abnormal liver enzymes and HCV-negative persons (0.9%). In conclusion, a greater proportion of blacks than persons of other races respond to HCV infection with an increase in iron stores. This finding may partly explain the reduced response of HCV-positive African-Americans to antiviral treatment. C1 Univ Washington, Med Ctr, Div Gastroenterol, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, NW Hepatitis C Resouce Ctr, Hlth Serv Res & Dev, Seattle, WA USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. RP Kowdley, KV (reprint author), Univ Washington, Med Ctr, Div Gastroenterol, Dept Med, Box 356174,1959 NE Pacific St, Seattle, WA 98195 USA. OI Dominitz, Jason/0000-0002-8070-7086 FU NIDDK NIH HHS [K24DK02957-01] NR 50 TC 37 Z9 37 U1 1 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD APR PY 2003 VL 37 IS 4 BP 795 EP 801 DI 10.1053/jhep.2003.50147 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 663KK UT WOS:000182004600012 PM 12668972 ER PT J AU McLean, DC Spruill, I Gevao, S Morrison, EYS Bernard, OS Argyropoulos, G Garvey, WT AF McLean, DC Spruill, I Gevao, S Morrison, EYS Bernard, OS Argyropoulos, G Garvey, WT TI Three novel mtDNA restriction site polymorphisms allow exploration of population affinities of African Americans SO HUMAN BIOLOGY LA English DT Article DE mitochondrial DNA; Gullah African American; restriction site polymorphism; admixture; population affinities ID HUMAN MITOCHONDRIAL GENOME; DNA; EVOLUTION; ADMIXTURE; SEQUENCE; PROPORTIONS AB To develop informative tools for the study of population affinities in African Americans, we sequenced the hypervariable segments I and 11 (HVS I and HVS II) of mitochondrial DNA (mtDNA) from 96 Sierra Leoneans; European Americans; rural, Gullah-speaking African Americans; urban African Americans living in Charleston, South Carolina; and Jamaicans. We identified single nucleotide polymorphisms (SNPs) exhibiting ethnic affinities, and developed restriction endonuclease tools to screen these SNPs. Here we show that three HVS restriction site polymorphisms (RSPs), EcoRV, FokI, and MfeI, exhibit appreciable differences in frequency (average delta = 0.4165) between putative African American parental populations (i.e., extant Africans living in Sierra Leone and European Americans). Estimates of European American mtDNA admixture, calculated from haplotypes composed of these three novel RSPs, show a cline of increasing admixture from Gullah-speaking African American (m = 0.0300) to urban Charleston African American (m = 0.0689) to West Coast African American (m = 0.1769) populations. This haplotype admixture in the Gullahs is the lowest recorded to date among African Americans, consistent with previous studies using autosomal markers. These RSPs may become valuable new tools in the study of ancestral affinities and admixture dynamics of African Americans. C1 Med Univ S Carolina, Sea Isl Families Project, Div Endocrinol Diabet & Med Genet, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Project Sugar, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Univ Sierra Leone, Coll Med & Allied Hlth Sci, Freetown, Sierra Leone. Univ W Indies, Dept Basic Med Sci, Biochem Sect, Kingston 7, Jamaica. Univ W Indies, Ctr Biotechnol, Kingston 7, Jamaica. Diabet Assoc Jamaica, Kingston, Jamaica. RP McLean, DC (reprint author), Med Univ S Carolina, Sea Isl Families Project, Div Endocrinol Diabet & Med Genet, Dept Med, Charleston, SC 29425 USA. FU NIDDK NIH HHS [DK-47461] NR 31 TC 22 Z9 23 U1 1 U2 4 PU WAYNE STATE UNIV PRESS PI DETROIT PA 4809 WOODWARD AVE, DETROIT, MI 48201-1309 USA SN 0018-7143 J9 HUM BIOL JI Hum. Biol. PD APR PY 2003 VL 75 IS 2 BP 147 EP 161 DI 10.1353/hub.2003.0035 PG 15 WC Biology; Genetics & Heredity SC Life Sciences & Biomedicine - Other Topics; Genetics & Heredity GA 681XE UT WOS:000183060200001 PM 12943155 ER PT J AU Mintzer, JE Kershaw, P AF Mintzer, JE Kershaw, P TI The efficacy of galantamine in the treatment of Alzheimer's disease: comparison of patients previously treated with acetylcholinesterase inhibitors to patients with no prior exposure SO INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE galantamine; efficacy; acetylcholinesterase inhibitors; Alzheimer's disease ID PLACEBO-CONTROLLED TRIAL; AD AB Background Acetylcholinesterase inhibitors (AChEIs) can provide benefits at the cognitive, behavioral, and functional levels to patients with Alzheimer's disease (AD). With more AChEIs now available, treatment considerations may include whether the patient has had prior exposure to an AChEI. Objective To compare the effects of galantamine in patients with AD who were previously exposed to AChEIs with its effects in patients with AD who had no previous exposure, using a post hoc analysis. Results Patients in groups treated with galantamine 16 mg/day and 24 mg/day achieved statistically significant improvements in ADAS-cog/11 scores in comparison with those who received placebo (naive: p = 0.003 and 0.005, respectively; prior exposure: p < 0.001 and 0.001. respectively). Similarly, a greater number of patients treated with galamainine 16 mg/day and 24 mg/day exhibited no change or improvement in their CIBIC-plus scores compared to patients who received placebo (naive: p < 0.001 and p = 0.077, respectively: prior exposure: p = 0.005 and p = 0.001, respectively). There were no significant differences in adverse events between naive patients and those with prior exposure to AChEIs. Conclusions Galantamine is effective and safe in patients with AD, regardless of previous exposure to AChEIs, Copyright (C) 2003 John Wiley Sons, Ltd. C1 Ralph H Johnson Dept Vet Affairs Med Ctr, N Charleston, SC USA. Janssen Pharmaceut Prod LP, Titusville, NJ USA. RP Mintzer, JE (reprint author), Alzeimers Res & Clin Programs, 5900 Core Rd,Suite 203, Charleston, SC 29406 USA. NR 11 TC 20 Z9 21 U1 0 U2 1 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 0885-6230 J9 INT J GERIATR PSYCH JI Int. J. Geriatr. Psychiatr. PD APR PY 2003 VL 18 IS 4 BP 292 EP 297 DI 10.1002/gps.826 PG 6 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 669LW UT WOS:000182353600005 PM 12673604 ER PT J AU Metlay, JP Strom, BL Asch, DA AF Metlay, JP Strom, BL Asch, DA TI Prior antimicrobial drug exposure: a risk factor for trimethoprim-sulfamethoxazole-resistant urinary tract infections SO JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY LA English DT Article; Proceedings Paper CT 38th Annual Meeting of the Infectious-Diseases-Society-of-America CY SEP 07-11, 2000 CL NEW ORLEANS, LOUISIANA SP Infect Dis Soc Amer ID ACUTE UNCOMPLICATED CYSTITIS; ESCHERICHIA-COLI; STREPTOCOCCUS-PNEUMONIAE; ANTIBIOTIC-RESISTANCE; INCREASING PREVALENCE; UNITED-STATES; BETA-LACTAM; CONSUMPTION; PENICILLIN; ERYTHROMYCIN AB Objectives: Antimicrobial drug use is believed to be an important risk factor for the emerging problem of antimicrobial drug resistance, yet strong evidence for the causal relationship in community settings has been limited. Detailed analysis of this risk factor at the level of the individual patient has been hampered by limited availability of drug exposure data among patients with outpatient infections. We used a novel data system to identify patterns of individual antimicrobial drug exposures associated with trimethoprim-sulfamethoxazole-resistant urinary tract infections (UTIs). Materials and methods: This was a retrospective case-control study. Subjects were veterans with Gram-negative UTIs seen at the Philadelphia VA Medical Center from 1 July 1996 to 31 December 1999. Subjects were linked to a national VA outpatient pharmacy database. Cases and controls were identified based on the results of trimethoprim-sulfamethoxazole susceptibility testing. Results: Three hundred and ninety-three veterans with UTIs could be linked to electronic pharmacy records. The overall rate of trimethoprim-sulfamethoxazole drug resistance was 13%, without significant annual variation. Antimicrobial drug exposure within 6 months was strongly associated with the probability of a trimethoprim-sulfamethoxazole-resistant infection (OR = 4.1,95% Cl 2.2-7.5). This association extended to exposure to other antimicrobial drugs in addition to trimethoprim-sulfamethoxazole and the overall association displayed a dose-response relationship in terms of the number of prior drug exposures. Conclusions: Prior antimicrobial drug exposure is a strong risk factor for infection with trimethoprim-sulfamethoxazole-resistant Gram-negative bacteria among patients with UTIs. C1 Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA 19104 USA. Univ Penn, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Dept Biostat, Philadelphia, PA 19104 USA. Univ Penn, Dept Epidemiol, Philadelphia, PA 19104 USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Metlay, JP (reprint author), Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA 19104 USA. OI Asch, David/0000-0002-7970-286X NR 31 TC 30 Z9 31 U1 0 U2 1 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 APR PY 2003 VL 51 IS 4 BP 963 EP 970 DI 10.1093/jac/dkg146 PG 8 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 670DV UT WOS:000182392900024 PM 12654756 ER PT J AU Havranek, EP Masoudi, FA Rumsfeld, JS Steiner, JF AF Havranek, EP Masoudi, FA Rumsfeld, JS Steiner, JF TI A broader paradigm for understanding and treating heart failure SO JOURNAL OF CARDIAC FAILURE LA English DT Article DE chronic illness model; heart failure; health-related quality of life; heart failure epidemiology ID QUALITY-OF-LIFE; IMPROVING PRIMARY-CARE; HEALTH-STATUS; CLINICAL-TRIALS; CHRONIC ILLNESS; MORTALITY; SURVIVAL; HOSPITALIZATIONS; DEPRESSION; PREDICTOR AB Several recent clinical trials in heart failure have failed to demonstrate improvements in survival, suggesting that new approaches must be adopted if there are to be further improvements in heart failure treatment. We propose a broader paradigm for heart failure care based on a chronic rather than an acute illness model. This approach recognizes a broader range of outcomes including patient-perceived health status, expanded populations of interest that more closely reflect the changing epidemiology of heart failure, and a wider scope of interventions that address co-morbidity and health behavior. This approach will require a rationally designed health care delivery system that applies the best available evidence to the care of individual patients with heart failure. C1 Denver Hlth Med Ctr, Div Cardiol, Dept Med, Denver, CO 80204 USA. Colorodo Hlth Sci Ctr, Div Cardiol, Dept Med, Denver, CO USA. Univ Colorado, Ctr Hlth Sci, Colorado Hlth Outcomes Program, Denver, CO USA. Denver Vet Affairs Med Ctr, Cardiol & Hlth Serv Res, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Div Gen Internal Med, Denver, CO USA. RP Havranek, EP (reprint author), Denver Hlth Med Ctr, Div Cardiol, Dept Med, 777 Bannock St, Denver, CO 80204 USA. NR 41 TC 6 Z9 6 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 APR PY 2003 VL 9 IS 2 BP 147 EP 152 DI 10.1054/jcaf.2003.21 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 669BW UT WOS:000182332900011 PM 12751136 ER PT J AU Weigle, DS Cummings, DE Newby, PD Breen, PA Frayo, RS Matthys, CC Callahan, HS Purnell, JQ AF Weigle, DS Cummings, DE Newby, PD Breen, PA Frayo, RS Matthys, CC Callahan, HS Purnell, JQ TI Roles of leptin and ghrelin in the loss of body weight caused by a low fat, high carbohydrate diet SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID FOOD-INTAKE; INSULIN-RESISTANCE; PLASMA LEPTIN; ACYLATED PEPTIDE; INDUCED OBESITY; HUMANS; ADIPOSITY; WOMEN; APPETITE; RATS AB Loss of body fat by caloric restriction is accompanied by decreased circulating leptin levels, increased ghrelin levels, and increased appetite. In contrast, dietary fat restriction often decreases adiposity without increasing appetite. Substitution of dietary carbohydrate for fat has been shown to increase the area under the plasma leptin vs. time curve (AUC) over the course of 24 h. This effect, if sustained, could explain the absence of a compensatory increase in appetite on a low fat diet. To clarify the effect of dietary fat restriction on leptin and ghrelin, we measured AUC for these hormones in human subjects after each of the following sequential diets: 2 wk on a weight-maintaining 35% fat (F), 45% carbohydrate (C), 20% protein (P) diet (n = 18); 2 wk on an isocaloric 15% F, 65% C, 20% P diet (n = 18); and 12 wk on an ad libitum 15% F, 65% C, 20% P diet (n = 16). AUC for leptin was similar on the isocaloric 15% F and 35% F diets (555 +/- 57 vs. 580 +/- 56 ng/ ml.24 h; P = NS). Body weight decreased from 74.6 +/- 2.4 to 70.8 +/- 2.7 kg on the ad libitum 15% F diet (P < 0.001) without compensatory increases in food consumption or AUC for ghrelin. Proportional amplitude of the 24-h leptin profile was increased after 12 wk on the 15% fat diet. We conclude that weight loss early in the course of dietary fat restriction occurs independently of increased plasma leptin levels, but that a later increase in amplitude of the 24-h leptin signal may contribute to ongoing weight loss. Fat restriction avoids the increase in ghrelin levels caused by dietary energy restriction. C1 Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA. Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98104 USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. RP Weigle, DS (reprint author), Univ Washington, Harborview Med Ctr, Box 359757,325 9th Ave, Seattle, WA 98104 USA. EM weigle@u.washington.edu FU NCRR NIH HHS [RR-00037]; NIDDK NIH HHS [DK-02860, DK-02689, DK-17047, DK-35816, DK-55460] NR 43 TC 129 Z9 136 U1 0 U2 4 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 APR PY 2003 VL 88 IS 4 BP 1577 EP 1586 DI 10.1210/jc.2002-021262 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 667BM UT WOS:000182211000027 PM 12679442 ER PT J AU Vahl, TP Paty, BW Fuller, BD Prigeon, RL D'Alessio, DA AF Vahl, TP Paty, BW Fuller, BD Prigeon, RL D'Alessio, DA TI Effects of GLP-1-(7-36)NH(2), GLP-1-(7-37), and GLP-1-(9-36)NH(2) on intravenous glucose tolerance and glucose-induced insulin secretion in healthy humans SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID GLUCAGON-LIKE PEPTIDE-1; GASTRIC-INHIBITORY POLYPEPTIDE; DIABETIC-PATIENTS; 7-36 AMIDE; IN-VIVO; PHYSIOLOGICAL INCRETIN; RECEPTOR; IV; DEGRADATION; METABOLITE AB Glucagon-like peptide 1 (GLP-1) is an insulin secretagogue synthesized in the intestine and released in response to meal ingestion. It is secreted primarily in two forms, GLP1-(7-37) and GLP-1-(7-36)NH(2), both of which bind to a specific GLP-1 receptor (GLP-1r) on the pancreatic beta-cell and augment glucose-stimulated insulin secretion. Once secreted, GLP-1-(7-36)NH(2) is rapidly metabolized to GLP-1-(9-36)NH(2), which is the predominant form of GLP-1 in postprandial plasma because of its relatively slower clearance. Although no clear biological role for GLP-1-(9-36)NH(2) in humans has been identified, recent studies in animals suggest two potential effects: to antagonize the effects of intact GLP-1 and to promote glucose disappearance in peripheral tissues. In the studies reported here we compared the independent effects of GLP-1-(7-36)NH(2), GLP-1-(7-37), and GLP-1-(9-36)NH(2) on parameters of iv glucose tolerance and determined whether GLP-1-(9-36) NH(2) inhibits the insulinotropic actions of GLP-1. Ten healthy subjects underwent 4 separate frequently sampled iv glucose tolerance tests during infusions of GLP-1-(7-37), GLP-1-(7-36)NH(2), GLP-1-(9-36)NH, or saline. Results from the iv glucose tolerance test were used to obtain indexes of beta-cell function (acute insulin response to glucose) and iv glucose tolerance (glucose disappearance constant), and the minimal model of glucose kinetics was used to obtain indexes of glucose effectiveness and insulin sensitivity. Compared with control studies, both GLP-1-(7-36)NH(2) and GLP-1-(7-37) significantly increased acute insulin response to glucose, glucose disappearance constant, glucose effectiveness, and glucose effectiveness at zero insulin, but did not change the insulin sensitivity index. In contrast, none of the parameters of glucose tolerance was measurably affected by GLP-1-(9-36) amide. In a second set of experiments, 10 healthy subjects had glucose-stimulated insulin secretion measured during an infusion of GLP-1-(7-36)NH(2) alone or with a simultaneous infusion of GLP-1-(9-36)NH(2) that increased plasma levels approximately 10-fold over those produced by unmetabolized GLP-1. Augmentation of glucose-stimulated insulin secretion by GLP-1-(7-36)NH(2) was not altered by the coadministration of GLP-1-(9-36)NH(2). Based on these results we conclude that GLP-1-(9-36)NH(2) does not regulate insulin release or glucose metabolism in healthy humans. C1 Univ Cincinnati, Div Endocrinol, Cincinnati, OH 45267 USA. Univ Washington, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP D'Alessio, DA (reprint author), Univ Cincinnati, Div Endocrinol, ML-0547, Cincinnati, OH 45267 USA. EM david.d'alessio@uc.edu FU NCRR NIH HHS [M01-RR-08084]; NIDDK NIH HHS [R01-DK-54263] NR 37 TC 94 Z9 102 U1 0 U2 9 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 APR PY 2003 VL 88 IS 4 BP 1772 EP 1779 DI 10.1210/jc.2002-021479 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 667BM UT WOS:000182211000057 PM 12679472 ER PT J AU Yang, CL Angell, J Mitchell, R Ellison, DH AF Yang, CL Angell, J Mitchell, R Ellison, DH TI WNK kinases regulate thiazide-sensitive Na-Cl cotransport SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID FUNCTIONAL EXPRESSION; GITELMANS-SYNDROME; DISTAL NEPHRON; MUTATIONS; HYPERTENSION; DIURETICS; DENSITY; TUBULE; KIDNEY; GENE AB Pseudohypoaldosteronism type II (PHAII) is an autosomal dominant disorder of hyperkalemia and hypertension. Mutations in two members of the WNK kinase family, WNK1 and WNK4, cause the disease. WNK1 mutations are believed to increase WNK1 expression; the effect of WNK4 mutations remains unknown. The clinical phenotype of PHAII is opposite to Gitelman syndrome, a disease caused by dysfunction of the thiazide-sensitive Na-Cl cotransporter. We tested the hypothesis that WNK kinases regulate the mammalian thiazide-sensitive Na-Cl cotransporter (NCC). Mouse WNK4 was cloned and expressed in Xenopus oocytes with or without NCC. Coexpression with WNK4 suppressed NCC activity by more than 85%. This effect did not result from defects in NCC synthesis or processing, but was associated with an 85% reduction in NCC abundance at the plasma membrane. Unlike WNK4, WNK1 did not affect NCC activity directly. WNK1, however, completely prevented WNK4 inhibition of NCC. Some WNK4 mutations that cause PHAII retained NCC-inhibiting activity, but the Q562E WNK4 demonstrated diminished activity, suggesting that some PHAII mutations lead to loss of NCC inhibition. Gain-of-function WNK1 mutations would be expected to inhibit WNK4 activity, thereby activating NCC, contributing to the PHAII phenotype. Together, these results identify WNK kinases as a previously unrecognized sodium regulatory pathway of the distal nephron. This pathway likely contributes to normal and pathological blood pressure homeostasis. C1 Oregon Hlth & Sci Univ, Dept Med, Div Nephrol & Hypertens, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Ellison, DH (reprint author), Oregon Hlth & Sci Univ, Dept Med, Div Nephrol & Hypertens, PP262,3314 SW US Vet Hosp Rd, Portland, OR 97239 USA. OI Ellison, David/0000-0003-2915-265X FU NIDDK NIH HHS [R01 DK-51496, R01 DK051496] NR 25 TC 303 Z9 311 U1 1 U2 9 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 APR PY 2003 VL 111 IS 7 BP 1039 EP 1045 DI 10.1172/JCI200317443 PG 7 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 662VY UT WOS:000181970600015 PM 12671053 ER PT J AU Song, YL Liu, CX McTeague, M Finegold, SM AF Song, YL Liu, CX McTeague, M Finegold, SM TI 16S ribosomal DNA sequence-based analysis of clinically significant gram-positive anaerobic cocci SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID SP-NOV; GENUS PEPTOSTREPTOCOCCUS; RNA GENE; IDENTIFICATION; SPECIMENS; BACTERIA; PROPOSAL; SYSTEMS; HUMANS AB Sequence analysis of the 16S rRNA gene represents a highly accurate and versatile method for bacterial classification and identification, even when the species in question is notoriously difficult to identify by phenotypic means. However, its use for identification based on public sequence databases is not without limitation due to the presence of ambiguous data in the databases. In this study, we evaluated the utility of 16S ribosomal DNA sequencing as a means of identifying clinically important gram-positive anaerobic cocci (GPAC) by sequencing 13 type strains of established GPAC species and 156 clinical isolates that had been studied only by phenotypic tests. Among the 13 type strains of GPAC species we tested, only 4 gave a "perfect" match with their corresponding sequences in GenBank, whereas the other 9 had lower sequence similarities (<98%). This indicates that data in the public database may be inaccurate at times. Based on the sequences of the 13 type strains obtained in this study, 84% (131 of 156) of the clinical isolates were accurately identified to species level, with the remaining 25 clinical strains revealing nine unique sequences that may represent eight novel species. This finding is in contrast to the phenotypic identification results, by which only 56% of isolates were correctly identified to species level. C1 W Los Angeles Vet Affairs Med Ctr, Res Serv, Los Angeles, CA 90073 USA. W Los Angeles Vet Affairs Med Ctr, Clin Microbiol Lab, Los Angeles, CA 90073 USA. W Los Angeles Vet Affairs Med Ctr, Infect Dis Sect, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Microbiol Mol Genet & Immunol, Los Angeles, CA 90073 USA. RP Song, YL (reprint author), W Los Angeles Vet Affairs Med Ctr, Res Serv, 11301 Wilshire Blvd,Rm E3-237,Bldg 304, Los Angeles, CA 90073 USA. NR 39 TC 51 Z9 54 U1 0 U2 0 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 APR PY 2003 VL 41 IS 4 BP 1363 EP 1369 DI 10.1128/JCM.41.4.1363-1369.2003 PG 7 WC Microbiology SC Microbiology GA 666LZ UT WOS:000182179900003 PM 12682115 ER PT J AU Lewis, JH Kilgore, ML Goldman, DP Trimble, EL Kaplan, R Montello, MJ Housman, MG Escarce, JJ AF Lewis, JH Kilgore, ML Goldman, DP Trimble, EL Kaplan, R Montello, MJ Housman, MG Escarce, JJ TI Participation of patients 65 years of age or older in cancer clinical trials SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID SOUTHWEST-ONCOLOGY-GROUP; ACUTE MYELOID-LEUKEMIA; CHEMOTHERAPY; WOMEN; UNDERREPRESENTATION; REPRESENTATION AB Purpose: Although 61% of new cases of cancer occur among the elderly, recent studies indicate that the elderly comprise only 25% of participants in cancer clinical trials. Further investigation into the reasons for low elderly participation is warranted. Our objective was to evaluate the participation of the elderly in clinical trials sponsored by the National Cancer Institute (NCI) and assess the impact of protocol exclusion criteria on elderly participation. Patients and Methods: We conducted a retrospective analysis using NCI data, analyzing patient and trial characteristics for 59,300 patients enrolled onto 495 NCI-sponsored, cooperative group trials, active from 1997 through 2000. Our main outcome measure was the proportion of elderly patients enrolled onto cancer clinical trials compared with the proportion of incident cancer patients who are elderly. Results: Overall, 32% of participants in phase II and III clinical trials were elderly, compared with 61% of patients with incident cancers in the United States who are elderly. The degree of underrepresentation was more pronounced in trials for early-stage cancers than in trials for late-stage cancers (P < .001). Furthermore, protocol exclusion criteria on the basis of organ-system abnormalities and functional status limitations were associated with lower elderly participation. We estimate that if protocol exclusions were relaxed, elderly participation in cancer trials would be 60%. Conclusion: The elderly are underrepresented in cancer clinical trials relative to their disease burden. Older patients are more likely to have medical histories that make them ineligible for clinical trials because of protocol exclusions. Insurance coverage for clinical trials is one step toward improvement of elderly access to clinical trials. Without a change in study design or requirements, this step may not be sufficient. (C) 2003 by American Society of Clinical Oncology. C1 RAND Hlth, Santa Monica, CA 90407 USA. Calif State Univ Los Angeles, Los Angeles, CA 90032 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. NCI, NIH, Bethesda, MD 20892 USA. RP Lewis, JH (reprint author), RAND, 1700 Main St, Santa Monica, CA 90407 USA. NR 37 TC 487 Z9 493 U1 0 U2 8 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 330 JOHN CARLYLE ST, STE 300, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD APR 1 PY 2003 VL 21 IS 7 BP 1383 EP 1389 DI 10.1200/JCO.2003.08.010 PG 7 WC Oncology SC Oncology GA 662XB UT WOS:000181973400028 PM 12663731 ER PT J AU Hendrick, V Smith, LM Hwang, S Altshuler, LL Haynes, D AF Hendrick, V Smith, LM Hwang, S Altshuler, LL Haynes, D TI Weight gain in breastfed infants of mothers taking antidepressant medications SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID MILK; FLUOXETINE; GROWTH AB Background. Little is known about the physical development of infants who are exposed to antidepressant medications through breast milk. Method: Seventy-eight breastfeeding women taking antidepressant medications were included in the study. Maternal mood was prospectively evaluated at 6, 12, and 18 months postpartum. Infants' weights were obtained from review of pediatric records. Data were gathered from 1997 to 2002. Results: Infants' weights were not significantly different from weights of 6-month-old breastfed infants from normative populations. However, infants of mothers who relapsed to relatively long-lasting major depressive episodes (lasting 2 months or more) following delivery weighed significantly (p = .002) less when compared with infants of mothers who relapsed to brief depressive episodes (< 2 months) and infants of mothers who did not relapse to depression in the postpartum period. This finding remained after including medication dosage and infant birth weight as covariates. Conclusion: Exposure to antidepressant medications through breast milk does not appear to affect infants' weight. However, infants exposed to maternal depression lasting 2 months or more appear to experience significantly lower weight gain than infants of euthymic mothers or mothers who experience brief (< 2 months) major depressive episodes. Maternal depression following delivery may influence behaviors that, over the course of 2 months or more, affect infants' weight gain. C1 Univ Calif Los Angeles, Neuropsychiat Inst & Hosp, Dept Psychiat & Behav Sci, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Harbor Med Ctr, Dept Pediat, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Hendrick, V (reprint author), Univ Calif Los Angeles, Neuropsychiat Inst & Hosp, Dept Psychiat & Behav Sci, UCLA Med Plaza,Bldg 300,Ste 2345, Los Angeles, CA 90095 USA. FU NCRR NIH HHS [M01 RR00425]; NIMH NIH HHS [MH01451-01] NR 14 TC 24 Z9 27 U1 1 U2 3 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 APR PY 2003 VL 64 IS 4 BP 410 EP 412 PG 3 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 672WH UT WOS:000182545700009 PM 12716242 ER PT J AU Olstein, J Gordon, A Conigliaro, J AF Olstein, J Gordon, A Conigliaro, J TI Intravenous ethanol and treatment for alcohol withdrawal syndrome in the perioperative period. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 77 EP 77 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300220 ER PT J AU Rehman, SU Basile, JN Clyburn, EB Shakaib, A Johnson, RH AF Rehman, SU Basile, JN Clyburn, EB Shakaib, A Johnson, RH TI Not every "OA" is due to "DJD" - Hemochromatosis presenting as "OA" SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Mt Pleasant, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 83 EP 83 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300248 ER PT J AU Pearlman, RA Beneda, HW Neuzil, KM AF Pearlman, RA Beneda, HW Neuzil, KM TI Ensuring clinician-patient communication with HIV testing. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 135 EP 135 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300483 ER PT J AU Arterburn, DE Crane, PK Sullivan, SD AF Arterburn, DE Crane, PK Sullivan, SD TI The coming epidemic of obesity in elderly Americans SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. RI Crane, Paul/C-8623-2014 NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 140 EP 140 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300505 ER PT J AU Arterburn, DE Crane, PK Veenstra, DL AF Arterburn, DE Crane, PK Veenstra, DL TI The efficacy and safety of sibutramine for weight loss: A systematic review SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. RI Crane, Paul/C-8623-2014 NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 140 EP 140 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300504 ER PT J AU Bryson, CL Davis, G Yueh, B McDonell, MB Micek, M Fihn, SD AF Bryson, CL Davis, G Yueh, B McDonell, MB Micek, M Fihn, SD TI Complimentary or alternative: Does alternative medicine use delay cancer therapy? SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 141 EP 141 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300509 ER PT J AU Chew, LD Nelson, KM Bradley, KA AF Chew, LD Nelson, KM Bradley, KA TI Association between alcohol consumption and diabetes care-data from the 2001 behavioral risk factor and surveillance system (BRFSS) SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 142 EP 142 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300515 ER PT J AU Fultz, S Rabeneck, L Rodriguez-Barradas, M Justice, AC AF Fultz, S Rabeneck, L Rodriguez-Barradas, M Justice, AC TI Hepatitis C confection is associated with an increased symptom burden in HIV positive veterans SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. VA Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 146 EP 146 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300534 ER PT J AU Mrus, JM Sherman, SN Ho, ML Hornung, RW Feinberg, J Fultz, SL Justice, AC Puchalski, CM Mandell, KL Tsevat, J AF Mrus, JM Sherman, SN Ho, ML Hornung, RW Feinberg, J Fultz, SL Justice, AC Puchalski, CM Mandell, KL Tsevat, J TI Factors associated with "short-term" and "long-term" adherence to antiretroviral therapy in patients with HIV/AIDS SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VAMC, Cincinnati, OH USA. Univ Cincinnati, Cincinnati, OH USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. George Washington Univ, Washington, DC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 152 EP 152 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300560 ER PT J AU Nelson, K Bradley, K AF Nelson, K Bradley, K TI Self-perception of weight among a national sample of overweight and obese Americans. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Washington, VA Puget Sound, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 153 EP 153 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300564 ER PT J AU Nguyen, J McDonell, MB Young, BA Fihn, SD AF Nguyen, J McDonell, MB Young, BA Fihn, SD TI Validation of patient self-report of diabetes mellitus. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Washington, Sch Med, Dept Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 153 EP 153 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300565 ER PT J AU Tsevat, J Sherman, SN Feinberg, J Mrus, JM Leonard, AC Mandell, KL Holmes, WC Justice, AC Fultz, SL Puchalski, CM AF Tsevat, J Sherman, SN Feinberg, J Mrus, JM Leonard, AC Mandell, KL Holmes, WC Justice, AC Fultz, SL Puchalski, CM TI Can life improve after developing HIV/AIDS? SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Cincinnati, Cincinnati, OH USA. Cincinnati VAMC, Cincinnati, OH USA. Univ Penn, Philadelphia, PA 19104 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. George Washington Univ, Washington, DC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 160 EP 160 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300596 ER PT J AU Beers, BB McDonald, VJ Quistberg, DA Ravenell, KL Asch, DA Shea, JA AF Beers, BB McDonald, VJ Quistberg, DA Ravenell, KL Asch, DA Shea, JA TI Disparities in health literacy between African American and now African American primary care patients. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 PVAMC, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RI Quistberg, D Alex/C-7953-2009 OI Quistberg, D Alex/0000-0001-9730-2686 NR 0 TC 12 Z9 12 U1 0 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 169 EP 169 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300637 ER PT J AU Chew, LD Bradley, KA AF Chew, LD Bradley, KA TI Brief questions to detect inadequate health literacy among VA patients. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 170 EP 170 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300644 ER PT J AU Long, JA Bamba, MI Kressin, NR AF Long, JA Bamba, MI Kressin, NR TI Occupation classification: No easy short cuts. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. VA Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 180 EP 180 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300691 ER PT J AU Long, JA Gomez, A Cox, M Asch, DA Shea, JA AF Long, JA Gomez, A Cox, M Asch, DA Shea, JA TI Racial sensitivity among first and second year medical students. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 180 EP 180 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300690 ER PT J AU Long, JA Melissa, BI Shea, JA AF Long, JA Melissa, BI Shea, JA TI Missing race data in VA based disparities research: A systematic review. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 180 EP 181 PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300692 ER PT J AU O'Malley, KJ Haidet, PM Sharf, B Collins, TC Tranh, A Johnson, ML Wray, NP AF O'Malley, KJ Haidet, PM Sharf, B Collins, TC Tranh, A Johnson, ML Wray, NP TI Trust in physician, facility, and system: Qualitative differences between ethnic groups. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Baylor Coll Med, Houston, TX 77030 USA. Houston VA Med Ctr, Houston, TX USA. Texas A&M Univ, College Stn, TX USA. Univ N Carolina, Sch Publ Hlth, Chapel Hill, NC USA. NR 0 TC 3 Z9 3 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 184 EP 184 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300708 ER PT J AU Petersen, LA Normand, S Druss, B Rosenheck, R AF Petersen, LA Normand, S Druss, B Rosenheck, R TI Process of care and outcome after acute myocardial infarction for patients with mental illness: Are there disparities? SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Houston VAMC, Houston, TX USA. Harvard Univ, Boston, MA 02115 USA. Yale Univ, West Haven, CT USA. NR 0 TC 11 Z9 13 U1 1 U2 3 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 185 EP 186 DI 10.1046/j.1440-1746.2003.02943.x PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300714 PM 12542604 ER PT J AU Shea, JA Guerra, C Weiner, J Aguirre, A Schaffer, M Asch, DA AF Shea, JA Guerra, C Weiner, J Aguirre, A Schaffer, M Asch, DA TI Health literacy and patient satisfaction. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Penn, Philadelphia, PA 19104 USA. Hlth Partners, Philadelphia, PA USA. PVAMC, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. NR 0 TC 1 Z9 1 U1 0 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 187 EP 188 PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300724 ER PT J AU Volpp, KG Epstein, A Williams, SV AF Volpp, KG Epstein, A Williams, SV TI Race-specific mortality effects of market reform in New Jersey. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Philadelphia VA Med Ctr, Philadelphia, PA USA. Univ Penn, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 189 EP 189 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300732 ER PT J AU Hightower, A Boyko, E Asthana, S Borson, S Falzgraf, S Baker, L Gleason, C Cholerton, B AF Hightower, A Boyko, E Asthana, S Borson, S Falzgraf, S Baker, L Gleason, C Cholerton, B TI Literacy predicts cognitive function in older adults. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Wisconsin, Madison, WI 53706 USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 194 EP 194 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300754 ER PT J AU Lawrence, VA Hazuda, HP Bradshaw, P Cornell, JE Mulrow, CD AF Lawrence, VA Hazuda, HP Bradshaw, P Cornell, JE Mulrow, CD TI Predicting elders' functional recovery after major abdominal surgery. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 195 EP 195 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300761 ER PT J AU Roman, GC Perdomo, CA Pratt, RD AF Roman, GC Perdomo, CA Pratt, RD TI Patients with vascular dementia differ from patients with Alzheimer's disease with respect to population characteristics and pattern of cognitive decline. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. Vet Adm Hosp, San Antonio, TX USA. Eisai Inc, Teaneck, NJ USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 198 EP 199 PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300776 ER PT J AU Roman, GC Perdomo, CA Pratt, RD AF Roman, GC Perdomo, CA Pratt, RD TI Donepezil improves cognition, global function and ability to perform activities of daily living in patients with vascular dementia. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. Vet Adm Hosp, San Antonio, TX USA. Eisai Inc, Teaneck, NJ USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 198 EP 198 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300775 ER PT J AU Goldzweig, C Washington, D Lanto, AB Yano, E AF Goldzweig, C Washington, D Lanto, AB Yano, E TI Organizational predictors of breast and cervical cancer screening. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. VA Greater Los Angeles HSR&D Ctr Excellence, Sepulveda, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 206 EP 206 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300811 ER PT J AU Petersen, LA Normand, S AF Petersen, LA Normand, S TI Access to coronary angiography in the regionalized veterans affairs (VA) health care delivery system. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Houston VAMC, Houston, TX USA. Harvard Univ, Boston, MA 02115 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 213 EP 213 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300842 ER PT J AU Rehman, SU Cope, DW Kilpatrick, AO Neitert, PJ Shakaib, A AF Rehman, SU Cope, DW Kilpatrick, AO Neitert, PJ Shakaib, A TI What to wear this morning? Effect of doctors' dress on patients' trust and confidence. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Med Univ S Carolina, Ralph Johnson VA Med Ctr, Mt Pleasant, MI USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Med Univ S Carolina, Charleston, SC 29425 USA. Med Univ S Carolina, Mt Pleasant, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 214 EP 214 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300848 ER PT J AU Shi, C Gralnek, IM Dulai, G Asch, SM AF Shi, C Gralnek, IM Dulai, G Asch, SM TI Are patients substituting over-the-counter H2-receptor antagonists for physician care? SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Calif Los Angeles, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 216 EP 216 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300858 ER PT J AU Volpp, KG Epstein, A Ketcham, J Williams, SV AF Volpp, KG Epstein, A Ketcham, J Williams, SV TI Market reform in New Jersey and its effect on mortality for inpatient medical conditions. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Philadelphia VA Med Ctr, Philadelphia, PA USA. Univ Penn, Philadelphia, PA 19104 USA. Univ Calif Berkeley, Berkeley, CA 94720 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 219 EP 219 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300873 ER PT J AU Yano, E Lanto, A Lee, M Rubenstein, LM Sherman, SE AF Yano, E Lanto, A Lee, M Rubenstein, LM Sherman, SE TI Does guideline-concordant clinical reorganization of smoking cessation care improve patient quit rates?: Results of a group randomized trial. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Greater Los Angeles HSR&D Ctr Excellence, Sepulveda, CA USA. RAND Corp, Sepulveda, CA USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 221 EP 221 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300880 ER PT J AU Mortensen, E Restrepo, M Anzueto, A Pugh, J AF Mortensen, E Restrepo, M Anzueto, A Pugh, J TI Guideline-concordant antimicrobial therapy and mortality in patients with community-acquired pneumonia. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 226 EP 227 PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300908 ER PT J AU Tsevat, J Puchalski, CM Sherman, SN Holmes, WC Feinberg, J Leonard, AC Mrus, JM Mandell, KL Pargament, KI Justice, AC Fultz, SL Ellison, CG McCullough, ME Peterman, AH AF Tsevat, J Puchalski, CM Sherman, SN Holmes, WC Feinberg, J Leonard, AC Mrus, JM Mandell, KL Pargament, KI Justice, AC Fultz, SL Ellison, CG McCullough, ME Peterman, AH TI Spirituality and religion in patients with HIV/AIDS. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Cincinnati, Cincinnati, OH USA. Cincinnati VAMC, Cincinnati, OH USA. George Washington Univ, Washington, DC USA. Univ Penn, Philadelphia, PA 19104 USA. Bowling Green State Univ, Bowling Green, OH 43403 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Texas, Austin, TX 78712 USA. Univ Miami, Coral Gables, FL 33124 USA. Evanston NW Healthcare, Evanston, IL USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 234 EP 234 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300943 ER PT J AU Haidet, P Kelly, P Kuebeler, M Richards, B Helmer, D Paterniti, D Snow, A Fortin, A Wagner, D Bentley, S Hatem, D Gracey, C Harrell, H Babu, V Wray, N Inui, T AF Haidet, P Kelly, P Kuebeler, M Richards, B Helmer, D Paterniti, D Snow, A Fortin, A Wagner, D Bentley, S Hatem, D Gracey, C Harrell, H Babu, V Wray, N Inui, T TI Measuring the hidden curricula of medical schools. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Houston VAMC, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. UMDNJ, Newark, NJ USA. Univ Calif Davis, Sacramento, CA 95817 USA. Yale Univ, New Haven, CT USA. MSUCHM, E Lansing, MI USA. MSUCOM, E Lansing, MI USA. Univ Massachusetts, Worcester, MA 01605 USA. Univ Rochester, Rochester, NY USA. Univ Florida, Gainesville, FL USA. Penn State Univ, Hershey, PA USA. Indiana Univ, Indianapolis, IN 46204 USA. NR 0 TC 1 Z9 1 U1 0 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 243 EP 243 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564300984 ER PT J AU Rosenfeld, KE Lorenz, K Hauser, J AF Rosenfeld, KE Lorenz, K Hauser, J TI To "Wit": Understanding the impact of the dramatic arts in medical education. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Greater Los Angeles, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Northwestern Univ, Chicago, IL 60611 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 253 EP 253 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564301033 ER PT J AU Rubenstein, LV Swanson, KA Meredith, L Lee, ML Ford, DE Rost, KM AF Rubenstein, LV Swanson, KA Meredith, L Lee, ML Ford, DE Rost, KM TI Are discomfort with depression care and/or clinical uncertainty associated with burnout among primary care clinicians? SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Greater Los Angeles, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. RAND, Santa Monica, CA USA. Johns Hopkins Univ, Baltimore, MD USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 254 EP 254 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564301036 ER PT J AU Johnson, KM Bradley, KA AF Johnson, KM Bradley, KA TI Exercise, television viewing, and obesity among female veterans. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 266 EP 267 PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564301096 ER PT J AU Takahashi, TA Johnson, KM Bradley, KA AF Takahashi, TA Johnson, KM Bradley, KA TI Young US adults at risk for HIV: Perceptions of risk and HIV testing practices. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 271 EP 271 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564301116 ER PT J AU Fancher, T Price, M Haidet, PM Paterniti, D AF Fancher, T Price, M Haidet, PM Paterniti, D TI Prolonged suffering or failure of conservative therapy: Considering patients' perspectives on elective total knee replacement. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Calif Davis, Sacramento, CA 95817 USA. Baylor Coll Med, Houston, TX 77030 USA. Houston VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 273 EP 273 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564301128 ER PT J AU Asch, SM McGlynn, EA Hogan, MM Shekelle, PG Rod, H Keesey, J Adams, J Rubenstein, L Kerr, EA AF Asch, SM McGlynn, EA Hogan, MM Shekelle, PG Rod, H Keesey, J Adams, J Rubenstein, L Kerr, EA TI Global quality of care in the veteran's administration as compared to a national sample. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 VA, Los Angeles, CA USA. RAND Corp, Santa Monica, CA USA. VA, Ann Arbor, MI USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 278 EP 279 PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564301153 ER PT J AU Shi, CW Asch, SM Fielder, E Gelberg, L Brook, RH Leake, B Shapiro, MF Dowling, P Nichol, M AF Shi, CW Asch, SM Fielder, E Gelberg, L Brook, RH Leake, B Shapiro, MF Dowling, P Nichol, M TI Usage patterns of over-the-counter phenazopyridine (pyridium) SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE pharmacy; survey; over-the-counter; phenazopyridine ID TO-OTC SWITCH; MEDICATION PRESCRIBING PATTERNS; SELF-MEDICATION; PHYSICIAN SERVICES; DRUGS; PRESCRIPTION; AVAILABILITY; ANTAGONISTS; RX; RECLASSIFICATION AB OBJECTIVES: Little is known about how the public uses formerly prescription medications that are available over-the-counter (OTC). This study examines whether consumers inappropriately use and substitute a recently widely distributed OTC urinary analgesic, phenazopyridine, for provider care. DESIGN/SETTING: We conducted a cross-sectional survey of a stratified cluster random sample of OTC phenazopyridine purchasers (N = 434) in 31 Los Angeles retail pharmacies over 5 months. Recruited by shelf advertisements, participants were 18 years or older who purchased a phenazopyridine product. Each completed a 25-item self-administered anonymous questionnaire. Inappropriate use was defined as 1) having medical contraindications to phenazopyridine, or 2) not having concurrent antibiotic and/or provider evaluation for the urinary symptoms. RESULTS: The survey response rate was 58%. Fifty-one percent of the respondents used OTC phenazopyridine inappropriately, and 38% substituted it for medical care. Multiple logistic regression analyses revealed that inappropriate use was correlated with having little time to see a provider (odds ratio [OR], 1.57; 95% confidence interval [95% CI], 1.26 to 1.96), receiving friend's or family's advice (OR, 1.25; 95% CI, 1.05 to 1.47), having prior urinary tract infections (OR, 0.49; 95% CI, 0.30 to 0.80), having used prescription phenazopyridine, (OR, 0.40; 95% CI, 0.25 to 0.63), and having back pain (OR, 0.34; 95% CI, 0.16 to 0.74). Similar correlates were found in those who substituted OTC phenazopyridine for provider care. Respondents with incorrect knowledge about phenazopyridine's mode of action had 1.9 times greater odds of inappropriate use and 2.2 times greater odds of substitution than those who had correct knowledge about this drug. CONCLUSION: Inappropriate use of OTC phenazopyridine appears common. Increasing the public's knowledge about reclassified drugs may help to mitigate this problem. C1 Univ Calif Los Angeles, Dept Family Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Gen Internal Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Social Sci Res Inst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med & Publ Hlth, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90095 USA. Univ So Calif, Dept Pharmaceut Econ & Policy, Los Angeles, CA USA. RAND Corp, Santa Monica, CA USA. Vet Affairs Greater Los Angeles, Dept Internal Med, Los Angeles, CA USA. RP Shi, CW (reprint author), Univ Calif Los Angeles, Dept Family Med, 924 Westwood Blvd,Suite 650, Los Angeles, CA 90095 USA. OI Dowling, Patrick /0000-0002-3492-1735 FU AHRQ HHS [F32 HS 11507-01, F32 HS011507] NR 41 TC 6 Z9 6 U1 0 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. 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