FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Gage, B Labovitz, A Persson, M Zabalgoitia, M Baruch, L Juul-Moller, S Horrow, J AF Gage, B Labovitz, A Persson, M Zabalgoitia, M Baruch, L Juul-Moller, S Horrow, J TI Predictors of stroke in 7329 patients with atrial fibrillation treated with anticoagulant therapy in the SPORTIF III and V trials SO STROKE LA English DT Meeting Abstract CT 30th International Stroke Conference CY FEB 02-04, 2005 CL New Orleans, LA SP Amer Stroke Assoc C1 Washington Univ, Sch Med, St Louis, MO USA. St Louis Univ Hosp, St Louis, MO USA. AstraZeneca R&D, Molndal, Sweden. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. Univ Hosp Malmo, Malmo, Sweden. AstraZeneca, Wilmington, DE 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 0039-2499 J9 STROKE JI Stroke PD FEB PY 2005 VL 36 IS 2 BP 423 EP 424 PG 2 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 904UR UT WOS:000227523800031 ER PT J AU Reese, SR Kudsk, KA Genton, L Ikeda, S AF Reese, SR Kudsk, KA Genton, L Ikeda, S TI L-selectin and alpha 4 beta 7 integrin, but not ICAM-1, regulate lymphocyte distribution in gut-associated lymphoid tissue of mice SO SURGERY LA English DT Article ID TOTAL PARENTERAL-NUTRITION; ADHESION MOLECULE-1 EXPRESSION; MUCOSAL IMMUNITY; BETA(7) INTEGRINS; BOMBESIN; ADDRESSIN; PRESERVATION; INTESTINE; ROUTE; MOUSE AB Background. Adhesion molecules on lymphocytes (L-selectin and alpha4beta7) and endothelium (MAdCAM-1 and ICAM-1) direct lymphocytes into the gut-associated lymphoid tissue (GALT) of mice. Parenteral nutrition and MAdCAM-1 blockade reduce GALT cell mass. This study examined the effects on GALT cell mass of blockade of L-selectin, alpha4beta7, and ICAM-1 with saturating doses of monoclonal antibodies. Methods. In experiment 1, L-selectin and alpha4beta7 expression were measured by flow cytometry in chow-fed mice. In experiment 2, 49 mice randomly received chow, parenteral nutrition, chow + intravenous (TV) anti-CD62L, chow + IV anti-LPAM-1, or chow + IV isotype control antibody. After 4 days, lymphocyte yields in GALT and respiratory and intestinal IgA levels were measured. In experiment 3, 2 7 mice randomly received chow, parenteral nutrition, chow + TV anti-ICAM-1 monoclonal antibody, or chow + TV isotype control antibody for 5 days. Lymphocyte counts and IgA Levels were determined as in experiment 2. Results. Some 80% of all circulating lymphocytes were positive for L-selectin and alpha4beta7. Lymphocyte counts in the Peyer's patches, lamina propria, and intraepithelial space were lower in the L-selectin and alpha4beta7 blockade groups (3.1, 1.8, and 0.9 X 10(6) and 2.1, 1.9, and 0.7 X 10(6), respectively) than in the chow group (5.9, 3.0, and 1.7 X 10(6); P < .02 vs the L-selectin group and P <.001 vs the alpha4beta7 group) and similar to the levels in the parenteral group. Respiratory and intestinal IgA levels are maintained in all groups except the parenteral group (P <.04 vs the chow group). ICAM-1 blockade did not influence cell counts or IgA levels. Conclusion. Most circulating lymphocytes have GALT homing potential. Their distribution into GALT is hindered by blockade of L-selectin or alpha4beta7, but not by ICAM-1. C1 Univ Wisconsin, Sch Med, Dept Surg, Ctr Clin Sci, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Vet Adm Surg Serv, Madison, WI USA. RP Kudsk, KA (reprint author), Univ Wisconsin, Sch Med, Dept Surg, Ctr Clin Sci, H4-730,600 Highland Ave, Madison, WI 53792 USA. EM kudsk@surgery.wisc.edu FU NIGMS NIH HHS [R01 GM 53439-06A1] NR 23 TC 9 Z9 10 U1 0 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 FEB PY 2005 VL 137 IS 2 BP 209 EP 215 DI 10.1016/j.surg.2004.08.003 PG 7 WC Surgery SC Surgery GA 895OV UT WOS:000226873700013 PM 15674203 ER PT J AU Sanches, M Sassi, RB Axelson, D Nicoletti, M Brambilla, P Hatch, JP Keshavan, MS Ryan, ND Birmaher, B Soares, JC AF Sanches, M Sassi, RB Axelson, D Nicoletti, M Brambilla, P Hatch, JP Keshavan, MS Ryan, ND Birmaher, B Soares, JC TI Subgenual prefrontal cortex of child and adolescent bipolar patients: a morphometric magnetic resonance imaging study SO PSYCHIATRY RESEARCH-NEUROIMAGING LA English DT Article DE neuroimaging; prefrontal cortex; bipolar disorder; adolescents ID MOOD DISORDERS; MRI; VOLUME; PATHOPHYSIOLOGY; SCHIZOPHRENIA; ABNORMALITIES; RELIABILITY; DEPRESSION; REDUCTION; VALIDITY AB The subgenual prefrontal cortex (SGPFC) plays an important role in emotional processing. We carried out a magnetic resonance imaging (MRI) study comparing the volume of the SGPFC in child and adolescent bipolar patients and healthy controls. The sample consisted of 15 children and adolescents who met DSM-IV criteria for bipolar disorder (mean age S.D.=15.5 +/- 3.5 years) and 21 healthy adolescents (mean age S.D.=16.9 +/- 3.8 years). MR images were obtained with a 1.5 T GE Signa Imaging System with Signa 5.4.3 software. SGPFC volumes were measured with the semi-automated software MedX (Sensor Systems, Sterling, VA, USA). ANCOVA was performed to compare SGPFC volumes between groups, using age, gender and intra-cranial volume (ICV) as covariates. The volumes (mean +/- S.D.) of the right and left SGPFC for bipolar patients were 291.27 +/- 88.70 mm(3) and 284.86 +/- 83.98 mm(3), respectively. For healthy controls, the right and left SGPFC volumes were 284.95 +/- 73.33 mm(3) and 307.55 +/- 73.67 mm(3), respectively. There were no statistically significant differences between groups regarding right or left SGPFC volumes. We found no evidence of volumetric abnormalities in the SGPFC of bipolar children and adolescents. (c) 2004 Elsevier Ireland Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Div Audie L Murphy, San Antonio, TX USA. Univ Fed Sao Paulo, Dept Psychiat, Sao Paulo, Brazil. Univ Sao Paulo, Sch Med, Dept Psychiat, Sao Paulo, Brazil. Univ Pittsburgh, Med Ctr, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA USA. Univ Udine, Dept Pathol & Expt & Clin Med, Sect Psychiat, I-33100 Udine, Italy. 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. EM soares@uthscsa.edu RI brambilla, paolo/B-4184-2010 OI brambilla, paolo/0000-0002-4021-8456 FU NIMH NIH HHS [MH 01736, MH 30915, MH 55123, MH 59929] NR 24 TC 46 Z9 46 U1 1 U2 6 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0925-4927 J9 PSYCHIAT RES-NEUROIM JI Psychiatry Res. Neuroimaging PD JAN 30 PY 2005 VL 138 IS 1 BP 43 EP 49 DI 10.1016/j.psychresns.2004.11.004 PG 7 WC Clinical Neurology; Neuroimaging; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 905ZW UT WOS:000227611300005 PM 15708300 ER PT J AU Rumsfeld, JS Ho, PM AF Rumsfeld, JS Ho, PM TI Depression and cardiovascular disease - A call for recognition SO CIRCULATION LA English DT Editorial Material DE editorials; myocardial infarction; depression; drugs, antidepressive; comorbidity ID MAJOR DEPRESSION; MYOCARDIAL-INFARCTION; RANDOMIZED-TRIAL; SERTRALINE; EVENTS; LIFE; SURVIVAL; STRESS; IMPACT; RISK C1 Denver Vet Affairs Med Ctr, Cardiol Sect, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Div Cardiol, Denver, CO 80262 USA. RP Rumsfeld, JS (reprint author), Denver Vet Affairs Med Ctr, Cardiol Sect, 1055 Clermont St, Denver, CO 80220 USA. EM John.Rumsfeld@med.va.gov NR 21 TC 114 Z9 115 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 JAN 25 PY 2005 VL 111 IS 3 BP 250 EP 253 DI 10.1161/01.CIR.0000154573.62822.89 PG 4 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 890HB UT WOS:000226501200003 PM 15668351 ER PT J AU Rockey, DC Poulson, E Niedzwiecki, D Davis, W Bosworth, HB Sanders, L Yee, J Henderson, J Hatten, P Burdick, S Sanyal, A Rubin, DT Sterling, M Akerkar, G Bhutani, MS Binmoeller, K Garvie, J Bini, EJ Mcuaid, K Foster, WL Thompson, WM Dachman, A Halvorsen, R AF Rockey, DC Poulson, E Niedzwiecki, D Davis, W Bosworth, HB Sanders, L Yee, J Henderson, J Hatten, P Burdick, S Sanyal, A Rubin, DT Sterling, M Akerkar, G Bhutani, MS Binmoeller, K Garvie, J Bini, EJ Mcuaid, K Foster, WL Thompson, WM Dachman, A Halvorsen, R TI Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison SO LANCET LA English DT Article ID COLORECTAL POLYPS; VIRTUAL COLONOSCOPY; CT COLONOGRAPHY; NEOPLASIA; CANCER; PERFORMANCE; SENSITIVITY; SCREEN; COLON AB Background The usefulness of currently available colon imaging tests, including air contrast barium enema (ACBE), computed tomographic colonography (CTC), and colonoscopy, to detect colon polyps and cancers is uncertain. We aimed to assess the sensitivity of these three imaging tests. Methods Patients with faecal occult blood, haematochezia, iron-deficiency anaemia, or a family history of colon cancer underwent three separate colon-imaging studies-ACBE, followed 7-14 days later by CTC and colonoscopy on the same day. The primary outcome was detection of colonic polyps and cancers. Outcomes were assessed by building an aggregate view of the colon, taking into account results of all three tests. Findings 614 patients completed all three imaging tests. When analysed on a per-patient basis, for lesions 10 mm or larger in size (n=63), the sensitivity of ACBE was 48% (95% Cl 35-61), CTC 59% (46-71, p=0.1083 for CTC vs ACBE), and colonoscopy 98% (91-100, p<0.0001 for colonoscopy vs CTC). For lesions 6-9 mm in size (n=116), sensitivity was 35% for ACBE (27-45), 51% for CTC (41-60, p=0.0080 for CTC vs ACBE), and 99% for colonoscopy (95-100, p<0.0001 for colonoscopy vs CTC). For lesions of 10 mm or larger in size, the specificity was greater for colonoscopy (0.996) than for either ACBE (0.90) or CTC (0.96) and declined for ACBE and CTC when smaller lesions were considered. Interpretation Colonoscopy was more sensitive than other tests, as currently undertaken, for detection of colonic polyps and cancers. These data have important implications for diagnostic use of colon imaging tests. C1 Duke Univ, Med Ctr, Durham, NC 27710 USA. Durham VA Med Ctr, Durham, NC USA. Univ Calif San Francisco, San Francisco VA Med Ctr, San Francisco, CA 94143 USA. Troy Internal Med, Troy, NY USA. Indian River Radiol, Vero Beach, FL USA. Univ Texas, Dallas, TX 75230 USA. Virginia Commonwealth Univ, Med Ctr, Richmond, VA USA. Univ Chicago, Chicago, IL 60637 USA. Univ Med & Dent New Jersey, Newark, NJ 07103 USA. Seacoast Gastroenterol, Exeter, NH USA. Univ Texas, Med Branch, Galveston, TX 77550 USA. Calif Pacific Med Ctr, San Francisco, CA 94115 USA. Univ Calif San Diego, San Diego, CA 92103 USA. NYU, New York, NY USA. RP Rockey, DC (reprint author), Duke Univ, Med Ctr, Box 3083,Sands Bldg,Rm 334,Res Dr, Durham, NC 27710 USA. EM dcrockey@acpub.duke.edu FU NCI NIH HHS [R01 CA82344] NR 28 TC 378 Z9 389 U1 1 U2 10 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD JAN 22 PY 2005 VL 365 IS 9456 BP 305 EP 311 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 889NL UT WOS:000226449600033 PM 15664225 ER PT J AU Collins, JF Lieberman, DA Durbin, TE Weiss, DG AF Collins, JF Lieberman, DA Durbin, TE Weiss, DG CA Veterans Affairs Cooperative Study TI Accuracy of screening for fecal occult blood on a single stool sample obtained by digital rectal examination: A comparison with recommended sampling practice SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID COLORECTAL-CANCER; NATIONAL-SURVEY; FINGER; COLONOSCOPY; GUIDELINES; MORTALITY; ADULTS; IMPACT AB Background: Many expert panels recommend colorectal cancer screening for average-risk asymptomatic individuals older than 50 years of age. Recent studies have found that 24% to 64% of primary care providers use only the digital fecal occult blood test (FOBT) as their primary screening test. The effectiveness of a single digital FOBT is unknown. Objective: To compare the sensitivity and specificity of digital FOBT and the recommended 6-sample at-home FOBT for advanced neoplasia in asymptomatic persons. Design: Prospective cohort study. Setting: 13 Veterans Affairs medical centers. Patients: 3121 asymptomatic patients 50 to 75 years of age Intervention: 2665 patients had 6-sample at-home FOBT and digital FOBT, followed by complete colonoscopy. Measurements: We measured the sensitivity of digital and 6-sample FOBT for advanced neoplasia and the specificity for no neoplasia. We calculated predictive values and likelihood ratios for advanced neoplasia, defined as tubular adenomas 10 mm or greater, adenomas with villous histology or high-grade dysplasia, or invasive cancer. Results: Of all participants, 96.8% were men; their average age was 63.1 years. The 6-sample FOBT and the single digital FOBT had specificities of 93.9% and 97.5%, respectively, as defined by studying 1656 patients with no neoplasia. Sensitivities for detection of advanced neoplasia in 284 patients were 23.9% for the 6-sample FOBT and 4.9% for the digital FOBT. The likelihood ratio for advanced neoplasia was 1.68 (95% Cl, 0.96 to 2.94) for positive results on digital FOBT and 0.98 (Cl, 0.95 to 1.01) for negative results. Limitations: Most patients were men. Conclusions: Single digital FOBT is a poor screening method for colorectal neoplasia and cannot be recommended as the only test. When digital FOBT is performed as part of a primary care physical examination, negative results do not decrease the odds of advanced neoplasia. Persons with these results should be offered at-home 6-sample FOBT or another type of screening test. C1 Dept Vet Affairs Med Ctr, Portland, OR USA. Dept Vet Affairs Med Ctr, Long Beach, CA USA. Dept Vet Affairs Med Ctr, Perry Point, MD USA. RP Collins, JF (reprint author), Portland VA Med Ctr, P3-GI,3710 SW Vet Hosp Rd,POB 1034, Portland, OR 97239 USA. NR 20 TC 141 Z9 141 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 JAN 18 PY 2005 VL 142 IS 2 BP 81 EP 85 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 915LQ UT WOS:000228306100001 PM 15657155 ER PT J AU Hagopian, K Ramsey, JJ Weindruch, R AF Hagopian, K Ramsey, JJ Weindruch, R TI Fructose metabolizing enzymes from mouse liver: influence of age and caloric restriction SO BIOCHIMICA ET BIOPHYSICA ACTA-GENERAL SUBJECTS LA English DT Article DE aging; aldolase; calorie restriction; fructokinase; fructose-1-phosphate; triokinase ID RAT-LIVER; GLUCOKINASE ACTIVITY; HORMONAL-REGULATION; REGULATORY PROTEIN; KINASE-ACTIVITY; ALDOLASE-B; PHOSPHOFRUCTOKINASE; 1-PHOSPHATE; DIETARY; RABBIT AB The influence of caloric restriction (CR) on the activities of liver fructose metabolizing enzymes and metabolite levels were studied in young (3 months) and old (30 months) mice. Fructokinase activity was increased (P<0.05) in both young and old CR mice when compared to controls while triokinase activity was increased (P<0.05) only in old CR versus control mice. Aldolase was not altered by CR in either old or young mice. No age-related differences in activities were observed in controls although a trend towards an increase was observed for triokinase, while significant age-related increases were observed for fructokinase and triokinase, but not aldolase, in CR mice. Both young and old mice on CR showed significant decreases in fructose and fructose-1-phosphate, however, no age-related changes in metabolite levels were observed for either control or CR mice. A fructose-1-phosphate kinase activity was also measured and found to be unchanged in both young and old mice on CR, but the activity was significantly lower in the old mice compared with young. We show here that the enzymes involved in fructose metabolism are influenced by CR and that this could contribute to alterations in gluconeogenesis and glycolysis observed with CR. (C) 2004 Elsevier B.V. All rights reserved. C1 Univ Calif Davis, Sch Vet Med, Dept Mol Biosci, Davis, CA 95616 USA. Univ Wisconsin, Sch Med, Dept Med, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. RP Hagopian, K (reprint author), Univ Calif Davis, Sch Vet Med, Dept Mol Biosci, 1 Shields Ave, Davis, CA 95616 USA. EM khagopian@ucdavis.edu FU NIA NIH HHS [P01 AG11915, R01 AG17902] NR 36 TC 9 Z9 9 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0304-4165 J9 BBA-GEN SUBJECTS JI Biochim. Biophys. Acta-Gen. Subj. PD JAN 18 PY 2005 VL 1721 IS 1-3 BP 37 EP 43 DI 10.1016/j.bbagen.2004.10.001 PG 7 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 889DA UT WOS:000226422500005 PM 15652177 ER PT J AU Shlipak, MG Sarnak, MJ Katz, R Fried, L Seliger, S Newman, A Siscovick, D Stehman-Breen, C AF Shlipak, MG Sarnak, MJ Katz, R Fried, L Seliger, S Newman, A Siscovick, D Stehman-Breen, C TI Cystatin-C and mortality in elderly persons with heart failure SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID RENAL-FUNCTION; RISK-FACTORS; MARKER; DYSFUNCTION; CREATININE AB OBJECTIVES We sought to evaluate cystatin-C, a novel measure of renal function, as a predictor of mortality in elderly persons with heart failure (HF) and to compare it with creatinine. BACKGROUND Renal function is an important prognostic factor in patients with HF, but creatinine levels, which partly reflect muscle mass, may be insensitive for detecting renal insufficiency. METHODS A total of 279 Cardiovascular Health Study participants with prevalent HF and measures of serum cystatin-C and creatinine were followed for mortality outcomes over a median of 6.5 years. RESULTS Median creatinine and cystatin-C levels were 1.05 mg/dl and 1.26 mg/l. Each standard deviation increase in cystatin-C (0.35 mg/l) was associated with a 31% greater adjusted mortality risk (95% confidence interval [CI] 20% to 43%, p < 0.001), whereas each standard deviation increase in creatinine (0.39 mg/dl) was associated with a 17% greater adjusted mortality risk (95% CI 1% to 36%, p = 0.04). When both measures were combined in a single adjusted model, cystatin-C remained associated with elevated mortality risk (hazard ratio 1.60, 95% CI 1.32 to 1.94), whereas creatinine levels appeared associated with lower risk (hazard ratio 0.73, 95% CI 0.57 to 0.95). CONCLUSIONS Cystatin-C is a stronger predictor of mortality than creatinine in elderly persons with HF. If confirmed in future studies, this new marker of renal function could improve risk stratification in patients with HF. (C) 2005 by the American College of Cardiology Foundation C1 Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Biostat, San Francisco, CA 94121 USA. Tufts Univ, New England Med Ctr, Dept Med, Div Nephrol, Boston, MA 02111 USA. Collaborat Hlth Studies Coordinating Ctr, Seattle, WA USA. Vet Affairs Pittsburgh Healthcare Syst, Renal Sect, Med Serv, Pittsburgh, PA USA. Univ Washington, Sch Med, Div Nephrol, Seattle, WA 98195 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Div Geriatr Med, Pittsburgh, PA 15260 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol & Hlth Serv, Seattle, WA 98195 USA. Amgen Inc, Thousand Oaks, CA 91320 USA. RP Shlipak, MG (reprint author), Vet Affairs Med Ctr, Gen Internal Med Sect, 4150 Clement St, San Francisco, CA 94121 USA. EM shlip@itsa.ucsf.edu RI Newman, Anne/C-6408-2013 OI Newman, Anne/0000-0002-0106-1150 FU NHLBI NIH HHS [N01 HC 85082, N01 HC 15103, N01 HC 35129, N01 HC 85079, N01 HC 85080, N01 HC 85081, N01 HC 85083, N01 HC 85084, N01 HC 85085, N01 HC 85086, R01 HL 073208] NR 14 TC 126 Z9 137 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 JAN 18 PY 2005 VL 45 IS 2 BP 268 EP 271 DI 10.1016/j.jacc.2004.09.061 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 889IY UT WOS:000226437900014 PM 15653026 ER PT J AU Stadtman, ER Van Remmen, H Richardson, A Wehr, NB Levine, RL AF Stadtman, ER Van Remmen, H Richardson, A Wehr, NB Levine, RL TI Methionine oxidation and aging SO BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS LA English DT Review DE methionine sulfoxide; methionine; methionine sulfoxide reductase; aging ID MANGANESE SUPEROXIDE-DISMUTASE; RADICAL-CATION COMPLEXES; SULFOXIDE REDUCTASE GENE; PROTEIN OXIDATION; TRABECULAR MESHWORK; CATARACTOUS LENSES; ESCHERICHIA-COLI; ALPHA-SYNUCLEIN; ENZYME-ACTIVITY; HUMAN-EYE AB It is well established that many amino acid residues of proteins are susceptible to oxidation by various forms of reactive oxygen species (ROS), and that oxidatively modified proteins accumulate during aging, oxidative stress, and in a number of age-related diseases. Methionine residues and cysteine residues of proteins are particularly sensitive to oxidation by ROS. However, unlike oxidation of other amino acid residues, the oxidation of these sulfur amino acids is reversible. Oxidation of methionine residues leads to the formation of both R- and S-stereoisomers of methionine sulfoxide (MetO) and most cells contain stereospecific methionine sulfoxide reductases (Msr's) that catalyze the thioredoxin-dependent reduction of MetO residues back to methionine residues. We summarize here results of studies, by many workers, showing that the MetO content of proteins increases with age in a number of different aging models, including replicative senescence and erythrocyte aging, but not in mouse tissues during aging. The change in levels of MetO may reflect alterations in any one or more of many different mechanisms, including (i) an increase in the rate of ROS generation; (ii) a decrease in the antioxidant capacity; (iii) a decrease in proteolytic activities that preferentially degrade oxidized proteins; or (iv) a decrease in the ability to convert MetO residues back to Met residues, due either to a direct loss of Msr enzyme levels or indirectly to a loss in the availability of the reducing equivalents (thioredoxin, thioredoxin reductase, NADPH generation) involved. The importance of Msr activity is highlighted by the fact that aging is associated with a loss of Msr activities in a number of animal tissues, and mutations in mice leading to a decrease in the Msr levels lead to a decrease in the maximum life span, whereas overexpression of Msr leads to a dramatic increase in the maximum life span. Published by Elsevier B.V. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 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, San Antonio, TX 78284 USA. NHLBI, Biochem Lab, Bethesda, MD 20892 USA. RP Stadtman, ER (reprint author), NIH, Bldg 50,Room 2140, Bethesda, MD 20892 USA. EM EarlStadtman@nih.gov RI Levine, Rodney/D-9885-2011 NR 47 TC 211 Z9 218 U1 1 U2 34 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1570-9639 J9 BBA-PROTEINS PROTEOM JI BBA-Proteins Proteomics PD JAN 17 PY 2005 VL 1703 IS 2 BP 135 EP 140 DI 10.1016/j.bbapap.2004.08.010 PG 6 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 899GE UT WOS:000227132100005 PM 15680221 ER PT J AU Kanwal, F Dulai, GS Spiegel, BMR Yee, HF Gralnek, IM AF Kanwal, F Dulai, GS Spiegel, BMR Yee, HF Gralnek, IM TI A comparison of liver transplantation outcomes in the pre- vs. post-MELD eras SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID PROGNOSTIC FACTORS; CIRRHOTIC-PATIENTS; SURVIVAL; ALLOCATION; MORTALITY; MODEL; RECIPIENTS; DISEASE; DONORS; IMPACT AB Background: The model for end stage liver disease (MELD)-based organ allocation system is designed to prioritize orthotopic liver transplantation (OLT) for patients with the most severe liver disease. However, there are no published data to confirm whether this goal has been achieved or whether the policy has affected long-term post-OLT survival. Aim: To compare pre-OLT liver disease severity and long-term (1 year) post-OLT survival between the pre- and post-MELD eras. Methods: Using the United Network of Organ Sharing database, we compared two cohorts of adult patients undergoing cadaveric liver transplant in the pre-MELD (n = 3857) and post-MELD (n = 4245) eras. We created multivariable models to determine differences in: (i) pre-OLT liver disease severity as measured by MELD; and (ii) 1-year post-OLT outcomes. Results: Patients undergoing OLT in the post-MELD era had more severe liver disease at the time of transplantation (mean MELD = 20.5) vs. those in the pre-MELD era (mean MELD = 17.0). There were no differences in the unadjusted patient or graft survival at 1 year post-OLT. This difference remained insignificant after adjusting for a range of prespecified recipient, donor, and transplant centre-related factors in multivariable survival analysis. Conclusions: Although liver disease severity is higher in the post- vs. pre-MELD era, there has been no change in long-term post-OLT patient or graft survival. These results indicate that the MELD era has achieved its primary goals by allocating cadaveric livers to the sickest patients without compromising post-OLT survival. C1 Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. VA Greater Los Angeles Hlth Care Syst, Div Gastroenterol Hepatol, Los Angeles, CA USA. VA Greater Los Angeles Hlth Care Syst, Div Gen Internal Med Hlth Serv Res, Los Angeles, CA USA. CURE Digest Dis Res, Los Angeles, CA USA. Ctr Study Digest Healthcare Qual & Outcomes, Los Angeles, CA USA. Univ Calif Los Angeles, Ctr Hlth Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA USA. RP Gralnek, IM (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 115,Room 215, Los Angeles, CA 90073 USA. EM igralnek@mednet.ucla.edu FU NCRR NIH HHS [RR0016188] NR 25 TC 47 Z9 56 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD JAN 15 PY 2005 VL 21 IS 2 BP 169 EP 177 DI 10.1111/j.1365-2036.2005.02321.x PG 9 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 892HA UT WOS:000226639700009 PM 15679767 ER PT J AU Kilbourne, AA Good, CB Sereika, SA Justice, AC Fine, MJ AF Kilbourne, AA Good, CB Sereika, SA Justice, AC Fine, MJ TI Algorithm for assessing patients' adherence to oral hypoglycemic medication SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Article; Proceedings Paper CT Annual Meeting of the Veterans-Health-Administration-Health-Services-Research-and-Development CY FEB, 2002 CL WASHINGTON, D.C. SP Vet Hlth Adm Hlth Serv Res & Dev ID PHARMACY RECORDS; REPORTED ADHERENCE; CLINICAL-TRIALS; CARE; VALIDATION C1 Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equity & Promot 151C, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Ctr Res Hlth Care, Core Fac, Dept Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Ctr Res Hlth Care, Core Fac, Dept Psychiat, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Nursing, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Biostat & Epidemiol, Pittsburgh, PA 15260 USA. W Haven Vet Affaires Med Ctr, West Haven, CT USA. Univ Pittsburgh, Dept Med, Ctr Res Hlth Care, Pittsburgh, PA 15260 USA. RP Kilbourne, AA (reprint author), Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equity & Promot 151C, Univ Dr C, Pittsburgh, PA 15240 USA. EM amy.kilbourne@med.va.gov FU PHS HHS [K23, K24] NR 32 TC 13 Z9 13 U1 5 U2 5 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 JAN 15 PY 2005 VL 62 IS 2 BP 198 EP 204 PG 7 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 892TF UT WOS:000226672200017 PM 15700895 ER PT J AU Blitzer, RD Iyengar, R Landau, EM AF Blitzer, RD Iyengar, R Landau, EM TI Postsynaptic signaling networks: Cellular cogwheels underlying long-term plasticity SO BIOLOGICAL PSYCHIATRY LA English DT Article DE dendrites; hippocampus; long-term potentiation; LTP; protein synthesis; RNA granules; tagging ID LOCAL PROTEIN-SYNTHESIS; AMPA RECEPTOR TRAFFICKING; ACTIN MESSENGER-RNA; KINASE-II; SYNAPTIC PLASTICITY; HIPPOCAMPAL-NEURONS; TETANIC STIMULATION; DENDRITIC SPINES; LATE-PHASE; LTP AB Learning depends on positive or negative changes in synaptic transmission that are synapse-specific and sustained. Synaptic signals can be directly measured and respond to certain kinds of stimulation by becoming persistently enhanced (long-term potentiation, LTP) or decreased (long-term depression, LTD). Studying LTP and LTD opens a window on to the molecular mechanisms of memory. Although changes in both pre- and postsynaptic strength have been implicatcd in LTP and LTD, most attention has been focused on changes in postsynaptic glutamate receptor density. This is controlled by intracellular Ca2+ ions via a network of signaling molecules. Changes in postsynaptic Ca2+ concentration depend on the coincidence of appropriate synaptic signals, as is found in learning situations. The long-term persistence of LTP and LTD requires gene transcription and translation. It is posited that local translation at the synapse, in a self-sustaining manner, mediates the persistence of long-term change despite constant turnover of the synaptic components. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Mt Sinai Sch Med, Dept Pharmacol & Biol Chem, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Psychiat Serv, Bronx, NY USA. RP Landau, EM (reprint author), Mt Sinai Sch Med, Dept Psychiat, Box 1215,1 Gustave Levy Pl, New York, NY 10029 USA. EM manny.landau@mssm.edu FU NIDA NIH HHS [DA015863] NR 69 TC 64 Z9 69 U1 0 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 JAN 15 PY 2005 VL 57 IS 2 BP 113 EP 119 DI 10.1016/j.biophsych.2004.02.031 PG 7 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 888BQ UT WOS:000226349600001 PM 15652868 ER PT J AU Montgomery, RB Makary, E Schiffman, K Goodell, V Disis, ML AF Montgomery, RB Makary, E Schiffman, K Goodell, V Disis, ML TI Endogenous anti-HER2 antibodies block HER2 phosphorylation and signaling through extracellular signal-regulated kinase SO CANCER RESEARCH LA English DT Article ID BREAST-CANCER CELLS; TUMOR-GROWTH; T-CELL; MONOCLONAL-ANTIBODIES; TRASTUZUMAB HERCEPTIN; ANTITUMOR RESPONSES; HER-2/NEU PROTEIN; IMMUNE-RESPONSES; EPITHELIAL-CELLS; ERBB2 RECEPTOR AB Immunologic targeting of the oncoprotein HER2/neu with monoclonal antibodies is an important component of current therapeutic strategies for patients with locally and systemically advanced breast cancer. Engineered antibodies targeting HER2 may have agonist or antagonist effects on HER2, ut little is known about whether endogenous antibodies modulate HER2 activity. Vaccination of patients with HER2 peptides successfully induced antibodies in a minority of patients with HER2-expressing malignancy. A subset of antibodies specifically suppressed phosphorylation of HER2 on tyrosine Y1248, a residue critical for HER2 signaling through extracellular signal-regulated kinase. These antibodies also suppressed extracellular signal-regulated kinase phosphorylation and inhibited colony formation in soft agar. The majority of the antibodies that suppressed HER2 phosphorylation displayed specificity for amino acids 328 to 345 and 369 to 384. The isotype of anti-HER2 antibodies was predominantly IgG3 of low avidity, suggesting a Th1 response to peptide vaccine. Endogenous anti-HER2 antibodies can effectively suppress HER2 kinase activity and downstream signaling to inhibit the transformed phenotype of HER2-expressing tumor cells. C1 Univ Washington, VA Puget Sound HCS, Dept Med, Div Oncol, Seattle, WA 98108 USA. RP Montgomery, RB (reprint author), Univ Washington, VA Puget Sound HCS, Dept Med, Div Oncol, 1660 S Columbian Way,111 ONC, Seattle, WA 98108 USA. EM rbmontgo@u.washington.edu FU NCI NIH HHS [U54 CA090818, CA82661, CA85218, CA7516]; NCRR NIH HHS [M01-RR-00037] NR 35 TC 42 Z9 43 U1 0 U2 1 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD JAN 15 PY 2005 VL 65 IS 2 BP 650 EP 656 PG 7 WC Oncology SC Oncology GA 887VV UT WOS:000226334500036 PM 15695410 ER PT J AU Weinberg, A Bloch, KC Li, SB Tang, YW Palmer, M Tyler, KL AF Weinberg, A Bloch, KC Li, SB Tang, YW Palmer, M Tyler, KL TI Dual infections of the central nervous system with Epstein-Barr virus SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID POLYMERASE-CHAIN-REACTION; CEREBROSPINAL-FLUID; HERPESVIRUSES; DIAGNOSIS; DNA AB We describe clinical and laboratory characteristics of 16 patients with central nervous system (CNS) infection caused by Epstein-Barr virus (EBV) and another pathogen. Seven of 10 immunocompromised patients had coinfection with viruses (3 with cytomegalovirus, 2 with JC virus, and 2 with varicella zoster virus) and 3 with nonviral pathogens (2 with pneumococcus and 1 with Cryptococcus species). Three of 6 immunocompetent patients had coinfections with viruses (1 each with herpes simplex virus, varicella zoster virus, and West Nile virus), and 3 had coinfections with nonviral pathogens (2 with Ehrlichia chaffeensis and 1 with Mycoplasma pneumoniae). The EBV load was similar in immunocompromised and immunocompetent patients and in patients with viral and nonviral coinfections. EBV lytic-cycle mRNA was detected in the cerebrospinal fluid of 5 of 6 tested samples, indicating EBV replication in the CNS during coinfection. C1 Univ Colorado, Hlth Sci Ctr, Sch Med, Dept Pediat, Denver, CO 80262 USA. Univ Colorado, Sch Med, Dept Med, Denver, CO 80262 USA. Univ Colorado, Sch Med, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Sch Med, Dept Immunol, Denver, CO 80262 USA. Univ Colorado, Sch Med, Dept Microbiol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Vanderbilt Univ, Dept Med, Nashville, TN USA. Vanderbilt Univ, Dept Prevent Med, Nashville, TN USA. Vanderbilt Univ, Dept Pathol, Nashville, TN USA. RP Weinberg, A (reprint author), Univ Colorado, Hlth Sci Ctr, Sch Med, Dept Pediat, Campus Box C227, Denver, CO 80262 USA. EM adriana.weinberg@uchsc.edu OI Tyler, Kenneth/0000-0003-3294-5888 FU ODCDC CDC HHS [U50/CCU416123-04] NR 9 TC 50 Z9 52 U1 0 U2 1 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 JAN 15 PY 2005 VL 191 IS 2 BP 234 EP 237 DI 10.1086/426402 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 881SK UT WOS:000225889500012 PM 15609233 ER PT J AU Sales, AE Pineros, SL Magid, DJ Every, NR Sharp, ND Rumsfeld, JS AF Sales, AE Pineros, SL Magid, DJ Every, NR Sharp, ND Rumsfeld, JS TI The association between clinical integration of care and transfer of veterans with acute coronary syndromes from primary care VHA hospitals SO BMC HEALTH SERVICES RESEARCH LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; PRACTITIONERS REFERRAL DECISIONS; PRACTICE GUIDELINES COMMITTEE; ARTERY BYPASS-SURGERY; MEDICAL-CARE; AMERICAN-COLLEGE; UNSTABLE ANGINA; UNITED-STATES; TASK-FORCE; OUTCOMES AB Background: Few studies report on the effect of organizational factors facilitating transfer between primary and tertiary care hospitals either within an integrated health care system or outside it. In this paper, we report on the relationship between degree of clinical integration of cardiology services and transfer rates of acute coronary syndrome (ACS) patients from primary to tertiary hospitals within and outside the Veterans Health Administration (VHA) system. Methods: Prospective cohort study. Transfer rates were obtained for all patients with ACS diagnoses admitted to 12 primary VHA hospitals between 1998 and 1999. Binary variables measuring clinical integration were constructed for each primary VHA hospital reflecting: presence of on-site VHA cardiologist; referral coordinator at the associated tertiary VHA hospital; and/or referral coordinator at the primary VHA hospital. We assessed the association between the integration variables and overall transfer from primary to tertiary hospitals, using random effects logistic regression, controlling for clustering at two levels and adjusting for patient characteristics. Results: Three of twelve hospitals had a VHA cardiologist on site, six had a referral coordinator at the tertiary VHA hospital, and four had a referral coordinator at the primary hospital. Presence of a VHA staff cardiologist on site and a referral coordinator at the tertiary VHA hospital decreased the likelihood of any transfer (OR 0.45, 95% CI 0.27-0.77, and 0.46, p = 0.002, CI 0.27-0.78). Conversely, having a referral coordinator at the primary VHA hospital increased the likelihood of transfer (OR 6.28, CI 2.92-13.48). Conclusions: Elements of clinical integration are associated with transfer, an important process in the care of ACS patients. In promoting optimal patient care, clinical integration factors should be considered in addition to patient characteristics. C1 VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98108 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Denver VA Med Ctr, Denver, CO USA. Colorado Permanente Clin Res Unit, Denver, CO USA. VA Puget Sound Hlth Care Syst, Serv Cardiol, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. RP Sales, AE (reprint author), VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98108 USA. EM ann.sales@med.va.gov; sandra.pineros@med.va.gov; david.j.magid@kp.org; nathan@frazierco.com; nancy.sharp@med.va.gov; john.rumsfeld@med.va.gov RI Sales, Anne/D-9678-2012 OI Sales, Anne/0000-0001-9360-3334 NR 25 TC 2 Z9 2 U1 0 U2 1 PU BIOMED CENTRAL LTD PI LONDON PA MIDDLESEX HOUSE, 34-42 CLEVELAND ST, LONDON W1T 4LB, ENGLAND SN 1472-6963 J9 BMC HEALTH SERV RES JI BMC Health Serv. Res. PD JAN 13 PY 2005 VL 5 AR 2 DI 10.1186/1472-6963-5-2 PG 9 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 891US UT WOS:000226607100001 PM 15649313 ER PT J AU Elchuri, S Oberley, TD Qi, WB Eisenstein, RS Roberts, LJ Van Remmen, H Jepstein, CJ Huang, TT AF Elchuri, S Oberley, TD Qi, WB Eisenstein, RS Roberts, LJ Van Remmen, H Jepstein, CJ Huang, TT TI CuZnSOD deficiency leads to persistent and widespread oxidative damage and hepatocarcinogenesis later in life SO ONCOGENE LA English DT Article DE CuZnSOD; hepatocellular carcinoma; aconitase; 8-oxo dG; cyclin D1; APEX1; Met ID HUMAN HEPATOCELLULAR-CARCINOMA; CARBONIC-ANHYDRASE-III; ZINC SUPEROXIDE-DISMUTASE; IRON REGULATORY PROTEINS; TRANSGENIC MICE; GLUTATHIONE-PEROXIDASE; ANTIOXIDANT ENZYMES; LIVER-REGENERATION; MITOCHONDRIAL-DNA; MAMMALIAN-CELLS AB Mice deficient in CuZn superoxide dismutase (CuZn-SOD) showed no overt abnormalities during development and early adulthood, but had a reduced lifespan and increased incidence of neoplastic changes in the liver. Greater than 70% of Sod1-/- mice developed liver nodules that were either nodular hyperplasia or hepatocellular carcinoma (HCC). Cross-sectional studies with livers collected from Sod1-/- and age-matched +/+ controls revealed extensive oxidative damage in the cytoplasm and, to a lesser extent, in the nucleus and mitochondria from as early as 3 months of age. A marked reduction in cytosolic aconitase, increased levels of 8-oxo dG and F2-isoprostanes, and a moderate reduction in glutathione peroxidase activities and porin levels were observed in all age groups of Sod1-/- mice examined. There were also age-related reductions in Mn superoxide dismutase activities and carbonic anhydrase III. Parallel to the biochemical changes, there were progressive increases in the DNA repair enzyme APEX1, the cell cycle control proteins cyclin D1 and D3, and the hepatocyte growth factor receptor Met. Increased cell proliferation in the presence of persistent oxidative damage to macromolecules likely contributes to hepatocarcinogenesis later in life. C1 Stanford Univ, Dept Neurol & Neurol Sci, Stanford, CA 94305 USA. Univ Wisconsin, Dept Pathol, Madison, WI 53706 USA. VA Hosp, Pathol Serv, Madison, WI 53705 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Wisconsin, Dept Nutr Sci, Madison, WI 53706 USA. Vanderbilt Univ, Dept Pharmacol, Nashville, TN 37232 USA. Vanderbilt Univ, Dept Med, Nashville, TN 37232 USA. Audie L Murphy Mem Vet Adm Med Ctr, GRECC, San Antonio, TX 78229 USA. Univ Calif San Francisco, Dept Pediat, San Francisco, CA 94341 USA. Palo Alto VA Hlth Care Syst, GRECC, Palo Alto, CA 94304 USA. RP Huang, TT (reprint author), Stanford Univ, Dept Neurol & Neurol Sci, 3801 Miranda Ave,Bldg 100,Room D3-101,Mail Stop 1, Palo Alto, CA 94304 USA. EM tthuang@stanford.edu RI Bell, Tiffany/F-4403-2010 FU NIA NIH HHS [AG16633, AG16998]; NIDDK NIH HHS [DK26657, DK47219]; NIGMS NIH HHS [GM15431, GM42056] NR 89 TC 321 Z9 338 U1 2 U2 14 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0950-9232 J9 ONCOGENE JI Oncogene PD JAN 13 PY 2005 VL 24 IS 3 BP 367 EP 380 DI 10.1038/sj.onc.1208207 PG 14 WC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity GA 887CH UT WOS:000226279700008 PM 15531919 ER PT J AU Singh, N Armstrong, DG Lipsky, BA AF Singh, N Armstrong, DG Lipsky, BA TI Preventing foot ulcers in patients with diabetes SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Review ID LOWER-EXTREMITY AMPUTATION; QUALITY-OF-LIFE; LIMITED JOINT MOBILITY; PERIPHERAL NEUROPATHY; CONTROLLED TRIAL; HIGH-RISK; TUNING FORK; THERAPEUTIC FOOTWEAR; CLINICAL EXAMINATION; NONDIABETIC PATIENTS AB Context Among persons diagnosed as having diabetes mellitus, the prevalence of foot ulcers is 4% to 10%, the annual population-based incidence is 1.0% to 4.1%, and the lifetime incidence may be as high as 25%. These ulcers frequently become infected, cause great morbidity, engender considerable financial costs, and are the usual first step to lower extremity amputation. Objective To systematically review the evidence on the efficacy of methods advocated for preventing diabetic foot ulcers in the primary care setting. Data Sources, Study Selection, and Data Extraction The EBSCO, MEDLINE, and the National Guideline Clearinghouse databases were searched for articles published between January 1980 and April 2004 using database-specific keywords. Bibliographies of retrieved articles were also searched, along with the Cochrane Library and relevant Web sites. We reviewed the retrieved literature for pertinent information, paying particular attention to prospective cohort studies and randomized clinical trials. Data Synthesis Prevention of diabetic foot ulcers begins with screening for loss of protective sensation, which is best accomplished in the primary care setting with a brief history and the Semmes-Weinstein monofilament. Specialist clinics may quantify neuropathy with biothesiometry, measure plantar foot pressure, and assess lower extremity vascular status with Doppler ultrasound and ankle-brachial blood pressure indices. These measurements, in conjunction with other findings from the history and physical examination, enable clinicians to stratify patients based on risk and to determine the type of intervention. Educating patients about proper foot care and periodic foot examinations are effective interventions to prevent ulceration. Other possibly effective clinical interventions include optimizing glycemic control, smoking cessation, intensive podiatric care, debridement of calluses, and certain types of prophylactic foot surgery. The value of various types of prescription footwear for ulcer prevention is not clear. Conclusions Substantial evidence supports screening all patients with diabetes to identify those at risk for foot ulceration. These patients might benefit from certain prophylactic interventions, including patient education, prescription footwear, intensive podiatric care, and evaluation for surgical interventions. C1 Vet Affairs Puget Sound Healthcare Syst, Dept Med, Div Endocrinol & Metab, Seattle, WA 98108 USA. Vet Affairs Puget Sound Healthcare Syst, Dept Med, Div Gen Internal Med & Infect Dis, Seattle, WA 98108 USA. Univ Washington, Sch Med, Seattle, WA USA. Rosalind Franklin Univ Med & Sci, Dr William M Scholl Coll Podiatr Med, Ctr Lower Extrem Ambulatory Res, Chicago, IL USA. RP Singh, N (reprint author), Vet Affairs Puget Sound Healthcare Syst, Dept Med, Div Endocrinol & Metab, Mailcode S-111-ENDO,1660 S Columbian Way, Seattle, WA 98108 USA. EM Nalini.Singh2@med.va.gov OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 128 TC 791 Z9 874 U1 15 U2 146 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 JAN 12 PY 2005 VL 293 IS 2 BP 217 EP 228 DI 10.1001/jama.293.2.217 PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA 885QC UT WOS:000226171000038 PM 15644549 ER PT J AU Oreskovich, MR Saxon, AJ Ellis, MLK Malte, CA Reoux, JP Knox, PC AF Oreskovich, MR Saxon, AJ Ellis, MLK Malte, CA Reoux, JP Knox, PC TI A double-blind, double-dummy, randomized, prospective pilot study of the partial Mu opiate agonist, buprenorphine, for acute detoxification from heroin SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE treatment; opiate dependence; buprenorphine; clonidine; detoxification ID OPIOID DETOXIFICATION; CLINICAL-TRIALS; FOLLOW-UP; CLONIDINE; WITHDRAWAL; INPATIENT; METHADONE; SYMPTOMS; ADDICTS; EFFICACY AB The optimum dose of buprenorphine for acute inpatient heroin detoxification has not been determined. This randomized, double-blind. double-dummy, pilot study compares two buprenorphine sublingual tablet dosing schedules to oral clonidine. Heroin users (N = 30) who met DSM-IV criteria for opioid dependence and achieved a Clinical Opiate Withdrawal Scale (COWS) score of 13 (moderate withdrawal).were randomized to receive higher dose buprenorphine (HD, 8-8-8-4-2 mg/day on days 1-5), lower dose buprenorphine (LD. 2-4-84-2 mg/day on days 1-5). or clonidine (C, 0.2-0.3-0.3-0.2-0.1 mg QID on days 1-5). COWS scores were obtained QID. Twenty-four hours after randomization. the percentages of subjects who achieved suppression of withdrawal, as defined by four consecutive COWS scores < 12. were: C = 11%, LD 40%, and HD = 60%. Generalized estimating equation regression models. controlling for baseline COWS and time. indicated that COWS scores over the course of 5 days were lower in both LD and HD compared to C (chi(2)(2) = 13.28. P = 0.001). Similar analyses examining, scores over time on the Adjective Rating Scale for Withdrawal (ARSW) and on a Visual Analog Scale of Opiate Craving (VAS) indicated an overall treatment effect on the VAS accounted for by a significant difference between HD and C, but no overall treatment effect on the ARSW There were no discontinuations due to treatment-related adverse events. Both HD and LD regimens are safe, and efficacious treatment for opioid detoxification. but HD demonstrated superiority to C on a greater number of measures. (C) 2004 Elsevier Ireland Ltd. All rights reserved. C1 Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98108 USA. Vet Affairs Puget Sound Healthcare Syst, Seattle, WA 98108 USA. Ctr Excellence Substance Abuse Treatment & Educ, Seattle, WA 98108 USA. Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. Recovery Ctr King Cty, Seattle, WA 98122 USA. RP Saxon, AJ (reprint author), Univ Washington, Sch Med, Dept Psychiat & Behav Sci, 1660 S Columbian Way, Seattle, WA 98108 USA. EM Andrew.Saxon@med.va.gov NR 37 TC 27 Z9 27 U1 2 U2 4 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 JAN 7 PY 2005 VL 77 IS 1 BP 71 EP 79 DI 10.1016/j.drugalcdep.2004.07.008 PG 9 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 888TQ UT WOS:000226397500009 PM 15607843 ER PT J AU Wijsman, EM Daw, EW Yu, XS Steinbart, EJ Nochlin, D Bird, TD Schellenberg, GD AF Wijsman, EM Daw, EW Yu, XS Steinbart, EJ Nochlin, D Bird, TD Schellenberg, GD TI APOE and other loci affect age-at-onset in Alzheimer's disease families with PS2 mutation SO AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS LA English DT Article DE modifier gene; Markov chain; Monte-Carlo; segregation analysis; complex trait; oligogenic ID APOLIPOPROTEIN-E GENOTYPE; PRECURSOR PROTEIN GENE; OF-ONSET; MISSENSE MUTATIONS; COGNITIVE DECLINE; EPSILON-4 ALLELE; E POLYMORPHISM; CHROMOSOME-14; ASSOCIATION; SEGREGATION AB Several kindreds of Volga German (VG) ancestry have a single PS2 mutation that causes an autosomal dominant form of Alzheimer's disease (AD). These families show a wide range in age-at-onset, which suggests the existence of modifying factors other than the PS2 mutation. To examine evidence for a genetic basis of variation in onset age, we performed a Bayesian oligogenic segregation and linkage analysis on nine VG families confirmed to have at least one affected PS2 carrier. This analysis simultaneously estimated the effects of APOE and PS2 and the number and effects of additional loci affecting AD age-at-onset. In addition, a family effect accounted for shared environmental effects. This analysis approach has the advantage of full use of the complete pedigree structure, as well as use of information on unsampled individuals with phenotypic data. These analyses provide evidence that APOE plays a small, but significant, role in modifying the age-at-onset in these VG families. The effects estimated for the APOE epsilon3 and epsilon4 genotypes were consistent with those estimated in previous analysis of late-onset AD families, with evidence for a dose-dependent relationship between number of epsilon4 alleles and age-at-onset. We estimated an similar to83% posterior probability of at least one modifier locus in addition to APOE, and that the fraction of the variance in age-at-onset attributable to PS2, APOE, other loci, and family effects is similar to70, similar to2, similar to6.5, and similar to8.5%, respectively. These results provide evidence that APOE and other loci modify onset in AD caused by PS2 mutation. (C) 2004 Wiley-Liss, Inc. C1 Univ Washington, Div Med Genet, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Dept Genome Sci, Seattle, WA USA. Univ Washington, Dept Stat, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Neurol, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. Univ Washington, Harborview Med Ctr, Neuropathol Lab, Seattle, WA 98104 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. Univ Washington, Dept Pharmacol, Seattle, WA 98195 USA. RP Wijsman, EM (reprint author), Univ Washington, Div Med Genet, Dept Med, BOX 357720, Seattle, WA 98195 USA. EM Wijsman@u.washington.edu OI Wijsman, Ellen/0000-0002-2725-6669 FU NIA NIH HHS [AG 11762, P50 AG005136, AG 05136, AG 21544]; NIGMS NIH HHS [GM 46255] NR 50 TC 42 Z9 46 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1552-4841 J9 AM J MED GENET B JI Am. J. Med. Genet. B PD JAN 5 PY 2005 VL 132B IS 1 BP 14 EP 20 DI 10.1002/ajmg.b.30087 PG 7 WC Genetics & Heredity; Psychiatry SC Genetics & Heredity; Psychiatry GA 885UG UT WOS:000226181900004 PM 15389756 ER PT J AU Beyth, RJ AF Beyth, RJ TI Patient self-management of anticoagulation: An idea whose time has come SO ANNALS OF INTERNAL MEDICINE LA English DT Editorial Material ID CHRONIC ILLNESS; CLINICAL-TRIAL; THERAPY; QUALITY; CARE C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. RP Beyth, RJ (reprint author), Michael E DeBakey Vet Affairs Med Ctr, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM RebeccaJ.Beyth@med.va.gov NR 16 TC 3 Z9 3 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 JAN 4 PY 2005 VL 142 IS 1 BP 73 EP 74 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 916DS UT WOS:000228366200008 PM 15630111 ER PT J AU Lindenfeld, J Page, RL Zolty, R Shakar, SF Levi, M Lowes, B Wolfel, EE Miller, GG AF Lindenfeld, J Page, RL Zolty, R Shakar, SF Levi, M Lowes, B Wolfel, EE Miller, GG TI Drug therapy in the heart transplant recipient - Part III: Common medical problems SO CIRCULATION LA English DT Article DE transplantation; drugs; immunology; rejection ID CORONARY-ARTERY-DISEASE; GLUCOCORTICOID-INDUCED OSTEOPOROSIS; RENAL-ALLOGRAFT RECIPIENTS; CARDIAC TRANSPLANTATION; LUNG-TRANSPLANTATION; BONE LOSS; INTERNATIONAL-SOCIETY; BLOOD-PRESSURE; DOUBLE-BLIND; TRIMETHOPRIM-SULFAMETHOXAZOLE C1 Univ Colorado, Hlth Sci Ctr, Div Cardiol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Ctr Womens Hlth Res, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Clin Pharm, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Div Infect Dis, Denver, CO 80262 USA. Vanderbilt Univ, Div Infect Dis, Nashville, TN USA. Denver VA Med Ctr, Div Cardiol, Denver, CO USA. RP Lindenfeld, J (reprint author), Univ Colorado, Hlth Sci Ctr, Div Cardiol, 4200 E 9th Ave,B-130, Denver, CO 80262 USA. EM joann.lindenfeld@UCHSC.edu OI Lowes, Brian/0000-0002-5919-2540 NR 81 TC 52 Z9 54 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 JAN 4 PY 2005 VL 111 IS 1 BP 113 EP 117 DI 10.1161/01.CIR.0000151609.60618.3C PG 5 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 884DR UT WOS:000226065300018 PM 15630040 ER PT J AU Groeneveld, PW Heidenreich, PA Garber, AM AF Groeneveld, PW Heidenreich, PA Garber, AM TI Trends in implantable cardioverter-defibrillator racial disparity - The importance of geography SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID ANTIARRHYTHMIC-DRUG THERAPY; ACUTE MYOCARDIAL-INFARCTION; REVASCULARIZATION PROCEDURES; VENTRICULAR ARRHYTHMIAS; MEDICARE BENEFICIARIES; SOCIOECONOMIC-STATUS; COMORBIDITY MEASURES; CARDIAC-ARREST; RATES; STATE AB OBJECTIVES The study was designed to determine whether racial disparity in utilization of the implantable cardioverter-defibrillator (ICD) has improved over time, and whether small-area geographic variation in ICD utilization contributed to national levels of racial disparity. BACKGROUND Although racial disparities in cardiac procedures have been well-documented, it is unknown whether there has been improvement over time. Low ICD utilization rates in predominantly black geographic areas may have exacerbated national levels of disparity. METHODS Discharge abstracts from elderly black and white Medicare beneficiaries hospitalized with ventricular arrhythmias from 1990 to 2000 were analyzed to determine if ICD implantation occurred within 90 days of initial hospitalization. Multivariate logistic regression models were constructed to assess the relationship between ICD implantation, year of admission, and the percentage of black inhabitants in each patient's county of hospitalization while controlling for clinical, hospital, and demographic characteristics. RESULTS There was improvement in ICD implantation racial disparity: In the period 1990 to 1992, black patients had an odds ratio of 0.52 (95% confidence interval [CI] 0.42 to 0.64) for receiving an ICD compared with whites. However, by 1999 to 2000, the odds ratio for blacks had risen to 0.69 (95% CI 0.61 to 0.78) (test-for-trend p = 0.01). Approximately 20% of this trend could be explained by reduction in geographic variation in ICD use between areas with larger black and predominantly white populations. CONCLUSIONS Rates of ICD implants became more equal among whites and blacks during the 1990s, although persistent disparity remained at the decade's end. Geographic equalization in cardiovascular procedure rates may be an essential mechanism in rectifying disparities in health care. (C) 2005 by the American College of Cardiology Foundation C1 Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Div Gen Internal Med, Philadelphia, PA USA. Vet Affairs Palo Alto Hlth Care Syst, Philadelphia, PA USA. Stanford Univ, Ctr Primary Care & Outcomes Res, Stanford, CA USA. Stanford Univ, Natl Bur Econ Res, Stanford, CA USA. RP Groeneveld, PW (reprint author), 1122 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM peter.groeneveld@med.va.gov RI Garber, Alan/F-1476-2010 OI Heidenreich, Paul/0000-0001-7730-8490 FU AHRQ HHS [T32-HS000028-17]; NIA NIH HHS [P01-AG005842-17] NR 36 TC 50 Z9 50 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 JAN 4 PY 2005 VL 45 IS 1 BP 72 EP 78 DI 10.1016/j.jacc.2004.07.061 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 883LF UT WOS:000226012600014 PM 15629377 ER PT J AU Rumsfeld, JS Peterson, ED AF Rumsfeld, JS Peterson, ED TI Care disparities - Moving from gray to black and white SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Editorial Material ID RACIAL-DIFFERENCES; QUALITY C1 Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Denver, CO 80220 USA. Duke Univ, Ctr Med, Duke Clin Res Inst, Durham, NC USA. RP Rumsfeld, JS (reprint author), Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, 1055 Clermont St, Denver, CO 80220 USA. EM John.Rumsfeld@med.va.gov NR 13 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 JAN 4 PY 2005 VL 45 IS 1 BP 79 EP 81 DI 10.1016/j.jacc.2004.10.012 PG 3 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 883LF UT WOS:000226012600015 PM 15629378 ER PT J AU D'Souza, I Schellenberg, GD AF D'Souza, I Schellenberg, GD TI Regulation of tau isoform expression and dementia SO BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR BASIS OF DISEASE LA English DT Review DE tau; dementia ID FAMILIAL FRONTOTEMPORAL DEMENTIA; PROTEIN PHOSPHATASE 2A; MICROTUBULE-ASSOCIATED PROTEINS; GLYCOGEN-SYNTHASE KINASE-3; PONTO-NIGRAL DEGENERATION; MULTIPLE-SYSTEM TAUOPATHY; PAIRED HELICAL FILAMENTS; SPLICE-SITE MUTATIONS; EXON 10; ALZHEIMERS-DISEASE AB In the central nervous system (CNS), aberrant changes in tau mRNA splicing and consequently in protein isoform ratios cause abnormal aggregation of tau and neurodegeneration. Pathological tau causes neuronal loss in Alzheimer's disease (AD) and a diverse group of disorders called the frontotemporal dementias (FTD), which are two of the most common forms of dementia and afflict more than 10 % of the elderly population. Autosomal dominant mutations in the tau gene cause frontotemporal dementia with parkinsonism-chromosome 17 type (FTDP-17). Just over half the mutations affect tau protein function and decrease its affinity for microtubules (MTs) or increase self-aggregation. The remaining mutations occur within exon 10 (E 10) and intron 10 sequences and alter complex regulation of E10 splicing by multiple mechanisms. FTDP-17 splicing mutations disturb the normally balanced levels of distinct protein. isoforms that result in altered biochemical and structural properties of tau. In addition to FTDP-17, altered tau isoform levels are also pathogenically associated with other FTD disorders such as progressive supranuclear palsy (PSP), corticobasal degeneration and Pick's disease; however, the mechanisms remain undefined and mutations in tau have not been detected. FTDP-17 highlights the association between splicing mutations and the pronounced variability in pathology as well as phenotype that is characteristic of inherited disorders. (C) 2004 Elsevier B.V. All rights reserved. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Dept Med, Div Geriatr & Geriat Med, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Pharmacol, Seattle, WA 98195 USA. RP Schellenberg, GD (reprint author), Univ Washington, Div Neurol, Dept Med, RG-27, Seattle, WA 98195 USA. EM neurol@u.washington.edu NR 117 TC 71 Z9 72 U1 0 U2 11 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0925-4439 J9 BBA-MOL BASIS DIS JI Biochim. Biophys. Acta-Mol. Basis Dis. PD JAN 3 PY 2005 VL 1739 IS 2-3 BP 104 EP 115 DI 10.1016/j.bbadis.2004.08.009 PG 12 WC Biochemistry & Molecular Biology; Biophysics; Cell Biology SC Biochemistry & Molecular Biology; Biophysics; Cell Biology GA 884XQ UT WOS:000226120400003 PM 15615630 ER PT J AU Riley, DE Krieger, JN AF Riley, DE Krieger, JN TI Short tandem repeat (STR) replacements in UTRs and introns suggest an important role for certain STRs in gene expression and disease SO GENE LA English DT Article DE short tandem repeats; prostate cancer; chronic prostatitis; hemophilia; tyrosine hydroxylase ID TYROSINE-HYDROXYLASE GENE; PROSTATE-CANCER RISK; DNA; ASSOCIATION; SUSCEPTIBILITY; SCHIZOPHRENIA; POLYMORPHISMS; SEQUENCES; SELECTION AB Some untranslated sequence (UTR)-localized, short tandem repeats (STRs) exhibit evidence of selection pressure, including STR-coupling preferences, STR conservation, interspecies STR-STR replacements, and STR variants implicated in certain diseases. We wished to determine if STR replacements occurred near disease-related genes, including previously unstudied STRs as well as some STRs already implicated in disease. Among nine strong-candidate prostate cancer (CaP)-predisposing genes, three [steroid 5-alpha-reductase 2 (Srd5A-2), macrophage scavenger receptor-1 (MSR-1), and tumor necrosis factor receptor-21 (Tnfr-21)] exhibited striking STR replacements (P<0.001). The glomerular disease-related gene, CD2AP, exhibited an STR replacement flanked by well-conserved sequences, suggesting an STR-focused process. Another glomerular disease-related gene, rabphilin 3A, exhibited at least two STR replacements at the same UTR position comparing Drosophila melanogaster, Mus musculus, and Homo sapiens. Two genes implicated in blood-clotting disorders, von Willebrand factor (vWA) and fibrinogen alpha (FGA), exhibited multiple-intron STR replacements among mammals, extending STR replacement phenomena to introns. Among primates, a tyrosine hydroxylase (THO1) intron STR, previously implicated in both schizophrenia and drug withdrawal delirium, exhibited frequent replacements. Some STR replacements were early events in gene divergence. When STR sequences of closely related species were available, sTR replacement was observed to be nearly as rapid as speciation. STR replacements expand the list of STR sequences that may contribute to genetic activity and to disease processes. (C) 2004 Elsevier B.V. All rights reserved. C1 VA Puget Sound Hlth Care Syst, Dept Res, Seattle, WA 98012 USA. Univ Washington, Dept Urol, Seattle, WA 98195 USA. RP Riley, DE (reprint author), VA Puget Sound Hlth Care Syst, Dept Res, Room 517,Bldg 1,1660 S Columbian Way, Seattle, WA 98012 USA. EM dri@u.washington.edu FU NIDDK NIH HHS [R01 DK38955] NR 30 TC 12 Z9 13 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0378-1119 J9 GENE JI Gene PD JAN 3 PY 2005 VL 344 BP 203 EP 211 DI 10.1016/j.gene.2004.09.034 PG 9 WC Genetics & Heredity SC Genetics & Heredity GA 896HG UT WOS:000226924600020 PM 15656986 ER PT J AU Green, WL AF Green, WL TI New questions regarding bioequivalence of levothyroxine preparations: A clinician's response SO AAPS JOURNAL LA English DT Review ID THYROTROPIN-SUPPRESSIVE THERAPY; RANDOMIZED CONTROLLED-TRIAL; QUALITY-OF-LIFE; THYROID-HORMONE; SUBCLINICAL HYPERTHYROIDISM; PRIMARY HYPOTHYROIDISM; RISK-FACTOR; THYROXINE; DISEASE; WOMEN C1 VA Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. RP Green, WL (reprint author), VA Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. EM annebillgreen@earthlink.net NR 39 TC 14 Z9 16 U1 0 U2 4 PU AMER ASSOC PHARMACEUTICAL SCIENTISTS PI ALEXANDRIA PA 1650 KING ST, STE 200, ALEXANDRIA, VA 22314-2747 USA SN 1550-7416 J9 AAPS J PY 2005 VL 7 IS 1 BP E54 EP E58 DI 10.1208/aapsj070107 PG 5 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 007SW UT WOS:000234991000007 PM 16146330 ER PT J AU Gracey, CF Haidet, P Branch, WT Weissmann, P Kern, DE Mitchell, G Frankel, R Inui, T AF Gracey, CF Haidet, P Branch, WT Weissmann, P Kern, DE Mitchell, G Frankel, R Inui, T TI Precepting humanism: Strategies for fostering the human dimensions of care in ambulatory settings SO ACADEMIC MEDICINE LA English DT Article ID ATTENDING PHYSICIANS; MEDICAL-EDUCATION; PERSONAL GROWTH; ROUNDS; COMMUNICATION; GUIDELINES; BEHAVIORS; ATTITUDES; EFFICIENT; AWARENESS AB Humanistic medical care is an important element of quality health care, and teaching humanism is increasingly recognized as an integral component of medical education. The goal of this article is to illustrate a series of tools that are effective in fostering both the provision and teaching of humanistic medical care in the ambulatory setting. Through a series of discussions, workshops, literature review, and practice, the authors have identified critical elements that promote the teaching of humanistic care. These elements include establishing a humanistic learning climate, creating clear individualized learning goals within a framework of humanism, developing an educational diagnosis of the learner, integrating psychosocial issues into the teaching intervention, reflecting on the learning experience with the learner, providing feedback throughout the teaching encounter, and planning follow-up with the learner. Strategies for implementation of these critical elements are presented with an emphasis on efficient educational interactions as required by busy ambulatory settings. Through the effective use of these teaching strategies, one can promote the teaching of the human dimensions of care in the outpatient setting. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Emory Univ, Sch Med, Dept Med, Atlanta, GA USA. Univ Minnesota, Sch Med, Fairview, MN USA. Johns Hopkins Bayview Med Ctr, Div Gen Internal Med, Baltimore, MD USA. Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. Indiana Univ, Sch Med, Indianapolis, IN USA. Indiana Univ, Sch Med, Roudebush VA Med Ctr, Indianapolis, IN USA. Regenstrief Inst Hlth Care, Dept Med, Indianapolis, IN USA. RP Gracey, CF (reprint author), Univ Rochester, Sch Med & Dent, Gen Med Unit, 601 Elmwood Ave, Rochester, NY 14642 USA. EM catherine-gracey@urmc.rochester.edu NR 37 TC 36 Z9 37 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD JAN PY 2005 VL 80 IS 1 BP 21 EP 28 DI 10.1097/00001888-200501000-00007 PG 8 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 885FS UT WOS:000226143100004 PM 15618087 ER PT J AU Haidet, P Kelly, A Chou, C AF Haidet, P Kelly, A Chou, C CA Culture Study Grp TI Characterizing the patient-centeredness of hidden curricula in medical schools: Development and validation of a new measure SO ACADEMIC MEDICINE LA English DT Article; Proceedings Paper 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 ID CONSENSUS STATEMENT; CARE; COMMUNICATION; EDUCATION; PERSPECTIVE; INTERVIEW; ATTITUDES; OUTCOMES AB Purpose The "hidden curriculum" has a powerful influence in shaping medical students' attitudes and behaviors toward patient care. The purpose of this project was to develop and test a tool (the C-3 Instrument) to help educators characterize and understand the hidden curriculum at their own institutions. Method In 2000, the authors developed survey items to measure three content areas of the hidden curriculum with respect to patient-centered care. These content areas include role modeling, students' patient-care experiences, and perceived support for students' own patient-centered behaviors. The survey was distributed to third- and fourth-year students at ten medical schools in the United States. Using factor analysis, the authors selected items for the final version of the C-3 Instrument. To examine validity, they compared instrument scores to results of a poll of members of two organizations devoted to teaching patient-centered care. Results A total of 890 students completed the survey. The mean age of students was 27 (SD 3). Fifty-two percent of students were women, and 70% were white. Twenty-nine items were selected for the C-3 Instrument, with internal consistency measures ranging from .67 to .93 for instrument subdimensions. In the validation analysis, summary scores for all three content areas of the C-3 Instrument were consistent with results of the poll of patient-centered organizations. Conclusion Despite some issues that still need to be resolved, the C-3 Instrument proved to be a reliable and valid tool that characterizes a medical school's hidden curriculum with respect to patient-centered care. It can be used to guide educational interventions by addressing the context that exists around formal teaching activities. It also makes possible the study of hidden curricula across multiple medical schools. Further research on the hidden curriculum should be aimed at developing a greater understanding of the dynamics between formal teaching activities and school culture. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Haidet, P (reprint author), Michael E DeBakey Vet Affairs Med Ctr, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM phaidet@bcm.tmc-edu NR 22 TC 49 Z9 50 U1 1 U2 10 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD JAN PY 2005 VL 80 IS 1 BP 44 EP 50 DI 10.1097/00001888-200501000-00012 PG 7 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 885FS UT WOS:000226143100008 PM 15618092 ER PT J AU Marder, SR AF Marder, SR TI Subjective experiences on antipsychotic medications: synthesis and conclusions SO ACTA PSYCHIATRICA SCANDINAVICA LA English DT Article DE schizophrenia; antipsychotics; dysphoria; extrapyramidal symptoms; dopamine ID QUALITY-OF-LIFE; SCHIZOPHRENIA; HALOPERIDOL; DYSPHORIA; DRUGS; NEUROLEPTICS; OLANZAPINE; AKATHISIA AB Objective: This report synthesizes the literature describing the phenomenology, clinical importance and biology of subjective responses to antipsychotic medications in schizophrenia. A patient's experience of an antipsychotic is important because unpleasant or dysphoric responses can impair therapeutic relationships, lead to medication non-adherence, and have direct negative effects on a patient's quality of life. Method: The author selectively reviewed early studies of subjective responses to antipsychotics and integrated this literature with the work of the other investigators in this special section. Results: There is substantial evidence that second-generation antipsychotics have advantages in causing fewer dysphoric responses when compared with first-generation agents. Clinical and neuroimaging studies suggest that dopamine blockade is an important determinant of many of these dysphorias. At this point in time it is unclear whether dysphoria results from extrapyramidal symptoms particularly akathisia and akinesia - or whether they are a direct result of decreased dopamine activity. Conclusion: Clinicians and researchers should continue to monitor dysphorias in schizophrenia. Contributions by the authors in this supplement provide new and more refined methods for measuring subjective responses in future studies. C1 W Los Angeles Vet Affairs Med Ctr, Psychiat Serv 116A, MIRECC VISN 22, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Marder, SR (reprint author), W Los Angeles Vet Affairs Med Ctr, Psychiat Serv 116A, MIRECC VISN 22, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM marder@ucla.edu NR 23 TC 27 Z9 28 U1 1 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0001-690X J9 ACTA PSYCHIAT SCAND JI Acta Psychiatr. Scand. PY 2005 VL 111 SU 427 BP 43 EP 46 DI 10.1111/j.1600-0447.2005.00544.x PG 4 WC Psychiatry SC Psychiatry GA 931JH UT WOS:000229481100007 ER PT J AU Abraham, NS Davila, JA Rabeneck, L Berger, DH El-Serag, HB AF Abraham, NS Davila, JA Rabeneck, L Berger, DH El-Serag, HB TI Increased use of low anterior resection for veterans with rectal cancer SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID QUALITY IMPROVEMENT PROGRAM; HOSPITAL PROCEDURE VOLUME; ADMINISTRATIVE DATABASES; CARE; SURVIVAL; OUTCOMES; ABDOMINOPERINEAL; ADENOCARCINOMA; MANAGEMENT; THERAPY AB Background: Two surgical procedures with curative intent are available to patients with rectal cancer: lower anterior resection and abdominoperineal resection; however, lower anterior resection may improve quality of life and functional status. Aim: To examine temporal changes in after lower anterior resection and abdominoperineal resection between 1989 and 2000. Potential factors associated with the use of lower anterior resection were evaluated. Methods: Using national administrative data, we identified patients who received lower anterior resection or abdominoperineal resection. Logistic regression models examined the association between use of lower anterior resection and time period of surgical resection. Results: A total of 5201 rectal cancer patients underwent resection. The use of lower anterior resection increased from 40.0% (1989-91) to 50.1% (1998-2000) paralleled by a corresponding decline in abdominoperineal resection (60.1 to 49.9%; P < 0.001). Patients who received surgery during 1992-94, 1995-97 and 1998-2000 were 6, 7 and 28% more likely to receive lower anterior resection, when compared with 1989-1991 after adjusting for demographic characteristics, co-morbidity and hospital surgical volume. Older age, lower co-morbidity score and lower hospital surgical volume were predictive of lower anterior resection. Conclusions: An increase in the use of lower anterior resection for rectal cancer was observed over time. This observed increase in use is not confined to high-volume hospitals. C1 Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Houston Ctr Gastroenterol, Houston, TX 77030 USA. Univ Toronto, Dept Med, Div Gastroenterol, Toronto, ON, Canada. Inst Clin Evaluat Sci, Toronto, ON, Canada. Houston VAMC, Houston Ctr Surg, Houston, TX USA. RP Abraham, NS (reprint author), Michael E DeBakey Vet Affairs Med Ctr, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM nabraham@bcm.tmc.edu FU NIDDK NIH HHS [K24 DK59318] NR 21 TC 8 Z9 8 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD JAN 1 PY 2005 VL 21 IS 1 BP 35 EP 41 DI 10.1111/j.1365-2036.2004.02286.x PG 7 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 887VP UT WOS:000226333900005 PM 15644043 ER PT J AU Peskind, ER Tsuang, DW Bonner, LT Pascualy, M Riekse, RG Snowden, MB Thomas, R Raskind, MA AF Peskind, ER Tsuang, DW Bonner, LT Pascualy, M Riekse, RG Snowden, MB Thomas, R Raskind, MA TI Propranolol for disruptive behaviors in nursing home residents with probable or possible Alzheimer disease - A placebo-controlled study SO ALZHEIMER DISEASE & ASSOCIATED DISORDERS LA English DT Article DE Alzheimer disease; betas-adrenergic; disruptive behaviors; long-term care; propranolol ID CEREBROSPINAL-FLUID; SENILE DEMENTIA; CONTROLLED-TRIAL; LOCUS-CERULEUS; DOUBLE-BLIND; DISTURBANCES; NOREPINEPHRINE; NEURONS; GALANTAMINE; AGGRESSION AB Objective: Enhanced behavioral responsiveness to central nervous system (CNS) norepinephrine (NE) in Alzheimer disease (AD) may contribute to the pathophysiology of disruptive behaviors such as aggression, uncooperativeness with necessary care, irritability, and pressured pacing. We evaluated the efficacy of the beta-adrenergic antagonist propranolol for treatment-resistant disruptive behaviors and overall behavioral status in nursing home residents with probable or possible AD. Methods: Thirty-one subjects (age 85 +/- 8 [SD]) with probable or possible AD and persistent disruptive behaviors that interfered with necessary care were randomized to propranolol (n = 17) or placebo (n = 14) in a double-blind study. Stable doses of previously prescribed psychotropics were maintained at pre-study dose during the Study. Following a propranolol or placebo dose titration period of Lip to 9 days (per a dosing algorithm), subjects were maintained on maximum achieved dose for 6 weeks. Primary outcome measures were the Neuropsychiatric Inventory (NPI) and the Clinical Global Impression of Change (CGIC). Results: Propranolol augmentation (mean achieved dose 106 +/- 38 mg/d) was significantly more effective than placebo for improving overall behavioral status on the total NPI score and CGIC. Improvement in individual NPI items within propranolol subjects was significant only for "agitation/aggression" and "anxiety," and reached borderline statistical significance favoring propranolol over placebo only for " agitation/aggression." Pressured pacing and irritability did not appear responsive to propranolol. In propranolol subjects rated "moderately improved" or "markedly improved" on the CGIC at the end of the double-blind study phase, improvement of overall behavioral status had diminished substantially after 6 months of open-label propranolol treatment. Conclusion: Short-term propranolol augmentation treatment appeared modestly effective and well tolerated for overall behavioral status in nursing home residents with probable or possible AD complicated by disruptive behaviors. Propranolol may be helpful specifically for aggression and uncooperativeness (the behaviors assessed by the NPI ''agitation/aggressiveness" item). However, the usefulness of propranolol in this very old and frail population was limited by the high frequency of relative contraindications to beta-adrenergic antagonist treatment and diminution of initial behavioral improvements over time. C1 Mental Illness Res Educ & Clin Ctr, VA Puget Sound Hlth Care Syst, Dept Vet Affairs NW Network VISN 20, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Dept Psychiat & Behav Sci, Seattle, WA USA. VA Puget Sound Hlth Care Syst, GRECC, Seattle, WA USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Calif San Diego, Div Biostat, Dept Family Med, San Diego, CA 92103 USA. Univ Calif San Diego, Dept Neurosci, San Diego, CA 92103 USA. RP Peskind, ER (reprint author), Mental Illness Res Educ & Clin Ctr, VA Puget Sound Hlth Care Syst, Dept Vet Affairs NW Network VISN 20, S-116 MIREEC,1660 S Columbian Way, Seattle, WA 98108 USA. EM peskind@u.washington.edu RI Tsuang, Debby/L-7234-2016 OI Tsuang, Debby/0000-0002-4716-1894 FU NIA NIH HHS [AG18644] NR 36 TC 37 Z9 37 U1 1 U2 2 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 JAN-MAR PY 2005 VL 19 IS 1 BP 23 EP 28 DI 10.1097/01.wad.0000155067.16313.5e PG 6 WC Clinical Neurology; Pathology SC Neurosciences & Neurology; Pathology GA 909IQ UT WOS:000227854000005 PM 15764868 ER PT J AU Vazirani, S Hays, RD Shapiro, MF Cowan, M AF Vazirani, S Hays, RD Shapiro, MF Cowan, M TI Effect of a multidisciplinary intervention on communication and collaboration among physicians and nurses SO AMERICAN JOURNAL OF CRITICAL CARE LA English DT Article AB BACKGROUND Improving communication and collaboration among doctors and nurses can improve satisfaction among participants and improve patients' satisfaction and quality of care. OBJECTIVE To determine the impact of a multidisciplinary intervention on communication and collaboration among doctors and nurses on an acute inpatient medical unit. METHODS During a 2-year period, an intervention unit was created that differed from the control unit by the addition of a nurse practitioner to each inpatient medical team, the appointment of a hospitalist medical director and the institution of daily multidisciplinary rounds. Surveys about communication and collaboration were administered to personnel in both units. Physicians were surveyed at the completion of each rotation on the unit; nurses, biannually. RESULTS Response rates for house staff (n = 111), attending physicians (n = 45), and nurses (n = 123) were 58%, 69% and 91%, respectively. Physicians in the intervention group reported greater collaboration with nurses than did physicians in the control group (P < .001); the largest effect was among the residents. Physicians in the intervention group reported better collaboration with the nurse practitioners than with the staff nurses (P < .001). Physicians in the intervention group also reported better communication with fellow physicians than did physicians in the control group (P = .006). Nurses in both groups reported similar levels of communication (P = .59) and collaboration (P = .47) with physicians. Nurses in the intervention group reported better communication with nurse practitioners than with physicians (P < .001). CONCLUSIONS The multidisciplinary intervention resulted in better communication and collaboration among the participants. C1 Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. RP Vazirani, S (reprint author), Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. EM reprints@aacn.org RI Hays, Ronald/D-5629-2013 FU AHRQ HHS [1R01 HS 10734]; NIA NIH HHS [AG 02004]; NIMHD NIH HHS [P20 MD 00148-01, P20 MD000148, P20 MD000148-03] NR 13 TC 104 Z9 104 U1 1 U2 15 PU AMER ASSOC CRITICAL CARE NURSES PI ALISO VIEJO PA 101 COLUMBIA, ALISO VIEJO, CA 92656 USA SN 1062-3264 J9 AM J CRIT CARE JI Am. J. Crit. Care PD JAN PY 2005 VL 14 IS 1 BP 71 EP 76 PG 6 WC Critical Care Medicine; Nursing SC General & Internal Medicine; Nursing GA 882DF UT WOS:000225918100010 PM 15608112 ER PT J AU Kramer, JR Giordano, TP Souchek, J Richardson, P Hwang, LY El-Serag, HB AF Kramer, JR Giordano, TP Souchek, J Richardson, P Hwang, LY El-Serag, HB TI The effect of HIV coinfection on the risk of cirrhosis and hepatocellular carcinoma in US. Veterans with hepatitis C SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article; Proceedings Paper CT 54th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY OCT 24-28, 2003 CL BOSTON, MA SP Amer Assoc Study Liver Diseases ID HUMAN-IMMUNODEFICIENCY-VIRUS; LIVER FIBROSIS PROGRESSION; NATURAL-HISTORY; UNITED-STATES; DRUG-USERS; INFECTION; HEMOPHILIACS; DISEASE; VIREMIA; COHORT AB OBJECTIVES: This study was conducted to determine whether HIV coinfection increases the risk of cirrhosis in HCV-infected patients in the HAART and pre-HAART eras. Further, the risk of hepatocellular carcinoma was also examined. METHODS: This retrospective cohort study was conducted among HCV-infected veterans who were seen at one of the 172 Veterans Health Administration hospitals between October 1, 1991 and September 30, 2000. Patients with prerecorded advanced liver disease were excluded. Incidence rates, cumulative incidence, and Cox proportional hazard ratios were calculated. RESULTS: There were 26,641 patients with HCV-only and 4,761 patients with HCV-HIV coinfection. The unadjusted incidence rate of cirrhosis was lower in patients with coinfection than HCV-only (p < 0.01). After controlling for demographics and confounders (including alcoholism and chronic hepatitis B), coinfection was not significantly associated with cirrhosis. However, there was an increased risk of cirrhosis in patients with coinfection compared to HCV-only during the pre-HAART era (before October 1, 1996) (hazard ratio = 1.48, 1.06-2.07, p = 0.02), but not among patients who entered the cohort during the HAART era. The unadjusted incidence rate of hepatocellular carcinoma in patients with coinfection and HCV-only was 1.3 and 2/1,000 person-years, respectively (p = 0.04). In the multivariate model, coinfection was not associated with hepatocellular carcinoma (hazard ratio = 0.84, p = 0.40). CONCLUSIONS: Coinfection was a significant risk factor for cirrhosis only during the pre-HAART era and was not associated with hepatocellular carcinoma, irrespective of time period. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Serv, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Infect Dis Sect, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Gastroenterol Sect, Houston, TX 77030 USA. Univ Texas, Hlth Sci Ctr, Sch Publ Hlth, Houston, TX USA. RP El-Serag, HB (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Serv, 152, Houston, TX 77030 USA. FU NIMH NIH HHS [1K23 MH 67505-01] NR 26 TC 96 Z9 97 U1 1 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD JAN PY 2005 VL 100 IS 1 BP 56 EP 63 DI 10.1111/j.1572-0241.2005.40670.x PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 883RJ UT WOS:000226033100011 PM 15654781 ER PT J AU Tran, T Davila, JA El-Serag, HB AF Tran, T Davila, JA El-Serag, HB TI The epidemiology of malignant gastrointestinal stromal tumors: An analysis of 1,458 cases from 1992 to 2000 SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID SMOOTH-MUSCLE TUMORS; OF-FUNCTION MUTATIONS; DIFFERENTIAL-DIAGNOSIS; C-KIT; SARCOMAS; TRACT; GRADE; LEIOMYOSARCOMAS; LEIOMYOMAS; PROGNOSIS AB OJECTIVES: The epidemiology of gastrointestinal stromal tumor has not been well examined, and prior studies often provide conflicting results. We conducted the first population-based study to evaluate the incidence and survival of malignant gastrointestinal stromal tumor in the United States. METHODS: We utilized the Surveillance, Epidemiology, and End Results registry from the National Cancer Institute to identify all cases of malignant gastrointestinal stromal tumor diagnosed from 1992 to 2000. The age-adjusted incidence rates and the survival rates were calculated. Cox proportional hazards models were used to examine the risk of mortality. RESULTS: Between 1992 and 2000, there were 1,458 cases of diagnosed gastrointestinal stromal tumor. The age-adjusted yearly incidence rate was 0.68/100,000. The mean age at diagnosis was 63 yr. Fifty-four percent were men and 46% were women. The incidence rate was higher among men and among Blacks. Fifty-one percent of cases were in the stomach, 36% small intestine, 7% colon, 5% rectum, and 1% in the esophagus. Fifty-three percent of cases were staged as localized, 19% regional, 23% distant, and 5% unstaged. The 1- and 5-yr relative survival rates were 80% and 45%, respectively. The Cox analysis showed that older age, Black race, advanced stage, and receipt of therapy were independent predictors of mortality. CONCLUSIONS: Malignant gastrointestinal stromal tumors rare, but are more common in the older population, men, and Blacks. Risk factors for mortality include older age, Black race, advanced stage, and no surgical intervention. C1 Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Houston Dept Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX USA. Houston Dept Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr, 2002 Holcombe Blvd,152, Houston, TX 77030 USA. NR 38 TC 245 Z9 270 U1 3 U2 13 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD JAN PY 2005 VL 100 IS 1 BP 162 EP 168 DI 10.1111/j.1572-0241.2005.40709.x PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 883RJ UT WOS:000226033100026 PM 15654796 ER PT J AU Sung, YJ Dawson, G Munson, J Estes, A Schellenberg, GD Wijsman, EM AF Sung, YJ Dawson, G Munson, J Estes, A Schellenberg, GD Wijsman, EM TI Genetic investigation of quantitative traits related to autism: Use of multivariate polygenic models with ascertainment adjustment SO AMERICAN JOURNAL OF HUMAN GENETICS LA English DT Article ID RECIPROCAL SOCIAL-BEHAVIOR; PERVASIVE DEVELOPMENTAL DISORDERS; FAMILY HISTORY; DIAGNOSTIC INTERVIEW; PEDIGREE ANALYSIS; INFANTILE-AUTISM; SAMPLING PROBLEM; SYMPTOM DOMAINS; GENOMIC SCREEN; TWIN AB Autism is a severe developmental disorder of unknown etiology but with evidence for genetic influences. Here, we provide evidence for a genetic basis of several quantitative traits that are related to autism. These traits, from the Broader Phenotype Autism Symptom Scale (BPASS), were measured in nuclear families, each ascertained through two probands affected by autism spectrum disorder. The BPASS traits capture the continuum of severity of impairments and may be more informative for genetic studies than are the discrete diagnoses of autism that have been used by others. Using a sample of 201 nuclear families consisting of a total of 694 individuals, we implemented multivariate polygenic models with ascertainment adjustment to estimate heritabilities and genetic and environmental correlations between these traits. Our ascertainment adjustment uses conditioning on the phenotypes of probands, requires no modeling of the ascertainment process, and is applicable to multiplex ascertainment and multivariate traits. This appears to be the first such implementation for multivariate quantitative traits. The marked difference between heritability estimates of the trait for language onset with and without an ascertainment adjustment (0.08 and 0.22, respectively) shows that conclusions are sensitive to whether or not an ascertainment adjustment is used. Among the five BPASS traits that were analyzed, the traits for social motivation and range of interest/flexibility show the highest heritability (0.19 and 0.16, respectively) and also have the highest genetic correlation (0.92). This finding suggests a shared genetic basis of these two traits and that they may be most promising for future gene mapping and for extending pedigrees by phenotyping additional relatives. C1 Univ Washington, Div Med Genet, Autism Ctr, Seattle, WA 98195 USA. Univ Washington, Div Gerontol & Geriatr Med, Autism Ctr, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Psychol, Autism Ctr, Seattle, WA 98195 USA. Univ Washington, Dept Pharmacol & Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Dept Genome Sci, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. RP Wijsman, EM (reprint author), Univ Washington, Div Med Genet, Autism Ctr, Box 357720, Seattle, WA 98195 USA. EM wijsman@u.washington.edu FU NICHD NIH HHS [U19 HD 35465, U19 HD035465]; NIGMS NIH HHS [R01 GM046255, R01 GM 46255] NR 67 TC 64 Z9 65 U1 6 U2 13 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 JAN PY 2005 VL 76 IS 1 BP 68 EP 81 DI 10.1086/426951 PG 14 WC Genetics & Heredity SC Genetics & Heredity GA 878JR UT WOS:000225643600006 PM 15547804 ER PT J AU Shrank, WH Young, HN Ettner, SL Glassman, P Asch, SM Kravitz, RL AF Shrank, WH Young, HN Ettner, SL Glassman, P Asch, SM Kravitz, RL TI Do the incentives in 3-tier pharmaceutical benefit plans operate as intended? Results from a physician leadership survey SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID HEALTH MAINTENANCE ORGANIZATION; PRESCRIPTION DRUGS; FORMULARIES; MEDICARE; COST; COPAYMENTS; IMPACT; CARE AB Background: Three-tier pharmaceutical benefit systems use graded co-payments to steer patients toward "preferred" formulary medications. Objectives: To evaluate physicians' knowledge of formularies and out-of-pocket costs in such systems, as well as their perceived responsibility for helping patients manage out-of-pocket costs. Study Design: Self-administered written survey. Methods: Physician leaders participating in the California Medical Association Leadership Conference were surveyed. Results: A total of 133 responses were received from 205 participants (65% response rate). Physicians reported that they were often unaware of patients' out-of-pocket costs at the time of prescribing. Fifty-nine percent of physicians reported that they never or seldom were aware of patients' "preferred" (lower cost) formulary options when prescribing, and 70% never or seldom were aware of patients' out-of-pocket costs when prescribing. Although 88% of physicians agreed that it is important that patients' out-of-pocket costs for prescription drugs are managed, only 25% strongly or somewhat agreed that it is their "responsibility" to help. Instead, 69% of physicians believed that it is the responsibility of the pharmacist to be familiar with patients' out-of-pocket costs. Physicians reported that they receive phone calls from pharmacists concerning formulary issues after 18.6% of the prescriptions they write. Conclusions: Physician leaders reported that they often do not possess the knowledge to assist patients in managing out-of-pocket costs for prescription drugs and they depend on pharmacists to communicate patient preferences in making prescribing decisions. As a result, price preferences are communicated indirectly, likely less efficiently, rather than intentionally when prescribing decisions are made. C1 VA Greater Los Angeles Hlth Care Syst, Div Gen Internal Med, Vet Affairs Hlth Serv Res & Dev Fellow, Los Angeles, CA 90073 USA. Univ Calif Davis, Serv Res Primary Care, Sacramento, CA USA. Univ Calif Davis, Dept Internal Med, Sacramento, CA USA. Univ Calif Los Angeles, Div Gen Internal Med & Htlh Serv Res, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA USA. RAND Corp, Santa Monica, CA USA. RP Shrank, WH (reprint author), VA Greater Los Angeles Hlth Care Syst, Div Gen Internal Med, Vet Affairs Hlth Serv Res & Dev Fellow, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM William.Shrank@med.va.gov OI Kravitz, Richard/0000-0001-5575-529X NR 32 TC 35 Z9 35 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 JAN PY 2005 VL 11 IS 1 BP 16 EP 22 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 886RF UT WOS:000226245300002 PM 15697096 ER PT J AU Spina, JR Glassman, PA Belperio, P Cader, R Asch, S AF Spina, JR Glassman, PA Belperio, P Cader, R Asch, S CA Primary Care Investigative Grp VA TI Clinical relevance of automated drug alerts from the perspective of medical providers SO AMERICAN JOURNAL OF MEDICAL QUALITY LA English DT Article DE attitude of health personnel; clinical decision support systems; drug interactions; computer-assisted drug therapy; medication errors; prevention; control ID PHYSICIAN ORDER ENTRY; ERRORS; CARE; INTERVENTION; COMPUTER; SYSTEM AB The authors used a real-time survey instrument and subsequent focus group among primary care clinicians at a large healthcare system to assess usefulness of automated drug alerts. Of 108 alerts encountered, 0.9% (n = 1) represented critical alerts, and 16% (n = 17) were significant drug interaction alerts. Sixty-one percent (n = 66) involved duplication of a medication or medication class. The rest (n = 24) involved topical medications, inhalers, or vaccines. Of the 84 potentially relevant alerts, providers classified 11% (9/84), or about 1 in 9, as useful. Drug interaction alerts were more often deemed useful than drug duplication alerts (44.4% versus 1.5%, P<.001). Focus group participants generally echoed these results when ranking the relevance of 15 selected alerts, although there was wide variance in ratings for individual alerts. Hence, a "smarter" system that utilizes a set of mandatory alerts while allowing providers to tailor use of other automated warnings may improve clinical relevance of drug alert systems. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RAND Corp, Santa Monica, CA USA. RP Spina, JR (reprint author), 11301 Wilshire Blvd,111G, Los Angeles, CA 90073 USA. EM jeffrey.spina@med.va.gov NR 21 TC 41 Z9 42 U1 1 U2 1 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 JAN-FEB PY 2005 VL 20 IS 1 BP 7 EP 14 DI 10.1177/1062860604273777 PG 8 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 894HO UT WOS:000226781900002 PM 15782750 ER PT J AU Sherman, SE Yano, EM Lanto, AB Simon, BF Rubenstein, LV AF Sherman, SE Yano, EM Lanto, AB Simon, BF Rubenstein, LV TI Smokers' interest in quitting and services received: Using practice information to plan quality improvement and policy for smoking cessation SO AMERICAN JOURNAL OF MEDICAL QUALITY LA English DT Article DE smoking cessation; counseling; primary care; cross-sectional analysis ID DEPRESSION; CARE AB Given the prevalence of smoking, its impact, and the benefits of cessation, helping smokers quit should be a top priority for health care organizations. To restructure health care delivery and guide future policy, the authors used baseline survey data from an 18-site Veterans Health Administration group randomized trial to assess the level of interest in quitting smoking for a practice population and determine what smoking cessation services they reported receiving. Among 1941 current smokers, 55% did not intend to quit in the next 6 months, and the remainder intended to quit in the next month (13%) to 6 months (32%). Forty-five percent reported a quit attempt in the prior year. While nearly two thirds of smokers reported being counseled about cessation within the past year, only 29% were referred to a cessation program, and 25% received a prescription for nicotine patches. Tobacco control efforts within this population should focus on increasing the rate of assisting patients with quitting. C1 VA Greater Los Angeles Healthcare Syst, Ctr Excellence Study Healthcare Provider Behav, VAHSR&D, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA USA. RP Sherman, SE (reprint author), Sepulveda Ambulatory Care Ctr 00PG, 16111 Plummer St, Sepulveda, CA 91343 USA. EM ssherman@ucla.edu OI Sherman, Scott/0000-0003-1752-7303 NR 28 TC 19 Z9 19 U1 0 U2 1 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 JAN-FEB PY 2005 VL 20 IS 1 BP 33 EP 39 DI 10.1177/1062860604273776 PG 7 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 894HO UT WOS:000226781900005 PM 15782753 ER PT J AU Groeneveld, PW Owens, DK AF Groeneveld, PW Owens, DK TI Cost-effectiveness of training unselected laypersons in cardiopulmonary resuscitation and defibrillation SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE cardiopulmonary resuscitation; cost-benefit analysis; education, non-professional; quality-adjusted life years; Markow chains ID HOSPITAL CARDIAC-ARREST; PUBLIC-ACCESS DEFIBRILLATION; IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR; AUTOMATED EXTERNAL DEFIBRILLATORS; MINNESOTA HEART SURVEY; BYSTANDER CPR; VENTRICULAR-FIBRILLATION; ETHNIC DISPARITIES; WITNESSED COLLAPSE; FAMILY MEMBERS AB Purpose: The cost-effectiveness of cardiopulmonary resuscitation (CPR) and defibrillation training for laypersons unselected for risk of encountering cases of cardiac arrest is not known. We compared the costs and health benefits of alternative resuscitation training strategies for adults without professional first-responder duties who are at average risk of encountering cases of out-of-hospital cardiac arrest. Methods: We constructed a cost-effectiveness analytic model. Data on cardiac arrest epidemiology and the effectiveness of CPR/defibrillation training were obtained from the medical literature. Instructional costs were determined from a survey of training programs. Downstream cardiac arrest survivor quality-adjusted life expectancy and long-term health care costs were derived from prior Studies. We compared three strategies for training unselected laypersons: CPR/defibrillation training alone, training combined with home defibrillator purchase, and no training. The main outcome measures were total instructional costs for trainees combined with health care costs for additional cardiac arrest survivors, and quality-adjusted survival for additional patients resuscitated by trainees. Results: CPR/defibrillation training yielded 2.7 quality-adjusted hours of life at a cost of $62 per trainee ($202,400 per quality-adjusted life-year [QALY] gained). Training laypersons in CPR/defibrillation with subsequent defibrillator purchase cost $2,489,700 per QALY. In contrast. CPR/defibrillation training cost less than $75,000 per QALY if trainees lived with persons older than 75 years or with persons who had cardiac disease, or if total training costs were less than $10. Conclusion: Training unselected laypersons in CPR/defibrillation is costly compared with other public health initiatives. Conversely, training laypersons selected by occupation, low training costs. or having high-risk household companions is substantially more efficient. (C) 2005 Elsevier Inc. All rights reserved. C1 Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Penn, Div Gen Internal Med, Philadelphia, PA USA. Leonard Davis Inst Hlth Econ, Philadelphia, PA USA. Vet Affairs Palo Alto Hlth Care Syst, Palo Alto, CA USA. Stanford Univ, Ctr Primary Care & Outcomes Res, Stanford, CA 94305 USA. RP Groeneveld, PW (reprint author), 1122 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM peter.groeneveld@med.va.gov FU AHRQ HHS [T32-HS000028] NR 73 TC 22 Z9 22 U1 1 U2 7 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 JAN PY 2005 VL 118 IS 1 BP 58 EP 67 DI 10.1016/j.amjmed.2004.08.014 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 888FN UT WOS:000226359700012 PM 15639211 ER PT J AU Adrogue, HJ AF Adrogue, HJ TI Consequences of inadequate management of hyponatremia SO AMERICAN JOURNAL OF NEPHROLOGY LA English DT Review DE hyponatremia; vasopressin; water excretion; salt-water balance ID CONGESTIVE-HEART-FAILURE; VASOPRESSIN-INDUCED ANTIDIURESIS; SERUM SODIUM CONCENTRATION; EFFECTIVE WATER CLEARANCE; NEUROLOGIC COMPLICATIONS; SYMPTOMATIC HYPONATREMIA; INAPPROPRIATE SECRETION; ANTAGONIST CONIVAPTAN; RECEPTOR ANTAGONISTS; V-2 ANTAGONIST AB Dilutional hyponatremia is a commonly observed disorder in hospitalized patients. It represents an excess of water in relation to prevailing sodium stores and is most often associated with a high plasma level of arginine vasopressin, including that found in patients with the syndrome of inappropriate antidiuretic hormone secretion. Hyponatremia may be classified as either acute or chronic depending on the rate of decline of serum sodium concentration, and can lead to a wide range of deleterious changes involving almost all body systems. Serious complications of dilutional hyponatremia most frequently involve the central nervous system. In fact, acute severe hyponatremia is potentially life-threatening and must be treated promptly and aggressively. Chronic hyponatremia often develops in patients with nonrenal diseases and is associated with increased morbidity and mortality. In patients hospitalized for congestive heart failure, hyponatremia is linked to a poor prognosis and increased length of hospital stay. Prompt recognition and optimal management of hyponatremia in hospitalized patients may reduce in-hospital mortality and symptom severity, allow for less intensive hospital care, decrease the duration of hospitalization and associated costs, and improve the treatment of underlying comorbid conditions and patients' quality of life. The proper treatment of dilutional hyponatremia, especially when chronic, must avoid increasing serum sodium too rapidly, which can lead to permanent or fatal neurologic sequelae. The treatment of hyponatremia may be facilitated by emerging therapies that block the actions of arginine vasopressin at V-2 and V-1a receptors to promote aquaresis, the electrolyte-sparing elimination of free water, and elevate serum sodium concentrations. Copyright (C) 2005 S. Karger AG, Basel. C1 Baylor Coll Med, Nephrol Sect, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. Dept Vet Affairs Med Ctr, Renal Sect, Houston, TX USA. RP Adrogue, HJ (reprint author), Baylor Coll Med, Nephrol Sect, 6550 Fannin,SM 1273, Houston, TX 77030 USA. EM hadrogue@bcm.tcm.edu RI chen, xuanlan/H-4158-2011 NR 54 TC 78 Z9 82 U1 1 U2 3 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0250-8095 J9 AM J NEPHROL JI Am. J. Nephrol. PY 2005 VL 25 IS 3 BP 240 EP 249 DI 10.1159/000086019 PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 942TQ UT WOS:000230306200008 PM 15914973 ER PT J AU Hathout, GM Fink, JR El-Saden, SM Grant, EG AF Hathout, GM Fink, JR El-Saden, SM Grant, EG TI Sonographic NASCET index: A new Doppler parameter for assessment of internal carotid artery stenosis SO AMERICAN JOURNAL OF NEURORADIOLOGY LA English DT Article ID DIGITAL-SUBTRACTION-ANGIOGRAPHY; DUPLEX CRITERIA; ENDARTERECTOMY TRIAL; ULTRASOUND; US; DIAGNOSIS; 70-PERCENT; DISEASE; MRA AB BACKGROUND AND PURPOSE: Established Doppler parameters for carotid stenosis assessment do not reflect North American Symptomatic Carotid Endarterectomy Trial (NASCET)-style methodology. We derived a Doppler parameter, termed sonographic NASCET index (SNI), and hypothesized that the SNI would provide greater angiographic correlation and better accuracy in predicting stenosis of 70% or greater than that of currently used peak systolic velocity (PSV) measurements. METHODS: Inclusion criteria of angiographically proved carotid stenoses of 40-95% and measured proximal and distal internal carotid artery Doppler PSV values were established. Occlusions and near occlusions were specifically excluded. Doppler and angiographic data meeting the inclusion criteria from 32 carotid bifurcations were identified; actual angiographic stenoses ranged 40-89%. SNI values were calculated for each vessel. PSV and SNI were correlated with angiography by using linear regression analysis. Accuracies of SNI and PSV in predicting stenosis of 70% or greater were compared at two thresholds. RESULTS: Correlation between SNI and angiography was superior to that between PSV and angiography (r(2) = 0.64 vs 0.38). PSV and SNI values that corresponded to 70% angiographic stenosis were 345 cm/s and 45.5, respectively. Accuracy of PSV of 345 cm/s or greater in predicting stenosis of 70% or greater was 78%, compared with 88% for SNI of 45.5 or greater. The SNI value that corresponded to a PSV threshold of 250 cm/s was 33. Accuracy of PSV of 250 cm/s or greater in predicting stenosis of 70% or greater was 81%, compared with 88% for SNI of 33 or greater. CONCLUSION: Correlation between SNI and angiography was greater than that between PSV and angiography. Accuracy of SNI in predicting stenosis of 70% or greater was also superior to that of PSV at two thresholds. These results suggest that SNI may be a better predictor of high-grade carotid stenosis than is PSV. C1 W Los Angeles Vet Affairs Med Ctr, Dept Radiol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Radiol, Los Angeles, CA USA. Univ So Calif, Med Ctr, Dept Radiol, Los Angeles, CA USA. RP Hathout, GM (reprint author), W Los Angeles Vet Affairs Med Ctr, Dept Radiol, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 32 TC 15 Z9 16 U1 0 U2 3 PU AMER SOC NEURORADIOLOGY PI OAK BROOK PA 2210 MIDWEST RD, OAK BROOK, IL 60521 USA SN 0195-6108 J9 AM J NEURORADIOL JI Am. J. Neuroradiol. PD JAN PY 2005 VL 26 IS 1 BP 68 EP 75 PG 8 WC Clinical Neurology; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging GA 893OO UT WOS:000226729300018 PM 15661704 ER PT J AU Burns, SP Breuninger, A Kaplan, C Marin, H AF Burns, SP Breuninger, A Kaplan, C Marin, H TI Hand-held dynamometry in persons with tetraplegia - Comparison of make- versus break-testing techniques SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Article DE spinal cord injuries; muscle strength; muscle spasticity; reproducibility of results ID SPINAL-CORD-INJURY; RELIABILITY; STRENGTH; INDIVIDUALS; MYOMETER; MUSCLES AB Objective: To compare make and break techniques for hand-held dynamometry in persons with tetraplegia. We compared the interrater and intrarater reliability, the relative forces, and variability between examiner techniques. Design: Two examiners with no previous hand-held dynamometry training performed hand-held dynamometry on the elbow flexors or extensors of 19 persons with upper limb weakness secondary to tetraplegia, using break and make techniques. Testing was performed in two sessions separated by 10 mins. Simultaneous recording from an electrogoniometer placed across the elbow was obtained for a subset of participants. Results: Break and make techniques both showed intraclass correlation coefficients exceeding 0.9 for interrater and intrarater reliability. The maximum expected difference for 95% of repeated measurements was 3.5 kg, with hand-held dynamometry strength values that averaged 7-11 kg. Average break/make ratios ranged from 1.38 +/- 0.29 to 1.49 +/- 0.37. The electrogoniometric data showed that the two examiners used similar testing technique, and small variations in technique were not associated with significant differences in strength recordings. Conclusion: Make and break techniques for hand-held dynamometry both show high reliability over a short intersession period when performed by inexperienced examiners on weak elbow flexors and extensors. C1 Vet Affairs Puget Sound Hlth Care Syst, Spinal Cord Injury Serv, Seattle, WA 98108 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Washington, Harborview Med Ctr, Harborview Injury Prevent & Res Ctr, Seattle, WA 98104 USA. RP Burns, SP (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Spinal Cord Injury Serv, SCI 128,1660 S Columbian Way, Seattle, WA 98108 USA. NR 26 TC 20 Z9 22 U1 0 U2 2 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 JAN PY 2005 VL 84 IS 1 BP 22 EP 29 DI 10.1097/01.PHM.0000150790.99514.C6 PG 8 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 884EE UT WOS:000226066600005 PM 15632485 ER PT J AU Shen, XX Li, QL Brent, GA Friedman, TC AF Shen, XX Li, QL Brent, GA Friedman, TC TI Regulation of regional expression in rat brain PC2 by thyroid hormone/characterization of novel negative thyroid hormone response elements in the PC2 promoter SO AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM LA English DT Article DE posttranslational processing; hypothyroidism; prohormone convertase; pituitary; regulation ID PROHORMONE CONVERTASES PC1; GENE-EXPRESSION; MESSENGER-RNA; IN-VITRO; PROPROTEIN CONVERTASES; ANTERIOR-PITUITARY; INTERMEDIATE LOBE; PRO-PROTEIN; DNA-BINDING; HALF-SITES AB The prohormone convertases (PCs) PC1 and PC2 are involved in the tissue-specific endoproteolytic processing of neuropeptide precursors within the secretory pathway. We previously showed that changes in thyroid status altered pituitary PC2 mRNA and that this regulation was due to triiodothyronine-dependent interaction of the thyroid hormone receptor (TR) with negative thyroid hormone response elements (nTREs) contained in a large proximal region of the human PC2 promoter. In the current study, we examined the in vivo regulation of brain PC2 mRNA by thyroid status and found that 6-n-propyl-2-thiouracil-induced hypothyroidism stimulated, whereas thyroxine-induced hyperthyroidism suppressed, PC2 mRNA levels in the rat hypothalamus and cerebral cortex. To address the mechanism of T-3 regulation of the PC2 gene, we used human PC2 (hPC2) promoter constructs transiently transfected into GH3 cells and found that triiodothyronine negatively and 9-cis-retinoic acid positively regulated hPC2 promoter activity. EMSAs, using purified TRalpha1 and retinoid X receptor-beta (RXRbeta) proteins demonstrated that TRalpha bound th distal putative nTRE-containing oligonucleotide in the PC2 promoter, and RXR bound to both nTRE-containing oligonucleotides. EMSAs with oligonucleotides containing deletion mutations of the nTREs demonstrated that the binding to TR and RXR separately is reduced, but specific binding to TR and RXR together persists even with deletion of each putative nTRE. We conclude that there are two novel TRE-like sequences in the hPC2 promoter and that these regions act in concert in a unique manner to facilitate the effects of thyroid hormone and 9-cis-retinoic acid on PC2. C1 Charles R Drew Univ Med & Sci, Dept Med, Div Endocrinol, Los Angeles, CA 90059 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90059 USA. W Los Angeles Vet Affairs Med Ctr, Dept Med, Div Endocrinol, Los Angeles, CA 90073 USA. RP Friedman, TC (reprint author), Charles R Drew Univ Med & Sci, Dept Med, Div Endocrinol, 1731 E 120th St, Los Angeles, CA 90059 USA. EM tefriedm@cdrewu.edu FU NCRR NIH HHS [U54-RR-14616-01, G21-RR-03026-13]; NIDA NIH HHS [DA-14659]; NIDDK NIH HHS [DK-67233] NR 61 TC 16 Z9 16 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1849 J9 AM J PHYSIOL-ENDOC M JI Am. J. Physiol.-Endocrinol. Metab. PD JAN PY 2005 VL 288 IS 1 BP E236 EP E245 DI 10.1152/ajpendo.00144.2004 PG 10 WC Endocrinology & Metabolism; Physiology SC Endocrinology & Metabolism; Physiology GA 893WC UT WOS:000226750200029 PM 15585599 ER PT J AU Ikonomidis, JS Hendrick, JW Parkhurst, AM Herron, AR Escobar, PG Dowdy, KB Stroud, RE Hapke, E Zile, MR Spinale, FG AF Ikonomidis, JS Hendrick, JW Parkhurst, AM Herron, AR Escobar, PG Dowdy, KB Stroud, RE Hapke, E Zile, MR Spinale, FG TI Accelerated LV remodeling after myocardial infarction in TIMP-1-deficient mice: effects of exogenous MMP inhibition SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE transgenic model; heart failure; myocardial hypertrophy ID MATRIX-METALLOPROTEINASE INHIBITION; SMOOTH-MUSCLE-CELLS; HEART-FAILURE; OXIDATIVE STRESS; TISSUE INHIBITOR; EXTRACELLULAR-MATRIX; TARGETED DELETION; NITRIC-OXIDE; DYSFUNCTION; MATRIX-METALLOPROTEINASE-9 AB Alterations in matrix metalloproteinases ( MMPs) and tissue inhibitors of MMPs (TIMPs) have been implicated in adverse left ventricular (LV) remodeling after myocardial infarction (MI). However, the direct mechanistic role of TIMPs in the post-MI remodeling process has not been completely established. The goal of this project was to define the effects of altering endogenous MMP inhibitory control through combined genetic and pharmacological approaches on post-MI remodeling in mice. This study examined the effects of MMP inhibition (MMPi) with PD-166793 ( 30 mg.kg(-1).day(-1)) on LV geometry and function (conductance volumetry) after MI in wild-type (WT) mice and mice deficient in the TIMP-1 gene [TIMP-1 knockout (TIMP1-KO)]. At 3 days after MI (coronary ligation), mice were randomized into four groups: WT-MI/MMPi (n = 10), TIMP1-KO-MI/MMPi (n = 10), WT-MI (n = 22), and TIMP1-KO-MI (n = 23). LV end-diastolic volume (EDV) and ejection fraction were determined 14 days after MI. Age-matched WT (n = 20) and TIMP1-KO (n = 28) mice served as reference controls. LVEDV was similar under control conditions in WT and TIMP1-KO mice (36 +/- 2 and 40 +/- 2 mul, respectively) but was greater in TIMP1-KO-MI than in WT-MI mice (48 +/- 2 vs. 61 +/- 5 mul, P < 0.05). LVEDV was reduced from MI-only values in WT-MI/MMPi and TIMP1-KO-MI/MMPi mice (42 &PLUSMN; 2 and 36 &PLUSMN; 2 μl, respectively, P < 0.05) but was reduced to the greatest degree in TIMP1-KO mice (P < 0.05). LV ejection fraction was reduced in both groups after MI and increased in TIMP1-KO-MI/MMPi, but not in WT-MI/MMPi, mice. These unique results demonstrated that myocardial TIMP-1 plays a regulatory role in post-MI remodeling and that the accelerated myocardial remodeling induced by TIMP-1 gene deletion can be pharmacologically "rescued" by MMP inhibition. These results define the importance of local endogenous control of MMP activity with respect to regulating LV structure and function after MI. C1 Med Univ S Carolina, Div Cardiothorac Surg, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Spinale, FG (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, Rm 625,Strom Thurmond Res Bldg,770 MUSC Complex,1, Charleston, SC 29425 USA. FU NCRR NIH HHS [P20 RR-16434]; NHLBI NIH HHS [HL-59165, P01 HL-48788-08] NR 41 TC 78 Z9 82 U1 0 U2 3 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD JAN PY 2005 VL 288 IS 1 BP H149 EP H158 DI 10.1152/ajpheart.00370.2004 PG 10 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 879QT UT WOS:000225733000024 PM 15598866 ER PT J AU Nemoto, S Razeghi, P Ishiyama, M De Freitas, G Taegtmeyer, H Carabello, BA AF Nemoto, S Razeghi, P Ishiyama, M De Freitas, G Taegtmeyer, H Carabello, BA TI PPAR-gamma agonist rosiglitazone ameliorates ventricular dysfunction in experimental chronic mitral regurgitation SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE valvular heart disease; function; lipid accumulation ID CONGESTIVE-HEART-FAILURE; VOLUME-OVERLOAD HYPERTROPHY; IDIOPATHIC DILATED CARDIOMYOPATHY; BETA-ADRENERGIC-BLOCKADE; FATTY-ACID OXIDATION; CONTRACTILE DYSFUNCTION; GENE-EXPRESSION; DOUBLE-BLIND; TRIAL; BISOPROLOL AB Previously we reported that the beneficial effects of beta-adrenergic blockade in chronic mitral regurgitation (MR) were in part due to induction of bradycardia, which obviously affects myocardial energy requirements. From this observation we hypothesized that part of the pathophysiology of MR may involve faulty energy substrate utilization, which in turn might lead to potentially harmful lipid accumulation as observed in other models of heart failure. To explore this hypothesis, we measured triglyceride accumulation in the myocardia of dogs with chronic MR and then attempted to enhance myocardial metabolism by chronic administration of the peroxisome proliferator-activated receptor ( PPAR)-gamma agonist rosiglitazone. Cardiac tissues were obtained from three groups of dogs that included control animals, dogs with MR for 3 mo without treatment, and dogs with MR for 6 mo that were treated with rosiglitazone ( 8 mg/day) for the last 3 mo of observation. Hemodynamics and contractile function (end-systolic stress-strain relationship, as measured by K index) were assessed at baseline, 3 mo of MR, and 6 mo of MR ( 3 mo of the treatment). Lipid accumulation in MR ( as indicated by oil red O staining score and TLC analysis) was marked and showed an inverse correlation with the left ventricular (LV) contractility. LV contractility was significantly restored after PPAR therapy (K index: therapy, 3.01 +/- 0.11*; 3 mo MR, 2.12 +/- 0.34; baseline, 4.01 +/- 0.29; ANOVA, P = 0.038; * P < 0.05 vs. 3 mo of MR). At the same time, therapy resulted in a marked reduction of intramyocyte lipid. We conclude that 1) chronic MR leads to intramyocyte myocardial lipid accumulation and contractile dysfunction, and 2) administration of the PPAR-γ agonist rosiglitazone ameliorates MR-induced LV dysfunction accompanied by a decline in lipid content. C1 Houston Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Univ Texas, Sch Med, Dept Internal Med, Div Cardiol, Houston, TX USA. RP Carabello, BA (reprint author), Houston Vet Affairs Med Ctr, Dept Med, 111MCL,2002 Holcombe Blvd, Houston, TX 77030 USA. EM blaseanthony.carabello@med.va.gov NR 33 TC 30 Z9 32 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD JAN PY 2005 VL 288 IS 1 BP H77 EP H82 DI 10.1152/ajpheart.01246.2003 PG 6 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 879QT UT WOS:000225733000013 PM 15345480 ER PT J AU Lenze, EJ Mulsant, BH Shear, MK Dew, MA Miller, MD Pollock, BG Houck, P Tracey, B Reynolds, CF AF Lenze, EJ Mulsant, BH Shear, MK Dew, MA Miller, MD Pollock, BG Houck, P Tracey, B Reynolds, CF TI Efficacy and tolerability of citalopram in the treatment of late-life anxiety disorders: Results from an 8-week randomized, placebo-controlled trial SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID ELIMINATION HALF-LIFE; BENZODIAZEPINE USE; COMORBID ANXIETY; CLINICAL-TRIALS; RATING-SCALE; DEPRESSION; COMMUNITY; RISK; POPULATION; PREVALENCE AB Objective: Anxiety disorders are highly prevalent in elderly persons. However, to date, the efficacy of selective serotonin reuptake inhibitors (SSRIs) for the treatment of anxiety disorders in this age group has not been established. Method: Thirty-four participants age 60 and older with a DSM-IV anxiety disorder (mainly generalized anxiety disorder) and a Hamilton Anxiety Rating Scale score of 17 or higher were randomly assigned under double-blind conditions to either citalopram or placebo. Response was defined as a score of 1 (very much improved) or 2 (much improved) on the Clinical Global improvement scale or a 50% reduction in the Hamilton anxiety scale score. Response and side effects with citalopram and placebo were compared by using chi-square tests and linear modeling. Results: Eleven (65%) of the 17 citalopram-treated participants responded by 8 weeks, versus four (24%) of the 17 placebo-treated participants. The most common and problematic side effect in the citalopram group was sedation. Conclusions: The authors believe this to be the first prospective controlled study to test the efficacy of an SSRI in the management of anxiety disorders among the elderly. These results support the efficacy of citalopram in late-life anxiety disorders. They need to be replicated in a larger study group. C1 Univ Pittsburgh, Sch Med, Dept Psychiat, Intervent Res Ctr Late Life Mood Disorders, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Lenze, EJ (reprint author), Western Psychiat Inst & Clin, 3811 OHara St,Rm E1124, Pittsburgh, PA 15213 USA. EM lenzeej@msx.upmc.edu FU NIMH NIH HHS [K23 MH-64196, MH-65416, P30 MH-52247] NR 36 TC 46 Z9 46 U1 2 U2 5 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD JAN PY 2005 VL 162 IS 1 BP 146 EP 150 DI 10.1176/appi.ajp.162.1.146 PG 5 WC Psychiatry SC Psychiatry GA 886VW UT WOS:000226262000022 PM 15625213 ER PT J AU Wirshing, DA Sergi, MJ Mintz, J AF Wirshing, DA Sergi, MJ Mintz, J TI A videotape intervention to enhance the informed consent process for medical and psychiatric treatment research SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article; Proceedings Paper CT 40th Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 09-14, 2001 CL WAIKOLOA, HI SP Amer Coll Neuropsychopharmacol AB Objective: This study evaluated a brief educational video designed to enhance the informed consent process for people with serious mental and medical illnesses who are considering participating in treatment research. Method: Individuals with schizophrenia who were being recruited for ongoing clinical trials, medical patients without self-reported psychiatric comorbidity, and university undergraduates were randomly assigned to view either a highly structured instructional videotape about the consent process in treatment research or a control videotape that presented only general information about bioethical issues in human research. Knowledge about informed consent was measured before and after viewing. Results: Viewing the experimental videotape resulted in larger gains in knowledge about informed consent. Standardized effect sizes were large in all groups. Conclusions: The videotape was thus an effective teaching tool across diverse populations, ranging from individuals with severe chronic mental illness to university undergraduates. C1 Greater Los Angeles VA Healthcare Syst, Dept Psychiat, Los Angeles, CA 90073 USA. Calif State Univ Northridge, Dept Psychol, Northridge, CA 91330 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. RP Mintz, J (reprint author), Greater Los Angeles VA Healthcare Syst, Dept Psychiat, 11301 Wilshire Blvd,116AR, Los Angeles, CA 90073 USA. EM jmintz@ucla.edu FU NIMH NIH HHS [R01-MH-68100-02] NR 8 TC 28 Z9 30 U1 0 U2 1 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD JAN PY 2005 VL 162 IS 1 BP 186 EP 188 DI 10.1176/appi.ajp.162.1.186 PG 3 WC Psychiatry SC Psychiatry GA 886VW UT WOS:000226262000030 PM 15625221 ER PT J AU Chen, L Suh, RD Barack, BM Ratib, O AF Chen, L Suh, RD Barack, BM Ratib, O TI Plain film diagnosis of congenital and acquired heart disease in adults SO AMERICAN JOURNAL OF ROENTGENOLOGY LA English DT Meeting Abstract CT 105th Annual Meeting of the American-Roentgen-Ray-Society CY MAY 15-20, 2005 CL New Orleans, LA SP Amer Roentgen Ray Soc C1 Univ Calif Los Angeles, Med Ctr, Los Angeles, CA 90024 USA. W Los Angeles Vet Adm Hosp, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ROENTGEN RAY SOC PI RESTON PA 1891 PRESTON WHITE DR, SUBSCRIPTION FULFILLMENT, RESTON, VA 22091 USA SN 0361-803X J9 AM J ROENTGENOL JI Am. J. Roentgenol. PY 2005 VL 184 IS 4 SU S BP 81 EP 81 PG 1 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 920VH UT WOS:000228717800320 ER PT J AU Hussein, MR Rashad, UM Hassanein, KA AF Hussein, MR Rashad, UM Hassanein, KA TI Touch imprint cytologic preparations and the diagnosis of head and neck mass lesions SO ANNALS OF ONCOLOGY LA English DT Letter ID HISTOLOGY; BIOPSIES C1 Assiut Univ, Sch Med, Dept Pathol, Assiut, Egypt. Assiut Univ, Sch Med, Dept Ear Nose & Throat, Assiut, Egypt. Assiut Univ, Sch Med, Dept Surg, Maxillofacial Head & Neck Surg Unit, Assiut, Egypt. S Valley Univ, Sch Med, Dept Pathol, Aswan, Egypt. S Valley Univ, Sch Med, Dept Surg, Maxillofascial Head & Neck Surg Unit, Aswan, Egypt. S Valley Univ, Sch Med, Dept Ear Nose & Throat, Aswan, Egypt. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. Univ Wisconsin, Sch Med, Madison, WI 53705 USA. RP Hussein, MR (reprint author), Assiut Univ, Sch Med, Dept Pathol, Assiut, Egypt. EM mrh17@swissinfo.org NR 5 TC 1 Z9 1 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0923-7534 J9 ANN ONCOL JI Ann. Oncol. PD JAN PY 2005 VL 16 IS 1 BP 171 EP 172 DI 10.1093/annonc/mdi026 PG 2 WC Oncology SC Oncology GA 885JR UT WOS:000226153400034 PM 15598957 ER PT J AU Maggard, MA Lane, KE O'Connell, JB Nanyakkara, DD Ko, CY AF Maggard, MA Lane, KE O'Connell, JB Nanyakkara, DD Ko, CY TI Beyond the clinical trials: How often is sentinel lymph node dissection performed for breast cancer? SO ANNALS OF SURGICAL ONCOLOGY LA English DT Article DE breast cancer; administrative data; Sentinel lymph node dissection; quality of care ID BIOPSY; LYMPHADENECTOMY; CARE AB Background: Sentinel lymph node dissection (SLND) has been shown to be a reasonable treatment option for early-stage breast cancer. Until recently, SLND was limited to clinical trials. Because this technique is now offered outside of trials, its prevalence is unknown. Methods: All patients with stage I or II breast cancer in the Surveillance, Epidemiology, and End Results national cancer registry (1998-2000) were evaluated. Data were collected for demographics, tumor characteristics, surgical resection, lymph node evaluation (SLND or complete axillary dissection), registry site, and year of diagnosis. Multivariate regression analysis was performed to identify predictors for receiving SLND. Results: A total of 54,772 patients diagnosed with breast cancer had undergone surgical lymph node evaluation; 27.2 % patients with stage I disease underwent SLND, as compared with 22.7 % for stage II. Older patients and minority groups were less likely to receive SLND. Receipt of SLND varied by registry site (7.9 % - 32.7 %). Multivariate regression showed that older patients had lower odds of receiving SLND (60-69 years: odds ratio,.73; P < .0001) as compared with younger patients. Additionally, blacks, Hispanics, and Asians had lower odds of receiving SLND (odds ratio of .64, .58, and .80, respectively; P < .0001). SLND use increased over the 3 years in the study (P < .0001). Conclusions: This population-based analysis showed relatively infrequent use of SLND for early-stage breast cancer. These results suggest a slow transition of this procedure from clinical trials into the community. Future work should be targeted at improving the rate at which patients receive this procedure, particularly for elderly and minority groups and low-use regions. C1 Univ Calif Los Angeles, Sch Med, Dept Surg, Los Angeles, CA 90095 USA. Robert Wood Johnson VA Clin Scholars Program, Los Angeles, CA 90024 USA. UCSF 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 Le Conte Ave,CHS,Room 72-215, Los Angeles, CA 90095 USA. EM mmaggard@mednet.ucla.edu NR 16 TC 21 Z9 21 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1068-9265 J9 ANN SURG ONCOL JI Ann. Surg. Oncol. PD JAN PY 2005 VL 12 IS 1 BP 41 EP 47 DI 10.1245/ASO.2005.03.050 PG 7 WC Oncology; Surgery SC Oncology; Surgery GA 893YI UT WOS:000226756600010 PM 15827777 ER PT S AU Hijazi, RA Cunningham, GR AF Hijazi, RA Cunningham, GR TI Andropause: Is androgen replacement therapy indicated for the aging male? SO ANNUAL REVIEW OF MEDICINE SE Annual Review of Medicine LA English DT Review; Book Chapter DE hypogonadism; testosterone deficiency; testosterone replacement therapy ID BONE-MINERAL DENSITY; HORMONE-BINDING GLOBULIN; MIDDLE-AGED MEN; PROSTATIC INTRAEPITHELIAL NEOPLASIA; BIOAVAILABLE TESTOSTERONE LEVELS; RANDOMIZED CONTROLLED-TRIAL; ADIPOSE-TISSUE DISTRIBUTION; SEX STEROID-LEVELS; HEALTHY OLDER MEN; HYPOGONADAL MEN AB The number of men in the United States greater than or equal to65 years of age is projected to increase from 14,452,000 in 2000 to 31,343,000 in 2030. Approximately 30% of men 60-70 years of age and 70% of men 70-80 years of age have low bioavailable or free testosterone levels. Symptoms and findings of testosterone deficiency are similar to those associated with aging. They include loss of energy, depressed mood, decreased libido, erectile dysfunction, decreased muscle mass and strength, increased fat mass, frailty, osteopenia, and osteoporosis. Several small clinical trials indicate that testosterone replacement therapy can improve many of these findings; however, the studies have not been powered to assess potential risks, such as the need for invasive treatment of benign prostatic hyperplasia, development of a clinical prostate cancer, or cardiovascular events. Thus, the benefit/risk ratio of testosterone replacement therapy in aging men is not known. C1 Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol & Cellular Biol, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. RP Hijazi, RA (reprint author), Baylor Coll Med, Dept Med, Houston, TX 77030 USA. EM rhijazi@bcm.tmc.edu; glennc@bcm.tmc.edu NR 123 TC 63 Z9 68 U1 2 U2 4 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0139 USA SN 0066-4219 BN 978-0-8243-0556-7 J9 ANNU REV MED JI Annu. Rev. Med. PY 2005 VL 56 BP 117 EP 137 DI 10.1146/annurev.med.56.082103.104518 PG 21 WC Medicine, General & Internal SC General & Internal Medicine GA 904ND UT WOS:000227504100008 PM 15660505 ER PT S AU Vijg, J Suh, Y AF Vijg, J Suh, Y TI Genetics of longevity and aging SO ANNUAL REVIEW OF MEDICINE SE Annual Review of Medicine LA English DT Review; Book Chapter DE oxidative stress; insulin signaling; energy metabolism; functional genomics; centenarians ID ADULT DROSOPHILA-MELANOGASTER; TRANSCRIPTION FACTOR FOXO3A; INSULIN SIGNALING PATHWAY; LIFE-SPAN EXTENSION; SNELL DWARF MOUSE; CAENORHABDITIS-ELEGANS; OXIDATIVE STRESS; C-ELEGANS; EXTENDED LONGEVITY; GROWTH-HORMONE AB Longevity, i.e., the property of being long-lived, has its natural limitation in the aging process. Longevity has a strong genetic component, as has become apparent from studies with a variety of organisms, from yeast to humans. Genetic screening efforts with invertebrates have unraveled multiple genetic pathways that suggest longevity is promoted through the manipulation of metabolism and the resistance to oxidative stress. To some extent, these same mechanisms appear to act in mammals also, despite considerable divergence during evolution. Thus far, evidence from population-based studies with humans suggests the importance of genes involved in cardiovascular disease as important determinants of longevity. The challenge is to test if the candidate longevity genes that have emerged from studies with model organisms exhibit genetic variation for life span in human populations. Future investigations are likely to involve large-scale case-control studies, in which large numbers of genes, corresponding to entire gene functional modules, will be assessed for all possible sequence variation and associated with detailed phenotypic information on each individual over extended periods of time. This should eventually unravel the genetic factors that contribute to each particular aging phenotype. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78245 USA. Ctr Geriatr Res Educ & Clin, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Vijg, J (reprint author), Univ Texas, Hlth Sci Ctr, San Antonio, TX 78245 USA. EM vijg@uthscsa.edu; suhy@uthscsa.edu FU NIA NIH HHS [R01 AG024391-02, AG17242, AG20438, AG23292, R01 AG024391, R01 AG024391-01, R01 AG024391-03, R01 AG024391-04, R01 AG024391-05, R03 AG023292, R03 AG023292-01, R03 AG023292-02]; NIEHS NIH HHS [ES11044] NR 91 TC 91 Z9 99 U1 2 U2 12 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0139 USA SN 0066-4219 BN 978-0-8243-0556-7 J9 ANNU REV MED JI Annu. Rev. Med. PY 2005 VL 56 BP 193 EP 212 DI 10.1146/annurev.med.56.082103.104617 PG 20 WC Medicine, General & Internal SC General & Internal Medicine GA 904ND UT WOS:000227504100012 PM 15660509 ER PT J AU Johnson, VA Hazelwood, JD Kovacs, EZ Summers, WC Chu, WJ Den Hollander, JA Bush, BA Nabors, LB Kilby, JM Kinney, FC Raper, JL Shelton, BJ Hartley, S Madan, A Netson, KL Buchthal, S Benos, DJ AF Johnson, VA Hazelwood, JD Kovacs, EZ Summers, WC Chu, WJ Den Hollander, JA Bush, BA Nabors, LB Kilby, JM Kinney, FC Raper, JL Shelton, BJ Hartley, S Madan, A Netson, KL Buchthal, S Benos, DJ TI Comprehensive analyses of plasma and cerebrospinal fluid (CSF) compartments for HIV drug resistance, viral load, and chemokine/cytokine levels linked to neuropsychiatric testing and NMR spectroscopy findings in HIV-infected subjects treated at a university-based HIV clinic SO ANTIVIRAL THERAPY LA English DT Meeting Abstract CT 14th International HIV Drug Resistance Workshop CY JUN 07-11, 2005 CL Quebec City, CANADA C1 Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Med, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Physiol & Biophys, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Radiol, Birmingham, AL 35233 USA. Univ Alabama, Sch Med, Dept Psychiat, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Neurol, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Biostat, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Psychol, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 1 U2 3 PU INT MEDICAL PRESS LTD PI LONDON PA 2-4 IDOL LANE, LONDON EC3R 5DD, ENGLAND SN 1359-6535 J9 ANTIVIR THER JI Antivir. Ther. PY 2005 VL 10 SU 1 BP S181 EP S181 PG 1 WC Infectious Diseases; Pharmacology & Pharmacy; Virology SC Infectious Diseases; Pharmacology & Pharmacy; Virology GA 972RL UT WOS:000232470800169 ER PT J AU Johnson, VA Hazelwood, JD Kovacs, EZ Summers, WC Chu, WJ Den Hollander, JA Bush, BA Nabors, LB Kilby, JM Kinney, FC Raper, JL Shelton, BJ Hartley, S Madan, A Netson, KL Buchthal, S Benos, DJ AF Johnson, VA Hazelwood, JD Kovacs, EZ Summers, WC Chu, WJ Den Hollander, JA Bush, BA Nabors, LB Kilby, JM Kinney, FC Raper, JL Shelton, BJ Hartley, S Madan, A Netson, KL Buchthal, S Benos, DJ TI Comprehensive analyses of plasma and cerebrospinal fluid (CSF) compartments for HIV drug resistance, viral load, and chemokine/cytokine levels linked to neuropsychiatric testing and NMR spectroscopy findings in HIV-infected subjects treated at a university-based HIV clinic SO ANTIVIRAL THERAPY LA English DT Meeting Abstract CT 14th International HIV Drug Resistance Workshop CY JUN 07-11, 2005 CL Quebec City, CANADA C1 Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Med, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Physiol & Biophys, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Radiol, Birmingham, AL 35233 USA. Univ Alabama, Sch Med, Dept Psychiat, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Neurol, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Biostat, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Psychol, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 1 U2 3 PU INT MEDICAL PRESS LTD PI LONDON PA 2-4 IDOL LANE, LONDON EC3R 5DD, ENGLAND SN 1359-6535 J9 ANTIVIR THER JI Antivir. Ther. PY 2005 VL 10 IS 4 MA 166 BP S181 EP S181 PG 1 WC Infectious Diseases; Pharmacology & Pharmacy; Virology SC Infectious Diseases; Pharmacology & Pharmacy; Virology GA 965PQ UT WOS:000231963100182 ER PT J AU Williams, DL Goldstein, G Minshew, NJ AF Williams, DL Goldstein, G Minshew, NJ TI Impaired memory for faces and social scenes in autism: clinical implications of memory dysfunction SO ARCHIVES OF CLINICAL NEUROPSYCHOLOGY LA English DT Article DE autism; memory; information processing ID WORKING-MEMORY; DIAGNOSTIC INTERVIEW; RETRIEVAL SCHEMES; YOUNG-CHILDREN; VISUAL MEMORY; INDIVIDUALS; DISORDER; INTACT; RECALL; DISCRIMINATION AB A clinical memory test, the Wechsler Memory Scale-III (WMS-III), was used to study the auditory and visual memory of 29 high-functioning adults with autism and 34 group-matched normal controls. The individuals with autism performed as well as the controls on immediate and delayed memory for word pairs and stories and on a verbal working memory task. The autism group was impaired on immediate and delayed recall of faces and of family scenes and had impaired spatial working memory. The integrity of verbal working memory and impaired spatial working memory is consistent with the findings of other studies and may reflect the greater computational demands of the spatial task. Most importantly, the deficits in memory for faces and common social scenes, complex visual/spatial stimuli, demonstrate the contribution of memory dysfunction in autism to deficits in real life function. (C) 2004 National Academy of Neuropsychology. Published by Elsevier Ltd. All rights reserved. C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Minshew, NJ (reprint author), Univ Pittsburgh, Sch Med, Webster Hall Suite 300,3811 O Hara St, Pittsburgh, PA 15213 USA. EM minshewnj@upmc.edu FU NICHD NIH HHS [HD35469]; NINDS NIH HHS [NS33355] NR 53 TC 56 Z9 56 U1 6 U2 18 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0887-6177 J9 ARCH CLIN NEUROPSYCH JI Arch. Clin. Neuropsychol. PD JAN PY 2005 VL 20 IS 1 BP 1 EP 15 DI 10.1016/j.acn.2002.08.001 PG 15 WC Psychology, Clinical; Psychology SC Psychology GA 886WI UT WOS:000226263200001 PM 15620811 ER PT J AU Smith, CO Lipe, HP Bird, TD AF Smith, CO Lipe, HP Bird, TD TI Impact of presymptomatic genetic testing for hereditary ataxia and neuromuscular disorders: Where is the evidence? In reply SO ARCHIVES OF NEUROLOGY LA English DT Letter C1 VA Puget Sound Hlth Care, Geriatr Res Educ & Clin Ctr S182, Seattle, WA 98108 USA. RP Bird, TD (reprint author), VA Puget Sound Hlth Care, Geriatr Res Educ & Clin Ctr S182, 1660 S Columbian Way, Seattle, WA 98108 USA. EM tomnroz@u.washington.edu NR 1 TC 0 Z9 0 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 JAN PY 2005 VL 62 IS 1 BP 164 EP 164 DI 10.1001/archneur.62.1.164-b PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 887FD UT WOS:000226290100025 ER PT J AU Davis, GE Schwartz, SR Veenstra, DL Yueh, B AF Davis, GE Schwartz, SR Veenstra, DL Yueh, B TI Cost comparison of surgery vs organ preservation for laryngeal cancer SO ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY LA English DT Article; Proceedings Paper CT 6th International Conference on Head and Neck Cancer CY AUG 09, 2004 CL Washington, DC SP Amer Head & Neck Soc ID QUALITY-OF-LIFE; MEDICAL DECISION-ANALYSIS; NECK-CANCER; INDUCTION CHEMOTHERAPY; SALVAGE SURGERY; ADVANCED HEAD; THERAPY; COMPLICATIONS; CARCINOMA; POSTTREATMENT AB Objective: To perform a cost minimization analysis of total laryngectomy with postoperative radiotherapy vs induction chemotherapy with subsequent radiotherapy in patients with advanced (stage III or IV) squamous cell carcinoma of the larynx. Design: Decision-analysis model using data from peer-reviewed trials, case series, meta-analyses, and Medicare diagnosis related group reimbursement rates. Setting and Patients: A hypothetical cohort of patients with stage III or IV laryngeal cancer. The perspective is that of a health care payer. Interventions: The hypothetical patient cohort could receive (1) surgery (total laryngectomy) with postoperative radiotherapy or (2) induction chemotherapy (fluorouracil and cisplatin) with radiotherapy followed by salvage surgery for patients failing to respond to chemotherapy. Main Outcome Measure: Overall difference in direct medical costs in 2003 US dollars between the 2 treatment arms from initiation to completion of treatment. Results: In the baseline analysis, the direct medical costs for the surgical arm were $30138 per patient. For the organ preservation arm, the direct medical costs were $33052 per patient. The finding that the surgical arm costs were lower was robust to all sensitivity analyses except for the extreme low estimate for the cost of chemotherapy. Conclusions: Our results suggest that total laryngectomy tomy with postopera Live radiotherapy costs nearly S30OLI less than organ preservation treatment for advanced laryngeal cancer. Given that survival appears equivalent between the 2 modalities, cost consideration and patient preference maybe important factors in decision making for the treatment of advanced laryngeal cancer. C1 Univ Washington, Dept Otorhinolaryngol Head & Neck Surg, Seattle, WA 98195 USA. Univ Washington, Dept Pharm, Pharmaceut Outcomes Res & Policy Program, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Ctr Excellence, Seattle, WA USA. RP Davis, GE (reprint author), Univ Washington, Dept Otorhinolaryngol Head & Neck Surg, 1959 NE Pacific St,Campus Box 356515, Seattle, WA 98195 USA. EM gedavis@u.washington.edu OI Yueh, Bevan/0000-0003-1380-1053 FU NIDCD NIH HHS [DC-00018]; ODCDC CDC HHS [CD-98318] NR 35 TC 23 Z9 23 U1 0 U2 0 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 JAN PY 2005 VL 131 IS 1 BP 21 EP 26 DI 10.1001/archotol.131.1.21 PG 6 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 887OC UT WOS:000226314400002 PM 15655180 ER PT J AU Kwarciak, AM Cooper, RA Ammer, WA Fitzgerald, SG Boninger, ML Cooper, R AF Kwarciak, AM Cooper, RA Ammer, WA Fitzgerald, SG Boninger, ML Cooper, R TI Fatigue testing of selected suspension manual wheelchairs using ANSI/RESNA standards SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article; Proceedings Paper CT RESNA 2003 Conference CY JUN 21-23, 2003 CL ATLANTA, GA SP RESNA DE durable medical equipment; materials testing; rehabilitation; wheelchairs ID WHOLE-BODY VIBRATION AB Objectives: To evaluate the durability and value of 3 common suspension manual wheelchairs and to compare the results with those of previously tested lightweight and ultra-lightweight folding-frame wheelchairs. Design: Standardized fatigue testing and cost analysis of 3 suspension manual wheelchairs front 3 different manufacturers. Setting: A rehabilitation engineering center. Specimens: Nine Suspension manual wheelchairs. Interventions: Wheelchairs were fitted with a standardized wheelchair test dummy and tested oil a series of fatigue tests, consistent with those developed by the International Organization for Standardization. Main Outcome Measures: Fatigue life (measured as the number of equivalent cycles completed) and value (equivalent cycles divided by cost) were compared among all wheelchairs. Results: Analysis of variance revealed significant differences (P less than or equal to .05) in the number of equivalent cycles among the suspension wheelchairs tested. When compared with previously tested ultra-lightweight and lightweight wheelchairs, the suspension wheelchairs failed to show significant improvements however, significant improvements were found between individual suspension and lightweight wheelchairs. Conclusions: We found little evidence to Suggest that suspension manual wheelchairs provide advantages in terms of durability or value over standard lightweight and ultra-lightweight folding-frame wheelchairs. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151R 1, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151R 1, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM rcooper@pitt.edu OI Boninger, Michael/0000-0001-6966-919X NR 16 TC 10 Z9 10 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 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD JAN PY 2005 VL 86 IS 1 BP 123 EP 129 DI 10.1016/j.apmr.2003.11.038 PG 7 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 887OJ UT WOS:000226315100023 PM 15641002 ER PT J AU Saam, T Ferguson, MS Yarnykh, VL Takaya, N Xu, D Polissar, NL Hatsukami, TS Yuan, C AF Saam, T Ferguson, MS Yarnykh, VL Takaya, N Xu, D Polissar, NL Hatsukami, TS Yuan, C TI Quantitative evaluation of carotid plaque composition by in vivo MRI SO ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY LA English DT Article DE atherosclerosis; magnetic resonance imaging; carotid artery; plaque ID HIGH-RESOLUTION MRI; ATHEROSCLEROTIC LESIONS; HISTOLOGICAL CLASSIFICATION; INTRAPLAQUE HEMORRHAGE; INVERSION-RECOVERY; EX-VIVO; ACCURACY; PROGRESSION; COMPONENTS; THICKNESS AB Objective - This study evaluates the ability of MRI to quantify all major carotid atherosclerotic plaque components in vivo. Methods and Results - Thirty-one subjects scheduled for carotid endarterectomy were imaged with a 1.5T scanner using time-of-flight -, T1-, proton density -, and T2-weighted images. A total of 214 MR imaging locations were matched to corresponding histology sections. For MRI and histology, area measurements of the major plaque components such as lipid-rich/necrotic core (LR/NC), calcification, loose matrix, and dense (fibrous) tissue were recorded as percentages of the total wall area. Intraclass correlation coefficients (ICCs) were computed to determine intrareader and inter-reader reproducibility. MRI measurements of plaque composition were statistically equivalent to those of histology for the LR/NC (23.7 versus 20.3%; P=0.1), loose matrix (5.1 versus 6.3%; P=0.1), and dense (fibrous) tissue (66.3% versus 64%; P=0.4). Calcification differed significantly when measured as a percentage of wall area (9.4 versus 5%; P<0.001). Intrareader and inter-reader reproducibility was good to excellent for all tissue components, with ICCs ranging from 0.73 to 0.95. Conclusions - MRI-based tissue quantification is accurate and reproducible. This application can be used in therapeutic clinical trials and in prospective longitudinal studies to examine carotid atherosclerotic plaque progression and regression. C1 Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Mt Whisper Light Stat Consulting, Seattle, WA USA. Univ Washington, Dept Surg, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Yuan, C (reprint author), Univ Washington, Dept Radiol, 1959 NE Pacific St,Box 357115, Seattle, WA 98195 USA. EM cyuan@u.washington.edu RI Yarnykh, Vasily/G-8757-2016; Yarnykh, Vasiliy/N-7635-2014 OI Yarnykh, Vasily/0000-0002-1583-8979; FU NHLBI NIH HHS [R01HL072262, R01HL56874] NR 30 TC 318 Z9 340 U1 0 U2 15 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 JAN PY 2005 VL 25 IS 1 BP 234 EP 239 DI 10.1161/01.ATV.0000149867.61851.31 PG 6 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 884DX UT WOS:000226065900039 PM 15528475 ER PT J AU Carl, PL Temple, BRS Cohen, PL AF Carl, PL Temple, BRS Cohen, PL TI Most nuclear systemic autoantigens are extremely disordered proteins: implications for the etiology of systemic autoimmunity SO ARTHRITIS RESEARCH & THERAPY LA English DT Article ID HUMAN TOPOISOMERASE-I; NATIVELY UNFOLDED PROTEINS; T-CELL EPITOPES; LA SS-B; LUPUS-ERYTHEMATOSUS; INTRINSIC DISORDER; PEPTIDE IMMUNIZATION; BINDING-SITES; ANTIGEN; APOPTOSIS AB Patients with systemic autoimmune diseases usually produce high levels of antibodies to self-antigens (autoantigens). The repertoire of common autoantigens is remarkably limited, yet no readily understandable shared thread links these apparently diverse proteins. Using computer prediction algorithms, we have found that most nuclear systemic autoantigens are predicted to contain long regions of extreme structural disorder. Such disordered regions would generally make poor B cell epitopes and are predicted to be under-represented as potential T cell epitopes. Consideration of the potential role of protein disorder may give novel insights into the possible role of molecular mimicry in the pathogenesis of autoimmunity. The recognition of extreme autoantigen protein disorder has led us to an explicit model of epitope spreading that explains many of the paradoxical aspects of autoimmunity - in particular, the difficulty in identifying autoantigen-specific helper T cells that might collaborate with the B cells activated in systemic autoimmunity. The model also explains the experimentally observed breakdown of major histocompatibility complex (MHC) class specificity in peptides associated with the MHC II proteins of activated autoimmune B cells, and sheds light on the selection of particular T cell epitopes in autoimmunity. Finally, the model helps to rationalize the relative rarity of clinically significant autoimmunity despite the prevalence of low specificity/low avidity autoantibodies in normal individuals. C1 Univ N Carolina, Dept Pharmacol, Chapel Hill, NC 27599 USA. Univ N Carolina, RL Juliano Struct Bioinformat Core Facil, Chapel Hill, NC 27599 USA. Univ Penn, Sch Med, Div Rheumatol, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Carl, PL (reprint author), Univ N Carolina, Dept Pharmacol, Chapel Hill, NC 27599 USA. EM plc@med.unc.edu NR 58 TC 14 Z9 15 U1 0 U2 0 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1478-6354 J9 ARTHRITIS RES THER JI Arthritis Res. Ther. PY 2005 VL 7 IS 6 BP R1360 EP R1374 DI 10.1186/ar1832 PG 15 WC Rheumatology SC Rheumatology GA 997TT UT WOS:000234272000030 PM 16277689 ER PT J AU Zhang, HD Gao, GP Clayburne, G Schumacher, HR AF Zhang, HD Gao, GP Clayburne, G Schumacher, HR TI Elimination of rheumatoid synovium in situ using a Fas ligand 'gene scalpel' SO ARTHRITIS RESEARCH & THERAPY LA English DT Article ID MEDIATED APOPTOSIS; FAS/FAS LIGAND; INHIBITORY PROTEIN; CELL APOPTOSIS; HTLV-I; ARTHRITIS; EXPRESSION; INDUCTION; MICE; SYNOVIOCYTES AB Surgical synovectomy to remove the inflammatory synovium can temporarily ameliorate rheumatoid inflammation and delay the progress of joint destruction. An efficient medically induced programmed cell death (apoptosis) in the rheumatoid synovium might play a role similar to synovectomy but without surgical tissue damage. Gene transfer of Fas ligand (FasL) has increased the frequency of apoptotic cells in mouse and rabbit arthritic synovium. In this study, we investigated whether repeated FasL gene transfer could remove human inflammatory synovial tissue in situ and function as a molecular synovectomy. Briefly, specimens of human synovium from joint replacement surgeries and synovectomies of rheumatoid arthritis (RA) patients were grafted subcutaneously into male C.B-17 severe combined immunodeficiency (SCID) mice. Injections of a recombinant FasL adenovirus (Ad-FasL) into the grafted synovial tissue at the dosage of 1011 particles per mouse were performed every two weeks. Three days after the fifth virus injection, the mice were euthanized by CO(2) inhalation and the human synovial tissues were collected, weighed and further examined. Compared to the control adenovirus-LacZ (Ad-LacZ) and phosphate buffered saline (PBS) injected RA synovium, the Ad-FasL injected RA synovium was dramatically reduced in size and weight (P<0.005). The number of both synoviocytes & mononuclear cells was significantly reduced. Interestingly, an approximate 15-fold increased frequency of apoptotic cells was observed in RA synovium three days after Ad-FasL injection, compared with control tissues. In summary, our in vivo investigation of gene transfer to human synovium in SCID mice suggests that repeated intra-articular gene transfer of an apoptosis inducer, such as FasL, may function as a 'gene scalpel' for molecular synovectomy to arrest inflammatory synovium at an early stage of RA. C1 Long Isl Univ, Sch Pharm, Div Pharmaceut & Ind Pharm, Brooklyn, NY 11201 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Zhang, HD (reprint author), Long Isl Univ, Sch Pharm, Div Pharmaceut & Ind Pharm, Brooklyn, NY 11201 USA. EM haidi.zhang@liu.edu FU NIAMS NIH HHS [2T32AR07442-12, T32 AR007442, R03AR47983] NR 44 TC 13 Z9 15 U1 0 U2 1 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1478-6354 J9 ARTHRITIS RES THER JI Arthritis Res. Ther. PY 2005 VL 7 IS 6 BP R1235 EP R1243 DI 10.1186/ar1811 PG 9 WC Rheumatology SC Rheumatology GA 997TT UT WOS:000234272000017 PM 16277676 ER PT J AU Chou, YF Huang, WB Dunn, JCY Miller, TA Wu, BM AF Chou, YF Huang, WB Dunn, JCY Miller, TA Wu, BM TI The effect of biomimetic apatite structure on osteoblast viability, proliferation, and gene expression SO BIOMATERIALS LA English DT Article DE apatite structure; bone tissue engineering; biomimetic material; osteoblast; gene expression; mRNA ID ORGANIC POLYMERS; BONE SIALOPROTEIN; EXTRACELLULAR-MATRIX; INORGANIC-PHOSPHATE; MC3T3-E1 CELLS; ASCORBIC-ACID; IN-VITRO; OSTEOCALCIN; DIFFERENTIATION; OSTEOPONTIN AB The conventional biomimetic apatite coating process can be accelerated by immersing substrates into concentrated simulated body fluid (5 x SBF) at 37 degreesC to form an initial coating of apatite precursor spheres, and transform the precursors into plate-like apatite structures. Depending on processing parameters, different apatite structures can be created over the same substrate. The purpose of this study is to investigate the effects of the different apatite microenvironment on cell spreading, viability, proliferation, and gene expression. MC3T3-E1 preosteoblasts were cultured on five surfaces: conventional apatite (CA), precursor apatite spheres (PreA), large plate-like apatites (LgA), small plate-like apatites (SmA), and tissue culture grade polystyrene (TCPS). PreA induced significantly higher cell death during the first two weeks. TCPS supported more uniform spreading (1 day) and higher proliferation (2 weeks) than CA, LgA, and SmA. Apatites restricted spreading and promoted the extension of cellular projections along the textured surfaces under confocal microscopy observation. By 3 weeks, LgA induced highest expression of mature osteogenic markers osteocalcin (OCN) and bone sialoprotein (BSP) in both regular and osteogenic culture media based on quantitative real-time RT-PCR. The results of this study suggest differential cell responses to subtle changes in apatite microenvironment. (C) 2004 Elsevier Ltd. All rights reserved. C1 Univ Calif Los Angeles, Dept Bioengn, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Mat Sci & Engn, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Weintraub Ctr Reconstruct Biotechnol, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Plast Surg Sect, Los Angeles, CA 90073 USA. RP Wu, BM (reprint author), Univ Calif Los Angeles, Dept Bioengn, 7523 Boelter Hall,420 Westwood Plaza, Los Angeles, CA 90095 USA. EM benwu@ucla.edu FU NIDCR NIH HHS [1R03 DE12956-01 A] NR 43 TC 148 Z9 154 U1 6 U2 30 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0142-9612 J9 BIOMATERIALS JI Biomaterials PD JAN PY 2005 VL 26 IS 3 BP 285 EP 295 DI 10.1016/j.biomaterials.2004.02.030 PG 11 WC Engineering, Biomedical; Materials Science, Biomaterials SC Engineering; Materials Science GA 855ZW UT WOS:000224014400005 PM 15262470 ER PT J AU Luoh, SW Bai, T AF Luoh, SW Bai, T TI GRB-7 promotes HER-2/Neu mediated signaling and tumor formation in breast cancer cells. SO BREAST CANCER RESEARCH AND TREATMENT LA English DT Meeting Abstract CT 28th Annual San Antonio Breast Cancer Symposium CY DEC 08-11, 2005 CL San Antonio, TX SP San Antonio Canc Inst, Baylor Coll Med, an NCI-Designated Clin Canc Ctr, Canc Therapy & Res Ctr, Univ Texas San Antonio, Hlth Sci Ctr C1 Portland VA Med Ctr, Portland, OR USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0167-6806 J9 BREAST CANCER RES TR JI Breast Cancer Res. Treat. PY 2005 VL 94 SU 1 BP S117 EP S118 PG 2 WC Oncology SC Oncology GA 985VP UT WOS:000233407100316 ER PT J AU Franco, GELF Litscher, SJ O'Neil, TK Piette, M Demant, P Blank, RD AF Franco, GELF Litscher, SJ O'Neil, TK Piette, M Demant, P Blank, RD TI Dual energy X ray absorptiometry of ex vivo HcB/Dem mouse long bones: Left are denser than right SO CALCIFIED TISSUE INTERNATIONAL LA English DT Article DE bone density technology; bone development; osteoporosis of animal models ID QUANTITATIVE TRAIT LOCI; ULNA IN-VIVO; MINERAL DENSITY; SCIATIC NEURECTOMY; INBRED STRAINS; PAW PREFERENCE; MECHANICAL-PROPERTIES; GENETIC-REGULATION; PROXIMAL FEMUR; HANDED MEN AB Dual energy X ray absorptiometry (DXA) has become a popular analytical technique in mice and other small animals. Comparative study of bone properties at different anatomical sites is an active area of study in model organisms. Such investigations require that site-specific data be generated and interpreted. There are no published data addressing the degree to which contralateral mouse bones resemble each other in the absence of an experimental intervention, nor are there data addressing the correlation of bone densitometry measurements between anatomically distant sites. To address these gaps in our knowledge, we used DXA to compare excised mouse femora and humeri. At the population level, left bones were slightly but significantly denser than right bones, with an overall adjusted bone mineral density (BMD) difference of 0.7 +/- 0.3 and 0.5 +/- 0.2 mg/cm(2) at the femur and humerus, respectively. At the level of bone pairs from a single animal, absolute adjusted BMD disparities between the right and left sides were 2.3 +/- 1.9 mg/cm(2) at the femur and 1.7 +/- 1.4 mg/cm(2) at the humerus. Correlation coefficients between left and right sides were 0.78 for adjusted BMD at both sites. The correlation coefficient between side-averaged femoral and humeral BMD was 0.81, but ranged between 0.70 and 0.75 when limited to ipsilateral or contralateral femur-humerus pairs. Our findings suggest the desirability of randomizing limbs for treatment in studies using contralateral limb controls. These observations may represent the densitometric manifestation of behavioral and neuroanatomical lateralization in laboratory mice. C1 Univ Wisconsin, Sch Med, Dept Med, Endocrinol Sect, Madison, WI 53792 USA. New York State Dept Hlth, Roswell Pk Mem Inst, Dept Mol & Cellular Biol, Buffalo, NY 14263 USA. William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. RP Franco, GELF (reprint author), Univ Wisconsin, Sch Med, Dept Med, Endocrinol Sect, 600 Highland Ave, Madison, WI 53792 USA. EM gel@medicine.wisc.edu NR 50 TC 2 Z9 2 U1 1 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0171-967X J9 CALCIFIED TISSUE INT JI Calcif. Tissue Int. PD JAN PY 2005 VL 76 IS 1 BP 26 EP 31 DI 10.1007/s00223-004-0073-5 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 891BY UT WOS:000226557500005 PM 15455186 ER PT J AU Hussein, MR AF Hussein, MR TI The relationships between p53 protein expression and the clinicopathological features in uveal melanomas SO CANCER BIOLOGY & THERAPY LA English DT Article DE p53; melanomas; clinical features ID GENE-MUTATIONS; MICROSATELLITE INSTABILITY; MALIGNANT MELANOMAS; TUMOR-SUPPRESSOR; OVEREXPRESSION; METASTASIS; APOPTOSIS; PATHWAYS; PATTERNS; MARKERS AB Background: p53 alterations are common events in cancer and may have some prognostic ramifications. Objectives: To investigate the uveal melanoma for: (1) the p53 expression patterns, (2) the relationships among p53 expression and clinicopathological features of these lesions. Materials and Methods: Using Immunoperoxidase-staining methods and mouse monoclonal antibodies, the expression of p53 protein in 60 uveal melanomas was examined. Results: Based on p53 immunoreactivity, the lesions were divided into two groups: the first group included 9 tumors (15%) and had p53 protein overexpression. The second group included 51 (85%) tumors and was lacking p53 expression. p53 protein overexpression was significantly associated with extraocular extension and vascular invasion (p values, 0.01 and 0.04). No significant correlation was found between p53 protein expression and the clinicopathologic features of these lesions. Conclusions: p53 protein overexpression occurs in the uveal melanoma and may be associated with some unfavorable histological features (invasion). C1 Univ Wisconsin, Sch Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Hussein, MR (reprint author), Assiut Univ, Dept Pathol, Fac Med, Assiut, Egypt. EM mth17@swissinfo.org NR 23 TC 5 Z9 6 U1 0 U2 0 PU LANDES BIOSCIENCE PI GEORGETOWN PA 810 SOUTH CHURCH STREET, GEORGETOWN, TX 78626 USA SN 1538-4047 J9 CANCER BIOL THER JI Cancer Biol. Ther. PD JAN PY 2005 VL 4 IS 1 BP 57 EP 59 PG 3 WC Oncology SC Oncology GA 948RF UT WOS:000230732700011 PM 15662123 ER PT J AU Ford, ME Havstad, SL Demers, R Johnson, CC AF Ford, ME Havstad, SL Demers, R Johnson, CC TI Effects of false-positive prostate cancer screening results on subsequent prostate cancer screening behavior SO CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION LA English DT Article; Proceedings Paper CT 55th Annual Meeting of the Gerontological-Society-of-America CY NOV 22-26, 2002 CL BOSTON, MA SP Gerontol Soc Amer ID AFRICAN-AMERICAN MEN; RACIAL-DIFFERENCES; ANTIGEN; COMMUNITY; KNOWLEDGE; PSA; WASHINGTON; STRATEGIES; CARCINOMA; DIAGNOSIS AB Objectives: Little is known about screening behavior following a false-positive prostate cancer screening result, which we have defined as a screening result with "abnormal/suspicious" labeling that did not result in a prostate cancer diagnosis within 14 months. The purpose of this analysis was to examine whether age, race, education, or previous false-positive prostate cancer screening results via prostate-specific antigen or digital rectal exam predict decision to obtain subsequent prostate cancer screening. Methods: Data were drawn from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. The study sample consisted of 2,290 older men (mean age, 62.8 years; range, 5575 years) who had false-positive (n = 318) or negative (n = 1,972) prostate-specific antigen or digital rectal exam baseline prostate cancer screening results. Multivariable logistic regression was used to assess the effect of false-positive results on subsequent prostate cancer screening behavior, adjusting for all covariates. Results: The multivariable model showed that being African American (P = 0.016), and having a high school education or less W = 0.007), having a previous false-positive prostate cancer screening result (P < 0.001), were predictive of not returning for prostate cancer screening in the following screening trial year. Conclusion: The study results highlight the importance of shared decision making between patients and their providers regarding the risks and benefits of prostate cancer screening, and follow-up options for abnormal prostate cancer screening results. Shared decision making may be especially important for African American men, whom prostate cancer disproportionately affects. C1 Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Henry Ford Hlth Sci Ctr, Dept Biostat & Res Epidemiol, Detroit, MI USA. Henry Ford Hlth Sci Ctr, Josephine Ford Canc Ctr, Detroit, MI USA. Michigan State Univ, Dept Med, E Lansing, MI 48824 USA. RP Ford, ME (reprint author), Baylor Coll Med, Dept Med, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM mford@bcm.tmc.edu OI Johnson, Christine Cole/0000-0002-6864-6604 FU NCI NIH HHS [N01 CN25522, N01-CN-25512]; NIA NIH HHS [P30 AG5286] NR 35 TC 18 Z9 18 U1 0 U2 1 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1055-9965 J9 CANCER EPIDEM BIOMAR JI Cancer Epidemiol. Biomarkers Prev. PD JAN PY 2005 VL 14 IS 1 BP 190 EP 194 PG 5 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 890TP UT WOS:000226534000026 PM 15668495 ER PT J AU Blanke, CD Corless, CL AF Blanke, CD Corless, CL TI State-of-the art therapy for gastrointestinal stromal tumors SO CANCER INVESTIGATION LA English DT Article DE gastrointestinal stromal tumor; GIST; imatinib mesylate; targeted therapy ID SOFT-TISSUE SARCOMAS; SOUTHWEST-ONCOLOGY-GROUP; PHASE-II; PROGNOSTIC-FACTORS; IMATINIB MESYLATE; SURGICAL-MANAGEMENT; CHEMOTHERAPY; DOXORUBICIN; LEIOMYOSARCOMAS; DACARBAZINE AB Until recently, there were few effective therapeutic options for patients with gastrointestinal stromal tumors (GISTs). Most patients undergoing even potentially curative resection for early-stage disease recurred if followed for a sufficiently long period, and treatment of advanced tumors with systemic chemotherapy was ineffective. Imatinib mesylate, a molecularly targeted agent that inhibits the KIT receptor tyrosine kinase, has now been demonstrated to be highly effective at inducing objective responses in GIST patients, and it improves overall survival. In locoregional disease, ongoing studies are assessing the use of imatinib pre-or postsurgery. In addition, other agents possessing activity against a variety of molecular targets are being tested in advanced disease. Questions remain about the optimal dose of imatinib, whether to continue drug in the setting of progressive disease, and how best to prevent or overcome resistance. C1 Oregon Hlth Sci Univ, Dept Med, Div Hematol & Med Oncol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Pathol, Portland, OR 97201 USA. OHSU Canc Inst, Portland, OR USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Blanke, CD (reprint author), Oregon Hlth Sci Univ, Dept Med, Div Hematol & Med Oncol, MC L-586,3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. EM blankec@ohsu.edu NR 40 TC 44 Z9 47 U1 4 U2 5 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 0735-7907 J9 CANCER INVEST JI Cancer Invest. PY 2005 VL 23 IS 3 BP 274 EP 280 DI 10.1081/CNV-200055972 PG 7 WC Oncology SC Oncology GA 932IK UT WOS:000229547200010 PM 15945512 ER PT J AU Virella, G Derrick, MB Pate, V Chassereau, C Thorpe, SR Lopes-Virella, MF AF Virella, G Derrick, MB Pate, V Chassereau, C Thorpe, SR Lopes-Virella, MF TI Development of capture assays for different modifications of human low-density lipoprotein SO CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY LA English DT Article ID GLYCATION END-PRODUCTS; ADVANCED GLYCOSYLATION; MONOCLONAL-ANTIBODY; IMMUNE-COMPLEXES; LYSINE RESIDUES; MODIFIED LDL; MALONDIALDEHYDE; DISEASE; AGE; AUTOANTIBODIES AB Antibodies to malondialdehyde (MDA)-modified low-density lipoprotein (LDL), copper-oxidized LDL (oxLDL), N-epsilon(carboxymethyl) lysine (CML)-modified LDL, and advanced glycosylation end product (AGE)-modified LDL were obtained by immunization of rabbits with in vitro-modified human LDL preparations. After absorption of apolipoprotein B (ApoB) antibodies, we obtained antibodies specific for each modified lipoprotein with unique patterns of reactivity. MDA-LDL antibodies reacted strongly with MDA-LDL and also with oxLDL. CML-LDL antibodies reacted strongly with CML-LDL and also AGE-LDL. oxLDL antibodies reacted with oxLDL but not with MDA-LDL, and AGE-LDL antibodies reacted with AGE-LDL but not with CML-LDL. Capture assays were set with each antiserum, and we tested their ability to capture ApoB-containing lipoproteins isolated from precipitated immune complexes (IC) and from the supernatants remaining after IC precipitation (free lipoproteins). All antibodies captured lipoproteins contained in IC more effectively than free lipoproteins. Analysis of lipoproteins in IC by gas chromatography-mass spectrometry showed that they contained MDA-LDL and CML-LDL in significantly higher concentrations than free lipoproteins. A significant correlation (r = 0.706, P < 0.019) was obtained between the MDA concentrations determined by chemical analysis and by the capture assay of lipoproteins present in IC. In conclusion, we have developed capture assays for different LDL modifications in human ApoB/E lipoprotein-rich fractions isolated from precipitated IC. This approach obviates the interference of IC in previously reported modified LDL assays and allows determination of the degree of modification of LDL with greater accuracy. C1 Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Metab Endocrinol & Nutr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Chem & Biochem, Charleston, SC 29425 USA. Ralph H Johnson VA 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. EM virellag@musc.edu FU NHLBI NIH HHS [P01-HL55782, P01 HL055782]; NIDDK NIH HHS [R37 DK019971, DK19971] NR 33 TC 21 Z9 23 U1 0 U2 2 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 JAN PY 2005 VL 12 IS 1 BP 68 EP 75 DI 10.1128/CDLI.12.1.68-75.2005 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 901GU UT WOS:000227271800008 PM 15642987 ER PT J AU Beaudoin, DR Wigren, C Eisenreich, C Bankson, DD AF Beaudoin, DR Wigren, C Eisenreich, C Bankson, DD TI Monomeric prolactin reference range and potential for improved evaluation of hyperprolactinemia SO CLINICAL CHEMISTRY LA English DT Meeting Abstract CT 57th Annual Meeting of the American-Association-for-Clinical-Chemistry CY JUL 24-28, 2005 CL Orlando, FL SP Amer Assoc Clin Chem C1 Univ Washington, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 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. PY 2005 VL 51 SU 6 BP A239 EP A240 PG 2 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 930YH UT WOS:000229452500772 ER PT J AU Ioannou, GN Weiss, NS Boyko, EJ Kowdley, KV Kahn, SE Carithers, RL Tsai, EC Dominitz, JA AF Ioannou, GN Weiss, NS Boyko, EJ Kowdley, KV Kahn, SE Carithers, RL Tsai, EC Dominitz, JA TI Is central obesity associated with cirrhosis-related death or hospitalization? A population-based, cohort study SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article ID BODY-FAT DISTRIBUTION; INSULIN-RESISTANCE SYNDROME; LIVER-DISEASE; NONALCOHOLIC STEATOHEPATITIS; COMPUTED-TOMOGRAPHY; RISK-FACTORS; HEPATOCELLULAR-CARCINOMA; CRYPTOGENIC CIRRHOSIS; CARDIOVASCULAR RISK; JAPANESE-AMERICANS AB Background & Aims: We aimed to determine the interaction between body fat distribution (central versus peripheral) and increased body mass index (BMI) with regards to the risk of cirrhosis-related death or hospitalization. Methods: Participants included 11,434 persons aged 25-74 years without evidence of cirrhosis at entry into the study or during the first 5 years of follow-up who were subsequently followed for a mean of :12.9 years as part of the first National Health and Nutrition Examination Survey. Participants were categorized into "normal-weight" (BMI < 25 kg/m(2) N = 5750), "overweight" (BMI 25 to < 30 kg/m(2), N 3770), and "obese" (BMI >= 30 kg/m(2), N = 1914). The subscapular to triceps skinfold thickness ratio (SFR) was used to categorize body fat distribution into central (SFR > 1, N = 5211) and peripheral (SFR :5 :1, N = 6223). Results: Cirrhosis resulted in death or hospitalization of 88 participants during 149,888 person-years of follow-up (59/100,000 person-years). Among persons with a central body fat distribution, cirrhosis-related deaths or hospitalizations were more common in obese persons (115/100,000 person-years, adjusted hazard ratio 2.2, 95% confidence interval [CI] 1.1-4.6) and in overweight persons (94/100,000 person-years, adjusted hazard ratio 1.5, 95% CI 0.8-3.0) compared to normal-weight persons (59/100,000 person-years). However, among persons with a peripheral fat distribution, there was no association between obesity (adjusted hazard ratio 0.7, 95% CI 0.3-:1.6) or overweight (adjusted hazard ratio 0.8, 95% CI 0.2-2.8) and cirrhosis-related death or hospitalization. Conclusions: The risk of cirrhosis-related death or hospitalization appears to be increased in the presence of cirrhosis, but only among persons with a central fat distribution. The excess risk associated with central obesity might be related to insulin resistance and hepatic steatosis. C1 Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Ctr, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, NW Hepatitis C Resource Ctr, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Epidemiol Resource & Informat Ctr, Seattle, WA USA. Univ Washington, Sch Med, Div Gastroenterol, Seattle, WA USA. Univ Washington, Sch Med, Div Gen Internal Med, Seattle, WA USA. Univ Washington, Sch Med, Div Metab Endocrinol & Nutr, Dept Med, Seattle, WA USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. RP Ioannou, GN (reprint author), Seattle VA Med Ctr, S-111 Gastro,1660 S Columbian Way, Seattle, WA 98108 USA. EM georgei@medicine.washington.edu OI Kahn, Steven/0000-0001-7307-9002; Dominitz, Jason/0000-0002-8070-7086; Boyko, Edward/0000-0002-3695-192X FU NIDDK NIH HHS [DK 02456, DK02957] NR 51 TC 16 Z9 16 U1 0 U2 3 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 JAN PY 2005 VL 3 IS 1 BP 67 EP 74 DI 10.1053/S1542-3565(04)00442-2 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 993UG UT WOS:000233980000011 PM 15645407 ER PT J AU Lin, JH Bashir, MM Zhang, W Werth, VP AF Lin, JH Bashir, MM Zhang, W Werth, VP TI Thalidomide, an anti-inflammatory medication, inhibits the induction of tumor necrosis factor-alpha (TNF alpha) in ultraviolet B (UVB)-irradiated human keratinocytes by destabilizing the TNF alpha mRNA SO CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 5th Annual Meeting of the Federation-of-Clinical-Immunology-Society CY MAY 12-16, 2005 CL Boston, MA SP Fed Clin Immunol Soc C1 Univ Penn, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, 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 1521-6616 J9 CLIN IMMUNOL JI Clin. Immunol. PY 2005 VL 115 SU 1 BP S258 EP S258 PG 1 WC Immunology SC Immunology GA 926DY UT WOS:000229104400724 ER PT J AU Virella, G Derrick, MB Chassereau, C Thorpe, SR Lopes-Virella, MF AF Virella, G Derrick, MB Chassereau, C Thorpe, SR Lopes-Virella, MF TI The autoimmune response to modified human low-density lipoprotein. SO CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 5th Annual Meeting of the Federation-of-Clinical-Immunology-Society CY MAY 12-16, 2005 CL Boston, MA SP Fed Clin Immunol Soc C1 Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC USA. Med Univ S Carolina, Dept Med, Charleston, SC USA. Ralph H Johnson VAMC, Charleston, SC USA. Univ S Carolina, Dept Chem & Biochem, Columbia, SC 29208 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 1521-6616 J9 CLIN IMMUNOL JI Clin. Immunol. PY 2005 VL 115 SU 1 BP S211 EP S211 PG 1 WC Immunology SC Immunology GA 926DY UT WOS:000229104400596 ER PT J AU Takayama, K Wang, C Besra, GS AF Takayama, K Wang, C Besra, GS TI Pathway to synthesis and processing of mycolic acids in Mycobacterium tuberculosis SO CLINICAL MICROBIOLOGY REVIEWS LA English DT Review ID ACYL CARRIER PROTEIN; KETOACYL-ACP SYNTHASE; CHAIN FATTY-ACIDS; CELL-FREE SYSTEM; CRYSTAL-STRUCTURE; CORYNEBACTERIUM-DIPHTHERIAE; PALMITIC ACID; BIOCHEMICAL-CHARACTERIZATION; ENZYMATIC CHARACTERIZATION; CYCLOPROPANE SYNTHETASE AB Mycobacterium tuberculosis is known to synthesize alpha-, methoxy-, and keto-mycolic acids. We propose a detailed pathway to the biosynthesis of all mycolic acids in M. tuberculosis. Fatty acid synthetase I provides C-20-S-coenzyme A to the fatty acid synthetase II system (FAS-IIA). Modules of FAS-IIA and FAS-IIB introduce cis unsaturation at two locations on a growing meroacid chain to yield three different forms of cis, cis-diunsaturated fatty acids (intermediates to alpha-, methoxy-, and keto-meroacids). These are methylated, and the mature meroacids and carboxylated C-26-S-acyl carrier protein enter into the final Claisen-type condensation with polyketide synthase-13 (Pks13) to yield mycolyl-S-Pks13. We list candidate genes in the genome encoding the proposed dehydrase and isomerase in the FAS-IIA and FAS-IIB modules. We propose that the processing of mycolic acids begins by transfer of mycolic acids from mycolyl-S-Pks13 to D-mannopyranosyl-1-phosphoheptaprenol to yield 6-O-mycolyl-beta-D-mannopyranosyl-1-phosphoheptaprenol and then to trehalose 6-phosphate to yield phosphorylated trehalose monomycolate (TMM-P). Phosphatase releases the phosphate group to yield TMM, which is immediately transported outside the cell by the ABC transporter. Antigen 85 then catalyzes the transfer of a mycolyl group from TMM to the cell wall arabinogalactan and to other TMMs to produce arabinogalactan-mycolate and trehalose dimycolate, respectively. We list candidate genes in the genome that encode the proposed mycolyltransferases I and II, phosphatase, and ABC transporter. The enzymes within this total pathway are targets for new drug discovery. C1 Univ Wisconsin, William S Middleton Mem Vet Hosp, Sch Med, Mycobacteriol Res Lab, Madison, WI 53705 USA. Univ Wisconsin, William S Middleton Mem Vet Hosp, Dept Med Microbiol & Immunol, Madison, WI 53705 USA. Univ Wisconsin, Dept Bacteriol, Madison, WI 53706 USA. Univ Birmingham, Sch Biosci, Birmingham B15 2TT, W Midlands, England. RP Takayama, K (reprint author), Univ Wisconsin, William S Middleton Mem Vet Hosp, Sch Med, Mycobacteriol Res Lab, 2500 Overlook Terrace, Madison, WI 53705 USA. EM Kuni.Takayama@med.va.gov NR 126 TC 302 Z9 322 U1 8 U2 74 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0893-8512 J9 CLIN MICROBIOL REV JI Clin. Microbiol. Rev. PD JAN PY 2005 VL 18 IS 1 BP 81 EP + DI 10.1128/CMR.18.1.81-101.2005 PG 23 WC Microbiology SC Microbiology GA 891IU UT WOS:000226575300005 PM 15653820 ER PT J AU Kharasch, ED Whittington, D Hoffer, C Krudys, K Craig, K Vicini, P Sheffels, P Lalovic, B AF Kharasch, ED Whittington, D Hoffer, C Krudys, K Craig, K Vicini, P Sheffels, P Lalovic, B TI Paradoxical role of cytochrome P450 3A in the bioactivation and clinical effects of levo-alpha-acetylmethadol - Importance of clinical investigations to validate in vitro drug metabolism studies SO CLINICAL PHARMACOKINETICS LA English DT Review ID LEVOMETHADYL ACETATE; NONINVASIVE PROBE; HUMAN HEPATOCYTES; OPIATE RECEPTORS; N-DEMETHYLATION; CYP3A4 ACTIVITY; LAAM; METHADONE; ALFENTANIL; DISPOSITION AB Objective: Levo-alpha-acetylmethadol (LAAM, levacetylmethadol) is a long-acting opioid agonist used for the prevention of opioid withdrawal. LAAM undergoes sequential N-demethylation to norLAAM and dinorLAAM, which are more potent and longer-acting than LAAM. Hepatic and intestinal microsomal N-demethylation in vitro is catalysed mainly by cytochrome P450 (CYP) 3A4; however, the role of CYP3A in LAAM disposition in humans in vivo is unknown. This investigation tested the hypothesis that CYP3A induction (or inhibition) would increase (or decrease) LAAM metabolism and bioactivation and, thus, clinical effects. It also related changes in LAAM disposition during enzyme inhibition or induction to any changes in pharmacological effect. Methods: Healthy volunteers (n = 13) completed the three-way, randomised, balanced crossover study. Subjects received oral LAAM (0.25 mg/kg) after CYP3A induction (rifampicin [rifampin]), inhibition (troleandomycin) or nothing (controls). Plasma and urine LAAM, norLAAM and dinorLAAM were determined by electrospray high-performance liquid chromatography/mass spectrometry (HPLC/MS). Dark-adapted pupil diameter change from baseline (miosis) was the LAAM effect measure. Results were analysed by noncompartmental methods and by a combined pharmacokinetic/pharmacodynamic model. Results: Compared with controls, CYP3A induction (or inhibition) decreased (or increased) plasma LAAM concentrations and mean area under the plasma concentration-time curve from time zero to infinity (AUC(infinity) 199 +/- 91 [control] versus 11.3 +/- 4.0 [rifampicin] and 731 +/- 229 ng center dot h/mL [troleandomycin]; p < 0.05), and increased (or decreased) median formation clearances of norLAAM (1740 versus 14 100 and 302 mL/h/kg; p < 0.05) and dinorLAAM (636 versus 7840 and 173 mL/h/kg; p < 0.05). Surprisingly, however, CYP3A induction (or inhibition) decreased (or increased) mean plasma metabolite AUC from 0 to 96 hours (AUC(96)) [norLAAM + dinorLAAM] (859 +/- 241 versus 107 +/- 48 and 1185 +/- 179 ng center dot h/mL; p < 0.05) and clinical effects (mean miosis AUC(96) 128 +/- 40 versus 22.5 +/- 14.9 and 178 +/- 81 mm 9 h; p < 0.05). Clinical effects were best correlated with plasma norLAAM concentrations. Conclusion: CYP3A mediates human LAAM N-demethylation and bioactivation to norLAAM and dinorLAAM in vivo. Paradoxically, however, CYP3A induction decreased and inhibition increased LAAM active metabolite concentrations and clinical effects. This suggests a CYP3A-mediated metabolic pathway leading to inactive metabolites, which predominates over CYP3A-dependent bioactivation. These results highlight the need for clinical investigations to validate in vitro drug metabolism studies. C1 Univ Washington, Dept Anesthesiol, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Anesthesiol, Seattle, WA USA. Univ Washington, Dept Med Chem, Seattle, WA 98195 USA. Univ Washington, Dept Bioengn, Seattle, WA USA. Univ Washington, Dept Pharmaceut, Seattle, WA 98195 USA. RP Kharasch, ED (reprint author), Univ Washington, Dept Anesthesiol, 1959 NE Pacific St RR-442,Box 356540, Seattle, WA 98195 USA. EM kharasch@u.washington.edu FU NCRR NIH HHS [M01-RR00037]; NIBIB NIH HHS [9P41EB-01975]; NIDA NIH HHS [R01-DA14211, K24-DA00417]; NIDCR NIH HHS [T32DE-07023] NR 52 TC 9 Z9 9 U1 0 U2 1 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 0312-5963 J9 CLIN PHARMACOKINET JI Clin. Pharmacokinet. PY 2005 VL 44 IS 7 BP 731 EP 751 DI 10.2165/00003088-200544070-00005 PG 21 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 945NF UT WOS:000230508500005 PM 15966756 ER PT J AU Palevsky, PM O'Connor, T Zhang, JHY Star, RA Smith, MW AF Palevsky, PM O'Connor, T Zhang, JHY Star, RA Smith, MW CA VA NIH Acute Renal Failure Trial N TI Design of the VA/NIH Acute Renal Failure Trial Network (ATN) study: intensive versus conventional renal support in acute renal failure SO CLINICAL TRIALS LA English DT Article ID CONTINUOUS VENOVENOUS HEMOFILTRATION; RESPIRATORY-DISTRESS-SYNDROME; ACUTE LUNG INJURY; REPLACEMENT THERAPY; RANDOMIZED-TRIAL; TIDAL VOLUMES; CARE-UNIT; DIALYSIS; INTERMITTENT; HEMODIALYSIS AB The optimal management of renal replacement therapy (RRT) in acute renal failure (ARF) is uncertain. The VA/NIH Acute Renal Failure Trail Network Study (ATN Study) tests the hypothesis that a strategy of intensive RRT will decrease 60-day all-cause mortality in critically ill patients with ARF. Dose separation between the two treatment arms is achieved by increasing the frequency of intermittent hemodialysis (IHD) and sustained low efficiency dialysis (SLED) treatments from three times per week to six times per week, and by increasing continuous venovenous hemodiafiltration (CVVHDF) effluent volume from 20 mL/kg/hr to 35 mL/kg/hr. In both treatment arms, subjects convert between IHD and CVVHDF or SLED as hemodynamic status changes over time. This strategy attempts to replicate the conversion between modalities of RRT that occurs in clinical practice. However, in order to implement this strategy, flexible criteria needed to be developed to provide a balance between the need for uniformity of treatment between groups and practitioner discretion regarding modality of RRT to maintain patient safety. In order to address safety and ethical issues similar to those raised by the Office of Human Research Protections in its review of the ARDS Network studies, a survey of practitioner practices was performed and observational data on the management of RRT in comparable critically ill patients with ARF managed outside of the research context is being collected prospectively. These data will help inform the study's DSMB and site IRB's of the relationship between the study's treatment arms and concurrent clinical practice. C1 VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA USA. VA Connecticut Healthcare Syst, Cooperat Studies Program, Coordinating Ctr, West Haven, CT USA. Natl Inst Hlth, Natl Inst Diab Digest & Kidney Dis, Bethesda, MD USA. VA Palo Alto Hlth Care Syst, Hlth Econ Resouce Ctr, Menlo Pk, CA USA. RP Palevsky, PM (reprint author), VA Pittsburgh Healthcare Syst, Renal Sect, Univ Dr, Pittsburgh, PA 15240 USA. EM palevsky@pitt.edu RI Smith, Mark/G-1522-2012 OI Smith, Mark/0000-0002-4582-9088; Palevsky, Paul/0000-0002-7334-5400 FU NIDDK NIH HHS [Y01 DK003508-03, Y01 DK003508-02, Y01 DK003508-01, Y1-DK-3508-01, Y1-DK-3508-01/02/03, Y01 DK003508] NR 35 TC 60 Z9 65 U1 0 U2 1 PU HODDER ARNOLD, HODDER HEADLINE PLC PI LONDON PA 338 EUSTON ROAD, LONDON NW1 3BH, ENGLAND SN 1740-7745 J9 CLIN TRIALS JI Clin. Trials PY 2005 VL 2 IS 5 BP 423 EP 435 DI 10.1191/1740774505cn116oa PG 13 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 982RH UT WOS:000233178800006 PM 16317811 ER PT J AU Rifai, MA Loftis, JM Hauser, P AF Rifai, MA Loftis, JM Hauser, P TI Interferon-alpha treatment of patients with hepatitis C - The role of a comprehensive risk-benefit assessment SO CNS DRUGS LA English DT Letter ID PSYCHIATRIC-DISORDERS; MANAGEMENT; INFECTION C1 NIMH, NIH, Bethesda, MD 20892 USA. Portland VA Med Ctr, Behavioral Hlth & Clin Neurosci Div, Portland, OR USA. Oregon Hlth Sci Univ, Dept Psychiat, Portland, OR 97201 USA. NW Hepatitis C Resource Ctr, Portland, OR USA. Portland VA Med Ctr, JENS Lab, Portland, OR USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. RP Rifai, MA (reprint author), NIMH, NIH, Bethesda, MD 20892 USA. NR 9 TC 4 Z9 4 U1 0 U2 0 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 1311, NEW ZEALAND SN 1172-7047 J9 CNS DRUGS JI CNS Drugs PY 2005 VL 19 IS 8 BP 719 EP 721 DI 10.2165/00023210-200519080-00009 PG 3 WC Clinical Neurology; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 956UJ UT WOS:000231325100009 PM 16097855 ER PT J AU Dellavalle, RP Drake, A Graber, M Heilig, LF Hester, EJ Johnson, KR McNealy, K Schilling, L AF Dellavalle, R. P. Drake, A. Graber, M. Heilig, L. F. Hester, E. J. Johnson, K. R. McNealy, K. Schilling, L. TI Statins and fibrates for preventing melanoma SO COCHRANE DATABASE OF SYSTEMATIC REVIEWS LA English DT Review ID CORONARY-HEART-DISEASE; DENSITY-LIPOPROTEIN CHOLESTEROL; BASE-LINE CHARACTERISTICS; SCANDINAVIAN SIMVASTATIN SURVIVAL; RANDOMIZED CONTROLLED TRIAL; PLACEBO-CONTROLLED TRIAL; LONG-TERM INTERVENTION; RENAL-TRANSPLANT RECIPIENTS; ACUTE MYOCARDIAL-INFARCTION; EXTREMITY ARTERIAL-DISEASE AB Background Effective treatment for advanced melanoma is lacking. While no drug therapy currently exists for prevention of melanoma, in vitro, case-control, and animal model evidence suggest that lipid-lowering medications, commonly taken for high cholesterol, might prevent melanoma. Objectives To assess the effects of statin or fibrate lipid-lowering medications on melanoma outcomes. Search strategy We searched the Cochrane Skin Group Specialised Register (February 2003), CENTRAL (The Cochrane Library Issue 1, 2005), MEDLINE (to March 2003), EMBASE (to September 2003), CANCERLIT (to October 2002), Web of Science (to May 2003), and reference lists of articles. We approached study investigators and pharmaceutical companies for additional information (published or unpublished studies). Selection criteria Trials involving random allocation of study participants, where experimental groups used statins or fibrates and participants were enrolled for at least four years of therapy. Data collection and analysis Three authors screened 109 abstracts of articles with titles of possible relevance. We then thoroughly examined the full text of 72 potentially relevant articles. We requested unpublished melanoma outcomes data from the corresponding author of each qualifying trial. Main results We identified 16 qualifying randomised controlled trials (RCTs) (seven statin, nine fibrate). Thirteen of these trials (involving 62,197 participants) provided data on incident melanomas (six statin, seven fibrate). A total of 66 melanomas were reported in groups receiving the experimental drug and 86 in groups receiving placebo or other control therapies. For statin trials this translated to an odds ratio of 0.90 (95% confidence interval 0.56 to 1.44) and for fibrate trials an odds ratio of 0.58 (95% confidence interval 0.19 to 1.82). Subgroup analyses failed to show statistically significant differences in melanoma outcomes by gender, melanoma occurrence after two years of participation in trial, stage or histology, or trial funding. Subgroup analysis by type of fibrate or statin also failed to show statistically significant differences, except for the statin subgroup analysis which showed reduced melanoma incidence for lovastatin, based on one trial only (odds ratio 0.52, 95% confidence interval 0.27 to 0.99). Authors' conclusions The melanoma outcomes data collected in this review of RCTs of statins and fibrates does not exclude the possibility that these drugs prevent melanoma. There was a 10% and 42% reduction for participants on statins and fibrates, respectively, however these results were not statistically significant. Until further evidence is established, limiting exposure to ultraviolet radiation remains the most effective way to reduce the risk of melanoma. C1 Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. RP Dellavalle, RP (reprint author), Denver Vet Affairs Med Ctr, 1055 Clermont St,Mail Stop 165, Denver, CO 80220 USA. EM robert.dellavalle@uchsc.edu NR 153 TC 16 Z9 16 U1 0 U2 2 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1469-493X J9 COCHRANE DB SYST REV JI Cochrane Database Syst Rev. PY 2005 IS 4 AR CD003697 DI 10.1002/14651858.CD003697.pub2 PG 47 WC Medicine, General & Internal SC General & Internal Medicine GA 096UK UT WOS:000241402100028 ER PT J AU Mendez, MF Chen, AK Shapira, JS Miller, BL AF Mendez, MF Chen, AK Shapira, JS Miller, BL TI Acquired sociopathy and frontotemporal dementia SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Article DE frontotemporal dementia; sociopathy; antisocial; aggression ID ANTISOCIAL PERSONALITY-DISORDER; FRONTAL-LOBE DEGENERATION; NON-ALZHEIMER TYPE; PREFRONTAL CORTEX; DECISION-MAKING; SOCIAL COGNITION; TEMPORAL VARIANT; CLINICAL PICTURE; HUMAN BRAIN; BEHAVIOR AB Background: It is not understood why some patients with frontotemporal dementia ( FTD) manifest sociopathic behavior. Objective: To examine the prevalence and characteristics of sociopathic behavior in FTD patients as compared to those with Alzheimer's disease ( AD). Methods and Participants: We surveyed a group of FTD patients and a group of AD patients for sociopathic behavior, evaluated the characteristics surrounding their acts, and compared the groups on neuropsychological tests and functional neuroimaging. Twenty-eight outpatients with FTD ( 15 men, 13 women; 61.9 +/- 7.1 years; Mini-Mental State Examination score 23.6 +/- 8.1) were compared with 28 patients with clinically probable AD ( 13 men, 15 women; 66.1 +/- 9.2 years; Mini-Mental State Examination score 21.3 +/- 5.3). Main outcome measures included: ( a) the prevalence of sociopathic acts; ( b) a structured interview; ( c) neuropsychological tests including the Frontal Assessment Battery, and ( d) clinically obtained positron emission tomography or single photon emission tomography scans. Results: Sixteen (57%) of the FTD patients had sociopathic behavior compared to two (7%) of the AD patients (chi(2) = 13.84, p < 0.001). Sociopathic acts among FTD patients included unsolicited sexual acts, traffic violations, physical assaults, and other unacceptable behaviors. On interview, the FTD patients with sociopathic acts were aware of their behavior and knew that it was wrong but could not prevent themselves from acting impulsively. They claimed subsequent remorse, but they did not act on it or show concern for the consequences. Among FTD patients with sociopathy, neuropsychological assessment showed impaired motor inhibition, and functional neuroimaging showed right frontotemporal involvement. Conclusion: The results suggest that sociopathy in FTD results from a combination of diminished emotional concern for the consequences of their acts and disinhibition consequent to right frontotemporal dysfunction. In many jurisdictions, FTD patients with sociopathy would not pass legal criteria for 'not guilty by reason of insanity'. Copyright (C) 2005 S. Karger AG, Basel. C1 VA Greater Los Angeles Healthcare Ctr, Neurobehav Unit 691116AF, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Los Angeles, CA 90024 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. RP Mendez, MF (reprint author), VA Greater Los Angeles Healthcare Ctr, Neurobehav Unit 691116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@UCLA.edu FU NIA NIH HHS [AG19724-01, P01 AG019724] NR 53 TC 51 Z9 52 U1 3 U2 13 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2005 VL 20 IS 2-3 BP 99 EP 104 DI 10.1159/000086474 PG 6 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 972YE UT WOS:000232488900008 PM 15980631 ER PT J AU Weintraub, D Moberg, PJ Culbertson, WC Duda, JE Katz, IR Stern, MB AF Weintraub, D Moberg, PJ Culbertson, WC Duda, JE Katz, IR Stern, MB TI Dimensions of executive function in Parkinson's disease SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Article DE Parkinson disease, executive impairment; planning function; inhibitory control ID POSITRON-EMISSION-TOMOGRAPHY; ANTERIOR CINGULATE CORTEX; DEMENTIA; DEPRESSION; PET; ASSOCIATION; IMPAIRMENT; MORTALITY; APATHY; SCALE AB Background: Executive impairment is common in Parkinson's disease (PD). However, it is unknown which dimensions of executive function are assessed by commonly used neuropsychological instruments and if clinical correlates of specific dimensions exist. Method: A convenience sample of 46 PD patients was evaluated with three executive function tests: the Tower of London-Drexel, the Trail-Making Test and the Stroop Color-Word Test. Factor analysis was used to probe for dimensions of executive control, and linear regression models were used to explore the association between the generated factors and other clinical features. Results: Factor analysis revealed two executive factors, one related to planning (eigenvalue = 4.2) and the other to inhibitory control ( eigenvalue = 1.8), together accounting for 75% of the variance in scores. In linear regression models, poorer planning was associated with increasing severity of apathy (t = 2.11, p = 0.041), and diminished inhibitory control was associated with increasing severity of parkinsonism ( t = 2.78, p = 0.008) and lower educational level ( t = - 2.23, p = 0.032). Conclusions: Planning deficits and diminished inhibitory control are two dimensions of executive impairment in PD, the former associated with decreased motivation and the latter with increased motor slowing. Similar performance on both executive and non-executive components of these instruments suggests that results of executive testing in PD may be confounded by non-executive deficits. Copyright (C) 2005 S. Karger AG, Basel. C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA USA. Drexel Univ, Dept Psychol, Philadelphia, PA 19104 USA. RP Weintraub, D (reprint author), 3535 Market St,Room 3003, Philadelphia, PA 19104 USA. EM weintrau@mail.med.upenn.edu FU NIMH NIH HHS [MH067894] NR 36 TC 36 Z9 37 U1 1 U2 14 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2005 VL 20 IS 2-3 BP 140 EP 144 DI 10.1159/000087043 PG 5 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 972YE UT WOS:000232488900013 PM 16020942 ER PT J AU Krishnan, LL Petersen, NJ Snow, AL Cully, JA Schulz, PE Graham, DP Morgan, RO Braun, U Moffett, ML Yu, HJ Kunik, ME AF Krishnan, LL Petersen, NJ Snow, AL Cully, JA Schulz, PE Graham, DP Morgan, RO Braun, U Moffett, ML Yu, HJ Kunik, ME TI Prevalence of dementia among Veterans Affairs medical care system users SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Article DE Veterans Affairs; Veterans Integrated Service Network; Alzheimer's disease; African-Americans ID WHITE COMMUNITY RESIDENTS; ALZHEIMERS-DISEASE; AFRICAN-AMERICANS; SENILE DEMENTIA; UNITED-STATES; OLDER PERSONS; POPULATION; HEALTH; DIAGNOSIS; AD AB Objectives: In an aging population, the number of veterans diagnosed with dementia is likely to increase. Knowledge of existing dementia prevalence will be beneficial in planning for future patient care needs. Our objectives were to assess the prevalence of the dementia diagnosis among those treated at Veterans Affairs (VA) medical centers and determine how it varies across race and Veterans Integrated Service Network (VISN). Materials and Methods: Data were collected on all veterans seen within the VA medical system from 1997 through the first half of 2001. Only veterans aged 65 and over were included in the study. Veterans were included if they had one of the following dementia ICD-9 codes: 290.XX, 291.2, 294.XX, 331.XX, 046.1, or 046.3. Results: The overall prevalence of dementia was 7.3%. The prevalence of dementia was similar among white patients and patients of other races, except African-American patients, in whom it was 50% higher. Across VISNs, the prevalence of dementia ranged from 5.8 to 9.4%. Alzheimer's disease was the most frequently diagnosed type of dementia within the VA, and inpatient service utilization and outpatient psychiatry visits by individuals with dementia were high relative to other VA patients. Discussion: The overall prevalence identified is consistent with that reported in the literature, as is the elevated prevalence in African-Americans versus whites. The data on prevalence by VISN may identify regional variation in either the types of dementia present or the diagnostic criteria used. The dementia diagnosis is clearly associated with substantial service use. Copyright (C) 2005 S. Karger AG, Basel. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Serv, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurol, Behav Neurol Sect, Houston, TX 77030 USA. Baylor Coll Med, Div Neurosci, Houston, TX 77030 USA. Vet Affairs S Cent Mental Illness Res Educ & Clin, Houston, TX USA. Michael E DeBakey Vet Affairs Med Ctr, Neurol Care Line, Houston, TX USA. RP Kunik, ME (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Serv, 152, Houston, TX 77030 USA. EM mkunik@bcm.tmc.edu RI Morgan, Robert/A-8577-2009; Moffett, Maurice/I-6664-2013; Graham, David /J-1158-2014 OI Moffett, Maurice/0000-0002-4536-9843; NR 42 TC 42 Z9 43 U1 1 U2 2 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2005 VL 20 IS 4 BP 245 EP 253 DI 10.1159/000087345 PG 9 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 972YF UT WOS:000232489000006 PM 16088141 ER PT J AU Roman, GC Wilkinson, DG Doody, RS Black, SE Salloway, SP Schindler, RJ AF Roman, GC Wilkinson, DG Doody, RS Black, SE Salloway, SP Schindler, RJ TI Donepezil in vascular dementia: Combined analysis of two large-scale clinical trials SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Article DE vascular dementia; cholinesterase inhibitors; donepezil; cognitive benefit; global function benefit ID ALZHEIMERS-DISEASE; EFFICACY; TOLERABILITY; POPULATIONS; MULTICENTER; MEMANTINE; SAFETY; STATE; AD AB Background and Objective: There are currently no drugs approved to treat vascular dementia (VaD). The objective of this study was to determine if treatment with donepezil, an acetylcholinesterase inhibitor, may provide benefit for VaD patients. Methods: Combined analysis of 2 identical randomized, double-blind, placebo-controlled, 24-week studies involving 1,219 patients enrolled at 109 investigational sites in the USA, Europe, Canada and Australia. Patients were randomized to receive donepezil 5 mg/day (n = 406) or 10 mg/day (after brief titration; n = 421) or placebo (n = 392). Patients were assessed on cognition [ Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), Mini-Mental State Examination (MMSE)], global function [Clinician's Interview-Based Impression of Change plus (CIBIC-plus), Clinical Dementia Rating-Sum of the Boxes (CDR-SB)] and function [ Alzheimer's Disease Functional Assessment and Change Scale (ADFACS); instrumental activities of daily living (ADFACS-IADL)]. Results: Both donepezil groups showed significant improvements in cognition compared with placebo (ADAS-cog, MMSE, p < 0.01). Significant global function benefits were seen on the CIBIC-plus in the 5 mg/day group (placebo vs. 5 mg/day, p < 0.001; vs. 10 mg/day, p = 0.006) and on the CDR-SB in the 10 mg/day group (placebo vs. 5 mg/day, p = 0.09; vs. 10 mg/day, p < 0.01). Significant functional benefits were also seen (ADFACS, placebo vs. 5 mg/day, p = 0.08; vs. 10 mg/day, p = 0.02; ADFACS-IADL, p < 0.05 for both donepezil groups). Donepezil was well tolerated, with low withdrawal rates due to adverse events. Conclusions: This combined analysis of the largest trial on VaD to date showed that donepezil-treated patients had significant benefits in cognition, global function and ability to perform IADL. Based on these findings and reported tolerability, donepezil should be considered as an important therapeutic element in the overall management of patients with VaD. Copyright (C) 2005 S. Karger AG, Basel. 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 78284 USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Brown Med Sch, Providence, RI USA. Pfizer Inc, New York, NY USA. Moorgreen Hosp, Memory Assessment & Res Ctr, Southampton, Hants, England. Univ Toronto, Sunnybrook & Womens Coll Hlth Sci Ctr, Dept Med Neurol, Toronto, ON, Canada. RP Roman, GC (reprint author), Univ Texas, Hlth Sci Ctr, Sch Med, Dept Med,Div Neurol, Mail Code 7883,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM romang@uthsca.edu OI Black, Sandra/0000-0001-7093-8289 NR 26 TC 48 Z9 56 U1 0 U2 4 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2005 VL 20 IS 6 BP 338 EP 344 DI 10.1159/000088494 PG 7 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 985GG UT WOS:000233364300002 PM 16192723 ER PT J AU Belfort, RS Harrison, S Brown, K Darland, C Finch, J Tio, F Gastaldelli, A Hardies, J Berria, R Dwivedi, S Havranek, R Balas, B Fincke, C DeFronzo, R Cusi, K AF Belfort, RS Harrison, S Brown, K Darland, C Finch, J Tio, F Gastaldelli, A Hardies, J Berria, R Dwivedi, S Havranek, R Balas, B Fincke, C DeFronzo, R Cusi, K TI Role of pioglitazone (PIO) in patients with non-alcoholic steatohepatitis (NASH) SO DIABETOLOGIA LA English DT Meeting Abstract CT 41st Annual Meeting of the European-Association-for-the-Study-of-Diabetes CY SEP 10-15, 2005 CL Athens, GREECE SP European Assoc Study Diabet C1 Univ Texas, Hlth Sci Ctr, Div Diabet, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Div Gastroenterol, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78284 USA. Brooke Army Med Ctr, Div Gastroenterol, San Antonio, TX USA. Vet Adm Med Ctr, Div Pathol, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PY 2005 VL 48 SU 1 MA 770 BP A280 EP A280 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 962OX UT WOS:000231743201367 ER PT J AU Kahn, SE Zinman, B Viberti, G Kravitz, BG Yu, D Heise, MA Freed, MI AF Kahn, SE Zinman, B Viberti, G Kravitz, BG Yu, D Heise, MA Freed, MI CA ADOPT Study Grp TI Obesity is a major determinant of the association of C-reactive protein levels with the number of metabolic syndrome components in recently diagnosed, drug-naive type 2 diabetes: the ADOPT study cohort SO DIABETOLOGIA LA English DT Meeting Abstract CT 41st Annual Meeting of the European-Association-for-the-Study-of-Diabetes CY SEP 10-15, 2005 CL Athens, GREECE SP European Assoc Study Diabet C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA USA. Mt Sinai Hosp, Toronto, ON M5G 1X5, Canada. KCL Guys Hosp, London, England. GlaxoSmithKline Inc, King Of Prussia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PY 2005 VL 48 SU 1 MA 683 BP A249 EP A249 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 962OX UT WOS:000231743201281 ER PT J AU Lipsky, BA Armstrong, DG Morgenstern, DE King, TR Abramson, MA AF Lipsky, BA Armstrong, DG Morgenstern, DE King, TR Abramson, MA TI Does a diabetic foot infection (DFI) wound score correlate with the clinical response to antibiotic treatment? Data from the SIDESTEP study SO DIABETOLOGIA LA English DT Meeting Abstract CT 41st Annual Meeting of the European-Association-for-the-Study-of-Diabetes CY SEP 10-15, 2005 CL Athens, GREECE SP European Assoc Study Diabet C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Rosalind Franklin Univ Med, Chicago, IL USA. RI Lipsky, Benjamin/B-4645-2013 NR 0 TC 2 Z9 2 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PY 2005 VL 48 SU 1 MA 974 BP A354 EP A354 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 962OX UT WOS:000231743202174 ER PT J AU Phan, J Peterfy, M Reue, K AF Phan, J Peterfy, M Reue, K TI Biphasic expression of lipin suggests dual roles in adipocyte development SO DRUG NEWS & PERSPECTIVES LA English DT Article ID FAMILIAL PARTIAL LIPODYSTROPHY; ADIPOSE-TISSUE DEVELOPMENT; PPAR-GAMMA; LAMIN A/C; IN-VITRO; DIFFERENTIATION; ADIPOGENESIS; GENE; MOUSE; MUTATION AB The identification of gene mutations that cause lipodystrophies, conditions characterized by a lack of normal adipose tissue, has revealed new proteins that play a role in adipocyte biology. Lipin is one such protein identified in a lipodystrophic mouse strain and found to be critical for normal adipocyte differentiation. Interestingly, lipin displays a biphasic expression pattern in adipocytes, with peaks of expression at two points during adipogenesis-a transient induction in preadipocytes prior to expression of peroxisome proliferator-activated receptor γ, and a second wave of expression in mature adipocytes. Thus, lipin appears to have critical roles in both adipocyte differentiation and in the function of mature adipocytes. © 2005 Prous Science. All rights reserved. C1 Univ Calif Los Angeles, Dept Human Genet, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Reue, K (reprint author), 11301 Wilshire Blvd,Bldg 113 Room 312, Los Angeles, CA 90073 USA. EM reuek@ucla.edu FU NHLBI NIH HHS [HL28481]; NIGMS NIH HHS [GM08042] NR 37 TC 20 Z9 20 U1 0 U2 2 PU PROUS SCIENCE, SA PI BARCELONA PA PO BOX 540, PROVENZA 388, 08025 BARCELONA, SPAIN SN 0214-0934 J9 DRUG NEWS PERSPECT JI Drug News Perspect. PD JAN-FEB PY 2005 VL 18 IS 1 BP 5 EP 11 DI 10.1358/dnp.2005.18.1.877165 PG 7 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 907TB UT WOS:000227739800001 PM 15753971 ER PT J AU Pierre, JM AF Pierre, JM TI Extrapyramidal symptoms with atypical antipsychotics - Incidence, prevention and management SO DRUG SAFETY LA English DT Review ID INDUCED TARDIVE-DYSKINESIA; PLACEBO-CONTROLLED TRIAL; VITAMIN-E TREATMENT; LOW-DOSE RISPERIDONE; LONG-TERM TREATMENT; DOUBLE-BLIND; SCHIZOAFFECTIVE DISORDER; SCHIZOPHRENIC-PATIENTS; MOVEMENT-DISORDERS; ACUTE EXACERBATION AB The treatment of schizophrenia changed drastically with the discovery of antipsychotic medications in the 1950s, the release of clozapine in the US in 1989 and the subsequent development of the atypical or novel antipsychotics. These newer medications differ from their conventional counterparts, primarily based on their reduced risk of extrapyramidal symptoms (EPS). EPS can be categorised as acute (dystonia, akathisia and parkinsonism) and tardive (tardive dyskinesia and tardive dystonia) syndromes. They are thought to have a significant impact on subjective tolerability and adherence with antipsychotic therapy in addition to impacting function. Unlike conventional antipsychotic medications, atypical antipsychotics have a significantly diminished risk of inducing acute EPS at recommended dose ranges. These drugs may also have a reduced risk of causing tardive dyskinesia and in some cases may have the ability to suppress pre-existing tardive dyskinesia. This paper reviews the available evidence regarding the incidence of acute EPS and tardive syndromes with atypical antipsychotic therapy. Estimates of incidence are subject to several confounds, including differing methods for detection and diagnosis of EPS, pretreatment effects and issues surrounding the administration of antipsychotic medications. The treatment of acute EPS and tardive dyskinesia now includes atypical antipsychotic therapy itself, although other adjunctive strategies such as antioxidants have also shown promise in preliminary trials. The use of atypical antipsychotics as first line therapy for the treatment of schizophrenia is based largely on their reduced risk of EPS compared with conventional antipsychotics. Nevertheless, EPS with these drugs can occur, particularly when prescribed at high doses. The EPS advantages offered by the atypical antipsychotics must be balanced against other important adverse effects, such as weight gain and diabetes mellitus, now known to be associated with these drugs. C1 VA Greater Los Angeles Healthcare Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Pierre, JM (reprint author), VA Greater Los Angeles Healthcare Ctr, 11301 Wilshire Blvd,Bldg 210 Room 15, Los Angeles, CA 90073 USA. EM joseph.pierre2@med.va.gov NR 161 TC 91 Z9 95 U1 2 U2 12 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 0114-5916 J9 DRUG SAFETY JI Drug Saf. PY 2005 VL 28 IS 3 BP 191 EP 208 DI 10.2165/00002018-200528030-00002 PG 18 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy; Toxicology SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy; Toxicology GA 906DB UT WOS:000227619600002 PM 15733025 ER PT J AU Haas, L AF Haas, L TI Management of diabetes Mellitus medications in the nursing home SO DRUGS & AGING LA English DT Article ID GLYCEMIC CONTROL; DRUG-THERAPY; METFORMIN; HYPOGLYCEMIA; PREVALENCE; INSULIN; CARE; RESIDENTS; GLUCOSE AB Nursing home staff are well aware of the increasing number of residents who experience diabetes mellitus. These residents consume an inordinate amount of resources and often have major disabilities and co-morbidities. Although nonpharmacological therapies, such as consistent carbohydrate intake and increased activity levels, are always indicated in diabetes management, pharmacological therapies are often necessary to prevent the acute complications of diabetes and delay some of the long-term complications. Residents with type 2 diabetes may be managed with oral antidiabetic agents and insulin, whereas residents with type 1 diabetes will always require insulin. Oral antidiabetic agents include insulin secretagogues, which stimulate endogenous insulin secretion and are most effective in leaner persons with type 2 diabetes. Metformin is another oral antidiabetic agent; this decreases inappropriate hepatic glucose release and is most effective in obese residents with high fasting blood glucose levels. The thiazolidinediones, also called glitazones, are insulin sensitisers that enable peripheral tissues to utilise insulin more effectively. The alpha-glucosidase inhibitors delay intestinal absorption of ingested carbohydrates. In addition to oral antidiabetic agents, insulin is frequently used in diabetes management. Insulin is always indicated in type 1 diabetes and is often necessary for residents with type 2 diabetes to optimise glycaemic control. Insulin can be rapid, fast, intermediate or long acting. In addition, basal insulin is now available. These insulins can be combined with each other and, in type 2 diabetes, with oral antidiabetic agents. In order to use pharmacological therapies appropriately, the glycaemic patterns of nursing home residents should be identified, using capillary blood glucose monitoring. Once these patterns have been identified, nonpharmacological therapies can be used, usually in conjunction with the many oral antidiabetic agents and various insulins available, to optimise glycaemic control in each resident. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, Seattle, WA 98108 USA. RP Haas, L (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, 1660 S Columbian Way 118, Seattle, WA 98108 USA. EM Linda.Haas@med.va.gov NR 45 TC 12 Z9 12 U1 0 U2 0 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 1170-229X J9 DRUG AGING JI Drugs Aging PY 2005 VL 22 IS 3 BP 209 EP 218 DI 10.2165/00002512-200522030-00003 PG 10 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 917XW UT WOS:000228503600003 PM 15813654 ER PT J AU Duron, RM Medina, MT Martinez-Juarez, IE Bailey, JN Perez-Gosiengfiao, KT Ramos-Ramirez, R Lopez-Ruiz, M Alonso, ME Ortega, RHC Pascual-Castroviejo, I Machado-Salas, J Mija, L Delgado-Escueta, AV AF Duron, RM Medina, MT Martinez-Juarez, IE Bailey, JN Perez-Gosiengfiao, KT Ramos-Ramirez, R Lopez-Ruiz, M Alonso, ME Ortega, RHC Pascual-Castroviejo, I Machado-Salas, J Mija, L Delgado-Escueta, AV TI Seizures of idiopathic generalized epilepsies SO EPILEPSIA LA English DT Review DE seizures; epilepsy; generalized; classification; treatment ID JUVENILE MYOCLONIC EPILEPSY; CHILDHOOD ABSENCE EPILEPSY; LONG-TERM PROGNOSIS; FOLLOW-UP; SUSCEPTIBILITY LOCUS; CALCIUM-CHANNELS; ASTATIC EPILEPSY; EYELID MYOCLONIA; VIDEO-EEG; GENE AB Idiopathic generalized epilepsies (IGEs) comprise at least 40% of epilepsies in the United States, 20% in Mexico, and 8% in Central America. Here, we review seizure phenotypes across IGE syndromes, their response to treatment and advances in molecular genetics that influence nosology. Our review included the Medline database from 1945 to 2005 and our prospectively collected Genetic Epilepsy Studies (GENESS) Consortium database. Generalized seizures occur with different and similar semiologies, frequencies, and patterns, ages at onset, and outcomes in different IGEs, suggesting common neuroanatomical pathways for seizure phenotypes. However, the same seizure phenotypes respond differently to the same treatments in different IGEs, suggesting different molecular defects across syndromes. De novo mutations in SCN1A in sporadic Dravet syndrome and germline mutations in SCN1A, SCN1B, and SCN2A in generalized epilepsies with febrile seizures plus have unraveled the heterogenous myoclonic epilepsies of infancy and early childhood. Mutations in GABRA1, GABRG2, and GABRB3 are associated with absence seizures, while mutations in CLCN2 and myoclonin/EFHC1 substantiate juvenile myoclonic epilepsy as a clinical entity. Refined understanding of seizure phenotypes, their semiology, frequencies, and patterns together with the identification of molecular lesions in IGEs continue to accelerate the development of molecular epileptology. C1 Univ Calif Los Angeles, David Geffen Sch Med, VA GLAHS Med Ctr, Calif Comprehens Epilepsy Program,Epilepsy Ctr Ex, Los Angeles, CA 90073 USA. Natl Autonomous Univ, Tegucigalpa, Honduras. Univ Calif Los Angeles, David Geffen Sch Med, Genet Epilepsy Studies Int Consortium, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Inst Neuropsychiat, Los Angeles, CA USA. Natl Inst Neurol & Neurosurg, Mexico City, DF, Mexico. Mexico Gen Hosp, Neurol & Neurosurg Unit, Mexico City, DF, Mexico. Autonomous Univ Sonora, Hermosillo, Sonora, Mexico. Univ Hosp La Paz, Madrid, Spain. Inst Neurol Sci, Lima, Peru. RP Delgado-Escueta, AV (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, VA GLAHS Med Ctr, Calif Comprehens Epilepsy Program,Epilepsy Ctr Ex, 11301 Wilshire Blvd,Bldg 500,Suite 3405, Los Angeles, CA 90073 USA. EM escueta@ucla.edu OI Martinez-Juarez, Iris E./0000-0001-6512-5312; Duron, Reyna M./0000-0002-9425-2289 NR 104 TC 29 Z9 30 U1 2 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2005 VL 46 SU 9 BP 34 EP 47 DI 10.1111/j.1528-1167.2005.00312.x PG 14 WC Clinical Neurology SC Neurosciences & Neurology GA 982ZP UT WOS:000233201200006 PM 16302874 ER PT J AU Niquet, J Liu, TT Wasterlain, TG AF Niquet, J Liu, TT Wasterlain, TG TI Programmed neuronal necrosis and status epilepticus SO EPILEPSIA LA English DT Article; Proceedings Paper CT 7th Workshop on Neurobiology of Epilepsy CY OCT 07-11, 2003 CL Ericeira, PORTUGAL DE status epilepticus; programmed necrosis; neuronal loss ID TRANSIENT CEREBRAL-ISCHEMIA; GLOBAL-ISCHEMIA; CELL-DEATH; HIPPOCAMPUS; ACTIVATION; SEIZURES; APOPTOSIS; INDUCTION; SURVIVAL; BRAIN AB We examined the mechanism of neuronal necrosis induced by hypoxia in dentate gyrus cultures or by status epilepticus (SE) in adult mice. Our observations showed that hypoxic necrosis can be an active process starting with early mitochondrial swelling and loss of the mitochondrial membrane potential, followed by cytochrome c release and caspase-9-dependent activation of caspase-3. This sequence of events (or program) was independent of protein synthesis and may be induced by energy failure and/or calcium overloading of mitochondria. We called this form of necrosis "programmed necrosis." After SE in adult mice, CA1 and CA3 pyramidal neurons displayed a necrotic morphology, associated with caspase-3 immuncireactivity and with double-stranded DNA breaks, suggesting that 11 programmed necrosis" may be involved in SE-induced neuronal loss. Key Words: Status epilepticus-Programmed necrosis-Neuronal loss. C1 VA Greater Los Angeles Healthcare Syst, Epilepsy Res Lab, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA USA. RP Niquet, J (reprint author), VA Greater Los Angeles Healthcare Syst, Epilepsy Res Lab, Res 151, Los Angeles, CA 90073 USA. EM jniquet@ucla.edu FU NINDS NIH HHS [NS 13 515] NR 18 TC 16 Z9 16 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2005 VL 46 SU 5 BP 43 EP 48 DI 10.1111/j.1528-1167.2005.01025.x PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 945JP UT WOS:000230499100008 PM 15987252 ER PT J AU Fujikawa, DG Chiueh, GM Allen, SG Shinmei, SS AF Fujikawa, DG Chiueh, GM Allen, SG Shinmei, SS TI Translocation of lysosomal cathepsin B and DNAse II to the nuclei of seizure-induced necrotic neurons SO EPILEPSIA LA English DT Meeting Abstract CT Joint Annual Meeting of the American-Epilepsy-Society/American-Clinical-Neurophsiology-Society CY DEC 02-06, 2005 CL Washington, DC SP Amer Epilepsy Soc, Amer Clin Neurophysiol Soc C1 VA Greater Los Angeles Healthcare Syst, Expt Neurol Lab, North Hills, CA USA. Univ Calif Los Angeles, Geffen Sch Med, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90024 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2005 VL 46 SU 8 BP 102 EP 102 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 973RK UT WOS:000232540100296 ER PT J AU Wallis, RA Panizzon, K AF Wallis, RA Panizzon, K TI 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors provides protection against depolarization injury to CA1 pyramidal neurons in rat hippocampal slices SO EPILEPSIA LA English DT Meeting Abstract CT Joint Annual Meeting of the American-Epilepsy-Society/American-Clinical-Neurophsiology-Society CY DEC 02-06, 2005 CL Washington, DC SP Amer Epilepsy Soc, Amer Clin Neurophysiol Soc C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2005 VL 46 SU 8 BP 128 EP 128 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 973RK UT WOS:000232540100373 ER PT J AU Naylor, DE Wasterlain, CG AF Naylor, DE Wasterlain, CG TI GABA synapses and the rapid loss of inhibition to dentate gyrus granule cells after brief perforant-path stimulation SO EPILEPSIA LA English DT Article; Proceedings Paper CT 7th Workshop on Neurobiology of Epilepsy CY OCT 07-11, 2003 CL Ericeira, PORTUGAL DE epilepsy; status epilepticus; GABA(A) receptors; paired-pulse inhibition; hippocampus ID SUSTAINING STATUS EPILEPTICUS; ACTIVITY-DEPENDENT DISINHIBITION; PAIRED-PULSE INHIBITION; RAT HIPPOCAMPUS; ELECTRICAL-STIMULATION; GABAERGIC INHIBITION; SYNAPTIC INHIBITION; PILOCARPINE MODEL; RECEPTORS; SEIZURES AB Purpose: To study the pharmacologic and synaptic basis for the early loss of paired-pulse inhibition that occurs in the perforant-path stimulation model of status epilepticus. Methods: Hippocampal slices were prepared from mate Wistar rats. Test paired pulses (20- to 50-ms interstimulus interval) of the perforant path were used before and after an abbreviated period of perforant-path stimulation (1-5 min; 2-Hz continuous with 20 Hz of 10 s/min pulses) while either recording field potentials from the dentate gyrus granule cell layer or directly measuring whole-cell patch-clamp currents from granule cells. Paired-pulse field recordings also were obtained during perfusion of the gamma-aminobutyric acid (GABA)A antagonist bicuculline. Results: Prolonged loss of paired-pulse inhibition occurs after brief (< 5 min) perforant-path stimulation in vitro (similar to results in vivo) with the paired-pulse population spike amplitude ratio (P2/P1) increasing from a baseline of 0.53 +/- 0.29 to 1.17 +/- 0.09 after perforant-path stimulation (p < 0.05). After perfusion with the GABA(A) antagonist, bicuculline, the P2/P1 ratio also increased from a baseline of 0.52 +/- 0.16 to 1.15 +/- 0.26 (p < 0.05). After 1-2 min of perforant-path stimulation, a 22 6% (p < 0.05) decrease occurred in the P2/P1 amplitude ratio of paired-pulse evoked inhibitory postsynaptic currents. Conclusions: Similar to in vivo, loss of paired-pulse inhibition occurs with brief perforant-path stimulation in vitro. GABA(A) antagonism causes a similar loss of paired-pulse inhibition, and the effects of perforant-path stimulation on Postsynaptic inhibitory currents also are consistent with the involvement of GABA(A) synaptic receptors. The findings suggest that loss of inhibition at GABA synapses may be an important early event in the initiation of status epilepticus. C1 Univ Calif Los Angeles, Dept Neurol, Vet Adm Greater Los Angeles Healthcare Ctr, Los Angeles, CA 90073 USA. RP Naylor, DE (reprint author), Univ Calif Los Angeles, Dept Neurol, Vet Adm Greater Los Angeles Healthcare Ctr, Los Angeles, CA 90073 USA. EM dnaylor@ucla.edu FU PHS HHS [N13515] NR 34 TC 23 Z9 24 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2005 VL 46 SU 5 BP 142 EP 147 DI 10.1111/j.1528-1167.2005.01022.x PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 945JP UT WOS:000230499100025 PM 15987269 ER PT J AU Gidal, BE Elliott, MB Jones, JC Molina, C AF Gidal, BE Elliott, MB Jones, JC Molina, C TI Treatment of hypovitaminosis D in patients receiving carbamazepine or phenytoin: Biopharmaceutical considerations SO EPILEPSIA LA English DT Meeting Abstract CT Joint Annual Meeting of the American-Epilepsy-Society/American-Clinical-Neurophsiology-Society CY DEC 02-06, 2005 CL Washington, DC SP Amer Epilepsy Soc, Amer Clin Neurophysiol Soc C1 Univ Wisconsin, Sch Pharm, Madison, WI 53706 USA. Univ Wisconsin, Dept Neurol, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Dept Neurol, Madison, WI 53705 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2005 VL 46 SU 8 BP 175 EP 176 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 973RK UT WOS:000232540100517 ER PT J AU Mazarati, AM Lu, X Bartfai, T AF Mazarati, AM Lu, X Bartfai, T TI Serotonergic projection from dorsal raphe into the hippocampus: Role in seizures and regulation by galanin type 1 (GalR1) and type 2 (GalR2) receptors SO EPILEPSIA LA English DT Meeting Abstract CT 26th International Epilepsy Congress CY AUG 28-SEP 01, 2005 CL Paris, FRANCE SP Int League Against Epilepsy, Int Bureau Epilepsy C1 W Los Angeles VA Med Ctr, Los Angeles, CA USA. Scripps Res Inst, La Jolla, CA USA. Univ Calif Los Angeles, D Geffen Sch Med, Los Angeles, CA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2005 VL 46 SU 6 BP 198 EP 198 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 964MN UT WOS:000231885301019 ER PT J AU Liu, HT Mazarati, A Wasterlai, C AF Liu, HT Mazarati, A Wasterlai, C TI Hippocampal circuitry during status epilepticus: Effect of neuropeptide plasticity and NMDA receptor trafficking. SO EPILEPSIA LA English DT Meeting Abstract CT 7th Workshop on the Neurobiology of Epilepsy CY OCT 07-11, 2003 CL Ericeira, PORTUGAL C1 Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Neurol, VA Greater Los Angeles, Hlth Care Syst, Los Angeles, CA 90024 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2005 VL 46 SU 5 BP 205 EP 205 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 945JP UT WOS:000230499100058 ER PT J AU Thompson, K AF Thompson, K TI Transplantation of genetically engineered GABA-producing cells into models of temporal lobe epilepsy. SO EPILEPSIA LA English DT Meeting Abstract CT 7th Workshop on the Neurobiology of Epilepsy CY OCT 07-11, 2003 CL Ericeira, PORTUGAL C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2005 VL 46 SU 5 BP 207 EP 207 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 945JP UT WOS:000230499100064 ER PT J AU Wasterlain, U Suchomelova, L Matagne, A Klitgaard, H Mazarati, A Shinmei, S Baldwin, R AF Wasterlain, U Suchomelova, L Matagne, A Klitgaard, H Mazarati, A Shinmei, S Baldwin, R TI Brivaracetam is a potent anticonvulsant in experimental status epilepticus SO EPILEPSIA LA English DT Meeting Abstract CT Joint Annual Meeting of the American-Epilepsy-Society/American-Clinical-Neurophsiology-Society CY DEC 02-06, 2005 CL Washington, DC SP Amer Epilepsy Soc, Amer Clin Neurophysiol Soc C1 VA Greater Los Angeles Hlth Care Syst, Epilepsy Res Lab, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. UCB Bioprod SA, Preclin CNS Res, Pharma Sector, Braine Lalleud, Belgium. NR 0 TC 9 Z9 9 U1 1 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2005 VL 46 SU 8 BP 219 EP 220 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 973RK UT WOS:000232540101031 ER PT J AU Mazarati, A Sankar, R AF Mazarati, A Sankar, R TI Role of hippocampal serotonergic transmission in anticonvulsant effects of electroconvulsive treatment SO EPILEPSIA LA English DT Meeting Abstract CT Joint Annual Meeting of the American-Epilepsy-Society/American-Clinical-Neurophsiology-Society CY DEC 02-06, 2005 CL Washington, DC SP Amer Epilepsy Soc, Amer Clin Neurophysiol Soc C1 W Los Angeles VA Med Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, D Geffen Sch Med, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2005 VL 46 SU 8 BP 224 EP 224 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 973RK UT WOS:000232540101042 ER PT J AU Cannon, JP Lee, TA Bolanos, JT Danziger, LH AF Cannon, JP Lee, TA Bolanos, JT Danziger, LH TI Pathogenic relevance of Lactobacillus: a retrospective review of over 200 cases SO EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES LA English DT Review ID VANCOMYCIN-RESISTANT LACTOBACILLI; LACTIC-ACID BACTERIA; INFECTIVE ENDOCARDITIS; ANTIMICROBIAL SUSCEPTIBILITY; ANTIBIOTIC SUSCEPTIBILITY; PLANTARUM ENDOCARDITIS; TRANSPLANT RECIPIENT; RHAMNOSUS SEPTICEMIA; NEUTROPENIC PATIENTS; TORULOPSIS-GLABRATA AB Given that Lactobacillus has been reported to be the causative pathogen in many types of infection despite debate regarding the organism's clinical significance, a literature review was conducted to investigate the treatments and outcomes of Lactobacillus infections reported to date. In this article, the characteristics of over 200 reported cases of Lactobacillus-associated infections are summarized. Lactobacillus was found to be frequently associated with endocarditis and bacteremia. Lactobacillus was also associated with a variety of other infections including, but not limited to, peritonitis, abscesses, and meningitis. The species casei and rhamnosus were the most common. The isolates tended to be most sensitive to erythromycin and clindamycin and most resistant to vancomycin. The species that was most sensitive to vancomycin was acidophilus. The overall mortality rate was nearly 30%. There was a significant association between mortality and polymicrobial infection (P=0.004). In the subset of patients with bacteremia, increased mortality was associated with inadequate treatment (P=0.001) and polymicrobial bacteremia (P=0.044). C1 Univ Illinois, Coll Pharm, Dept Pharm Practice, Chicago, IL 60611 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Serv Pharm, Hines, IL 60141 USA. Northwestern Univ, Feinberg Sch Med, Dept Med, Div Gen Internal Med,Ctr Healthcare Studies, Chicago, IL 60611 USA. Univ Illinois, Coll Pharm, Ctr Pharmacoecon Res, Chicago, IL 60612 USA. Univ Illinois, Dept Med, Infect Dis Sect, Chicago, IL 60612 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Midw Ctr Hlth Serv & Policy Res, Hines, IL 60141 USA. RP Danziger, LH (reprint author), Univ Illinois, Coll Pharm, Dept Pharm Practice, 833 S Wood St,Mail Code 886, Chicago, IL 60611 USA. EM danziger@uic.edu NR 113 TC 151 Z9 164 U1 4 U2 16 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0934-9723 J9 EUR J CLIN MICROBIOL JI Eur. J. Clin. Microbiol. Infect. Dis. PD JAN PY 2005 VL 24 IS 1 BP 31 EP 40 DI 10.1007/s10096-004-1253-y PG 10 WC Infectious Diseases; Microbiology SC Infectious Diseases; Microbiology GA 889RD UT WOS:000226459200006 PM 15599646 ER PT J AU Rahman, I AF Rahman, I TI Redox regulation of chromatin modeling in response to cigarette smoke: Impact on pro-inflammatory gene transcription SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Meeting Abstract CT 12th Annual Meeting Society-for-Free-Radical-Biology-and-Medicine CY NOV 16-20, 2005 CL Austin, TX SP Soc Free Rad Biol & Med C1 Univ Colorado, Denver VAMC, Denver, CO 80202 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 0891-5849 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PY 2005 VL 39 SU 1 BP S2 EP S2 PG 1 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 985VL UT WOS:000233406700002 ER PT S AU Gleason, CE Carlsson, CM Johnson, S Atwood, C Asthana, S AF Gleason, CE Carlsson, CM Johnson, S Atwood, C Asthana, S BE Singh, M Simpkins, JW TI Clinical pharmacology and differential cognitive efficacy of estrogen preparations SO FUTURE OF HORMONE THERAPY: WHAT BASIC SCIENCE AND CLINICAL STUDIES TEACH US SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on the Future of Estrogen and Hormone Therapy Postmenopausal Women CY NOV 05-07, 2004 CL Ft Worth, TX SP Univ N Texas Hlth Sci Ctr DE estrogens; conjugated equine estrogen; 17 beta-estradiol; Alzheimer's disease; cognition; memory ID HORMONE REPLACEMENT THERAPY; RANDOMIZED CONTROLLED-TRIAL; HEALTHY POSTMENOPAUSAL WOMEN; CONJUGATED EQUINE ESTROGENS; SURGICALLY MENOPAUSAL WOMEN; CORONARY-HEART-DISEASE; BRAIN METABOLIC-CHANGE; BETA-AMYLOID TOXICITY; TRANSDERMAL ESTRADIOL; RECEPTOR MODULATORS AB Menopause is associated with a significant decline in levels of estrogen, which reportedly leads to several distressing symptoms and adverse health effects on various target tissues including those on bones, heart, and brain. Although effective, the long-term safety and feasibility of therapy with both unopposed and opposed oral conjugated equine estrogen has been questioned by the recent findings of both the Women's Health Initiative (WHI) and the Women's Health Initiative Memory Study (WHIMS). The findings of both these studies have raised several critical issues related to hormone therapy that need to be systematically evaluated in clinical studies. Specifically, these issues relate to the differential efficacy and adverse-effects profile of various forms of estrogen and progestins, the importance of the route of administration of estrogen, the best timing to initiate postmenopausal hormone therapy, and the efficacy of cyclic versus continuous hormone therapy. This article focuses on estrogen and discusses issues related to selecting the best form and route of administration of the hormone. It includes information on basic clinical pharmacology of various forms of estrogen, neuroendocrinology of the menopause, neurobiology of estradiol and estrone, and results of selected basic science and human intervention studies with relevance to identifying the best form and route of administration of estrogen. C1 William S Middleton Mem Vet Adm Med Ctr, GRECC 11G, Madison, WI 53705 USA. Univ Wisconsin, Sch Med, Sect Geriatr & Gerontol, Dept Med, Madison, WI 53706 USA. RP Gleason, CE (reprint author), William S Middleton Mem Vet Adm Med Ctr, GRECC 11G, 2500 Overlook Terrace, Madison, WI 53705 USA. EM ceg@medicine.wisc.edu NR 112 TC 33 Z9 33 U1 1 U2 3 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-584-2 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2005 VL 1052 BP 93 EP 115 DI 10.1196/annals.1347.007 PG 23 WC Endocrinology & Metabolism; Multidisciplinary Sciences; Obstetrics & Gynecology SC Endocrinology & Metabolism; Science & Technology - Other Topics; Obstetrics & Gynecology GA BDE44 UT WOS:000233076700007 PM 16024754 ER PT S AU Webber, KM Casadesus, G Marlatt, MW Perry, G Hamlin, CR Atwood, CS Bowen, RL Smith, MA AF Webber, KM Casadesus, G Marlatt, MW Perry, G Hamlin, CR Atwood, CS Bowen, RL Smith, MA BE Singh, M Simpkins, JW TI Estrogen bows to a new master: The role of gonadotropins in Alzheimer pathogenesis SO FUTURE OF HORMONE THERAPY: WHAT BASIC SCIENCE AND CLINICAL STUDIES TEACH US SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on the Future of Estrogen and Hormone Therapy Postmenopausal Women CY NOV 05-07, 2004 CL Ft Worth, TX SP Univ N Texas Hlth Sci Ctr DE Alzheimer disease; andropause; estrogen; gonadotropins; luprolide acetate; luteinizing hormone; menopause ID RANDOMIZED CONTROLLED-TRIAL; HEALTH INITIATIVE MEMORY; LUTEINIZING-HORMONE; POSTMENOPAUSAL WOMEN; REPLACEMENT THERAPY; PLUS PROGESTIN; DISEASE; DEMENTIA; RISK; PREVALENCE AB Epidemiological data showing a predisposition of women to develop Alzheimer disease (AD) led many researchers to investigate the role of sex steroids, namely estrogen, in disease pathogenesis. Although there is circumstantial support for the role of estrogen, the unexpected results of the Women's Health Initiative (WHI) Memory Study, which reported an increase in the risk for probable dementia and impaired cognitive performance in postmenopausal women treated with a combination of estrogen and progestin, have raised serious questions regarding the protective effects of estrogen. Although explanations for these surprising results vary greatly, the WHI Memory Study cannot be correctly interpreted without a complete investigation of the effects of the other hormones of the hypothalamic-pituitary-gonadal (HPG) axis on the aging brain. Certain hormones of the HPG axis, namely, the gonadotropins (luteinizing hormone and follicle-stimulating hormone), are not only involved in regulating reproductive function via a complex feedback loop but are also known to cross the blood-brain barrier. We propose that the increase in gonadotropin concentrations, and not the decrease in steroid hormone (e.g., estrogen) production following menopause/andropause, is a potentially primary causative factor for the development of AD. In this review, we examine how the gonadotropins may play a central and determining role in modulating the susceptibility to, and progression of, AD. On this basis, we suggest that the results of the WHI Memory Study are not only predictable but also avoidable by therapeutically targeting the gonadotropins instead of the sex steroids. C1 Case Western Reserve Univ, Inst Pathol, Cleveland, OH 44106 USA. Univ Wisconsin, Sch Med, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53706 USA. Voyager Pharmaceut Corp, Raleigh, NC 27615 USA. RP Smith, MA (reprint author), Case Western Reserve Univ, Inst Pathol, 2085 Adelbert Rd, Cleveland, OH 44106 USA. EM mark.smith@case.edu RI Smith, Mark/A-9053-2009; Perry, George/A-8611-2009 OI Perry, George/0000-0002-6547-0172 NR 39 TC 25 Z9 26 U1 1 U2 2 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-584-2 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2005 VL 1052 BP 201 EP 209 DI 10.1196/annals.1347.020 PG 9 WC Endocrinology & Metabolism; Multidisciplinary Sciences; Obstetrics & Gynecology SC Endocrinology & Metabolism; Science & Technology - Other Topics; Obstetrics & Gynecology GA BDE44 UT WOS:000233076700014 PM 16024763 ER PT J AU Dominitz, JA Boyko, EJ Koepsell, TD Heagerty, PJ Maynard, C Sporleder, JL AF Dominitz, JA Boyko, EJ Koepsell, TD Heagerty, PJ Maynard, C Sporleder, JL CA VA Cooperative Study Grp 488 TI Elevated prevalence of hepatitis C infection in users of United States Veterans medical centers SO HEPATOLOGY LA English DT Article ID NON-B-HEPATITIS; VIRUS-INFECTION; NON-A; MULTIPLE IMPUTATION; VIRAL-HEPATITIS; RISK-FACTORS; EPIDEMIOLOGY; POPULATION AB Several studies suggest veterans have a higher prevalence of hepatitis C virus infection than nonveterans, possibly because of military exposures. The purpose of this study was to estimate the prevalence of anti-hepatitis C antibody and evaluate factors associated with infection among users of Department of Veterans Affairs medical centers. Using a two-staged cluster sample, 1,288 of 3,863 randomly selected veterans completed a survey and underwent home-based phlebotomy for serological testing. Administrative and clinical data were used to correct the prevalence estimate for nonparticipation. The prevalence of anti-hepatitis C antibody among serology participants was 4.0% (95% CI, 2.6%-5.5%). The estimated prevalence in the population of Veterans Affairs medical center users was 5.4% (95% CI, 3.3%-7.5%) after correction for sociodemographic and clinical differences between participants and nonparticipants. Significant predictors of seropositivity included demographic factors, period of military service (e.g., Vietnam era), prior diagnoses, health care use, and lifestyle factors. At least one traditional risk factor (transfusion or intravenous drug use) was reported by 30.2% of all subjects. Among those testing positive for hepatitis C antibody, 78% either had a transfusion or had used injection drugs. Adjusting for injection drug use and nonparticipation, seropositivity was associated with tattoos and incarceration. Military-related exposures were not found to be associated with infection in the adjusted analysis. In conclusion, the prevalence of hepatitis C in these subjects exceeds the estimate from the general US population by more than 2-fold, likely reflecting more exposure to traditional risk factors among these veterans. C1 VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, NW Hepatitis C Resource Ctr, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth, Dept Hlth Serv, Seattle, WA 98195 USA. RP Dominitz, JA (reprint author), VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, S-111 Gastro,1660 S Columbian Way, Seattle, WA 98108 USA. EM jason.dominitz@med.va.gov RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814; Dominitz, Jason/0000-0002-8070-7086; Boyko, Edward/0000-0002-3695-192X NR 31 TC 137 Z9 137 U1 0 U2 2 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD JAN PY 2005 VL 41 IS 1 BP 88 EP 96 DI 10.1002/hep.20502 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 886RC UT WOS:000226245000014 PM 15619249 ER PT J AU Hirsh, D Heinrichs, C Leenders, B Wong, ACK Cummings, DE Chanoine, JP AF Hirsh, D Heinrichs, C Leenders, B Wong, ACK Cummings, DE Chanoine, JP TI Ghrelin is suppressed by glucagon and does not mediate glucagon-related growth hormone release SO HORMONE RESEARCH LA English DT Article DE ghrelin; glucagon; growth hormone; glucose; insulin ID INSULIN-INDUCED HYPOGLYCEMIA; GH-DEFICIENT CHILDREN; CIRCULATING GHRELIN; STIMULATION TESTS; ACYLATED PEPTIDE; ENERGY-BALANCE; FOOD-INTAKE; SECRETION; STOMACH; GLUCOSE AB Background: Glucagon stimulation is routinely used as a provocative test to assess growth hormone (GH) sufficiency in pediatrics. Ghrelin also markedly stimulates GH secretion. Because glucagon stimulates the promoter of the ghrelin gene in vitro as well as ghrelin secretion by the perfused rat stomach, we sought to determine whether ghrelin mediates glucagon-induced GH secretion. Methods: We compared ghrelin, GH, insulin and glucose responses following administration of 0.03 mg/kg intravenously (iv; max. 1 mg) and 0.1 mg/kg intramuscularly (im; max. 2 mg) of glucagon in two groups (n = 10-11/group) of GH-sufficient children. We also measured ghrelin before and 6 min after iv administration of 1 mg glucagon in 21 adult subjects. Results: In children, glucagon caused a 26% decrease in ghrelin and a 72% increase in glucose concentrations that were independent of the dose or administration route of glucagon. In contrast, the insulin response was 2-3 times higher following administration of 0.1 mg/kg im compared to 0.03 mg/kg of glucagon iv. There was a significant correlation between the maximum decrease in ghrelin and increases in glucose (p = 0.03) but not in insulin. There was a significant correlation between ghrelin and GH area under the curve after controlling for the dose of glucagon ( p = 0.03) but not for the maximum increase in glucose. In normal adults, glucagon administration caused a 7% decrease in ghrelin concentrations after 6 min ( p = 0.0002). Conclusion: Ghrelin does not play a causal role in the GH response to pharmacological glucagon administration, which suppresses ghrelin levels starting a few minutes after injection. Copyright (C) 2005 S. Karger AG, Basel. C1 Univ British Columbia, British Columbia Childrens Hosp, Endocrinol & Diabet Unit, Vancouver, BC V6H 3V4, Canada. Free Univ Brussels, Hop Enfants Reine Fabiola, Unite Endocrinol Pediat, Brussels, Belgium. Univ Washington, VA Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. RP Chanoine, JP (reprint author), Univ British Columbia, British Columbia Childrens Hosp, Endocrinol & Diabet Unit, Room K4-212,4480 Oak St, Vancouver, BC V6H 3V4, Canada. EM jchanoine@cw.bc.ca FU NIDDK NIH HHS [R01 DK61516] NR 51 TC 16 Z9 16 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0301-0163 J9 HORM RES JI Horm. Res. PY 2005 VL 63 IS 3 BP 111 EP 118 DI 10.1159/000084569 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 922ON UT WOS:000228847400002 PM 15775713 ER PT J AU Oshima, M Deitiker, PR Mosier, DR Smith, RG Atassi, MZ AF Oshima, M Deitiker, PR Mosier, DR Smith, RG Atassi, MZ TI Responses in vitro of peripheral blood lymphocytes from patients with myasthenia gravis to stimulation with human acetylcholine receptor ot-chain peptides: Analysis in relation to age, thymic abnormality, and ethnicity SO HUMAN IMMUNOLOGY LA English DT Article DE acetylcholine receptor; autoimmunity; myasthenia gravis; T cell ID T-CELL RECOGNITION; ALPHA-SUBUNIT; EXTRACELLULAR PART; SYNTHETIC PEPTIDES; ANTIGENIC SITES; ANTIBODY; EPITOPES; CLONES; LINES; REPERTOIRE AB Peripheral blood lymphocytes (PBLs) were isolated from 24 patients with myasthenia gravis of three ethnic groups (Caucasian, African American, and Hispanic) and ten healthy individuals. We determined the in vitro proliferative responses of the PBL samples to each of 18 overlapping synthetic peptides corresponding to the entire main extracellular domain (residues 1-210) of the a-subunit of human acetylcholine receptor. The profiles of the T-cell responses (expressed in stimulation index [SI]) to the peptides varied among the 24 patient samples. There was a significant difference in the overall patient responses relative to controls toward 17 of 18 peptides. T cells from the patients gave responses greater than control mean SI + 4 standard deviation (Z(SI) > 4) to 2similar to9 peptides/sample. Six peptides, alpha23-38, alpha34-49, alpha78-93, alpha122-138, alpha146-162, and alpha182-198, were recognized with Z > 4 level by 42% to 58% of the patients' PBLs. The grouped patient responses, divided according to age, thymic diagnosis, or ethnicity, were compared with controls and with each other. Significant differences were observed between early- and late-onset cases in recognition of residues alpha34-49 (p = 0.015) and alpha78-93 (p = 0.053), and in recognition of residues alpha12-27, alpha56-71, alpha134-150, and alpha146-162 (0.0072 < p < 0.064) when two ethnic groups were compared with each other. Human Immunology 66, 32-42 (2005). (C) American Society for Histocompatibility and Immunogenetics, 2005. Published by Elsevier Inc. C1 Baylor Coll Med, Dept Biochem & Mol Biol, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. ME DeBakey VA Med Ctr, Neurol & Med Res Serv, Houston, TX USA. Univ Texas, Med Branch, Dept Neurol, Galveston, TX USA. RP Oshima, M (reprint author), Baylor Coll Med, Dept Biochem & Mol Biol, 1 Baylor Plaza, Houston, TX 77030 USA. NR 37 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 0198-8859 J9 HUM IMMUNOL JI Hum. Immunol. PD JAN PY 2005 VL 66 IS 1 BP 32 EP 42 DI 10.1016/j.humimm.2004.09.015 PG 11 WC Immunology SC Immunology GA 894WG UT WOS:000226821700005 PM 15620460 ER PT J AU Matsunaga, J Sanchez, Y Xu, XY Haake, DA AF Matsunaga, J Sanchez, Y Xu, XY Haake, DA TI Osmolarity, a key environmental signal controlling expression of leptospiral proteins LigA and LigB and the extracellular release of LigA SO INFECTION AND IMMUNITY LA English DT Article ID OUTER-MEMBRANE; ESCHERICHIA-COLI; MOLECULAR CHARACTERIZATION; FILAMENTOUS HEMAGGLUTININ; BORDETELLA-PERTUSSIS; LOG-PHASE; INTERROGANS; GROWTH; SECRETION; DETERMINANTS AB The high-molecular-weight leptospiral immunoglobulin-like repeat (Lig) proteins are expressed only by virulent low-passage forms of pathogenic Leptospira species. We examined the effects of growth phase and environmental signals on the expression, surface exposure, and extracellular release of LigA and LigB. LigA was lost from stationary-phase cells, while LigB expression was maintained. The loss of cell-associated LigA correlated with selective release of a lower-molecular-weight form of LigA into the culture supernatant, while LigB and the outer membrane lipoprotein LipL41 remained associated with cells. Addition of tissue culture medium to leptospiral culture medium induced LigA and LigB expression and caused a substantial increase in released LigA. The sodium chloride component of tissue culture medium was primarily responsible for the enhanced release of LigA. Addition of sodium chloride, potassium chloride, or sodium sulfate to leptospiral medium to physiological osmolarity caused the induction of both cell-associated LigA and LigB, indicating that osmolarity regulates the expression of Lig proteins. Osmotic induction of Lig expression also resulted in enhanced release of LigA and increased surface exposure of LigB, as determined by surface immunofluorescence. Osmolarity appears to be a key environmental signal that controls the expression of LigA and LigB. C1 VA Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA USA. RP Matsunaga, J (reprint author), VA Greater Los Angeles Healthcare Syst, Div Infect Dis, B113-R225, Los Angeles, CA 90073 USA. EM jamesm@ucla.edu FU NIAID NIH HHS [AI-34431, R01 AI034431, R01 AI034431-08, R21 AI034431, R29 AI034431] NR 35 TC 62 Z9 62 U1 0 U2 0 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 JAN PY 2005 VL 73 IS 1 BP 70 EP 78 DI 10.1128/IAI.73.1.70-78.2005 PG 9 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 883TD UT WOS:000226037700006 PM 15618142 ER PT J AU Viray, M Linkin, D Maslow, JN Stieritz, DD Carson, LS Bilker, WB Lautenbach, E AF Viray, M Linkin, D Maslow, JN Stieritz, DD Carson, LS Bilker, WB Lautenbach, E TI Longitudinal trends in antimicrobial susceptibilities across long-term-care facilities: Emergence of fluoroquinolone resistance SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID SKILLED NURSING FACILITY; ESCHERICHIA-COLI; STAPHYLOCOCCUS-AUREUS; KLEBSIELLA-PNEUMONIAE; RISK-FACTORS; HOME RESIDENTS; INFECTION; COLONIZATION; BACTERIA; UNIT AB BACKGROUND Antibiotic resistance in the longterm-care facility (LTCF) setting is of increasing concern due to both the increased morbidity and mortality related to infections in this debilitated population and the potential for transfer of resistant organisms to other healthcare settings. Longitudinal trends in antibiotic resistance in LTCFs have not been well described. DESIGN: Correlational longitudinal survey study. SETTING: Four LTCFs in Pennsylvania. SUBJECTS: All clinical cultures of residents of the participating LTCFs (700 total beds) from 1998 through 2003. We assessed the annual prevalence of resistance to various antimicrobials of interest for the following organisms: Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus aureus, and enterococcus species. RESULTS: A total of 4,954 clinical isolates were obtained during the study. A high prevalence of antimicrobial resistance was noted for many organism-drug combinations. This was especially true for fluoroquinolone susceptibility among the Enterobacteriaceae (susceptibility range, 51.3% to 92.2%). In addition, the prevalence of resistance to various agents differed significantly across study sites. Finally, significant increasing trends in resistance were noted over time and were most pronounced for fluoroquinolone susceptibility among the Enterobacteriaceae. CONCLUSIONS: The prevalence of antimicrobial resistance has increased significantly in LTCFs, although trends have varied substantially across different institutions. These trends have been particularly pronounced for fluoroquinolone resistance among the Enterobacteriaceae. These findings demonstrate that antimicrobial resistance is widespread and increasing in LTCFs, highlighting the need for future studies to more clearly elucidate the risk factors for, and potential interventions against, emerging resistance in these settings. C1 Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Div Infect Dis, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Div Geriatr, Dept Med, Philadelphia, PA 19104 USA. RP Lautenbach, E (reprint author), Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, 825 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM elautenb@cceb.med.upenn.edu FU AHRQ HHS [U18-HS10399]; NIDDK NIH HHS [DK-02987-01] NR 35 TC 48 Z9 48 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD JAN PY 2005 VL 26 IS 1 BP 56 EP 62 DI 10.1086/502487 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 888JH UT WOS:000226369700008 PM 15693409 ER PT J AU Bernal, SD AF Bernal, Samuel D. TI Biotherapy of Breast Cancer SO INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS LA English DT Meeting Abstract C1 [Bernal, Samuel D.] Univ Calif Los Angeles, VA Greater Los Angeles Hlth Syst, Los Angeles, CA USA. [Bernal, Samuel D.] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0924-8579 J9 INT J ANTIMICROB AG JI Int. J. Antimicrob. Agents PY 2005 VL 26 SU 1 BP S34 EP S34 PG 1 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA V79JE UT WOS:000205364200084 ER PT J AU Bernal, SD AF Bernal, Samuel D. TI Biotherapy of breast cancer SO INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS LA English DT Meeting Abstract C1 [Bernal, Samuel D.] Univ Calif Los Angeles, Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. [Bernal, Samuel D.] Univ Calif Los Angeles, VA Greater Los Angeles Hlth Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0924-8579 J9 INT J ANTIMICROB AG JI Int. J. Antimicrob. Agents PY 2005 VL 26 SU 1 BP S34 EP S34 PG 1 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA V54FN UT WOS:000203664700083 ER PT J AU Bernal, SD AF Bernal, Samuel D. TI Lung Cancer Differentiation and Targeted Therapies SO INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS LA English DT Meeting Abstract C1 [Bernal, Samuel D.] Univ Calif Los Angeles, VA Greater Angeles Hlth Syst, Los Angeles, CA USA. [Bernal, Samuel D.] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0924-8579 J9 INT J ANTIMICROB AG JI Int. J. Antimicrob. Agents PY 2005 VL 26 SU 1 BP S47 EP S47 PG 1 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA V79JE UT WOS:000205364200126 ER PT J AU Skrabski, A Kopp, M Rozsa, S Rethelyi, J Rahe, RH AF Skrabski, A Kopp, M Rozsa, S Rethelyi, J Rahe, RH TI Life meaning: An important correlate of health in the Hungarian population SO INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE LA English DT Article DE life meaning; premature oncological mortality; premature cardiovascular mortality; self-rated health; well-being; depression; self-efficacy; spirituality; religion; ways of coping; social support ID SELF-RATED HEALTH; CORONARY-ARTERY-DISEASE; CROSS-SECTIONAL ASSOCIATIONS; MALE MORTALITY-RATES; MIDDLE-AGED FEMALE; CHANGING SOCIETY; HEART-DISEASE; CARDIOVASCULAR-DISEASE; GENERAL-POPULATION; COPING INVENTORY AB One of the 5 coping scales in Rahe's Brief Stress and Coping Inventory, entitled Life Meaning, was examined in relation to demographic characteristics, other coping measures, and health status in a sample of 12,640 Hungarian participants, Participants were selected to represent the country's population according to sex, age, and place of residence. The study also explored the contribution of life meaning to the, explanation of variations of middle-aged (45-64 years) male and female mortality rates across 150 subregions in Hungary. On an ecological level life meaning proved to be inversely related to male and female oncological, female cardiovascular and total premature mortality rates in the 150 subregions of Hungary and on an individual level to participants' reported health status. In the total sample of individuals after controlling for gender age, and education, life meaning scores showed strong correlations with the World Health Organization well-being scale, with self-rated absence of depression, with self-rated health, and with self-rated absence of disability. Although relatively unrelated to age, gender, and education, life meaning was positively related to self-efficacy, importance of religion, problem-oriented coping, and social support. C1 Semmelweis Univ, Inst Behav Sci, H-1089 Budapest, Hungary. Eotvos Lorand Univ, Inst Psychol, Budapest, Hungary. Vet Affairs Puget Sound Hlth Care Syst, Amer Lake Div, Tacoma, WA USA. RP Kopp, M (reprint author), Semmelweis Univ, Inst Behav Sci, H-1089 Budapest, Hungary. EM kopmar@net.sote.hu OI Rethelyi, Janos/0000-0002-3641-012X NR 52 TC 38 Z9 40 U1 1 U2 5 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1070-5503 J9 INT J BEHAV MED JI Int. J. Behav. Med. PY 2005 VL 12 IS 2 BP 78 EP 85 DI 10.1207/s15327558ijbm1202_5 PG 8 WC Psychology, Clinical SC Psychology GA 933BE UT WOS:000229598100005 PM 15901216 ER PT J AU Haidet, P O'Malley, KJ Sharf, BF Gladney, AP Tran, AN Greisinger, AJ Ashton, CM Street, RL AF Haidet, P O'Malley, KJ Sharf, BF Gladney, AP Tran, AN Greisinger, AJ Ashton, CM Street, RL TI Associations between the impact of terrorism and health perceptions of patients SO INTERNATIONAL JOURNAL OF PSYCHIATRY IN MEDICINE LA English DT Article; Proceedings Paper CT 25th Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 01-05, 2002 CL ATLANTA, GA SP Soc Gen Internal Med DE terrorism; chronic disease; health status; internal-external control; physician-patient relations; primary health care; patient-centered care; health behavior ID ILLNESS; SCALES AB Objective: Previous studies have demonstrated the effects of the September 11th 2001 terrorist attacks on anxiety and anxiety-related conditions in Americans. However, data regarding associations between the attacks and patients' health perceptions are lacking. The objective of this study was to explore associations between the personal impact of the September 11th attacks and patients' perceptions of health and illness. Method: We performed a cross-sectional survey of 303 adult African-American, Caucasian, and Hispanic patients at primary care clinics in Houston, Texas. Data were collected between October 15, 2001 and March 11 2002. We developed items to measure the impact of the September 11th attacks and patients' quality of life. Previously validated scales were used to measure health status, health locus of control, preferences regarding the patient-physician relationship, and patients' explanatory models of illness. Results: Twenty-two percent of patients reported no impact from the attacks, 41% reported mildly negative impact, 22% reported moderately negative impact, and 15% reported extremely negative impact in their lives. In multivariate analysis, demographic characteristics were not associated with impact from the attacks. However, patients who perceived a more external locus of control with respect to health and patients who reported greater meaning of illness in their lives also reported more negative impact from the September 11th attacks. Conclusions: The September 11th terrorist attacks had at least a somewhat negative impact for a majority of patients far from the site of the nearest attack, and regardless of their demographic backgrounds. The amount of negative impact that patients perceived as a result of the terrorist attacks correlates with certain illness perceptions, including an external health locus of control and a perception of greater meaning of illness in one's life. Such correlations may indicate an effect of terrorism on patients' illness behaviors. Further research is needed to better understand effects of the threat of terror-ism on the general health and illness behaviors of patients. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Texas A&M Univ, College Stn, TX USA. Kelsey Res Fdn, Houston, TX USA. Kelsey Seybold Clin, Houston, TX USA. RP Haidet, P (reprint author), 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM phaidet@bcm.tmc.edu FU AHRQ HHS [P01 HS10876] NR 16 TC 0 Z9 0 U1 5 U2 7 PU BAYWOOD PUBL CO INC PI AMITYVILLE PA 26 AUSTIN AVE, PO BOX 337, AMITYVILLE, NY 11701 USA SN 0091-2174 J9 INT J PSYCHIAT MED JI Int. J. Psychiatr. Med. PY 2005 VL 35 IS 3 BP 249 EP 258 DI 10.2190/DW00-WCKK-8B37-BJA6 PG 10 WC Psychiatry SC Psychiatry GA 002OS UT WOS:000234621400004 PM 16480240 ER PT J AU Schwartz, DL Ford, E Rajendran, J Yueh, B Coltrera, MD Virgin, J Anzai, Y Haynor, D Lewellyn, B Mattes, D Meyer, J Phillips, M Leblanc, M Kinahan, P Krohn, K Eary, J Laramore, GE AF Schwartz, DL Ford, E Rajendran, J Yueh, B Coltrera, MD Virgin, J Anzai, Y Haynor, D Lewellyn, B Mattes, D Meyer, J Phillips, M Leblanc, M Kinahan, P Krohn, K Eary, J Laramore, GE TI FDG-PET/CT imaging for preradiotherapy staging of head-and-neck squamous cell carcinoma SO INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS LA English DT Article; Proceedings Paper CT 45th Annual Meeting of the American-Society-for-Therapeutic-Radiology-and-Oncology CY OCT 19-23, 2003 CL Salt Lake City, UT SP Amer Soc Therapeut Radiol & Oncol DE head-and-neck cancer; positron emission tomography; multimodality imaging; image-guided radiotherapy; cancer staging ID POSITRON-EMISSION-TOMOGRAPHY; LYMPH-NODE METASTASES; LOCALLY ADVANCED HEAD; RADIATION-THERAPY; COMPUTED-TOMOGRAPHY; LUNG-CANCER; NASOPHARYNGEAL CARCINOMAS; EXTRACRANIAL HEAD; RANDOMIZED-TRIAL; RADIOTHERAPY AB Purpose: Image localization of head-and-neck squamous cell carcinoma lags behind current techniques to deliver a precise radiation dose with intensity-modulated radiotherapy. This pilot study prospectively examined the use of registered 18-F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT for preradiotherapy staging of the neck. Methods and Materials: Sixty-three patients with squamous cell carcinoma of the oral cavity, oropharynx, larynx, or hypopharynx were enrolled into an institutional FDG-PET imaging protocol between September 2000 and June 2003. Of these patients, 20 went on to immediate neck dissection surgery and were studied further. Of these 20, 17 (85%) had American Joint Committee on Cancer Stage III or IV disease. All patients underwent preoperative FDG-PET and contrast-enhanced CT of the head and neck. FDG-PET/CT images were created using a nonrigid image registration algorithm developed at the University of Washington. Alternate primary and nodal gross tumor volumes were contoured with radiotherapy treatment planning software, blinded to each other and to the pathology results. One set of volumes was designed with CT guidance alone and the other with the corresponding FDG-PET/CT images. Neck dissection specimens were subdivided into surgical nodal levels intraoperatively, and the histopathologic findings were correlated with the CT and FDG-PET/CT nodal level findings. Results: FDG-PET/CT detected 17 of 17 heminecks and 26 of 27 nodal zones histologically positive by dissection (100% and 96% sensitivity, respectively). The nodal level staging sensitivity and specificity for FDG-PET/CT was 96% (26 of 27) and 98.5% (68 of 69), respectively. FDG-PET/CT correctly detected nodal disease in 2 patients considered to have node-negative disease by CT alone. Agreement between the imaging results and pathology findings was stronger for FDG-PET/CT (kappa 0.95, 95% confidence interval 0.82-0.99) than for CT alone (kappa 0.81, 95% confidence interval 0.63-0.91; p = 0.06 by two-sided McNemar's testing). Conclusion: These early findings suggest that FDG-PET/CT is superior to CT alone for geographic localization of diseased neck node levels. Confirmatory trials to substantiate the accuracy of FDG-PET/CT neck staging should be prioritized. (C) 2005 Elsevier Inc. C1 Univ Washington, Sch Med, Dept Radiat Oncol 174, Seattle, WA 98108 USA. Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Div Nucl Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Radiat Oncol, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Surg & Perioperat Care, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Hlth Sci Res & Dev, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Pathol, Seattle, WA USA. RP Schwartz, DL (reprint author), Univ Washington, Sch Med, Dept Radiat Oncol 174, 1660 S Columbian Way, Seattle, WA 98108 USA. EM docdls@u.washington.edu OI Yueh, Bevan/0000-0003-1380-1053; Meyer, Juergen/0000-0003-4350-2222; Kinahan, Paul/0000-0001-6461-3306 FU NCI NIH HHS [CA42045] NR 55 TC 122 Z9 138 U1 0 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0360-3016 J9 INT J RADIAT ONCOL JI Int. J. Radiat. Oncol. Biol. Phys. PD JAN 1 PY 2005 VL 61 IS 1 BP 129 EP 136 DI 10.1016/j.ijrobp.2004.03.040 PG 8 WC Oncology; Radiology, Nuclear Medicine & Medical Imaging SC Oncology; Radiology, Nuclear Medicine & Medical Imaging GA 886LV UT WOS:000226229700020 PM 15629603 ER PT J AU Craft, S Watson, GS Baker, L Cholerton, B Reger, M Plymate, S Fishel, M Kahn, S AF Craft, S Watson, GS Baker, L Cholerton, B Reger, M Plymate, S Fishel, M Kahn, S TI Treatment with the insulin-sensitizing PPAR-? agonist rosiglitazone preserves cognition and modulates plasma a-amyloid in patients with AD and amnestic MCI SO INTERNATIONAL PSYCHOGERIATRICS LA English DT Meeting Abstract C1 Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Sch Med, VA Puget Sound, Dept Psychiat Geriatr Res, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4211 USA SN 1041-6102 J9 INT PSYCHOGERIATR JI Int. Psychogeriatr. PY 2005 VL 17 SU 2 BP 104 EP 104 PG 1 WC Psychology, Clinical; Geriatrics & Gerontology; Gerontology; Psychiatry; Psychology SC Psychology; Geriatrics & Gerontology; Psychiatry GA 984RQ UT WOS:000233322400196 ER PT J AU Streim, J Barg, F Tomcho, T Kinosian, B AF Streim, J Barg, F Tomcho, T Kinosian, B TI Factors affecting glycemic control in aging diabetics with serious mental illness SO INTERNATIONAL PSYCHOGERIATRICS LA English DT Meeting Abstract C1 Philadelphia VA Med Ctr, Sect Geriatr Psychiat, MIRECC, Philadelphia, PA USA. Univ Penn, Dept Family Med, Philadelphia, PA 19104 USA. Mental Illness Res Educ & Clin Ctr, Med Ctr, Philadelphia, PA USA. Philadelphia VA Med Ctr, MIRECC, Div Geriatr Med, Philadelphia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4211 USA SN 1041-6102 J9 INT PSYCHOGERIATR JI Int. Psychogeriatr. PY 2005 VL 17 SU 2 BP 282 EP 283 PG 2 WC Psychology, Clinical; Geriatrics & Gerontology; Gerontology; Psychiatry; Psychology SC Psychology; Geriatrics & Gerontology; Psychiatry GA 984RQ UT WOS:000233322400528 ER PT J AU Schmidt, S Messamore, E AF Schmidt, S Messamore, E TI Acamprosate joins short list of drugs for alcoholism SO JOURNAL OF ADDICTIONS NURSING LA English DT Editorial Material ID DEPENDENT PATIENTS; PLACEBO; MULTICENTER C1 Hazelden Fdn, Springbrook, OR USA. Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. RP Schmidt, S (reprint author), Hazelden Fdn, Springbrook, OR USA. NR 6 TC 0 Z9 0 U1 0 U2 0 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1088-4602 J9 J ADDICT NURS JI J. Addict. Nurs. PY 2005 VL 16 IS 3 BP 147 EP 147 DI 10.1080/10884600500197949 PG 1 WC Substance Abuse; Nursing SC Substance Abuse; Nursing GA 048WY UT WOS:000237978400009 ER PT J AU Kulig, CC Beresford, TP AF Kulig, CC Beresford, TP TI Hepatitis C in alcohol dependence: Drinking versus disulfiram SO JOURNAL OF ADDICTIVE DISEASES LA English DT Article DE hepatitis-C; disulfiram; alcohol dependence ID LIVER-DISEASE; SUPERVISED DISULFIRAM; INTERFERON THERAPY; VIRUS-INFECTION; RISK-FACTORS; MAINTENANCE; PREVALENCE; NALTREXONE; ANTIBODIES; CIRRHOSIS AB Hepatitis C virus (HCV) infects alcohol dependent (AD) individuals disproportionately. Disulfiram for timely abstinence in HCV+ AD cases remains controversial. Our literature review suggests that (1) active drinking accelerates HCV-related liver damage and that abstinence is associated both (2) with a slower course of HCV+ hepatic deterioration and (3) with enhanced response to antiviral HCV treatment. Further, (4) the risk of disulfiram liver injury appears much lower than that from alcohol, (5) HCV+AD individuals require close monitoring during the first 6 months of disulfiram treatment, and (6) early discontinuation of disulfiram usually reverses harmful effects when these occur. Although systematic data are sparse, continued drinking appears much more liver toxic than does disulfiram in this group. Disulfiram therapy may allow (I) prolonged abstinence leading to successful antiviral therapy for HCV, and (2) time to begin behavioral treatments that facilitate long-term abstinence. Sizeable prospective studies of HCV+ AD treatment are badly needed. C1 Denver VA Med Ctr, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80262 USA. RP Beresford, TP (reprint author), Denver VA Med Ctr, 1055 Clermont St, Denver, CO 80220 USA. EM thomas.beresford@uchsc.edu FU NIAAA NIH HHS [AA 12095, AA 14010] NR 46 TC 6 Z9 6 U1 1 U2 1 PU HAWORTH PRESS INC PI BINGHAMTON PA 10 ALICE ST, BINGHAMTON, NY 13904-1580 USA SN 1055-0887 J9 J ADDICT DIS JI J. Addict. Dis. PY 2005 VL 24 IS 2 BP 77 EP 89 DI 10.1300/J069v24n02_07 PG 13 WC Substance Abuse SC Substance Abuse GA 919JP UT WOS:000228614600007 PM 15784525 ER PT J AU Page, ST Herbst, KL Amory, JK Coviello, AD Anawalt, BD Matsumoto, AM Bremner, WJ AF Page, ST Herbst, KL Amory, JK Coviello, AD Anawalt, BD Matsumoto, AM Bremner, WJ TI Testosterone administration suppresses adiponectin levels in men SO JOURNAL OF ANDROLOGY LA English DT Article DE androgen; hypogonadal; leptin ID HEALTHY-YOUNG MEN; HORMONE-BINDING GLOBULIN; ADIPOSE-SPECIFIC PROTEIN; INSULIN SENSITIVITY; OLDER MEN; PROSTATE-CANCER; PLASMA-CONCENTRATIONS; ARTERIAL STIFFNESS; ANDROGEN RECEPTOR; BODY-COMPOSITION AB Testosterone (T) administration to men increases lean body mass and decreases fat mass. Adiponectin is produced by adipocytes and is thought to influence insulin sensitivity. In this study, we sought to determine whether experimental alterations in serum T change adiponectin levels in normal men. We measured adiponectin levels in 28 healthy men ages 18-35 years before and during treatment with a potent gonadotropin-releasing-hormone (GnRH) antagonist, acyline. Decreased T levels led to increased serum adiponectin within 7 days; maximal adiponectin levels were reached on day 21 (baseline 8.6 +/- 0.9 compared with 12.2 +/- 1.0 mug/mL on day 21, P (.)<05) and persisted through day 30, despite no significant changes in body mass index (BMI) and an increase in leptin. The addition of T to acyline, maintaining serum T levels within the normal range, prevented the increase in adiponectin following acyline alone. In a second study, 25 men aged 55-85 years were treated with 3 weeks of high-dose T (testosterone enanthate [TE], 600 mg/wk intramuscularly). With high serum T levels, adiponectin levels decreased significantly by day 21 of treatment (baseline 14.3 +/- 1.9 compared with 10.8 +/- 1.5 mug/mL, P <.05 vs baseline and placebo), BMI slightly increased, and leptin levels were decreased. We conclude that adiponectin levels increase within days of experimental T deficiency in normal men, and the increase in adiponectin is prevented by T replacement. Furthermore, supraphysiologic T administration results in decreased adiponectin levels. Our data support the hypothesis that T, its metabolites, or both directly suppress adipocyte production of adiponectin. C1 Univ Washington, Med Ctr, Div Endocrinol & Metab, Sch Med,Geriatr Res Educ & Clin Ctr, Seattle, WA 98915 USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Calif Los Angeles, Charles Drew Univ, Dept Med, Los Angeles, CA USA. RP Page, ST (reprint author), Univ Washington, Med Ctr, Div Endocrinol & Metab, Sch Med,Geriatr Res Educ & Clin Ctr, 1959 NE Pacific,Box 357138, Seattle, WA 98915 USA. EM page@u.washington.edu FU NCRR NIH HHS [M01-RR-00037]; NHLBI NIH HHS [HL007028]; NIA NIH HHS [K23 AG027238]; NICHD NIH HHS [U54-HD-12629] NR 45 TC 101 Z9 109 U1 0 U2 2 PU AMER SOC ANDROLOGY, INC PI LAWRENCE PA C/O ALLEN PRESS, INC PO BOX 368, LAWRENCE, KS 66044 USA SN 0196-3635 J9 J ANDROL JI J. Androl. PD JAN-FEB PY 2005 VL 26 IS 1 BP 85 EP 92 PG 8 WC Andrology SC Endocrinology & Metabolism GA 880WA UT WOS:000225819300014 PM 15611571 ER PT J AU Harris, BS Gourdie, RG O'Brien, TX AF Harris, BS Gourdie, RG O'Brien, TX TI Atrioventricular conduction system and transcription factors Nkx2.5 and Msx2 SO JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY LA English DT Editorial Material ID CONGENITAL HEART-DISEASE; MUTATIONS; LINEAGE; MICE; EXPRESSION; PATHWAYS C1 Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Cell Biol & Anat, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Off Res & Dev, Charleston, SC USA. RP O'Brien, TX (reprint author), Med Univ S Carolina, Dept Med, 135 Rutledge Ave,Suite 1201 Cardiol, Charleston, SC 29425 USA. EM obriente@musc.edu NR 17 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL FUTURA PUBLISHING, INC PI MALDEN PA 350 MAIN STREET, MALDEN, MA 01248-5018 USA SN 1045-3873 J9 J CARDIOVASC ELECTR JI J. Cardiovasc. Electrophysiol. PD JAN PY 2005 VL 16 IS 1 BP 86 EP 87 DI 10.1046/j.1540-8167.2005.04667.x PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 888UC UT WOS:000226398700019 PM 15673395 ER PT J AU Saam, T Kerwin, WS Chu, BC Cai, JM Kampschulte, A Hatsukami, TS Zhao, XQ Polissar, NL Neradilek, B Yarnykh, VL Flemming, K Huston, J Insull, W Morrisett, JD Rand, SD Demarco, KJ Yuan, C AF Saam, T Kerwin, WS Chu, BC Cai, JM Kampschulte, A Hatsukami, TS Zhao, XQ Polissar, NL Neradilek, B Yarnykh, VL Flemming, K Huston, J Insull, W Morrisett, JD Rand, SD Demarco, KJ Yuan, C TI Sample size calculation for clinical trials using magnetic resonance imaging for the quantitative assessment of carotid atherosclerosis SO JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE LA English DT Article DE carotid arteries; atherosclerosis; magnetic resonance imaging ID INTIMA-MEDIA THICKNESS; HIGH-RESOLUTION MRI; RANDOMIZED CONTROLLED-TRIAL; IN-VIVO; CORONARY ATHEROSCLEROSIS; PLAQUE COMPOSITION; FIBROUS CAP; EX-VIVO; ACCURACY; ARTERY AB Purpose. To provide sample size calculation for the quantitative assessment of carotid atherosclerotic plaque using non-invasive magnetic resonance imaging in multi-center clinical trials. Methods. As part of a broader double-blind randomized trial of an experimental pharmaceutical agent, 20 asymptomatic placebo-control subjects were recruited from 5 clinical sites for a multi-center study. Subjects had 4 scans in 13 weeks on GE 1.5 T scanners, using TOF, T1-/PD-/T2- and contrast-enhanced T1-weighted images. Measurement variability was assessed by comparing quantitative data from the index carotid artery over the four time points. The wall/outer wall (W/OW) ratio was calculated as wall volume divided by outer wall Volume. The percent lipid-rich/necrotic core (%LR/NC) and calcification (%Ca) were measured as a proportion of the vessel wall. For %LR/NC and %Ca, Only those Subjects that exhibited LR/NC or Ca components were used in the analysis. Results. Measurement error was 5.8% for wall volume, 3.2% for W/OW ratio, 11.1%, for %LR/NC volume and 18.6% for %Ca volume. Power analysis based on these values shows that a Study with 14 participants in each group could detect a 5% change in W/OW ratio, 10% change in wall volume, and 20% change in %LR/NC volume (power = 80%, p < .05). The calculated measurement errors presume any true biological changes were negligible over the 3 months that subjects received placebo. Conclusion. In vivo MRI is capable of quantifying plaque volume and plaque composition, such as %lipid-rich/necrotic core and %calcification, in the clinical setting of a multi-center trial with low inter-scan variability. This Study provides the basis for sample size calculation Of future MRI trials. C1 Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Univ Washington, Dept Surg, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. Mt Whisper Light Stat Consulting, Seattle, WA USA. Mayo Clin, Dept Neurol, Rochester, MN USA. Mayo Clin, Dept Radiol, Rochester, MN USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Med Coll Wisconsin, Dept Radiol, Milwaukee, WI 53226 USA. Michigan State Univ, Dept Radiol, E Lansing, MI 48824 USA. RP Yuan, C (reprint author), Univ Washington, Dept Radiol, 1959 NE Pacific St,Box 357115, Seattle, WA 98195 USA. EM cyuan@u.washington.edu RI Yarnykh, Vasily/G-8757-2016; Yarnykh, Vasiliy/N-7635-2014 OI Yarnykh, Vasily/0000-0002-1583-8979; NR 24 TC 76 Z9 77 U1 0 U2 4 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1097-6647 J9 J CARDIOV MAGN RESON JI J. Cardiov. Magn. Reson. PY 2005 VL 7 IS 5 BP 799 EP 808 DI 10.1080/10976640500287703 PG 10 WC Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging SC Cardiovascular System & Cardiology; Radiology, Nuclear Medicine & Medical Imaging GA 989HN UT WOS:000233663600009 PM 16353440 ER PT J AU Makhijani, NS Bischoff, DS Yamaguchi, DT AF Makhijani, NS Bischoff, DS Yamaguchi, DT TI Regulation of proliferation and migration in retinoic acid treated C3H10T1/2 cells by TGF-beta Isoforms SO JOURNAL OF CELLULAR PHYSIOLOGY LA English DT Article ID GROWTH-FACTOR-BETA; BONE MORPHOGENETIC PROTEIN-2; MESENCHYMAL PROGENITOR CELLS; OSTEOBLAST-LIKE CELLS; PLATELET ALPHA-GRANULES; FETAL-RAT CALVARIA; TRANSFORMING GROWTH-FACTOR-BETA-1; GENE-EXPRESSION; MC3T3-E1 CELLS; IN-VITRO AB Proliferation of mesenchymal precursors of osteogenic and chondrogenic cells and migration of these precursors to repair sites are important early steps in bone repair. Transforming growth factor-beta (TGF-P) has been implicated in the promotion of bone repair and may have a role in these processes. Three isoforms of TGF-beta, TGF-Pbeta1, -beta2, and -beta3, are expressed in fracture healing, however, their specific roles in the repair process are unknown. Differential actions of the TGF-P isoforms on early events of bone repair were explored in the multipotent mesenchymal precursor cell line, C3H10TI/2. Cell migration was determined using a modified Boyden chamber in response to concentrations of each isoform ranging from 10(-12) to 10(-9) g/ml. All three isoforms demonstrated a dose-dependent chemotactic stimulation of untreated C3H10T1/2 cells. Checkerboard assays indicated that all three isoforms also stimulated chemokinesis of the untreated cells. C3H10T1/2 cells treated with all-trans-retinoic acid (ATRA) and expressing relatively higher levels of osteoblastic gene markers such as alkaline phosphatase and collagen type 1, lower levels of chondrocytic gene markers collagen type 11 and aggrecan, and unchanged levels of the adipose marker adipsin did not demonstrate significant chemokinesis or chemotaxis in response to TGF-beta1 or-beta3 at concentrations ranging from 10-12 to 10-9 g/ml. In the ATRA-treated cells, TGF-beta2 stimulated a significant increase in chemotaxis only at the highest concentration tested. Cell proliferation was assessed by mitochondrial dehydrogenase activity and cell counts at TGF-beta concentrations from 10(-11) to 10(-8) g/ml. None of the TGF-beta isoforms stimulated cell proliferation in untreated or ATRA-treated C3H10T1/2 cells. Analysis of TGF-P receptors (TGF-PRI, -betaR2, and -betaR3) showed a 1.6- to 2.8-fold decrease in mRNA expression of these receptors in ATRA-treated cells. In conclusion: (1) while all three TGF-beta isoforms stimulate chemotaxis/chemokinesis of multipotent C3H10T1/ 2 cells, TGF-P] and -beta3 do not stimulate chemotaxis in C3H10TI/2 cells treated with ATRA while TGF-beta2 stimulated chemotaxis only at the highest concentration tested. (2) TGF-beta isoforms do not appear to stimulate cell proliferation in C3H10T1/ 2 cells in either a multipotent state or after ATRA treatment when expressing higher levels of alkaline phosphatase and collagen type I gene markers. (3) Decrease in mRNA expression for TGF-betaRI, -betaR2, and -betaR3 upon ATRA treatment could potentially explain the lack of chemotaxis/chemokinesis in these cells expressing higher levels of alkaline phosphatase and collagen type 1. J. Cell. Physiol. 202: 304-313, 2005. Published 2004 Wiley-Liss, lnc. C1 VA Greater Los Angeles Healthcare Syst, Res Serv 151, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. RP Yamaguchi, DT (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv 151, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM dean.yamaguchi@med.va.gov NR 60 TC 13 Z9 17 U1 0 U2 2 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0021-9541 J9 J CELL PHYSIOL JI J. Cell. Physiol. PD JAN PY 2005 VL 202 IS 1 BP 304 EP 313 DI 10.1002/jcp.20128 PG 10 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 876RF UT WOS:000225514300032 PM 15389595 ER PT J AU Jepson, C Asch, DA Hershey, JC Ubel, PA AF Jepson, C Asch, DA Hershey, JC Ubel, PA TI In a mailed physician survey, questionnaire length had a threshold effect on response rate SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE data collection health care surveys; questionnaire design AB Objective: To examine the association between questionnaire length and response rate in a mailed survey of generalist physicians randomly selected from the American Medical Association master file. Study Design and Setting: In a pilot study, otherwise similar questionnaires of 30 different lenghts (849 to 1,867 words) were mailed to 192 physicians in April 1999. In the main study, questionnaires of 16 different lengths (564, to 988 words) were mailed to 1,700 physicians between June 1999 and January 2000. Results: In the pilot study, response rate decreased from 60% for questionnaires 849 words in length to 16.7%, for questionnaires over 1,800 words in length. Logistic regression revealed an odds ratio of 0.887 (95%CI 0.813, 0.968; p = 0.006) for word count, expressed in units of 100 words. In the main study, response rate varied between 51.5% and 71.4%. Logistic regression showed no association between response and word count (OR 0.988; 95%CI 0.896, 1.090; p = 0.81). Conclusion: There appears to have been a threshold in these studies of approximately 1,000 words. Questionnaires above the threshold had lower response rates than those below it (38.0% vs. 59.4%). (C) 2005 Elsevier Inc. All rights reserved. C1 Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Philadelphia, PA 19104 USA. Univ Michigan, Div Gen Internal Med, Ann Arbor, MI 48109 USA. Vet Affairs Med Ctr, Ann Arbor, MI USA. Program Improving Hlth Care Decis, Ann Arbor, MI USA. RP Jepson, C (reprint author), Univ Penn, Sch Med, Dept Psychiat, 3535 Market St,Room 4017, Philadelphia, PA 19104 USA. EM cjepson@mail.med.upenn.edu OI Asch, David/0000-0002-7970-286X FU NCI NIH HHS [R01-CA78052-01] NR 3 TC 100 Z9 100 U1 2 U2 10 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 JAN PY 2005 VL 58 IS 1 BP 103 EP 105 DI 10.1016/j.jclinepi.2004.06.004 PG 3 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 892WV UT WOS:000226681600014 PM 15649678 ER PT J AU Pisegna, JR Martindale, RG AF Pisegna, JR Martindale, RG TI Acid suppression in the perioperative period SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Review DE aspiration pneumonitis; acid suppression; perioperative period; intravenous proton pump inhibitor ID GASTROESOPHAGEAL-REFLUX DISEASE; PROTON-PUMP INHIBITORS; INTRAVENOUS PANTOPRAZOLE; PULMONARY ASPIRATION; MECHANICAL VENTILATION; CONTINUOUS-INFUSION; GENERAL-ANESTHESIA; ELECTIVE SURGERY; GASTRIC CONTENTS; INTRAGASTRIC PH AB Aspiration of oropharyngeal and gastric contents during surgery, although infrequent, is a recognized complication of general anesthesia that carries significant risk for serious complications. Complications of aspiration have been reported to cause 10% to 30% of anesthesia-related deaths. Unconsciousness interferes with multiple biologic mechanisms that guard the airway against aspiration, and this is compounded in surgery by anesthesia- induced neurologic impairment and the risks related to placement of nasogastric and endotracheal tubes. Consequences of anesthesia-related aspiration include aspiration pneumonia, acute respiratory distress syndrome, pulmonary edema, and long-term complications such as laryngotracheal damage and decreased lung compliance. Therefore, averting aspiration, particularly in the elderly and other high-risk patients, should be part of the perioperative plan. Although antacids and histamine(2)-receptor antagonists have been used perioperatively with some success, they are limited by short duration of action and systemic side effects, among other factors. Proton pump inhibitors are currently being investigated in surgical patients at risk for aspiration or stress ulcers and seem to be potent, extremely effective, and well tolerated. This article reviews the risks for, and potential outcomes of, anesthesia-related aspiration, identifies high-risk populations, and outlines the experience to date with available preventive treatments. C1 VA Greater Los Angeles Hlth Care Syst, Div Gastroenterol & Hepatol, Los Angeles, CA USA. Med Coll Georgia, Gastrointestinal Surg Serv, Augusta, GA 30912 USA. RP Pisegna, JR (reprint author), W Los Angeles VA Med Ctr, GI Div, Digest Dis Res Ctr, Bldg 115,Rm 316,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jpisegna@ucla.edu NR 72 TC 9 Z9 11 U1 1 U2 3 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 JAN PY 2005 VL 39 IS 1 BP 10 EP 16 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 881YD UT WOS:000225904500004 PM 15599203 ER PT J AU Frost, JD Hrachovy, RA AF Frost, JD Hrachovy, RA TI Pathogenesis of infantile spasms: A model based on developmental desynchronization SO JOURNAL OF CLINICAL NEUROPHYSIOLOGY LA English DT Article DE infantile spasms; epilepsy; encephalopathy; pathogenesis ID CORTICOTROPIN-RELEASING HORMONE; HUMAN BRAIN-STEM; WEST-SYNDROME; CEREBROSPINAL-FLUID; DELAYED MYELINATION; PARTIAL SEIZURES; SEROTONIN RECEPTORS; SURGICAL-TREATMENT; BETA-ENDORPHIN; REDUCED ACTH AB Infantile spasms is a severe epileptic encephalopathy of infancy. The fundamental cause is unknown, although a number of predisposing conditions are recognized. In this article, the authors critically review current knowledge concerning the pathophysiologic basis of infantile spasms and propose a new model based on developmental desynchronization. It is suggested that infantile spasms may result from a particular temporal desynchronization of two or more central nervous system developmental processes, resulting in a specific disturbance of brain function. The disturbance of function is postulated to be crucially dependent on an unbalanced maturational pattern, in which certain brain systems become dysfunctional owing to divergent developmental status. An important aspect of this model is the idea that disturbed function of a specific kind can result from multiple causative factors, and so can be associated with a variety of different anatomic and/or biochemical abnormalities. Thus, this concept is compatible with the observed diversity of pathologic findings and multiplicity of etiological associations observed in infantile spasms patients. C1 Methodist Hosp, Dept Neurophysiol, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Texas Childrens Hosp, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurol, Peter Kellaway Sect Neurophysiol, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurosci, Houston, TX 77030 USA. RP Frost, JD (reprint author), Methodist Hosp, Dept Neurophysiol, Michael E DeBakey Vet Affairs Med Ctr, 6565 Fannin,MS M587, Houston, TX 77030 USA. EM jamesf@bcm.tmc.edu NR 85 TC 55 Z9 60 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0736-0258 J9 J CLIN NEUROPHYSIOL JI J. Clin. Neurophysiol. PD JAN-FEB PY 2005 VL 22 IS 1 BP 25 EP 36 DI 10.1097/01.WNP.0000149893.12678.44 PG 12 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 895SM UT WOS:000226883600003 PM 15689710 ER PT J AU Shores, MM Moceri, VM Sloan, KL Matsumoto, AM Kivlahan, DR AF Shores, MM Moceri, VM Sloan, KL Matsumoto, AM Kivlahan, DR TI Low testosterone levels predict incident depressive illness in older men: Effects of age and medical morbidity SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID PLACEBO-CONTROLLED TRIAL; BONE-MINERAL DENSITY; REPLACEMENT THERAPY; HYPOGONADAL MEN; MAJOR DEPRESSION; REFRACTORY DEPRESSION; HEALTH-SERVICES; SYMPTOMS; DISORDER; MOOD AB Objective: Prior studies found that chronic low testosterone levels are associated with an increased risk of depression. We investigated whether low testosterone levels in older men predict depressive illness over 2 years, while controlling for age and medical morbidity. Method: Participants were 748 men, aged 50 years or older, without prior ICD-9-diagnosed depressive illness, with a testosterone level obtained between 1995 and 1997. Measures were age, mean total testosterone levels (low: less than or equal to 2.5 ng/mL), medical morbidity, and incidence and time to depressive illness. Results: Men with low testosterone levels had a greater 2-year incidence of depressive illness (18.5% vs. 10.4%, df = 1. p = .006) and a shorter time to onset of depressive illness (log-rank chi(2) = 8.1. df = 1, p = .004). The unadjusted hazard ratio (HR) for depressive illness in men with low testosterone levels was 1.9 (95% confidence interval [CI] = 1.2 to 3.0, p = .005). After adjustment for age and medical morbidity, men with low testosterone levels continued to have a shorter time to depressive illness (adjusted HR = 2.1; 95% CI = 1.3 to 3.2, p = .002). Due to a significant interaction between age and medical morbidity, we conducted stratified Cox regression analyses and found that low testosterone levels and high medical morbidity or an age of 50 to 65 years were associated with increased depressive illness (p = .002). Conclusion: Low testosterone levels are associated with an earlier onset and greater incidence of depressive illness. Men with low testosterone levels who had high medical morbidity or were aged 50 to 65 years had an increased risk for depressive illness. Further prospective studies are needed to examine the role of testosterone in depressive illness in older men. C1 Univ Washington, Dept Psychiat & Behav Sci, VA Puget Sound Hlth Care Syst, GRECC, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98108 USA. RP Shores, MM (reprint author), Univ Washington, Dept Psychiat & Behav Sci, VA Puget Sound Hlth Care Syst, GRECC, 1660 S Columbian Way,S-182, Seattle, WA 98108 USA. EM molly_shores@med.va.gov NR 52 TC 69 Z9 71 U1 3 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 JAN PY 2005 VL 66 IS 1 BP 7 EP 14 PG 8 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 890DZ UT WOS:000226493200002 PM 15669883 ER PT J AU O'Brien, CP AF O'Brien, CP TI Benzodiazepine use, abuse, and dependence SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID TERM THERAPEUTIC USE; CLINICAL PHARMACOKINETICS; PANIC DISORDER; WITHDRAWAL; DIAZEPAM; ALPRAZOLAM; DISCONTINUATION; LIABILITY; CARBAMAZEPINE; CLONAZEPAM AB Although benzodiazepines are invaluable in the treatment of anxiety disorders, they have some potential for abuse and may cause dependence or addiction. It is important to distinguish between addiction to and normal physical dependence on benzodiazepines. Intentional abusers of benzodiazepines usually have other substance abuse problems. Benzodiazepines are usually a secondary drug of abuse-used mainly to augment the high received from another drug or to offset the adverse effects of other drugs. Few cases of addiction arise from legitimate use of benzodiazepines. Pharmacologic dependence, a predictable and natural adaptation of a body system long accustomed to the presence of a drug, may occur in patients taking therapeutic doses of benzodiazepines. However, this dependence, which generally manifests itself in withdrawal symptoms upon the abrupt discontinuation of the medication, may be controlled and ended through dose tapering, medication switching, and/or medication augmentation. Due to the chronic nature of anxiety, long-term low-dose benzodiazepine treatment may be necessary for some patients; this continuation of treatment should not be considered abuse or addiction. C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. RP O'Brien, CP (reprint author), Univ Penn, Dept Psychiat, 3900 Chestnut St 6178, Philadelphia, PA 19104 USA. EM obrien@mail.trc.upenn.edu NR 42 TC 168 Z9 174 U1 9 U2 37 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 PY 2005 VL 66 SU 2 BP 28 EP 33 PG 6 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 904SS UT WOS:000227518600005 PM 15762817 ER PT J AU Weaver, EM Maynard, C Yueh, B AF Weaver, Edward M. Maynard, Charles Yueh, Bevan TI Beware of the " ..." SO JOURNAL OF CLINICAL SLEEP MEDICINE LA English DT Letter C1 [Weaver, Edward M.; Maynard, Charles; Yueh, Bevan] Univ Washington, Sch Med, Vet Affairs Puget Sound Healthcare Syst, Seattle, WA USA. RP Weaver, EM (reprint author), Univ Washington, VAPSHCS 112 OTO,1660 S Columbian Way, Seattle, WA 98108 USA. EM eweaver@u.washington.edu OI Maynard, Charles/0000-0002-1644-7814 FU NHLBI NIH HHS [K23 HL068849-02, K23 HL068849] NR 3 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CTR, STE 920, WESTCHESTER, IL 60154 USA SN 1550-9389 EI 1550-9397 J9 J CLIN SLEEP MED JI J. Clin. Sleep Med. PY 2005 VL 1 IS 4 BP 434 EP 434 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA V44VC UT WOS:000209775500044 PM 17564417 ER PT J AU Green, MF Glahn, D Engel, SA Nuechterlein, KH Sabb, F Strojwas, M Cohen, MS AF Green, MF Glahn, D Engel, SA Nuechterlein, KH Sabb, F Strojwas, M Cohen, MS TI Regional brain activity associated with visual backward masking SO JOURNAL OF COGNITIVE NEUROSCIENCE LA English DT Article ID SCHIZOPHRENIC-PATIENTS; CORTEX; FMRI; AREAS; PERFORMANCE; ATTENTION; REGISTRATION; RECOGNITION; ACTIVATION; MECHANISMS AB In visual backward masking, the visibility of a briefly presented visual target is disrupted by a mask that is presented shortly thereafter. The goal of the current study was to identify regions in the human cortex that may provide the neural basis of visual masking. We searched for areas whose activity correlated with perception as we systematically varied the strength of masking. A total of 13 subjects performed a backward masking task during functional magnetic resonance imaging. Target and mask were presented at three delay intervals ( 34, 68, and 102 msec) and behavioral measures confirmed that the targets were more visible at longer masking intervals. Two sets of regions of interest were identified: Distinct regions in the visual cortex (V1/V2, LO, hMT+) were segregated using scans to localize visual processing drawn from the existing literature. Additional cortical regions were selected in a data-driven approach based on their activity during the backward masking task. For each set, we determined the regions whose magnitude of activation increased at longer masking intervals. Nine of the subjects provided valid behavioral performance data on the visual masking task and imaging data from these subjects were used for subsequent analysis. The scans of visual processing areas identified four regions, including: early visual areas (V1 and V2), the motion-sensitive regions in the lateral occipital (LO) lobe (hMT+), and two components ( dorsal and ventral) of the object-sensitive region, LO. Of these, the ventral and dorsal LO regions were sensitive to the strength of the mask. For the data-driven approach, six regions were identified on the basis of a difference map in which all masking intervals were contrasted with rest. These included the inferior parietal, anterior cingulate, precentral, insula, thalamic, and occipital areas. The predicted effects of more activity with weaker masking were seen in the thalamus, inferior parietal, and anterior cingulate. This study isolated three types of visual processing areas. The first included regions that subserve key stages of vision ( including object and motion processing). The second type responded to the presentation of briefly presented visual stimuli, regardless of masking interval. The third type ( selected from the first two) included regions sensitive to the interval between the target and mask. These latter regions ( including ventral LO, inferior parietal, anterior cingulate, and thalamus) may form the neural substrate of backward masking. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Geffen Sch Med, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. RP Green, MF (reprint author), Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Geffen Sch Med, Med Plaza 300,Rm 2263, Los Angeles, CA 90095 USA. EM mgreen@ucla.edu RI Cohen, Mark/C-6610-2011 OI Cohen, Mark/0000-0001-6731-4053 FU NEI NIH HHS [EY12722]; NIMH NIH HHS [MH43293] NR 52 TC 35 Z9 35 U1 0 U2 1 PU M I T PRESS PI CAMBRIDGE PA FIVE CAMBRIDGE CENTER, CAMBRIDGE, MA 02142 USA SN 0898-929X J9 J COGNITIVE NEUROSCI JI J. Cogn. Neurosci. PD JAN PY 2005 VL 17 IS 1 BP 13 EP 23 DI 10.1162/0898929052880011 PG 11 WC Neurosciences; Psychology, Experimental SC Neurosciences & Neurology; Psychology GA 890WT UT WOS:000226542500002 PM 15701236 ER PT J AU Davalos, D Martin, L Freedman, R AF Davalos, D Martin, L Freedman, R TI Nicotine effects on mismatch negativity in schizophrenia SO JOURNAL OF COGNITIVE NEUROSCIENCE LA English DT Meeting Abstract CT 12th Annnual Meeting of the Cognitive-Neuroscience-Society CY APR 09-12, 2005 CL New York, NY SP Cognit Neurosci Soc C1 Univ Colorado, Hlth Sci Ctr, Boulder, CO 80309 USA. Denver VA Med Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU M I T PRESS PI CAMBRIDGE PA FIVE CAMBRIDGE CENTER, CAMBRIDGE, MA 02142 USA SN 0898-929X J9 J COGNITIVE NEUROSCI JI J. Cogn. Neurosci. PY 2005 SU S BP 78 EP 78 PG 1 WC Neurosciences; Psychology, Experimental SC Neurosciences & Neurology; Psychology GA 909RP UT WOS:000227878700321 ER PT J AU Klein, RL McHenry, MB Lok, KH Hunter, SJ Le, NA Jenkins, AJ Zheng, DJ Semler, A Page, G Brown, WV Lyons, TJ Garvey, WT AF Klein, RL McHenry, MB Lok, KH Hunter, SJ Le, NA Jenkins, AJ Zheng, DJ Semler, A Page, G Brown, WV Lyons, TJ Garvey, WT CA DCCTEDIC Res Grp TI Apolipoprotein C-III protein concentrations and gene polymorphisms in type I diabetes - Associations with microvascular disease complications in the DCCT/EDIC cohort SO JOURNAL OF DIABETES AND ITS COMPLICATIONS LA English DT Article ID CORONARY-ARTERY DISEASE; FAMILIAL COMBINED HYPERLIPIDEMIA; FRAGMENT-LENGTH-POLYMORPHISMS; LIPOPROTEIN-LIPASE ACTIVITY; INSULIN-RESPONSE ELEMENT; A-I; TRIGLYCERIDE-RICH; HEART-DISEASE; APO-CIII; HYPERTRIGLYCERIDEMIA AB Aim: We investigated the associations of apolipoprotein C-III (apoCIII) protein and apoCIII gene variation with microvascular disease complications in Type 1 diabetes. Methods: The serum apoCIII concentration, and both a T-455-->C and a SacI gene polymorphisms were determined in 409 patients in the DCCT/EDIC cohort of patients with Type 1 diabetes. Correlations with albumin excretion rate (AER) and the severity of retinopathy were investigated. Results: Higher apoCIII concentrations were associated (P < .0001) with increased triglycerides (r = .78), total (r = .61) and LDL (r = .40) cholesterol, apoAI (r = .26), and apoB (r = .50), AER (r = .08), and the severity of retinopathy (ETDRS score, r = .11), and these relationships persisted after controlling for age, gender, body mass index (BMI), and HbA1c level. The apoCIII concentration was significantly higher in the group of patients with macroalbuminuria (AERs 300 mg/24 h) compared to the groups with microalbuminuria (AER 40-299 mg/24 h; P < .0001) or normoalbuminuria (AER < 40 mg/24 h) (P < .0001). The apoCIII concentration also was significantly higher in the group of patients with severe retinopathy (ETDRS 10-23) compared to those with moderate (ETDRS 4-9: P < .02) or mild retinopathy (ETDRS 1-3; P < .0001). Neither the T-455-->C polymorphism nor a SacI polymorphism in the 3' UTR were associated with circulating apoCIII concentrations, nor the severity of nephropathy or retinopathy. Conclusions: Elevated apoCIII levels have been associated with increased macrovascular disease risk. In the DCCT/EDIC cohort of patients, there was an independent positive association of apoCIII level with microvascular complications of Type 1 diabetes. Published by Elsevier Inc. 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 USA. Med Univ S Carolina, Dept Biometry & Epidemiol, Charleston, SC 29425 USA. Univ Alabama, Dept Nutr Sci, Birmingham, AL 35294 USA. Emory Univ, Div Atherosclerosis & Lipid Metab, Atlanta, GA 30322 USA. Univ Melbourne, St Vincents Hosp, Dept Med, Fitzroy, Vic 3065, Australia. Univ Oklahoma, Hlth Sci Fdn, Sect Endocrinol Diabet & Hypertens, Oklahoma City, OK USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Box NDIC DCCT, 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 RI Jenkins, Alicia/N-2482-2015 FU NHLBI NIH HHS [P01-HL55782] NR 49 TC 16 Z9 18 U1 1 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 JAN-FEB PY 2005 VL 19 IS 1 BP 18 EP 25 DI 10.1016/j.jdiacomp.2004.04.005 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 896VF UT WOS:000226961400003 PM 15642486 ER PT J AU Rashid, RM Achille, NJ Lee, JM Lathers, DMR Young, MRI AF Rashid, RM Achille, NJ Lee, JM Lathers, DMR Young, MRI TI Decreased T-cell proliferation and skewed immune responses in LLC-bearing mice SO JOURNAL OF ENVIRONMENTAL PATHOLOGY TOXICOLOGY AND ONCOLOGY LA English DT Article DE cancer; Lewis lung carcinoma; T cells; dendritic cells; splenocytes; APC; Con A; anti-CD3; cytokines ID MURINE DENDRITIC CELLS; LUNG-CANCER PATIENTS; IMMUNOLOGICAL DYSFUNCTION; ANTITUMOR IMMUNITY; NITRIC-OXIDE; NECK-CANCER; IN-VIVO; TUMOR; ANTIGEN; TH2 AB Deficits in immune cell responses have been reported in cancer patients. We used the murine Lewis lung carcinoma (LLC) model to better understand these deficits. The goal of this study was to determine if the immune responses of LLC tumor-bearing (TB) mice differ from control mice and whether the difference could be attributed to either antigen-presenting cells (APC) or to T cells. Tumors were first allowed to grow in vivo for approximately 2 weeks. Splenocytes were then isolated for in vitro proliferation and cytokine release studies. The results showed a decrease in mitogen-stimulated proliferation by unfractionated splenocyte cultures from TB mice when compared to control mice in response to concanavalin A (Con A), a T-cell mitogen. Decreased responses were also observed when the APC spleen cell fraction from TB mice was cultured with normal T cells, although proliferation was more prominently reduced in cultures of TB T cells plus normal APC. Also, splenocytes from TB mice secreted significantly increased levels of IFN-gamma, IL-4, and IL-10. Admixing APC from control mice with TB T cells significantly decreased levels of IL-4 and IL-10 secretion as compared to the levels secreted by cocultures of TB T cells and TB APC. The decreased cytokine profile in the presence of normal A-PC despite the presence of TB T cells suggests that A-PC contributes to the immune dysfunction, including Th skewing of tumor bearers, possibly through their influence on T-cell expansion and cytokine production. Finally, our assessment of the APC population contributing to the observed immune dysfunction-i.e., dendritic cells or macrophages-showed that the proliferation of TB T cells was decreased regardless of the APC population with which they were cocultured. However, normal T-cell proliferation was only reduced by the addition of TB macrophages and not by the addition of TB dendritic cells. In conclusion, our results demonstrate that LLC TB mice have a skewed immune response characterized by a decreased proliferative response with both T cells and A-PC affected by the presence of tumor. C1 Loyola Univ, Ctr Med, Dept Pathol, Maywood, IL 60153 USA. Loyola Univ, Ctr Med, Dept Pharmacol, Maywood, IL 60153 USA. Loyola Univ, Ctr Med, Dept Biochem, Maywood, IL 60153 USA. Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Res Serv, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Otolaryngol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. RP Rashid, RM (reprint author), Loyola Univ, Ctr Med, Dept Pathol, 2160 S 1st Ave,Bldg 102,Room 2638, Maywood, IL 60153 USA. EM Rrashid@lumc.edu FU NCI NIH HHS [CA85266, CA97813, CA79768, 1F31CA103768-01] NR 69 TC 6 Z9 7 U1 0 U2 1 PU BEGELL HOUSE INC PI NEW YORK PA 145 MADISON AVE, STE 601, NEW YORK, NY 10016-7892 USA SN 0731-8898 J9 J ENVIRON PATHOL TOX JI J. Environ. Pathol. Toxicol. Oncol. PY 2005 VL 24 IS 3 BP 175 EP 192 DI 10.1615/JEnvPathToxOncol.v24.i3.40 PG 18 WC Toxicology SC Toxicology GA 950LT UT WOS:000230859400004 PM 16050802 ER PT J AU Russell, LB Suh, DC Safford, MM AF Russell, LB Suh, DC Safford, MM TI Time requirements for diabetes self-management: Too much for many? SO JOURNAL OF FAMILY PRACTICE LA English DT Article ID MEDICATION ADHERENCE; AFRICAN-AMERICAN; CARE; BARRIERS; OUTCOMES; WOMEN AB Background In Crossing the Quality Chasm, the Institute of Medicine laid out principles to improve quality of care and identified chronic diseases as a starting point. One of those principles was the wise use of patient time, but current recommendations for chronic conditions do not consider time spent on self-care or its impact on patients' lives. Objective To estimate the time, required for recommended diabetes self-care. Methods A convenience sample of 8 certified diabetes educators derived consensus-based estimates of the time required for all self-care tasks recommended by the American Diabetes Association. Results For experienced patients with type 2 diabetes controlled by oral agents, recommended self-care would require more than 2 extra hours daily. Elderly patients and those with newly diagnosed disease, or those with physical limitations, would need more time. Exercise and diet, required for self-care of many chronic conditions, are the most time-consuming tasks. Conclusion The time required by recommended self-care is substantial. Crossing the duality Chasm suggests how clinicians and guideline developers can help patients make the best use of their self-care time: elicit the patient's perspective; develop evidence on the health consequences of self-care tasks; and respect patients' time. C1 Rutgers State Univ, Inst Hlth Hlth Care Policy & Aging Res, New Brunswick, NJ 08903 USA. Rutgers State Univ, Dept Pharm Practice & Adm, Piscataway, NJ USA. Univ Alabama, Sch Med, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. RP Safford, MM (reprint author), MT 643,1717 11th Ave S, Birmingham, AL 35294 USA. EM msafford@uab.edu NR 24 TC 53 Z9 53 U1 0 U2 4 PU DOWDEN PUBLISHING CORP PI MONTVALE PA 110 SUMMIT AVE, MONTVALE, NJ 07645-1712 USA SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD JAN PY 2005 VL 54 IS 1 BP 52 EP 56 PG 5 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 891RV UT WOS:000226599300012 PM 15623407 ER PT J AU Allen, E Nicolaidis, C Helfand, M AF Allen, E Nicolaidis, C Helfand, M TI The evaluation of rectal bleeding in adults - A cost-effectiveness analysis comparing four diagnostic strategies SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Review DE rectal bleeding; hematochezia; cost-effectiveness analysis; diagnosis; colorectal cancer ID DOUBLE-CONTRAST BARIUM; QUALITY-OF-LIFE; COLORECTAL-CANCER; ENEMA EXAMINATION; FLEXIBLE SIGMOIDOSCOPY; COLONIC POLYPS; COLONOSCOPIC PERFORATIONS; UNRESECTED POLYPS; GENERAL-PRACTICE; SINGLE-CONTRAST AB BACKGROUND: Though primary care patients commonly present with rectal bleeding, the optimal evaluation strategy remains unknown. OBJECTIVE: To compare the cost-effectiveness of four diagnostic strategies in the evaluation of rectal bleeding. DESIGN: Cost-effectiveness analysis using a Markov decision model. DATA SOURCES:Systematic review of the literature, Medicare reimbursement data, Surveillance, Epidemiology, and End Results (SEER) Cancer Registry. TARGET POPULATION: Patients over age 40 with otherwise asymptomatic rectal bleeding. TIME HORIZON: The patient's lifetime. PERSPECTIVE: Modified societal perspective. INTERVENTIONS: Watchful waiting, flexible sigmoidoscopy, flexible sigmoidoscopy followed by air contrast barium enema (FS+ACBE), and colonoscopy. OUTCOME MEASURES: Incremental cost-effectiveness ratio. RESULTS OF BASE-CASE ANALYSIS: The incremental cost-effectiveness ratio for colonoscopy compared with flexible sigmoidoscopy was $5,480 per quality-adjusted year of life saved (QALY). Watchful waiting and FS+ACBE were more expensive and less effective than colonoscopy. RESULTS OF SENSITIVITY ANALYSES: The cost of colonoscopy was reduced to $1,686 per QALY when age at entry was changed to 45. Watchful waiting became the least expensive strategy when community procedure charges replaced Medicare costs, when age at entry was maximized to 80, or when the prevalence of polyps was lowered to 7%, but the remaining strategies provided greater life expectancy at relatively low cost. The strategy of FS+ACBE remained more expensive and less effective in all analyses. In the remaining sensitivity analyses, the incremental cost-effectiveness of colonoscopy compared with flexible sigmoidoscopy never rose above $34,000. CONCLUSIONS: Colonoscopy is a cost-effective method to evaluate otherwise asymptomatic rectal bleeding, with a low cost per QALY compared to other strategies. C1 Portland Vet Affairs Med Ctr, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Allen, E (reprint author), Portland Vet Affairs Med Ctr, P3-Med,POB 1034, Portland, OR 97207 USA. EM allenel@ohsu.edu NR 107 TC 9 Z9 9 U1 1 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 JAN PY 2005 VL 20 IS 1 BP 81 EP 90 DI 10.1111/j.1525-1497.2005.40077.x PG 10 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 895YF UT WOS:000226899900014 PM 15693933 ER PT J AU Gerrity, MS Tierney, W AF Gerrity, MS Tierney, W TI Online early and other changes in JGIM SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material C1 Portland VA Med Ctr, Portland, OR USA. Indiana Univ, Sch Med, Indianapolis, IN 46204 USA. RP Gerrity, MS (reprint author), Portland VA Med Ctr, Portland, OR USA. NR 5 TC 2 Z9 2 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 JAN PY 2005 VL 20 IS 1 BP 95 EP 95 DI 10.1111/j.1525-1497.2005.04003.x PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 895YF UT WOS:000226899900016 ER PT J AU Budoff, JE Lichtman, DM AF Budoff, JE Lichtman, DM TI Spontaneous wrist fusion: An unusual complication of Kienbock's disease SO JOURNAL OF HAND SURGERY-AMERICAN VOLUME LA English DT Article DE autofusion; avascular necrosis; carpus; radial; shortening; spontaneous fusion; ankylosis; lunate; Kienbock's disease ID INTRAOSSEOUS PRESSURE; LUNATE; RADIUS AB We report a case of spontaneous wrist fusion occurring in a magnetic resonance image (MRI)-proven stage I Kienbock's disease. The purpose of this case 'report' is to make hand surgeons aware of this potential finding and to alert hand surgeons and radiologists that diffuse MRI changes of the lunate may not necessarily be pathognomonic for Kienbock's disease. (Copyright (C) 2005 by the American Society for Surgery of the Hand.). C1 Baylor Coll Med, Dept Orthopaed Surg, Houston, TX 77030 USA. John Peter Smith Hosp, Dept Orthopaed Surg, Ft Worth, TX USA. Houston VAMC, Dept Orthopaed, Houston, TX USA. RP Budoff, JE (reprint author), Baylor Coll Med, Dept Orthopaed Surg, 6550 Fannin,2500, Houston, TX 77030 USA. NR 13 TC 1 Z9 1 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 0363-5023 J9 J HAND SURG-AM JI J. Hand Surg.-Am. Vol. PD JAN PY 2005 VL 30A IS 1 BP 59 EP 64 DI 10.1016/j.jhsa.2004.09.003 PG 6 WC Orthopedics; Surgery SC Orthopedics; Surgery GA 896EK UT WOS:000226917200008 PM 15680556 ER PT J AU Budoff, JE Kraushaar, BS Ayala, G AF Budoff, JE Kraushaar, BS Ayala, G TI Flexor carpi unaris tendinopathy SO JOURNAL OF HAND SURGERY-AMERICAN VOLUME LA English DT Article DE flexor carpi ulnaris; tendinosis; tendinopathy; ulnar-sided wrist pain; flexor carpi ulnaris tendinopathy ID ACUTE CALCIFIC TENDINITIS; TENNIS ELBOW; PERITENDINITIS CALCAREA; SURGICAL-TREATMENT; WRIST; TENDINOSIS; TENDON; HAND AB Purpose: This study describes the pathology of flexor carpi ulnaris (FCU) tendinopathy and its treatment. Methods: Five patients (1 bilateral) who failed nonsurgical management of FCU tendinopathy had FCU tendon debridement. The excised tendon was examined histologically and 4 patients (1 bilateral) were followed-up for at least 12 months. Results: The pathology was degenerative tendinosis (angiofibroblastic hyperplasia) in all specimens, identical to that observed in tennis elbow and the rotator cuff. Surgical excision of the pathologic degeneration gave excellent pain relief in all cases. Conclusions: The pathology of FCU tendinopathy (ie, degenerative tendinosis) is similar to that of other extrasynovial tendons. Surgical debridement of the pathologic tendinosis tissue is effective treatment for patients who fail nonsurgical management. Copyright (C) 2005 by the American Society for Surgery of the Hand. C1 Baylor Coll Med, Dept Orthopaed Surg, Dept Pathol, Houston, TX 77030 USA. Houston VA Med Ctr, Spring Valley, NY USA. RP Budoff, JE (reprint author), 6550 Fannin,2525, Houston, TX 77030 USA. NR 37 TC 11 Z9 11 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 0363-5023 J9 J HAND SURG-AM JI J. Hand Surg.-Am. Vol. PD JAN PY 2005 VL 30A IS 1 BP 125 EP 129 DI 10.1016/j.jhsa.2004.07.018 PG 5 WC Orthopedics; Surgery SC Orthopedics; Surgery GA 896EK UT WOS:000226917200019 PM 15680567 ER PT J AU Bogaert, Y Grippa, J Nemenoff, R Reusch, JEB AF Bogaert, Y Grippa, J Nemenoff, R Reusch, JEB TI cAMP response element binding protein and collagen 1 impact on vascular smooth muscle cell gene regulation and phenotype. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Denver VAMC, Denver, CO USA. Univ Colorado, Denver, CO 80202 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 387 BP S146 EP S146 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700400 ER PT J AU Dahms, WJ Wagner, B Gorin, Y Abboud, HE AF Dahms, WJ Wagner, B Gorin, Y Abboud, HE TI NADPH oxidase-derived reactive oxygen species generation is increased in puromycin aminonucleoside nephropathy. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Div Nephrol, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 331 BP S312 EP S312 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700851 ER PT J AU Goel, A Brooks-Worrell, B Chiu, H Palmer, JP AF Goel, A Brooks-Worrell, B Chiu, H Palmer, JP TI T cell proliferative and cytokine responses to islet proteins in autoantibody negative type 2 patients. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 431 BP S153 EP S154 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700444 ER PT J AU Kertesz, S Rose, S Palonen, K Kirk, K Halanych, J Safford, M Kiefe, C AF Kertesz, S Rose, S Palonen, K Kirk, K Halanych, J Safford, M Kiefe, C TI Access to outpatient diabetes care for homeless and housed veterans: More equal than not? SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Univ Alabama, Birmingham, AL USA. Birmingham VA Med Ctr, Birmingham, AL USA. VA Qual Scholars, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 3 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 226 BP S292 EP S293 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700746 ER PT J AU Kulig, CC Beresford, TP Everson, GT AF Kulig, CC Beresford, TP Everson, GT TI Correlations between fatty acid ethyl ester levels, feeding status and serum lipids after acute alcohol ingestion. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Denver VA Med Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 415 BP S151 EP S151 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700428 ER PT J AU Lee, MJ Feliers, D Choudhury, GG Kasinath, BS AF Lee, MJ Feliers, D Choudhury, GG Kasinath, BS TI Glucose-induced hypertrophy of glomerular epithelial cells: A role for AMP kinase. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Univ Texas, Hlth Sci Ctr, S Texas Vet Healthcare Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 436 BP S331 EP S331 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700956 ER PT J AU Mariappan, MM Choudhury, GG Kasinath, BS AF Mariappan, MM Choudhury, GG Kasinath, BS TI High glucose, high insulin and their combination induce laminin BETA-1 synthesis in proximal tubular epithelial (MCT) cells: Involvement of translation mechanism. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 426 BP S329 EP S329 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700946 ER PT J AU Njoku, CJ Gilkeson, GS Patrick, KS Oates, JC AF Njoku, CJ Gilkeson, GS Patrick, KS Oates, JC TI Effect of inducible nitric oxide synthase inhibitors on isoprostane production in murine lupus nephritis. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 362 BP S317 EP S317 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700882 ER PT J AU Pereira, RI Draznin, B AF Pereira, RI Draznin, B TI Effect of insulin on adiponectin secretion from 3t3-L1 adipocytes is phosphatidylinositol 3-kinase dependent. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 UCHSC, Denver, CO USA. Denver VAMC, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 459 BP S158 EP S158 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700472 ER PT J AU Rehman, SU Hutchison, FN Egan, BM AF Rehman, SU Hutchison, FN Egan, BM TI Comparison of racial/ethnic differences in blood pressure control rates among VA and non-VA hypertensive men. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 399 BP S324 EP S324 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700919 ER PT J AU Schauer, I Reusch, J AF Schauer, I Reusch, J TI Effects of free fatty acids on intracellular signaling through CREB protein in vascular smooth muscle cells: Implications for atherosclerosis. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Denver VAMC, Denver, CO USA. Univ Colorado, Denver, CO 80202 USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 456 BP S158 EP S158 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700469 ER PT J AU Scremin, M Leach, C Kunkel, C AF Scremin, M Leach, C Kunkel, C TI Thermal skin hyperemia as a diagnostic tool in peripheral vascular disease. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Western Univ Hlth Sci, Coll Osteopath Med Pacific, Pomona, CA 91766 USA. VA Greater Los Angeles Healthcare Syst, Pomona, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 1 BP S78 EP S78 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700015 ER PT J AU Tong, J McNeely, MJ Hull, RL Carr, DB Utzschneider, KM Shofer, JB Boyko, EJ Leonetti, DL Kahn, SE Fujimoto, WY AF Tong, J McNeely, MJ Hull, RL Carr, DB Utzschneider, KM Shofer, JB Boyko, EJ Leonetti, DL Kahn, SE Fujimoto, WY TI Intra-abdominal fat predicts future development of the metabolic syndrome in non-diabetic Japanese-Americans. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 318 BP S134 EP S134 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700331 ER PT J AU Utzschneider, KM Prigeon, RL Carr, DB Tong, J Hull, RL Knopp, RH Kahn, SE AF Utzschneider, KM Prigeon, RL Carr, DB Tong, J Hull, RL Knopp, RH Kahn, SE TI Evidence fora hyperbolic relationship between insulin sensitivity and the insulin response derived from an oral glucose tolerance test. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract 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 B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 167 BP S107 EP S107 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700181 ER PT J AU Vanek, C Kansagor, JN Munsey, T Olson, DA Belknap, JK Shea, M Orwoll, ES Klein, RF AF Vanek, C Kansagor, JN Munsey, T Olson, DA Belknap, JK Shea, M Orwoll, ES Klein, RF TI Genetic dissection of femoral bone strength in mice. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Portland VA Med Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 400 BP S148 EP S148 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700413 ER PT J AU Wagner, B Gorin, Y Ricono, JM Abboud, HE AF Wagner, B Gorin, Y Ricono, JM Abboud, HE TI The phospholipase C-gamma domain of the platelet-derived growth factor receptor beta inhibits platelet-derived growth factor receptor dependent Akt/PKB and ERK1/2 pathways in metanephric mesenchymal cells. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Univ Texas, Hlth Sci Ctr, Div Nephrol, San Antonio, TX USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 434 BP S330 EP S330 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700954 ER PT J AU Wang, CCL Draznin, B AF Wang, CCL Draznin, B TI Insulin and oxidant stress effects on early growth response gene-1 expression are mediated differently in vascular smooth muscle cells. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Denver VA Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 159 BP S105 EP S105 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700173 ER PT J AU Weisbart, RH Chan, G Wakelin, R Nishimura, RN Hansen, JE Chang, SS Baresi, L Chamberlain, JS AF Weisbart, RH Chan, G Wakelin, R Nishimura, RN Hansen, JE Chang, SS Baresi, L Chamberlain, JS TI Development of a lupus anti-DNA antibody as an intracellular delivery vehicle for protein transduction of micro-dystrophin. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract C1 Vet Affairs Greater Los Angeles Hlth Care Syst, Dept Res, Sepulveda, CA USA. Olive View UCLA Med Ctr, Sylmar, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA USA. Calif State Univ Northridge, Dept Biol, Northridge, CA 91330 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2005 VL 53 IS 1 SU S MA 292 BP S129 EP S129 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 890VR UT WOS:000226539700305 ER PT J AU Wall, TC Mian, MAH Ray, MN Casebeer, L Collins, BC Kiefe, CI Weissman, N Allison, JJ AF Wall, TC Mian, MAH Ray, MN Casebeer, L Collins, BC Kiefe, CI Weissman, N Allison, JJ TI Improving physician performance through Internet-based interventions: Who will participate? SO JOURNAL OF MEDICAL INTERNET RESEARCH LA English DT Article DE physician recruitment; chlamydia; chlamydiosis; Internet-based interventions; continuing medical education ID CONTINUING MEDICAL-EDUCATION; PRIMARY-CARE RESEARCH; RECRUITMENT AB Background: The availability of Internet-based continuing medical education is rapidly increasing, but little is known about recruitment of physicians to these interventions. Objective: The purpose of this study was to examine predictors of physician participation in an Internet intervention designed to increase screening of young women at risk for chlamydiosis. Methods: Eligibility was based on administrative claims data, and eligible physicians received recruitment letters via fax and/or courier. Recruited offices had at least one physician who agreed to participate in the study by providing an email address. After one physician from an office was recruited, intensive recruitment of that office ceased. Email messages reminded individual physicians to participate by logging on to the Internet site. Results: Of the eligible offices, 325 (33.2%) were recruited, from which 207 physicians (52.8%) participated. Recruited versus nonrecruited offices had more eligible patients (mean number of eligible patients per office: 44.1 vs 33.6; P < .001), more eligible physicians (mean number of eligible physicians per office: 6.2 vs 4.1; P < .001), and fewer doctors of osteopathy (mean percent of eligible physicians per office who were doctors of osteopathy: 20.5% vs 26.4%; P = .02). Multivariable analysis revealed that the odds of recruiting at least one physician from an office were greater if the office had more eligible patients and more eligible physicians. More participating versus nonparticipating physicians were female (mean percent of female recruited physicians: 39.1% vs 27.0%; P = .01); fewer participating physicians were doctors of osteopathy (mean percent of recruited physicians who were doctors of osteopathy: 15.5% vs 23.9%; P = .04) or international medical graduates (mean percent of recruited physicians who were international graduates: 12.3% vs 23.8%; P = .003). Multivariable analysis revealed that the odds of a physician participating were greater if the physician was older than 55 years (OR = 2.31; 95% CI = 1.09-4.93) and was from an office with a higher Chlamydia screening rate in the upper tertile (OR = 2.26; 95% CI = 1.23-4.16). Conclusions: Physician participation in an Internet continuing medical education intervention varied significantly by physician and office characteristics. C1 Univ Alabama, Dept Pediat, Birmingham, AL USA. Univ Alabama, Ctr Outcomes & Effectiveness Res & Educ, Birmingham, AL USA. Univ Alabama, Sch Hlth Related Profess, Birmingham, AL USA. Univ Alabama, Dept Hlth Serv Adm, Birmingham, AL USA. Univ Alabama, Div Continuing Med Educ, Birmingham, AL USA. Univ Alabama, Dept Med, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Wall, TC (reprint author), 1616 6th Ave S,Suite 201, Birmingham, AL 35233 USA. EM twall@peds.uab.edu FU AHRQ HHS [U18 HS011124, U18 HS11124] NR 14 TC 10 Z9 10 U1 0 U2 2 PU JOURNAL MEDICAL INTERNET RESEARCH PI TORONTO PA TORONTO GENERAL HOSPITAL, R FRASER ELLIOTT BLDG, 4TH FL, R 4S435, 190 ELIZABETH ST, TORONTO, ON M5G 2C4, CANADA SN 1438-8871 J9 J MED INTERNET RES JI J. Med. Internet Res. PY 2005 VL 7 IS 4 BP 25 EP 34 AR e48 DI 10.2196/jmir.7.4.e48 PG 10 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA 010SK UT WOS:000235218000003 PM 16236700 ER PT J AU Kitsis, RN Mann, DL AF Kitsis, RN Mann, DL TI Apoptosis and the heart: a decade of progress SO JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY LA English DT Editorial Material DE apoptosis; heart; decade of progress ID CARDIAC MYOCYTE APOPTOSIS; FAILING HUMAN HEART; TRANSGENIC MICE; IN-VIVO; INJURY; FAILURE; DEATH; OVEREXPRESSION; CARDIOMYOPATHY AB In this Focused Issue we have attempted to highlight several important areas concerning the role of apoptosis in the heart. Seven articles written by leading investigators in the field should provide a timely review of our current understanding of the role of apoptosis in the adult mammalian heart. (C) 2004 Elsevier Ltd. All rights reserved. C1 Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Winters Ctr Heart Failure Res, Houston, TX 77030 USA. Yeshiva Univ Albert Einstein Coll Med, Ctr Canc, Bronx, NY 10461 USA. Yeshiva Univ Albert Einstein Coll Med, Cardiovasc Res Ctr, Dept Med, Bronx, NY 10461 USA. Yeshiva Univ Albert Einstein Coll Med, Cardiovasc Res Ctr, Dept Cell Biol, Bronx, NY 10461 USA. RP Mann, DL (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Winters Ctr Heart Failure Res, MS 524,6565 Fannin, Houston, TX 77030 USA. EM dmann@bcm.tmc.edu OI Mann, Douglas /0000-0002-2516-0145 NR 14 TC 30 Z9 35 U1 0 U2 2 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 JAN PY 2005 VL 38 IS 1 BP 1 EP 2 DI 10.1016/j.yjmcc.2004.11.008 PG 2 WC Cardiac & Cardiovascular Systems; Cell Biology SC Cardiovascular System & Cardiology; Cell Biology GA 889DL UT WOS:000226423600001 PM 15623416 ER PT J AU Oh, DS Lieu, SN Yamaguchi, DJ Tachiki, K Lambrecht, N Ohning, GV Sachs, C Germano, PM Pisegna, JR AF Oh, DS Lieu, SN Yamaguchi, DJ Tachiki, K Lambrecht, N Ohning, GV Sachs, C Germano, PM Pisegna, JR TI PACAP regulation of secretionland proliferation of pure populations of gastric ECL cells SO JOURNAL OF MOLECULAR NEUROSCIENCE LA English DT Article DE ECL cells; Fluor-PACAP; FACS; PAC1 ID ENTEROCHROMAFFIN-LIKE CELLS; ACID-SECRETION; RAT AB The gastric enterochromaffin-like (ECL) cell plays a major role in the regulation of gastric acid secretion. We have previously described that Pituitary Adenylate Cyclase-Activating Polypeptide (PACAP) is present on myenteric neurons in the rat and colocalizes with its high-affinity receptor, PAC1, expressed on the surface of gastric ECL cells. The study of ECL cell physiology has been hampered by the inability to isolate and purify ECL cells to homogeneity. Density gradient elutriation alone yields only 65-70% purity of ECL cells. In the present study, we used fluorescence-activated cell sorting (FACS) with a novel fluorescent ligand, Fluor-PACAP-38, for isolating pure ECL cells. FACS was used to isolate ECL cells based on their relatively small size, low density, and ability to bind the fluorescent ligand Fluor-PACAP-38. The sorted cells were unambiguously identified as ECL cells by immunohistochemical analysis using anti-PACAP type-I (PAC1), anti-histidine decarboxylase (HDC), and anti-somatostatin antibodies. Further confocal microscopy demonstrated that Fluor-PACAP-38, a ligand with a higher affinity for PAC1, bound to extracellular receptors of these FACS-purified cells. FACS yielded an average of 2 million ECL cells/4 rat stomachs, and > 99% of the sorted cells were positive for PAC1 receptor and HDC expression. The absence of immunohistochemical staining for somatostatin indicated lack of contamination by gastric D cells, which are similar in size and shape to the ECL cells. Internalization of PACAP receptors and a rapid Ca2+ response in purified ECL cells were observed upon PACAP activation, suggesting that these cells are viable and biologically active. These ECL cells demonstrated a dose-dependent stimulation of proliferation in response to PACAP, with a maximum of 30% proliferation at a concentration of 10(-7)M. Microarray studies were performed to confirm the expression of genes specific for ECL cells. These results demonstrate that rat gastric ECL cells can be isolated to homogeneity by using a combination of density gradient centrifugation, followed by cell sorting using Fluor-PACAP. These techniques now allow microarray studies to be performed in ECL cells to characterize their functional gene expression and will facilitate pharmacological, biochemical, and molecular studies on ECL cell function. C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Gastroenterol & Hepatol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Res & Dev, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, CURE, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, VA Digest Dis Res Ctr, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, VA Digest Dis Res Ctr, Dept Pathol & Lab Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, VA Digest Dis Res Ctr, Dept Physiol, Los Angeles, CA 90073 USA. RP Pisegna, JR (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Gastroenterol & Hepatol, Los Angeles, CA 90073 USA. EM jpisegna@ucla.edu NR 8 TC 10 Z9 11 U1 0 U2 2 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0895-8696 J9 J MOL NEUROSCI JI J. Mol. Neurosci. PY 2005 VL 26 IS 1 BP 85 EP 97 DI 10.1385/JMN26:03:85 PG 13 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 944FT UT WOS:000230412700008 PM 15968088 ER PT J AU Luttrell, LM AF Luttrell, LM TI Composition and function of G protein-coupled receptor signalsomes controlling mitogen-activated protein kinase activity SO JOURNAL OF MOLECULAR NEUROSCIENCE LA English DT Article; Proceedings Paper CT 2nd Wenner-Gren International Symposium CY SEP 08-11, 2004 CL Stockholm, SWEDEN SP Wenner-Gren Fdn DE G protein-coupled receptor; focal adhesion; epidermal growth factor; arrestin; mitogen-activated protein kinase; extracellular signal-regulated kinase ID EPIDERMAL-GROWTH-FACTOR; NUCLEAR EXPORT SIGNAL; SMOOTH-MUSCLE-CELLS; BETA-ARRESTIN; ANGIOTENSIN-II; EGF RECEPTOR; ERK ACTIVATION; BETA(2)-ADRENERGIC RECEPTOR; REGULATED KINASES; CLATHRIN ADAPTER AB Seven membrane-spanning G protein-coupled receptors (GPCRs) function as ligand-activated guanine nucleotide exchange factors for heterotrimeric guanine nucleotide-binding (G) proteins that relay extracellular stimuli by activating intracellular effector enzymes or ion channels. Recent work, however, has shown that GPCRs also participate in numerous other protein-protein interactions that generate intracellular signals in conjunction with, or even independent of, G-protein activation. Nowhere has the importance of protein complex assembly in GPCR signaling been demonstrated more clearly than in the control of the spatial and temporal activity of the extracellular signal-regulated kinase (ERK1/2) mitogen-activated protein (MAP) kinase cascade. ERK1/2 activation by GPCRs often involves cross talk with classical receptor tyrosine kinases or focal adhesion complexes, which scaffold the assembly of a Ras activation complex. Even more surprising is the phenomenon of G protein-independent signaling using beta-arrestins, proteins originally characterized for their role in homologous GPCR desensitization, as scaffolds for the assembly of a multiprotein signalsome directly upon the GPCR. Although both forms of signaling lead to MAP kinase activation, the pathways appear to be functionally, as well as mechanistically, distinct. Transactivated receptor tyrosine kinases mediate rapid and transient MAP kinase activation that favors nuclear translocation of the kinases and transcriptional activation. In contrast, beta-arrestin-dependent signaling produces a slower and more sustained increase in MAP kinase activity that is often restricted to the cytosol. Together, these highly organized signaling complexes dictate the location, duration, and ultimate function of GPCR-stimulated MAP kinase activity. C1 Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29401 USA. RP Luttrell, LM (reprint author), Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. EM luttrell@musc.edu FU NIDDK NIH HHS [DK 55524, DK 64353] NR 56 TC 78 Z9 82 U1 0 U2 3 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0895-8696 J9 J MOL NEUROSCI JI J. Mol. Neurosci. PY 2005 VL 26 IS 2-3 SI SI BP 253 EP 263 DI 10.1385/JMN/06:02:253 PG 11 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 944FU UT WOS:000230412800017 PM 16012199 ER PT J AU Ayasolla, KR Giri, S Singh, AK Singh, I AF Ayasolla, Kamesh R. Giri, Shailendra Singh, Avtar K. Singh, Inderjit TI 5-aminoimidazole-4-carboxamide-1-beta-4-ribofuranoside (AICAR) attenuates the expression of LPS- and A beta peptide-induced inflammatory mediators in astroglia SO JOURNAL OF NEUROINFLAMMATION LA English DT Article AB Background: Alzheimer's disease (AD) pathology shows characteristic 'plaques' rich in amyloid beta (A beta) peptide deposits. Inflammatory process-related proteins such as pro-inflammatory cytokines have been detected in AD brain suggesting that an inflammatory immune reaction also plays a role in the pathogenesis of AD. Glial cells in culture respond to LPS and A beta stimuli by upregulating the expression of cytokines TNF-alpha, IL-1 beta, and IL-6, and also the expression of proinflammatory genes iNOS and COX-2. We have earlier reported that LPS/A beta stimulation-induced ceramide and ROS generation leads to iNOS expression and nitric oxide production in glial cells. The present study was undertaken to investigate the neuroprotective function of AICAR (a potent activator of AMP-activated protein kinase) in blocking the pro-oxidant/proinflammatory responses induced in primary glial cultures treated with LPS and A beta peptide. Methods: To test the anti-inflammatory/anti-oxidant functions of AICAR, we tested its inhibitory potential in blocking the expression of pro-inflammatory cytokines and iNOS, expression of COX-2, generation of ROS, and associated signaling following treatment of glial cells with LPS and A beta peptide. We also investigated the neuroprotective effects of AICAR against the effects of cytokines and inflammatory mediators (released by the glia), in blocking neurite outgrowth inhibition, and in nerve growth factor-(NGF) induced neurite extension by PC-12 cells. Results: AICAR blocked LPS/A beta-induced inflammatory processes by blocking the expression of proinflammatory cytokine, iNOS, COX-2 and MnSOD genes, and by inhibition of ROS generation and depletion of glutathione in astroglial cells. AICAR also inhibited down-stream signaling leading to the regulation of transcriptional factors such as NF kappa B and C/EBP which are critical for the expression of iNOS, COX-2, MnSOD and cytokines (TNF-alpha/IL-1 beta and IL-6). AICAR promoted NGF-induced neurite growth and reduced neurite outgrowth inhibition in PC-12 cells treated with astroglial conditioned medium. Conclusion: The observed anti-inflammatory/anti-oxidant and neuroprotective functions of AICAR suggest it as a viable candidate for use in treatment of Alzheimer's disease. C1 [Ayasolla, Kamesh R.; Giri, Shailendra; Singh, Inderjit] Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. [Ayasolla, Kamesh R.] Med Univ S Carolina, Dept Pathol, Charleston, SC 29425 USA. [Ayasolla, Kamesh R.] Med Univ S Carolina, Dept Obstet & Gynaecol, Charleston, SC 29425 USA. [Singh, Avtar K.] Ralph H Johnson VA Med Ctr, Dept Pathol, Charleston, SC 29425 USA. RP Singh, I (reprint author), Med Univ S Carolina, Dept Pediat, 171 Ashley Ave, Charleston, SC 29425 USA. EM ayasolkr@musc.edu; giris@musc.edu; Avtar.Singh@med.va.gov; singhi@musc.edu OI Ayasolla, kameshwar/0000-0002-4265-2168 FU National Institutes of Health [NS-22576, NS-34741, NS-40144, NS-40810, NS-37766] FX The authors wish to thank Dr. Shailendra Giri for his immense help during various stages of experimentation and in the process of preparation of the manuscript. We also thank Ramandeep Rattan for laboratory assistance, Dr. Manu Jatana for his assistance with microscopy and Ms. Joyce Bryan for secretarial help. This work was supported in parts by grants (NS-22576, NS-34741, NS-40144, NS-40810 and NS-37766) from National Institutes of Health. NR 67 TC 18 Z9 18 U1 0 U2 2 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1742-2094 J9 J NEUROINFLAMM JI J. Neuroinflamm. PY 2005 VL 2 AR 21 DI 10.1186/1742-2094-2-21 PG 21 WC Immunology; Neurosciences SC Immunology; Neurosciences & Neurology GA V29PC UT WOS:000208759300021 PM 16174294 ER PT J AU Bhidayasiri, R Miyata, H Bronstein, JM Schweitzer, J Saber, PA Vinters, HV AF Bhidayasiri, R Miyata, H Bronstein, JM Schweitzer, J Saber, PA Vinters, HV TI Postmortem analysis of pallidotomy in Parkinson's disease SO JOURNAL OF NEUROLOGY LA English DT Letter ID HEAT-STRESS C1 Univ Calif Los Angeles, Med Ctr, Reed Neurol Res Inst, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Med Ctr, Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. W Los Angeles Vet Affairs Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Los Angeles, CA 90027 USA. Tottori Univ, Fac Med, Inst Neurol Sci, Dept Neuropathol, Tottori 6838504, Japan. Kaiser Permanente Med Ctr, Dept Surg, Los Angeles, CA 90027 USA. Kaiser Permanente Med Ctr, Dept Pathol, Los Angeles, CA 90027 USA. RP Bhidayasiri, R (reprint author), Univ Calif Los Angeles, Med Ctr, Reed Neurol Res Inst, Dept Neurol, 710 Westwood Plaza, Los Angeles, CA 90095 USA. EM rbh@ucla.edu OI Bhidayasiri, Roongroj/0000-0002-6901-2064 FU NIA NIH HHS [P01 AG 16570]; NINDS NIH HHS [P50 NS 38367] NR 4 TC 1 Z9 1 U1 0 U2 0 PU DR DIETRICH STEINKOPFF VERLAG PI DARMSTADT PA PO BOX 10 04 62, D-64204 DARMSTADT, GERMANY SN 0340-5354 J9 J NEUROL JI J. Neurol. PD JAN PY 2005 VL 252 IS 1 BP 100 EP 102 DI 10.1007/s00415-005-0593-6 PG 3 WC Clinical Neurology SC Neurosciences & Neurology GA 887RB UT WOS:000226322100018 PM 15654563 ER PT J AU Behnam, K Phillips, ML Sliva, JDP Brochmann, EJ Duarte, MEL Murray, SS AF Behnam, K Phillips, ML Sliva, JDP Brochmann, EJ Duarte, MEL Murray, SS TI BMP binding peptide: a BMP-2 enhancing factor deduced from the sequence of native bovine bone morphogenetic protein/non-collagenous protein SO JOURNAL OF ORTHOPAEDIC RESEARCH LA English DT Article AB Forty years ago, Marshall Urist described a partially purified extract of dermineralized bone matrix which induced the formation of ectopic bone. This substance, bone rnorphogenetic protein/non-collagenous protein (BMP\NCP), was never purified to homogeneity but other investigators used similar starting materials to clone a number of recombinant B-MPs. Urist recognized that his material probably contained the BMPs which had been cloned by others but always contended that it contained another, more potent, bone inducing material which differed significantly in its physical and chemical properties from the known BMPs. We have used Urist's protocol to isolate a protein that has the chemical and physical properties of Urist's "BMP". It is an 18.5 kD fragment of the bone matrix protein, SPP-24. This fragment contains the cystatin-like domain of SPP-24. We have located a 19 amino acid region which is similar to the TGF-beta/BMP-binding region of fetuin. a member of the cystatin family of protease inhibitors. A cyclic peptide, which we call BMP binding peptide (BBP) was generated rising this sequence. The peptide avidly bound rhBMP-2 with a K-D of 3 x 10(-5) M. When implanted alone in mouse muscle, the peptide frequently induced dystrophic calcification. When implanted with rhBMP-2. the peptide enhanced the osteogenic activity of the recombinant molecule. We hypothesize that Urist's "BMP" was a fragment of SPP-24 which influenced bone induction by binding to bone morphogenetic proteins. BBP may be clinically useful because of its effects on other bone-inducing Substances. Published by Elsevier Ltd. on behalf of Orthopaedic Research society. C1 Greater Los Angeles VA Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Sepulveda Ambulatory Care Ctr & Nursing Home, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Dept Physiol Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, DOE Biochem, Dept Chem & Biochem, Instrumentat Facil, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Fed Rio de Janeiro, Dept Histol & Embryol, BR-21941590 Rio De Janeiro, Brazil. RP Murray, SS (reprint author), Greater Los Angeles VA Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Sepulveda Ambulatory Care Ctr & Nursing Home, 16111 Plummer St, Sepulveda, CA 91343 USA. EM murrayes@ulca.edu NR 8 TC 36 Z9 38 U1 1 U2 8 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0736-0266 J9 J ORTHOP RES JI J. Orthop. Res. PD JAN PY 2005 VL 23 IS 1 BP 175 EP 180 DI 10.1016/j.orthres.2004.05.001 PG 6 WC Orthopedics SC Orthopedics GA 888BJ UT WOS:000226348900023 PM 15607890 ER PT J AU Genton, L Kudsk, KA Reese, SR Ikeda, S AF Genton, L Kudsk, KA Reese, SR Ikeda, S TI Enteral feeding preserves gut Th-2 cytokines despite mucosal cellular adhesion molecule-1 blockade SO JOURNAL OF PARENTERAL AND ENTERAL NUTRITION LA English DT Article ID LYMPHOID-TISSUE; EXPRESSION; MICE; NUTRITION; ADDRESSIN; MADCAM-1; IL-10; CELLS; LYMPHOCYTES AB Background: Parenteral nutrition (PN) decreases gut-associated lymphoid tissue (GALT), the intestinal IgA stimulating cytokines IL-4 and IL-10 in gut homogenates, intestinal IgA levels and the expression of Peyer patch (PP) mucosal cellular adhesion molecule-1 (MAdCAM-1), an adhesion molecule found on the high endothelial venules of PP and other tissues. IL-4 in PP stimulates MAdCAM expression in vitro. MAdCAM-1 blockade with MECA-367 reduces GALT cell populations to PN levels but maintains intestinal IgA levels if the animals are chow fed. This study compares IL-4 levels in PP of chow and PN fed mice and measures the effects of MAdCAM blockade on IL-4 and IL-10 levels in gut homogenates of chow fed mice. We hypothesized that in vivo IL-4 levels drop in PP of PN fed mice and IL-4 and IL-10 levels are maintained after MAdCAM-1 blockade in chow fed mice. Methods: Exp 1: 18 mice received chow or PN for 5 days to determine PP IL-4 levels. Exp 2: 44 mice were randomized to chow + control monoclonal antibody (mAb), chow + MECA-367 (anti-MAdCAM-1 mAb) or FIN for 4 days before measurement of IL-4 and IL-10 levels in gut homogenates. Results: Exp 1: IL-4 levels in vivo were lower in PP of PN-fed mice than chow fed mice (92.0 +/- 15.1 pg/mL vs 251.1 +/- 14.8, p = .0003). Exp 2: IL-4 levels were significantly higher in chow + control mAb (187.1 +/- 44.1 pg/mL) and chow + MECA-367 (110.9 +/- 19.1 pg/mL) groups than PN mice (21.8 +/- 30.6 pg/mL, p < .02 vs chow + control or chow + MECA-367). IL-10 levels were significantly lower with PN (23.1 +/- 40.9 pg/mL) with chow+control (174.0 +/- 22.2 pg/mL p < .01), or chow + MECA-367 (181.7 +/- 23.1 pg/mL, p < .02 vs PN). Conclusions: PN-feeding reduces in vivo IL-4 levels in PP (consistent with lowered MAdCAM-1 expression) and IL-4 and IL-10 levels in gut homogenates compared with chow. Despite MAdCAM-1 blockade, enteral feeding preserved gut IL-4 levels and increased IL-10 levels consistent with preserved IgA levels. C1 Univ Wisconsin, Sch Med, Dept Surg, Clin Sci Ctr H4 730, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Vet Adm Surg Serv, Madison, WI USA. RP Kudsk, KA (reprint author), Univ Wisconsin, Sch Med, Dept Surg, Clin Sci Ctr H4 730, 600 Highland Ave, Madison, WI 53792 USA. EM kudsk@surgery.wisc.edu FU NIGMS NIH HHS [R01 GM53439-06A1] NR 20 TC 9 Z9 9 U1 0 U2 1 PU AMER SOC PARENTERAL & ENTERAL NUTRITION PI SILVER SPRING PA 8630 FENTON STREET SUITE 412, SILVER SPRING, MD 20910 USA SN 0148-6071 J9 JPEN-PARENTER ENTER JI J. Parenter. Enter. Nutr. PD JAN-FEB PY 2005 VL 29 IS 1 BP 44 EP 47 DI 10.1177/014860710502900144 PG 4 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 887MN UT WOS:000226310300007 PM 15715273 ER PT J AU Johnson, CE Handberg, E Dobalian, A Gurol, N Pearson, V AF Johnson, CE Handberg, E Dobalian, A Gurol, N Pearson, V TI Improving perinatal and neonatal patient safety - The AHRQ patient safety indicators SO JOURNAL OF PERINATAL & NEONATAL NURSING LA English DT Article DE administrative data; patient safety; quality indicators ID HOSPITALS; MORTALITY; RATES AB This study reviews the development and implementation of the Agency for Healthcare Research and Quality (AHRQ) patient safety indicators (PSIs). The genesis of the use of administrative data as a tool to combat safety problems is presented, and how indicators were constructed using various administrative codes. Examples of how the PSIs are being used to identify potential safety problems within the general population are presented, with a special emphasis on how these are being used within the perinatal and neonatal arena to understand current issues within that subpopulation. Results from studies within the general population and targeted at perinatal and neonatal patients are presented. Finally, suggestions are discussed for clinicians to use the AHRQ PSIs as one of their early warning tools for potential safety-related problems. C1 N Florida S Georgia Vet Hlth Syst, Rehabil Outcomes Res Ctr Excellence, Gainesville, FL 32608 USA. Univ Florida, Dept Hlth Serv Res Management & Policy, Coll Publ Hlth & Hlth Profess, Gainesville, FL USA. Univ Florida, Div Cardiovasc Med, Gainesville, FL USA. VA Greater Los Angeles Healthcare Syst, Ctr Excellence Study Healthcare Provider Behav, Sepulveda Ambulatroy Care Ctr & Nursing Home, Sepulveda, CA USA. Shands AGH, Maternal Child Serv, Gainesville, FL USA. RP Johnson, CE (reprint author), N Florida S Georgia Vet Hlth Syst, Rehabil Outcomes Res Ctr Excellence, 1601 SW Archer Rd, Gainesville, FL 32608 USA. EM christopher.Johnson4@med.va.gov NR 16 TC 9 Z9 9 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0893-2190 J9 J PERINAT NEONAT NUR JI J. Perinat. Neonatal Nurs. PD JAN-MAR PY 2005 VL 19 IS 1 BP 15 EP 23 PG 9 WC Nursing; Obstetrics & Gynecology; Pediatrics SC Nursing; Obstetrics & Gynecology; Pediatrics GA 899MR UT WOS:000227149000007 PM 15796421 ER PT J AU Crosby, MB Svenson, JL Zhang, J Nicol, CJ Gonzalez, FJ Gilkeson, GS AF Crosby, MB Svenson, JL Zhang, J Nicol, CJ Gonzalez, FJ Gilkeson, GS TI Peroxisome proliferation-activated receptor (PPAR)gamma is not necessary for synthetic PPAR gamma agonist inhibition of inducible nitric-oxide synthase and nitric oxide SO JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS LA English DT Article ID NF-KAPPA-B; RECEPTOR-GAMMA; 15-DEOXY-DELTA(12,14)-PROSTAGLANDIN J(2); MACROPHAGE ACTIVATION; IN-VITRO; INFLAMMATORY CYTOKINES; INDUCED ARTHRITIS; IFN-GAMMA; LIGANDS; GENE AB Peroxisome proliferation-activated receptor (PPAR)gamma agonists inhibit inducible nitric-oxide synthase (iNOS), tumor necrosis factor-alpha, and interleukin-6. Because of these effects, synthetic PPARgamma agonists, including thiazolidinediones, are being studied for their impact on inflammatory disease. The anti-inflammatory concentrations of synthetic PPARgamma agonists range from 10 to 50 muM, whereas their binding affinity for PPARgamma is in the nanomolar range. The specificity of synthetic PPARgamma agonists for PPARgamma at the concentrations necessary for anti-inflammatory effects is thus in question. We report that PPARgamma is not necessary for the inhibition of iNOS by synthetic PPARgamma agonists. RAW 264.7 macrophages possess little PPARgamma, yet lipopolysaccharide (LPS)/interferon (IFN) gamma-induced iNOS was inhibited by synthetic PPARgamma agonists at 20 muM. Endogenous PPARgamma was inhibited by the transfection of a dominant-negative PPARgamma construct into murine mesangial cells. In the transfected cells, synthetic PPARgamma agonists inhibited iNOS production at 10 muM, similar to nontransfected cells. Using cells from PPARgamma Cre/lox conditional knockout mice, baseline and LPS/IFN gamma-induced nitric oxide levels were higher in macrophages lacking PPARgamma versus controls. However, synthetic PPARgamma agonists inhibited iNOS at 10 muM in the PPARgamma-deficient cells, similar to macrophages from wild-type mice. These results indicate that PPARgamma is not necessary for inhibition of iNOS expression by synthetic PPARgamma agonists at concentrations over 10 muM. Intrinsic PPARgamma function, in the absence of synthetic agonists, however, may play a role in inflammatory modulation. C1 Med Univ S Carolina, Dept Med, Div Rheumatol & Immunol, Charleston, SC 29425 USA. NCI, Met Lab, NIH, Bethesda, MD USA. Ralph H Johnson VA Med Ctr, Med Res Serv, Charleston, SC USA. RP Gilkeson, GS (reprint author), Med Univ S Carolina, Dept Med, Div Rheumatol & Immunol, 96 Jonathon Lucas St,Suite 912,POB 25063, Charleston, SC 29425 USA. EM gilkeson@musc.edu FU NIAMS NIH HHS [AR45476, AR47451] NR 40 TC 38 Z9 39 U1 1 U2 1 PU AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3995 USA SN 0022-3565 J9 J PHARMACOL EXP THER JI J. Pharmacol. Exp. Ther. PD JAN PY 2005 VL 312 IS 1 BP 69 EP 76 DI 10.1124/jpet.104.074005 PG 8 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 880CM UT WOS:000225766400009 PM 15356214 ER PT J AU Cook, KF Roddey, TS O'Malley, KJ Gartsman, GM AF Cook, KF Roddey, TS O'Malley, KJ Gartsman, GM TI Development of a Flexilevel Scale for use with computer-adaptive testing for assessing shoulder function SO JOURNAL OF SHOULDER AND ELBOW SURGERY LA English DT Article; Proceedings Paper CT Closed Meeting of the American-Shoulder-and-Elbow-Surgeons CY OCT, 2003 CL Dana Point, CA ID ITEM RESPONSE THEORY; HEADACHE IMPACT; HEALTH-STATUS; RELIABILITY; OUTCOMES; RECOMMENDATIONS; 21ST-CENTURY; VALIDITY AB In a 5-year study, a self-report measure of shoulder function-the Flexilevel Scale of Shoulder Function (FLEX-SF)-was developed by use of item response theory. A large pool of candidate items (N = 68) was developed. A questionnaire that included the 68 items, another scale of shoulder function, and clinical and demographic questions were administered to 400 persons with shoulder complaints. Patients' responses to the 68 items were calibrated by use of Andrich's rating scale model. Thirty-three items were selected from the pool and subdivided into three overlapping testlets targeting low, medium, and high shoulder function. A table translates raw scores on testlets to a common mathematical metric. The validity and reliability of the FLEX-SF was evaluated in a longitudinal study of 199 patients. The FLEX-SF scores were highly reliable and exhibited excellent validity (including responsiveness). We report on a simulation of a computer-adaptive test of shoulder function. This simulation is based on the developmental items we tested for use in the FLEX-SF. The results indicate that greater measurement efficiency can be achieved with a computer-adaptive test format. C1 Houston VAMC, Houston, TX 77030 USA. Texas Womans Univ, Measurement Excellence & Training Resource Inform, Vet Affairs Hlth Serv Res & Dev Resource Ctr, Denton, TX 76204 USA. Univ Texas, Sch Med, Houston, TX USA. Pearson Educ Measurement, Austin, TX USA. RP Cook, KF (reprint author), Houston VAMC, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM karonc@bcm.tmc.edu NR 24 TC 12 Z9 12 U1 3 U2 4 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 1058-2746 J9 J SHOULDER ELB SURG JI J. Shoulder Elbow Surg. PD JAN-FEB PY 2005 VL 14 IS 1 SU S BP 90S EP 94S DI 10.1016/j.jse.2004.09.024 PG 5 WC Orthopedics; Sport Sciences; Surgery SC Orthopedics; Sport Sciences; Surgery GA 902CH UT WOS:000227328400014 PM 15726093 ER PT J AU Souza, AL Boninger, ML Fitzgerald, SG Shimada, SD Cooper, RA Ambrosio, F AF Souza, AL Boninger, ML Fitzgerald, SG Shimada, SD Cooper, RA Ambrosio, F TI Upper limb strength in individuals with spinal cord injury who use manual wheelchairs SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE wheelchair; isokinetic; strength; torque; spinal cord injuries; shoulder; rotator cuff impingement ID SHOULDER PAIN; IMPINGEMENT SYNDROME; ISOKINETIC SHOULDER; ROTATOR CUFF; PARAPLEGIA; PROPULSION; TORQUE; MEN; ABNORMALITIES; IMBALANCE AB Introduction: Manual wheelchair users have been found to be at risk for secondary upper extremity injuries. Purpose: The primary goal of this study was to compare shoulder strength and muSCIe imbalance of individuals with paraplegia to case-wise matched unimpaired controls (UC). A secondary goal was to evaluate the impact of age and neurologic level of injury (NLI) on weight-normalized strength (WNS). Methods: The SCI group (n = 28) and the UC group (n = 28) completed bilateral shoulder isokinetic strength testing in the sagittal, frontal, and horizontal plane at 60 degrees/second using the BioDex system. Strength ratios, an indicator of muSCIe imbalance, were also calculated. Results: No significant difference was seen in shoulder strength or strength ratios between the SCI group and the UC group. However, NLI was significantly related to WNS on several planes in the SCI group. Therefore, we dichotomized the SCI group into equal groups based on an NLI. The Low-SCI group was significantly stronger than the High-SCI group in most planes (P < 0.05). The High-SCI group was significantly weaker than the UC in extension (P < 0.01) and a trend (P < 0.01) was seen in flexion, abduction, and external rotation. The Low-SCI group was significantly stronger in abduction than the UC. Conclusion: WNS at the shoulder correlated with NLI. It is likely that this is related to contributions of the trunk and abdominal muscles during testing, since proximal trunk strength aids in generating forces distally. This study and others of strength in individuals with paraplegia may overestimate shoulder strength. C1 Univ Pittsburgh, Human Engn Res Lab, VA Ctr Excellence, Highland Dr VA Med Ctr, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15206 USA. Biomech Consultants Calif, Davis, CA USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15206 USA. RP Boninger, ML (reprint author), Univ Pittsburgh, Human Engn Res Lab, VA Pittsburgh Healthcare Syst, 151R-1,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM boninger@pitt.edu OI Boninger, Michael/0000-0001-6966-919X NR 31 TC 7 Z9 7 U1 1 U2 7 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. PY 2005 VL 28 IS 1 BP 26 EP 32 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 005PF UT WOS:000234835600009 PM 15832901 ER PT J AU Burns, SP Nelson, AL Bosshart, HT Goetz, LL Harrow, JJ Gerhart, KD Bowers, H Krasnicka, B Guihan, M AF Burns, SP Nelson, AL Bosshart, HT Goetz, LL Harrow, JJ Gerhart, KD Bowers, H Krasnicka, B Guihan, M TI Implementation of clinical practice guidelines for prevention of thromboembolism in spinal cord injury SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE spinal cord injuries; venous thrombosis; thromboembolism; practice guidelines; anticoagulants; patient education; prophylaxis; low-molecular-weight heparin ID DEEP-VEIN THROMBOSIS; VENOUS THROMBOSIS; DUPLEX ULTRASOUND; DOSE HEPARIN; PROPHYLAXIS; REHABILITATION; SURVEILLANCE; PERFORMANCE; ENOXAPARIN; ADMISSION AB Background/Objectives: The purpose of this study was to determine whether publication of the "Prevention of Thromboembolism in Spinal Cord Injury" clinical practice guideline (CPG) changed patient management and whether adherence to CPG recommendations improved after a targeted implementation strategy. Methods: Data were abstracted from medical records of 134 and 520 patients with acute and chronic spinal cord injury (SCI), respectively, from 6 Veterans Affairs medical centers over 3 time periods: prepublication (T1), preimplementation (T2), and postimplementation (T3) of the CPG. Targeted interventions were developed to address provider-perceived barriers to guideline adherence, based on findings from focus groups conducted at each site. The interventions incorporated two implementation strategies: standardized documentation templates/standing orders and social marketing /outreach visits. Results: Use of the specified duration for pharmacologic prophylaxis increased from 60% to 65% to 75% of patients with acute SCI in T1, T2, and T3, respectively (P = 0.060 and 0.041 for T1 vs T2 and T2 vs T3, respectively). Rates of use for individual pharmacologic prophylaxis agents changed significantly over the course of the study, with use of low-molecular-weight heparin increasing from 7% in T1 to 42% in T3. Physical assessments for thrombosis on hospitalization days I and 30 improved between T2 and T3. Use of prophylaxis in chronically injured patients with new risk factors for thromboembolism increased from 16% to 31% to 34% during T1, T2, and T3 (P = 0.001 and 0.87, respectively). Conclusions: The CPG publication had only a modest effect on practice. Use of structured implementation further increased the adherence to some CPG recommendations for thromboembolism prophylaxis. Similar implementation strategies should be considered for CPG recommendations with low adherence and high potential for morbidity and mortality. C1 VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv 128, Seattle, WA 98108 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. James A Haley Vet Adm Med Ctr, Patient Safety Ctr Inquiry, Tampa, FL 33612 USA. James A Haley Vet Adm Med Ctr, SCI Serv, Tampa, FL 33612 USA. VA Med Ctr, SCI Serv, Augusta, GA USA. VA N Texas Hlth Care Syst, SCI Serv, Dallas, TX USA. Univ Texas, SW Med Ctr, Dallas, TX 75230 USA. VA San Diego Hlth Care Syst, SCI Serv, San Diego, CA USA. VA Med Ctr, SCI Serv, Miami, FL USA. Vet Affairs Edward Hines Jr Hosp, Midw Ctr Hlth Serv & Policy Res, Hines, IL USA. Vet Affairs Edward Hines Jr Hosp, Cooperat Studies Program, Hines, IL 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. EM spburns@u.washington.edu NR 36 TC 15 Z9 15 U1 0 U2 0 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. PY 2005 VL 28 IS 1 BP 33 EP 42 PG 10 WC Clinical Neurology SC Neurosciences & Neurology GA 005PF UT WOS:000234835600010 PM 15832902 ER PT J AU Kendall, RW Jacquemin, G Frost, R Burns, SP AF Kendall, RW Jacquemin, G Frost, R Burns, SP TI Creatine supplementation for weak muscles in persons with chronic tetraplegia: A randomized double-blind placebo-controlled crossover trial SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE creatine; spinal cord injuries; tetraplegia; muscle strength; fatigue ID SPINAL-CORD INJURY; AMYOTROPHIC-LATERAL-SCLEROSIS; EXERCISE PERFORMANCE; MUSCULAR STRENGTH; RELEASE TEST; MONOHYDRATE; QUADRIPLEGIA; RECRUITMENT; INGESTION; CAPACITY AB Background and Objectives: Creatine supplementation improves muscle strength in some patient populations with neurologic disorders. The purpose of this study was to determine whether creatine supplementation improves muscle strength and endurance in weak upper limb muscles in persons with tetraplegia, and whether it improves function. Methods: Outpatients with tetraplegia and mild wrist extensor weakness were randomized to receive either creatine or placebo in a double-blind crossover design. During creatine supplementation, participants were loaded with 10 g orally twice per day for 6 days, then maintained on 5 g daily until undergoing testing. Main outcome measures, performed at baseline, after placebo, and after creatine supplementation, included maximal voluntary wrist extensor isometric contraction strength (MVC), endurance times for 5 submaximal wrist extensor contractions, and the Grasp and Release Test for hand function. Results: Eight individuals (7 men, 1 woman) with tetraplegia met inclusion criteria and completed all study phases. The mean age of participants was 48 years, and 7 of 8 had C6 motor level injuries. There were no significant differences in MVC, endurance times, or hand function for creatine vs placebo. Conclusion: Creatine does not improve MVC and endurance of weak wrist extensors and does not improve hand function in individuals with tetraplegia. C1 Univ Utah, Div Phys Med & Rehabil, Salt Lake City, UT USA. Univ Montreal, Inst Readaptat Montreal, Montreal, PQ, Canada. VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv, Seattle, WA USA. Univ Washington, Harborview Injury Prevent & Res Ctr, Seattle, WA 98195 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Burns, SP (reprint author), VA Puget Sound Hlth Care Syst, SCI 128, Spinal Cord Injury Serv, 1660 S Columbian Way, Seattle, WA 98108 USA. EM spburns@u.washington.edu NR 32 TC 6 Z9 7 U1 0 U2 2 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. PY 2005 VL 28 IS 3 BP 208 EP 213 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 005PJ UT WOS:000234836000003 PM 16048138 ER PT J AU Goldstein, B Weaver, FM Hammond, MC AF Goldstein, B Weaver, FM Hammond, MC TI New CDC recommendations: Annual influenza vaccination recommended for individuals with spinal cord injuries SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Editorial Material ID DEATH C1 Dept Vet Affairs, VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98195 USA. Hines VA Med Ctr, Dept Vet Affairs, Midw Ctr Hlth Serv & Policy Res, Hines, IL USA. RP Goldstein, B (reprint author), VAPSHCS, Spinal Cord Injury & Disorders Strateg Healthcare, 128NAT,1660 S Columbian Way, Seattle, WA 98108 USA. EM barry.goldstein@med.va.gov NR 12 TC 4 Z9 4 U1 0 U2 0 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. PY 2005 VL 28 IS 5 BP 383 EP 384 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 005PN UT WOS:000234836400003 PM 16869084 ER PT J AU Goetz, LL Nelson, AL Guihan, M Bosshart, HT Harrow, JJ Gerhart, KD Krasnicka, B Burns, SP AF Goetz, LL Nelson, AL Guihan, M Bosshart, HT Harrow, JJ Gerhart, KD Krasnicka, B Burns, SP TI Provider adherence to implementation of clinical practice guidelines for neurogenic bowel in adults with spinal cord injury SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE spinal cord injuries; neurogenic bowel; practice guidelines; consensus guidelines; patient education AB Background/Objectives: Clinical Practice Guidelines (CPGs) have been published on a number of topics in spinal cord injury (SCI) medicine. Research in the general medical literature shows that the distribution of CPGS has a minimal effect on physician practice without targeted implementation strategies. The purpose of this study was to determine (a) whether dissemination of an SCI CPG improved the likelihood that patients would receive CPG recommended care and (b) whether adherence to CPG recommendations could be improved through a targeted implementation strategy. Specifically, this study addressed the "Neurogenic Bowel Management in Adults with Spinal Cord Injury" Clinical Practice Guideline published in March 1998 by the Consortium for Spinal Cord Medicine Methods: CPG adherence was determined from medical record review at 6 Veterans Affairs SCI centers for 3 time periods: before guideline publication (T1), after guideline publication but before CPG implementation (T2), and after targeted CPG implementation (T3). Specific implementation strategies to enhance guideline adherence were chosen to address the barriers identified by SCI providers in focus groups before the intervention. Results: Overall adherence to recommendations related to neurogenic bowel did not change between T1 and T2 (P = not significant) but increased significantly between T2 and T3 (P < 0.001) for 3 of 6 guideline recommendations. For the other 3 guideline recommendations, adherence rates were noted to be high at T1. Conclusions: While publication of the CPG alone did not alter rates of provider adherence, the use of a targeted implementation plan resulted in increases in adherence rates with some (3 of 6) CPG recommendations for neurogenic bowel management. C1 VA N Texas Hlth Care Syst, Spinal Cord Injury Serv 128, Dallas, TX 75216 USA. Univ Texas, SW Med Ctr, Dallas, TX USA. James A Haley VA Med Ctr, SCI Serv, Tampa, FL USA. James A Haley VA Med Ctr, Patient Safety Ctr Inquiry, Tampa, FL USA. Vet Affairs Edward Hines Jr Hosp, Midw Ctr Hlth Serv & Policy Res, Hines, IL USA. VA Med Ctr, Sci Serv, Augusta, GA USA. VA San Diego Hlth Care Syst, SCI Serv, San Diego, CA USA. Edward Hines Jr VA Hosp, Cooperat Studies Program, Hines, IL USA. VA Puget Sound Hlth Care Syst, SCI Serv, Seattle, WA USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Goetz, LL (reprint author), VA N Texas Hlth Care Syst, Spinal Cord Injury Serv 128, 4500 S Lancaster Rd, Dallas, TX 75216 USA. EM lance.goetz@med.va.gov NR 25 TC 13 Z9 14 U1 1 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. PY 2005 VL 28 IS 5 BP 394 EP 406 PG 13 WC Clinical Neurology SC Neurosciences & Neurology GA 005PN UT WOS:000234836400005 PM 16869086 ER PT J AU Ambrosio, F Boninger, ML Souza, AL Fitzgerald, SG Koontz, AM Cooper, RA AF Ambrosio, F Boninger, ML Souza, AL Fitzgerald, SG Koontz, AM Cooper, RA TI Biomechanics and strength of manual wheelchair users SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE force; shoulder pain; wheelchair propulsion; pushrim biomechanics; spinal cord injuries; muscle strength; strength training; paraplegia ID UPPER-EXTREMITY; IMPINGEMENT SYNDROME; SHOULDER PAIN; PUSHRIM BIOMECHANICS; GLENOHUMERAL JOINT; PROPULSION; PARAPLEGIA; PATTERNS; KINETICS; MUSCLES AB Background/Objective: Previous investigations have identified muscular imbalance in the shoulder as a source of pain and injury in manual wheelchair users. Our aim was to determine whether a correlation exists between strength and pushrim biomechanical variables including: tangential (motive) force (Ft), radial force (Fr), axial force (Fz), total (resultant) force (FR), fraction of effective force (FEF), and cadence. Methods: Peak isokinetic shoulder strength (flexion [FLX], extension [EXT], abduction [ABD], adduction [ADD], internal rotation [IR], and external rotation [ER]) was tested in 22 manual wheelchair users with a BioDex system for 5 repetitions at 60 degrees/s. Subjects then propelled their own manual wheelchair at 2 speeds, 0.9 m/s (2 mph) and 1.8 m/s (4 mph), for 20 seconds, during which kinematic (OPTOTRAK) and kinetic (SMAR(WHEEL)) data were collected. Peak isokinetic forces in the cardinal planes were correlated with pushrim biomechanical variables. Results: All peak torque strength variables correlated significantly (P <= 0.05) with Ft, Fir, and FIR, but were not significantly correlated with Fz, FEF, or cadence. Finally, there were no relationships found between muscle strength ratios (for example, FLX/EXT) and Ft, Fr, FIR, Fz, or FEF. Conclusion: There was a correlation between strength and force imparted to the pushrim among wheelchair users; however, there was no correlation found in wheelchair propulsion or muscle imbalance. Clinicians should be aware of this, and approach strength training and training in wheelchair propulsion techniques separately. C1 Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15206 USA. VA Med Ctr, AVA Ctr Excellence, Human Engn Res Labs, Pittsburgh, PA USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15260 USA. RP Boninger, ML (reprint author), Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Human Engn Res Labs, 151R-1,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM boninger@pitt.edu OI Boninger, Michael/0000-0001-6966-919X FU PHS HHS [H133A011107] NR 36 TC 25 Z9 25 U1 5 U2 10 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. PY 2005 VL 28 IS 5 BP 407 EP 414 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 005PN UT WOS:000234836400006 PM 16869087 ER PT J AU Cluver, JS Schuyler, D Frueh, BC Brescia, F Arana, GW AF Cluver, JS Schuyler, D Frueh, BC Brescia, F Arana, GW TI Remote psychotherapy for terminally ill cancer patients SO JOURNAL OF TELEMEDICINE AND TELECARE LA English DT Article ID TELEPSYCHIATRY; SATISFACTION; SERVICE AB We conducted a feasibility study of remote psychotherapy in 10 terminally ill cancer patients with diagnoses of adjustment disorder or major depression. Subjects received six sessions of individual cognitive therapy with the same therapist. Sessions alternated between face-to-face sessions and remote sessions delivered by analogue videophone. After each therapy session, a brief questionnaire was used to evaluate the subjects' level of satisfaction with the session, sense of connectedness to the therapist and overall progress being made in the therapy. Nine patients completed the study. Of 53 completed therapy sessions, 21 were by videophone and 32 were conducted face to face. Participants reported strong positive perceptions and acceptance after almost all therapy sessions, regardless of service delivery mode. The study suggests that there may be a role for the delivery of psychotherapy using low-bandwidth videophones. C1 Ralph H Johnson VAMC, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Med Univ S Carolina, Div Hematol Oncol, Charleston, SC 29425 USA. RP Cluver, JS (reprint author), Ralph H Johnson VAMC, 109 Bee St, Charleston, SC 29401 USA. EM cluverj@musc.edu NR 13 TC 21 Z9 22 U1 0 U2 3 PU ROYAL SOC MEDICINE PRESS LTD PI LONDON PA 1 WIMPOLE STREET, LONDON W1G 0AE, ENGLAND SN 1357-633X J9 J TELEMED TELECARE JI J. Telemed. Telecare PY 2005 VL 11 IS 3 BP 157 EP 159 DI 10.1258/1357633053688741 PG 3 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 923QT UT WOS:000228925100008 PM 15901444 ER PT J AU Frueh, BC Henderson, S Myrick, H AF Frueh, BC Henderson, S Myrick, H TI Telehealth service delivery for persons with alcoholism SO JOURNAL OF TELEMEDICINE AND TELECARE LA English DT Article ID TELECOMMUNICATION; TELEPSYCHIATRY; CARE AB Videoconferencing at a bandwidth of 384 kbit/s was used in open sessions for subjects with alcohol use disorders (AUD). Study participants received eight sessions of group therapy over a four-week period from an accredited addictions counsellor. Outcome assessment included self-report measures, a qualitative interview and a chart review. Of the 18 subjects who started the study, 14 attended at least four sessions of therapy, completed self-report assessments and the thematic interview. The participants reported high levels of satisfaction with telepsychiatry, found the intervention to be highly credible, had good session attendance and attrition comparable to that expected with conventional same-room treatment. In all, 82% of subjects reported that they would recommend the service to a friend or family member. The results demonstrate the feasibility of using videoconferencing for service delivery to adults with AUD, and encourage the future performance of randomized controlled trials. C1 Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Med Univ S Carolina, Charleston, SC 29425 USA. RP Frueh, BC (reprint author), VAMC, MHS, 109 Bee St, Charleston, SC 29401 USA. EM fruehbc@musc.edu FU AHRQ HHS [HS11642]; NIAAA NIH HHS [AA00314]; NIMH NIH HHS [MH01660] NR 10 TC 31 Z9 31 U1 0 U2 0 PU ROYAL SOC MEDICINE PRESS LTD PI LONDON PA 1 WIMPOLE STREET, LONDON W1G 0AE, ENGLAND SN 1357-633X J9 J TELEMED TELECARE JI J. Telemed. Telecare PY 2005 VL 11 IS 7 BP 372 EP 375 DI 10.1258/135763305774472060 PG 4 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 980RT UT WOS:000233036600009 PM 16238840 ER PT J AU Weinberger, LE Sreenivasan, S Garrick, T Osran, H AF Weinberger, LE Sreenivasan, S Garrick, T Osran, H TI The impact of surgical castration on sexual recidivism risk among sexually violent predatory offenders SO JOURNAL OF THE AMERICAN ACADEMY OF PSYCHIATRY AND THE LAW LA English DT Article ID TESTICULAR CANCER; SERUM TESTOSTERONE; MEN; BEHAVIOR; MEDROXYPROGESTERONE; NEUROBIOLOGY; PARAPHILIAS; ASSESSMENTS; ANDROGEN; ISSUES AB The relationship of surgical castration to sexual recidivism in a sexually violent predator/sexually dangerous person (SVP/SDP) population is reviewed. A review of the literature on castrated sex offenders reveals a very low incidence of sexual recidivism. The low sexual recidivism rates reported are critiqued in light of the methodologic limitations of the studies. Better designed testicular/prostate cancer studies have demonstrated that, while sexual desire is reduced by orchiectomy, the capacity to develop an erection in response to sexually stimulating material is not eliminated. The relevance of this literature to SVP/SDP commitment decisions and ethics is discussed. Two vignettes of castrated, high-risk sex offenders illustrate how to address risk reduction. Two tables are presented: the first outlines individual case data from a difficult-to-obtain report, and the second summarizes the most frequently cited castration studies on sexual recidivism. Orchiectomy may have a role in risk assessments; however, other variables should be considered, particularly as the effects can be reversed by replacement C1 Univ S Carolina, Keck Sch Med, Inst Psychiat Law & Behav Sci, Los Angeles, CA 90086 USA. Greater Los Angeles VA Med Ctr, Forens Outreach Serv, Los Angeles, CA USA. Greater Los Angeles VA Med Ctr, Gen Hosp Psychiat, Los Angeles, CA USA. Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA USA. Atascadero State Hosp, Atascadero, CA USA. RP Weinberger, LE (reprint author), Univ S Carolina, Inst Psychiat & Law, POB 86125, Los Angeles, CA 90086 USA. NR 58 TC 27 Z9 27 U1 0 U2 11 PU AMER ACAD PSYCHIATRY LAW PI BLOOMFIELD PA ONE REGENCY DR, PO BOX 30, BLOOMFIELD, CT 06002 USA SN 1093-6793 J9 J AM ACAD PSYCHIATRY JI J. Am. Acad. Psychiatry Law PY 2005 VL 33 IS 1 BP 16 EP 36 PG 21 WC Law; Psychiatry SC Government & Law; Psychiatry GA 907WL UT WOS:000227748700004 PM 15809235 ER PT J AU Raisch, DW Fudala, PJ Saxon, AJ Walsh, R Casadonte, P Ling, W Johnson, BA Malkerneker, U Ordorica, P Williford, WO Sather, MR AF Raisch, DW Fudala, PJ Saxon, AJ Walsh, R Casadonte, P Ling, W Johnson, BA Malkerneker, U Ordorica, P Williford, WO Sather, MR TI Pharmacists' and technicians' perceptions and attitudes toward dispensing buprenorphine/naloxone to patients with opioid dependence SO JOURNAL OF THE AMERICAN PHARMACISTS ASSOCIATION LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Pharmacists-Association CY MAR 28-APR 01, 2003 CL New Orleans, LA SP Amer Pharmacists Assoc DE opioid dependence; buprenorphine; naloxone; community and ambulatory pharmacy; pharmaceutical care; prescription forgery; drug diversion; attitudes; perceptions ID OPIATE ADDICTION; PAIN; NALOXONE AB Objective: To assess the perceptions and attitudes of pharmacists and pharmacy technicians involved in an office-based opioid dependence treatment program using buprenorphine/naloxone. Design: Cross-sectional attitudinal assessment. Setting: Community, outpatient hospital, and clinic pharmacies. Participants: Pharmacists and technicians participating in a clinical trial of opioid dependence treatment using buprenorphine/naloxone. Intervention: Written and telephone surveys followed by interviews with open-ended items. Main Outcome Measures: Attitudes and perceptions regarding opioid dependent patients and use of buprenorphine/naloxone for treatment of opioid dependence. Results: Pharmacies in seven states (New York, Virginia, Illinois, Florida, Texas, California, and Washington) participated in the clinical trial. A total of 40 pharmacists and pharmacy technicians responded to the initial written survey, representing 27 of the 32 pharmacies (84%). Follow-up interviews were obtained from one individual at 30 of those pharmacies (93.8%). Most pharmacy personnel (77.5%) involved with this study were not more concerned about theft or break-ins and would be willing to participate in opioid dependence treatment as the medication became available commercially (70%). The majority of respondents (85%) indicated that patients did not cause problems at their pharmacies. Compared with their experiences in administering other narcotic medications, most respondents did not express increased concern regarding prescription forgery (75%) or diversion (80%) of buprenorphine/naloxone. Conclusion: The majority of respondents expressed positive attitudes and perceptions regarding patients treated for opioid dependence with buprenorphine/naloxone. C1 Clin Res Pharm Coordinating Ctr, Vet Affairs Cooperat Studies Program, Albuquerque, NM 87106 USA. Vet Affairs Med Ctr, Albuquerque, NM 87106 USA. Vet Affairs Puget Sound Hlth Care Syst, Addict Patient Care Line, Albuquerque, NM USA. NIDA, Div Treatment Res & Dev, Regulatory Affairs Branch, NIH, Bethesda, MD USA. Univ Calif Los Angeles, David Geffen Sch Med, Integrated Substance Abuse Programs, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. Univ Virginia, Dept Psychiat Med, Charlottesville, VA USA. Hines Vet Affairs Med Ctr, Chicago, IL USA. James A Haley Vet Hosp, Mental Hlth & Behav Sci Serv, Tampa, FL USA. RP Raisch, DW (reprint author), Clin Res Pharm Coordinating Ctr, Vet Affairs Cooperat Studies Program, 2401 Ctr, Albuquerque, NM 87106 USA. EM dennis.raisch@csp.research.med.va.gov FU NIDA NIH HHS [3Y01-DA030011-04] NR 20 TC 10 Z9 11 U1 4 U2 4 PU AMER PHARMACEUTICAL ASSN PI WASHINGTON PA 2215 CONSTITUTION AVE NW, WASHINGTON, DC 20037 USA SN 1544-3191 J9 J AM PHARM ASSN JI J. Am. Pharm. Assoc. PD JAN-FEB PY 2005 VL 45 IS 1 BP 23 EP 32 DI 10.1331/1544345052843200 PG 10 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 915TK UT WOS:000228333900009 PM 15730114 ER PT J AU Young, BA Katon, WJ Von Korff, N Simon, GE Lin, EHB Ciechanowski, PS Bush, T Oliver, M Ludman, EJ Boyko, EJ AF Young, BA Katon, WJ Von Korff, N Simon, GE Lin, EHB Ciechanowski, PS Bush, T Oliver, M Ludman, EJ Boyko, EJ TI Racial and ethnic differences in microalbuminuria prevalence in a diabetes population: The pathways study SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article; Proceedings Paper CT 64th Annual Meeting of the American-Diabetes-Association CY JUN 04-08, 2004 CL Orlando, FL SP Amer Diabetes Assoc ID STAGE RENAL-DISEASE; NUTRITION EXAMINATION SURVEY; EPITHELIAL SODIUM-CHANNEL; URINARY ALBUMIN EXCRETION; RENIN-ANGIOTENSIN SYSTEM; 3RD NATIONAL-HEALTH; AFRICAN-AMERICANS; BLOOD-PRESSURE; MEXICAN-AMERICANS; KIDNEY-DISEASE AB The objective of this study was to determine whether racial or ethnic differences in prevalence of diabetic microalbuminuria were observed in a large primary care population in which comparable access to health care exists. A cross-sectional analysis of survey and automated laboratory data 2969 primary care diabetic patients of a large regional health maintenance organization was conducted. Study data were analyzed for racial/ethnic differences in microalbuminuria (30 to 300 mg albumin/g creatinine) and macroalbuminuria (>300 mg albumin/g creatinine) prevalence among diabetes registry-identified patients who completed a survey that assessed demographics, diabetes care, and depression. Computerized pharmacy, hospital, and laboratory data were linked to survey data for analysis. Racial/ethnic differences in the odds of microalbuminuria and macroalbuminuria were assessed by unconditional logistic regression, stratified by the presence of hypertension. Among those tested, the unadjusted prevalence of micro- or macroalbuminuria was 30.9%, which was similar among the various racial/ethnic groups. Among those without hypertension, microalbuminuria was twofold greater (odds ratio [OR] 2.01; 95% confidence interval [CI] 1.14 to 3.53) and macroalbuminuria was threefold greater (OR 3.17; 95% CI 1.09 to 9.26) for Asians as compared with whites. Among those with hypertension, adjusted odds of microalbuminuria were greater for Hispanics (OR 182; 95% CI 1.16 to 12.57) than whites, whereas adjusted odds of macroalbuminuria were threefold greater for blacks (OR 3.32; 95% CI 1.26 to 8.76) than for whites. For most racial/ethnic minorities, hypertriglyceridemia was significantly associated with greater odds of micro- and macroalbuminuria. Among a large primary care population, racial/ethnic differences exist in the adjusted prevalence of microalbuminuria and macroalbuminuria depending on hypertension status. In this setting, racial/ ethnic differences in early diabetic nephropathy were observed despite comparable access to diabetes care. C1 Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA USA. VA Puget Sound Hlth Care Syst E 152, Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. NW Kidney Ctrs, Seattle, WA USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Ctr Hlth Studies, Grp Hlth Cooperat, Seattle, WA USA. RP Young, BA (reprint author), VA Puget Sound Hlth Care Syst E 152, Epidemiol Res & Informat Ctr, 1660 S Columbian Way, Seattle, WA 98108 USA. EM youngb@u.washington.edu OI Boyko, Edward/0000-0002-3695-192X FU NIMH NIH HHS [MH 01643, MH 4-1739] NR 81 TC 46 Z9 47 U1 0 U2 0 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 JAN PY 2005 VL 16 IS 1 BP 219 EP 228 PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 883JZ UT WOS:000226008700030 PM 15563572 ER PT J AU Hilsabeck, RC Hassanein, TI Ziegler, EA Carlson, MD Perry, W AF Hilsabeck, RC Hassanein, TI Ziegler, EA Carlson, MD Perry, W TI Effect of interferon-alpha on cognitive functioning in patients with chronic hepatitis C SO JOURNAL OF THE INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY LA English DT Article DE neuropsychological impairment; HCV; chronic liver disease ID HEALTH SURVEY SF-36; QUALITY-OF-LIFE; TUMOR-NECROSIS-FACTOR; RHEUMATOID-ARTHRITIS; ALFA THERAPY; NEUROTOXICITY; BRAIN; DISORDERS; INFECTION; FATIGUE AB Treatment with inter feron- alpha (IFN-alpha) has been shown to adversely affect cognitive functioning in patients with a variety of medical disorders, but information about the effects of IFN-alpha on cognitive functioning in patients with chronic hepatitis C (CHC) is limited. The purpose of this study was to examine the effects of IFN-alpha on neuropsychological test performance in CHC patients. Participants were 30 patients with CHC, 11 who underwent IFN-a therapy and 19 who did not. All participants were tested at baseline (i.e., pretreatment) and approximately 6 months later with the Symbol Digit Modalities Test and Trail Making Test. Results revealed that the treatment group performed significantly worse than untreated CHC patients on Part B of the Trail Making Test after approximately 6 months of treatment. No significant group differences were found on Part A of the Trail Making Test or Symbol Digit Modalities Test. Findings suggest that CHC patients undergoing treatment with IFN-a may experience reduced abilities to benefit from practice but suffer no decrements in performance after 6 months of treatment. Additional research is needed to replicate these findings and to explore risk factors for susceptibility to IFN-alpha-induced effects. C1 Texas Tech Univ, Ctr Hlth Sci, Dept Neuropsychiat & Behav Sci, Lubbock, TX 79409 USA. Univ Calif San Diego, Dept Med, Div Hepatol, San Diego, CA 92103 USA. Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. RP Hilsabeck, RC (reprint author), S Texas Vet Hlth Care Syst, Psychol Serv 116B, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. EM Robin.Hilsabeck@med.va.gov NR 56 TC 26 Z9 27 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4211 USA SN 1355-6177 J9 J INT NEUROPSYCH SOC JI J. Int. Neuropsychol. Soc. PD JAN PY 2005 VL 11 IS 1 BP 16 EP 22 PG 7 WC Clinical Neurology; Neurosciences; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 906CA UT WOS:000227616900002 PM 15686604 ER PT J AU Harris, MR AF Harris, MR TI The librarian's roles in the systematic review process: a case study SO JOURNAL OF THE MEDICAL LIBRARY ASSOCIATION LA English DT Article AB Question/Setting: Although the systematic review has become a research standard, little information addresses the actions of the librarian on a systematic review team. Method: This article is an observational case study that chronicles a librarian's required involvement, skills, and responsibilities in each stage of a real-life systematic review. Main Results: Examining the review process reveals that the librarian's multiple roles as an expert searcher, organizer, and analyzer form an integral part of the Cochrane Collaboratior's criteria for conducting systematic reviews. Moreover, the responsibilities of the expert searcher directly reflect the key skills and knowledge depicted in the "Definition of Expert Searching" section of the Medical Library Association's policy statement, "Role of Expert Searching in Health Sciences Libraries." Conclusion: Although the librarian's multiple roles are important in all forms of medical research, they are crucial in a systematic review. As an expert searcher, the librarian must interact with the investigators to develop the terms required for a comprehensive search strategy in multiple appropriate sources. As an organizer and analyzer, the librarian must effectively manage the articles and document the search, retrieval, and archival processes. C1 S Texas Vet Hlth Care Syst, VERDICT, San Antonio, TX 78229 USA. RP Harris, MR (reprint author), S Texas Vet Hlth Care Syst, VERDICT, 7400 Merton Minter Blvd,11C6, San Antonio, TX 78229 USA. EM mharris@verdict.uthscsa.edu NR 22 TC 23 Z9 27 U1 0 U2 8 PU MEDICAL LIBRARY ASSOC PI CHICAGO PA 65 EAST WACKER PLACE, STE 1900, CHICAGO, IL 60601-7298 USA SN 1536-5050 J9 J MED LIBR ASSOC JI J. Med. Libr. Assoc. PD JAN PY 2005 VL 93 IS 1 BP 81 EP 87 PG 7 WC Information Science & Library Science SC Information Science & Library Science GA 893OL UT WOS:000226729000015 PM 15685279 ER PT J AU Nicosia, RF Zhu, WH Fogel, E Howson, KM Aplin, AC AF Nicosia, RF Zhu, WH Fogel, E Howson, KM Aplin, AC TI A new ex vivo model to study venous angiogenesis and arterio-venous anastomosis formation SO JOURNAL OF VASCULAR RESEARCH LA English DT Article DE anastomosis; angiogenesis; aorta; collagen; endothelium; pericyte; vein; vena cava ID ENDOTHELIAL GROWTH-FACTOR; RAT AORTA; ASSAY AB Explants of rat inferior vena cava embedded in collagen gel and cultured under serum-free conditions produced microvascular outgrowths composed of endothelial cells and pericytes. Exogenous vascular endothelial growth factor ( VEGF) and basic fibroblast growth factor ( bFGF) dose-dependently stimulated angiogenesis and induced the formation of complex networks of highly branched microvessels. VEGF and the VEGF/bFGF combination also promoted pericyte recruitment. Medium conditioned by untreated vena cava cultures contained endogenous VEGF, and a blocking antibody against VEGF significantly reduced the spontaneous angiogenic response of the explants. Vena cava explants exhibited a greater capacity to form neovessels than aortic rings when tested in parallel cultures from the same animal. When compared with aorta-derived microvessels, neovessels of vena cava origin were longer and had fewer pericytes. Vena cava-aorta cocultures produced extensive anastomosing networks of microvessels, which were primarily contributed by the venous explants. Because of its florid angiogenesis and exquisite sensitivity to angiogenic factor stimulation, the vena cava model may provide novel insights into the regulation of the angiogenic process, which typically initiates from the venous side of the vascular bed. Combined with the aortic ring model, this new assay may also enhance our understanding of the mechanisms of anastomosis formation between the arterial and the venous circulations. Copyright (C) 2005 S. Karger AG, Basel. C1 VA Puget Sound Hlth Care Syst, Div Pathol & Lab Med, Seattle, WA 98108 USA. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. RP Nicosia, RF (reprint author), VA Puget Sound Hlth Care Syst, Div Pathol & Lab Med S113 Lab, 1660 S Columbian Way, Seattle, WA 98108 USA. EM roberto.nicosia@med.va.gov FU NHLBI NIH HHS [HL52585] NR 18 TC 24 Z9 27 U1 0 U2 4 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1018-1172 J9 J VASC RES JI J. Vasc. Res. PY 2005 VL 42 IS 2 BP 111 EP 119 DI 10.1159/000083457 PG 9 WC Physiology; Peripheral Vascular Disease SC Physiology; Cardiovascular System & Cardiology GA 917CV UT WOS:000228434500003 PM 15665546 ER PT J AU Butt, AA Wagener, M Shakil, AO Ahmad, J AF Butt, AA Wagener, M Shakil, AO Ahmad, J TI Reasons for non-treatment of hepatitis C in veterans in care SO JOURNAL OF VIRAL HEPATITIS LA English DT Article DE hepatitis C; treatment; veterans; adherence; viral hepatitis ID INJECTION-DRUG USERS; VIRUS-INFECTION; HEPATOCELLULAR-CARCINOMA; PEGINTERFERON ALPHA-2A; PLUS RIBAVIRIN; PREVALENCE; INTERFERON; THERAPY; RISK AB We prospectively studied 354 patients with hepatitis C virus (HCV) infection who were referred to a hepatology specialty clinic to find the reasons for non-treatment of HCV. The median age was 48 years (range 27-77 years), 98.5% were male and 71% were white. Seventy per cent of the patients were not treated. The most common reasons for non-treatment were non-adherence to follow-up visit (24%), normal liver enzymes (14%), concurrent medical problems (11%), alcohol and drug use (9%), psychiatric problems (7%), advanced liver disease (7%), referral for transplant evaluation (6.4%) and patient refusal, transfer of care to another facility and non-detectable HCV RNA levels (5% each). The reason was not recorded for 5% of the patients and was treatment deferred in 2.4% while waiting for pegylated interferon approval. Non-treatment was more likely in patients with less than 12 years of education and a history of incarceration. Patients who were lost to follow-up and refused treatment were more likely to have current alcohol and drug use and a history of incarceration. C1 Univ Pittsburgh, Div Infect Dis, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Div Gastroenterol Hepatol & Nutr, Pittsburgh, PA USA. RP Butt, AA (reprint author), 36014 5th Ave,Suite 3A,Falk Med Bldg, Pittsburgh, PA 15213 USA. EM butta@msx.dept-med.pitt.edu NR 16 TC 64 Z9 64 U1 0 U2 1 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 1352-0504 J9 J VIRAL HEPATITIS JI J. Viral Hepatitis PD JAN PY 2005 VL 12 IS 1 BP 81 EP 85 DI 10.1111/j.1365-2893.2005.00547.x PG 5 WC Gastroenterology & Hepatology; Infectious Diseases; Virology SC Gastroenterology & Hepatology; Infectious Diseases; Virology GA 889QR UT WOS:000226458000012 PM 15655052 ER PT J AU Saab, S Lee, C Shpaner, A Ibrahim, AB AF Saab, S Lee, C Shpaner, A Ibrahim, AB TI Seroepidemiology of hepatitis A in patients with chronic liver disease SO JOURNAL OF VIRAL HEPATITIS LA English DT Article DE hepatitis A seroprevalence; chronic liver disease ID DRUG-USERS; VACCINATION; VIRUSES AB Hepatitis A virus (HAV) rarely causes fulminant hepatic failure in the general population. Yet it is a cause of significant morbidity and mortality in patients with chronic liver disease (CLD), in whom routine HAV vaccination is recommended. However, studies of HAV seroprevalence and exposure predictors in populations with CLD are scarce. We have studied a cohort of 473 patients with various causes of CLD between July 2000 and June 2002. Patients were stratified on the basis of age, gender, ethnicity and aetiology of liver disease. The HAV seroprevalence in patients with CLD was compared with that in the general population. We used a logistic regression analysis to identify independent predictors of HAV exposure. Of the 473 patients studied, HAV seroprevalence was available for 454 individuals. HCV, HBV, alcohol, and HCV and alcohol were the causes of CLD in 337, 72, 37 and eight patients, respectively. The overall HAV seroprevalence was 55% in the studied cohort. The age-stratified HAV prevalence for ages 21-30, 31-40, 41-50, 51-60, 61-70 and greater than 70 years was 44, 51, 44, 63, 65 and 64%, respectively. Hispanic ethnicity, Asian ethnicity, alcohol use and ages of 51-70 years were found to be independent predictive variables of prior exposure to HAV. HAV infection in patients with CLD causes considerable morbidity and mortality. We demonstrated that age-stratified seroprevalence of HAV in patients with CLD of various aetiologies is significantly higher than that of the general population, and identified several independent predictors of HAV prior exposure. C1 Univ Calif Los Angeles, Med Ctr, Div Digest Dis, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dumont UCLA Liver Transplant Ctr, Dept Surg, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Epidemiol Sch Publ Hlth, Los Angeles, CA 90095 USA. W Los Angeles Vet Adm Med Ctr, Los Angeles, CA USA. RP Saab, S (reprint author), Univ Calif Los Angeles, Med Ctr, Div Digest Dis, Dept Med, 44-138 CHS MC 168417,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM ssaab@mednet.ucla.edu NR 19 TC 16 Z9 16 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 1352-0504 J9 J VIRAL HEPATITIS JI J. Viral Hepatitis PD JAN PY 2005 VL 12 IS 1 BP 101 EP 105 DI 10.1111/j.1365-2893.2005.00551.x PG 5 WC Gastroenterology & Hepatology; Infectious Diseases; Virology SC Gastroenterology & Hepatology; Infectious Diseases; Virology GA 889QR UT WOS:000226458000016 PM 15655056 ER PT J AU Martin, JL Mory, AK Alessi, CA AF Martin, JL Mory, AK Alessi, CA TI Nighttime oxygen desaturation and symptoms of sleep-disordered breathing in long-stay nursing home residents SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MD SP Amer Geriatr Soc ID APNEA; MORTALITY; DEMENTIA; OXIMETRY; ADULTS; RISK AB Background. Sleep-disordered breathing (SDB) is common in older adults and has been implicated as a cause of decreased quality of life and even death. Sparse data exist on SDB in the nursing home setting. The authors evaluated SDB (using attended nocturnal pulse oximetry) in nursing home residents with daytime sleepiness and nighttime sleep disturbance. Methods. Pulse oximetry was used to estimate the prevalence of nighttime oxygen desaturation in 109 long-stay nursing home residents (mean [standard deviation] age = 86.2 [9.2] years: 74% women). Pulse oximetry findings were compared to a structured observational measurement of symptoms of SDB, the Observational Sleep Assessment Instrument. Seventy-one participants had concurrent wrist actigraphy to estimate total sleep time during oximetry recording. Results. Using the oxygen desaturation index (ODI: average number of oxygen desaturations 4% or more below the baseline level per hour), the authors found that 40% of the residents had abnormal ODI (ODI more than 5, which is suggestive of SDB). Of all observational variables assessed, only loud breathing during sleep was significantly correlated with ODI (r = .284; p = .003). When ODI was adjusted for estimated total sleep time, higher adjusted ODI was associated with higher body mass index (kg/m(2)). Conclusions. Abnormal ODI is common in nursing home residents. Observed loud breathing at night and high body mass index may suggest that further assessment of SDB is indicated. Future research should determine the importance of SDB and abnormal nocturnal oxygen desaturation on functioning and quality of life in nursing home residents. C1 Univ Calif Los Angeles, Multicampus Program Geriatr Med & Gerontol, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Geriatr Res Educ & Clin Ctr, Los Angeles, CA USA. Jefferson Med Coll, Philadelphia, PA USA. RP Martin, JL (reprint author), Vet Adm Med Ctr, GRECC 11E,16111 Plummer St, Sepulveda, CA 91343 USA. FU NIA NIH HHS [AG13885] NR 23 TC 16 Z9 16 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 JAN PY 2005 VL 60 IS 1 BP 104 EP 108 PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 902MF UT WOS:000227360500016 PM 15741291 ER PT J AU Stern, RE Yueh, B Lewis, C Norton, S Sie, KCY AF Stern, RE Yueh, B Lewis, C Norton, S Sie, KCY TI Recent epidemiology of pediatric cochlear implantation in the United States: Disparity among children of different ethnicity and socioeconomic status SO LARYNGOSCOPE LA English DT Article DE cochlear implant; epidemiology; pediatrics ID NEONATAL HEARING IMPAIRMENT; SPEECH-PERCEPTION; IDENTIFICATION; INFANTS; CARE AB Objectives/Hypothesis. Congenital severe to profound sensorineural hearing loss (SNHL) is found in higher proportions of children with minority and/or lower socioeconomic status (SES). Cochlear implants were approved by the U.S. Food and Drug Administration for use in children with bilateral severe to profound SNHL in 1990. The objectives of the study were as follows: 1) to study the epidemiology of pediatric cochlear implantation, assessing whether cochlear implant technology is provided to children with severe to profound SNHL in proportion to their racial/ethnic or SES, and 2) to compare data provided by a national health care database with data provided by cochlear implant manufacturers. Study Design: Patients aged 0 to 18 years who underwent cochlear implantation in 1997 using a cross-sectional study design. Methods. Analyses were made of pediatric cochlear implant patients, using data from the 1997 Health Care and Utilization Project/Kids' Inpatient Database. Relative rates of implantation compared with rates of severe to profound SNHL were calculated using national estimates generated from census and Galludet Research Institution data. Logistic regression analysis was carried out to compare implanted children of different racial/ethnic backgrounds. A surrogate measure of socioeconomic status was used based on the median household income of the patient's home ZIP code. Information was also obtained from the two companies producing U.S. Food and Drug Administration-approved cochlear implants in 1997 and used to determine whether the data obtained from the Health Care and Utilization Project/Kids' Inpatient Database were representative of the national cohort of implanted children. Results. The Health Care and Utilization Project/Kids' Inpatient Database identified 124 children who underwent cochlear implant surgery in 1997. White and Asian children were implanted at higher rates than Hispanic and black children. Furthermore, white and Asian children received implants at greater rates than would be expected based on prevalence of severe to profound SNHL. The relative rate (RR) of implantation, defined as the proportion of children who received cochlear implants divided by the proportion of children with severe to profound SNHL (in each race/ethnicity group compared with the same ratio in white children), was similar in white (RR = 1.00) and Asian (RR = 0.93) children but markedly different in Hispanic (RR = 0.28) and black (RR = 0.10) children. Comparison of SES information from the Health Care and Utilization Project/Kids' Inpatient Database population with the manufacturers' database suggested that the Health Care and Utilization Project/Kids' Inpatient Database is representative of all implanted children in the United States. Both sources of information suggested that children receiving cochlear implants in the United States in 1997 resided in above-average SES areas. Conclusion: White and Asian children with severe to profound SNHL had higher proportionate rates of cochlear implantation than black and Hispanic children in 1997. Implanted children were more likely to live in areas (represented by ZIP codes) with higher median incomes. Although there was a disparity in rate of cochlear implantation based on race/ethnicity and surrogate measures of SES, these data did not allow the authors to determine the causes for these differences. C1 Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Hlth Serv, Seattle, WA 98195 USA. Childrens Hosp & Reg Med Ctr, Dept Otolaryngol Head & Neck Surg, Seattle, WA USA. RP Stern, RE (reprint author), 1959 NE Pacific,BB 1165 HSC,Box 356515, Seattle, WA 98195 USA. EM restern@u.washington.edu OI Yueh, Bevan/0000-0003-1380-1053 NR 14 TC 33 Z9 35 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0023-852X J9 LARYNGOSCOPE JI Laryngoscope PD JAN PY 2005 VL 115 IS 1 BP 125 EP 131 DI 10.1097/01.mlg.0000150698.61624.3c PG 7 WC Medicine, Research & Experimental; Otorhinolaryngology SC Research & Experimental Medicine; Otorhinolaryngology GA 887YF UT WOS:000226340700025 PM 15630380 ER PT S AU Vijg, J Busuttil, RA Bahar, R Dolle, MET AF Vijg, J Busuttil, RA Bahar, R Dolle, MET BE Cutler, RG Harman, SM Heward, C Gibbons, M TI Aging and genome maintenance SO LONGEVITY HEALTH SCIENCES: THE PHOENIX CONFERENCE SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Phoenix Conference on Longevity Health Sciences CY DEC 11-14, 2003 CL Scottsdale, AZ SP AURORA Fdn, Exeter Life Sci, Int Soc Hlth Aging Res, Kronos Lab Res Inst, Oxidat Stress & Aging Assoc DE genome instability; somatic mutations; gene regulation; aging ID TRANSGENIC MOUSE MODEL; IN-VIVO MUTATIONS; SOMATIC MUTATION; GENE-EXPRESSION; AGE; MICE; ACCUMULATION; CHROMOSOME; REARRANGEMENTS; TRANSCRIPTOME AB Genomic instability in somatic cells has been implicated as a major stochastic mechanism of aging. Using a transgenic mouse model with chromosomally integrated lacZ mutational target genes, we found mutations to accumulate with age at an organ- and tissue-specific rate. Also the spectrum of age-accumulated mutations was found to differ greatly from organ to organ; while initially similar, mutation spectra of different tissues diverged significantly over the lifetime. To explain how genomic instability, which is inherently stochastic, can be a causal factor in aging, it is proposed that randomly induced mutations may adversely affect normal patterns of gene regulation, resulting in a mosaic of cells at various stages on a trajectory of degeneration, eventually resulting in cell death or neoplastic transformation. To directly address this question we demonstrate that it is now possible to analyze single cells, isolated from old and young tissues, for specific alterations in gene expression. C1 Univ Texas, Hlth Sci Ctr, STCBM, San Antonio, TX 78245 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Vijg, J (reprint author), Univ Texas, Hlth Sci Ctr, STCBM, 15355 Lambda Dr,Suite 2-200, San Antonio, TX 78245 USA. EM vijg@uthscsa.edu FU NIA NIH HHS [AG17242] NR 34 TC 38 Z9 41 U1 0 U2 2 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-561-3 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2005 VL 1055 BP 35 EP 47 DI 10.1196/annals.1323.007 PG 13 WC Biochemistry & Molecular Biology; Genetics & Heredity; Geriatrics & Gerontology; Multidisciplinary Sciences SC Biochemistry & Molecular Biology; Genetics & Heredity; Geriatrics & Gerontology; Science & Technology - Other Topics GA BDY44 UT WOS:000236116400004 PM 16387716 ER PT S AU Lopes-Virella, MF Thorpe, SR Derrick, MB Chassereau, C Virella, G AF Lopes-Virella, MF Thorpe, SR Derrick, MB Chassereau, C Virella, G BE Baynes, JW Monnier, VM Ames, JM Thorpe, SR TI The immunogenicity of modified lipoproteins SO MAILLARD REACTION: CHEMISTRY AT THE INTERFACE OF NUTRITION, AGING, AND DISEASE SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT 8th International Symposium on the Maillard Reaction CY AUG 29-SEP 01, 2004 CL Charleston, SC SP Asahi Kasei Pharma, Avents, BASF, Biostratum, Univ S Carolina, Coll Sci & Math, Danisco, Danone Vitapole, Ctr Rech Daniel Carasso, DSM, Estee Lauder Co, Inlight Solut, IUBMB, Juvenile Diabet Res Fdn, KOWA, Oregon State Univ, Linus Pauling Inst, LOreal, Med Univ S Carolina, Merck, NIA, Nestle, Renascience, Univ S Carolina, Res & Hlth Sci, Taisho Pharmaceut Co Ltd, UNILEVER DE atherosclerosis; inflammation; autoimmunity; anti-lipoprotein antibodies; modified lipoproteins; diabetes; diabetic complications; Maillard reaction; AGE-LDL ID LOW-DENSITY-LIPOPROTEIN; CORONARY-ARTERY-DISEASE; CONTAINING IMMUNE-COMPLEXES; OXIDIZED LDL; DIABETES-MELLITUS; ATHEROSCLEROTIC LESIONS; LYSINE RESIDUES; ANTIBODIES; AUTOANTIBODIES; MALONDIALDEHYDE AB The immunogenicity of modified low-density lipoprotein (mLDL) has been demonstrated both in laboratory animals and humans. Circulating human mLDL antibodies, purified by affinity chromatography, are predominantly of the IgG isotype, subclasses I and 3. The purified antibodies react with malondialdehyde-lysine and carboxymethyl-lysine epitopes, but also recognize minimally modified forms of LDL that do not contain significant amounts of those two epitopes. The quantitative assays of mLDL and mLDL antibodies in serum samples by enzymoinummoassay (EIA) are unreliable owing to the interference of preformed circulating immune complexes (CICs). Isolation of CICs by precipitation with low concentrations of polyethylene glycol followed by analysis of antigens and antibodies contained in the precipitates is a technically complex approach, but one that yields valuable data. With this approach we have confirmed that the IgG antibodies involved in IC formation belong to the proinflammatory IgG1 and IgG3 isotypes, have a higher avidity than those that remain unbound in the supernatant after CIC precipitation, and are of higher avidity in diabetic patients with macroalbuminuria than in those with normal albuminuria. We have also developed capture assays for different forms of mLDL. These assays have shown a significant enrichment in mLDL of the precipitated ICs. The enrichment is also more pronounced in the CICs obtained from diabetic patients with macroalbuminuria. In conclusion, isolation and characterization of LDL-ICs appears to yield information of significant value that is not derived from other approaches to measure LDL modifications and their corresponding antibodies in humans. C1 Med Univ S Carolina, Dept Med, Div Endocrinol Metab & Nutr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC 29403 USA. Univ S Carolina, Dept Chem & Biochem, Columbia, SC 29208 USA. RP Virella, G (reprint author), Strom Thurmond Res Bldg,114 Doughty St,Room 529, Charleston, SC 29425 USA. EM virellam@musc.edu.edu FU NHLBI NIH HHS [HL-55782] NR 36 TC 3 Z9 3 U1 0 U2 1 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-531-1 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2005 VL 1043 BP 367 EP 378 DI 10.1196/annals.1333.043 PG 12 WC Biochemistry & Molecular Biology; Chemistry, Applied; Multidisciplinary Sciences; Physiology SC Biochemistry & Molecular Biology; Chemistry; Science & Technology - Other Topics; Physiology GA BCY08 UT WOS:000231834100043 PM 16037258 ER PT S AU Klein, RL Semler, AJ Baynes, JW Thorpe, SR Lyons, TJ Jenkins, AJ AF Klein, RL Semler, AJ Baynes, JW Thorpe, SR Lyons, TJ Jenkins, AJ BE Baynes, JW Monnier, VM Ames, JM Thorpe, SR TI Glycation does not alter LDL-induced secretion of tissue plasminogen activator and plasminogen activator inhibitor-1 from human aortic endothelial cells SO MAILLARD REACTION: CHEMISTRY AT THE INTERFACE OF NUTRITION, AGING, AND DISEASE SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT 8th International Symposium on the Maillard Reaction CY AUG 29-SEP 01, 2004 CL Charleston, SC SP Asahi Kasei Pharma, Avents, BASF, Biostratum, Univ S Carolina, Coll Sci & Math, Danisco, Danone Vitapole, Ctr Rech Daniel Carasso, DSM, Estee Lauder Co, Inlight Solut, IUBMB, Juvenile Diabet Res Fdn, KOWA, Oregon State Univ, Linus Pauling Inst, LOreal, Med Univ S Carolina, Merck, NIA, Nestle, Renascience, Univ S Carolina, Res & Hlth Sci, Taisho Pharmaceut Co Ltd, UNILEVER DE fibrinolysis; lipoproteins; LDL; glycation; endothelial cells; tissue plasminogen activator; plasminogen activator inhibitor-1 ID LOW-DENSITY-LIPOPROTEIN; FIBRINOLYTIC REGULATORS; GENERATION AB Diabetes may induce both quantitative and qualitative changes in lipoproteins, especially low-density lipoprotein (LDL). Effects of LDL glycation on endothelial cell secretion of tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) have not been fully elucidated. Human aortic endothelial cell (HAEC) tPA and PAI-1 production were determined after incubation with LDL (50 to 500 mu g/mL protein, 24 h) from three sources: (1) nondiabetic LDL (N-LDL) modified in vitro to form six preparations: native, nonmodified (N); glycated (G); minimally oxidized (MO); minimally oxidized and glycated (MOG); heavily oxidized (HO); and heavily oxidized and glycated (HOG); (2) in vivo glycated and relatively nonglycated LDL subfractions from type 1 diabetic patients; (3) LDL from type I diabetic patients and matched controls, which was subfractionated using density gradient ultracentrifugation. In experiments using LDL modified in vitro, the rate of tPA release by HAECs incubated with N-LDL (83 +/- 4 ng/mg cell protein/24 h) did not differ significantly from those incubated with G-LDL (73 7), MO-LDL (74 +/- 13), or MOG-LDL (66 +/- 15) and was not influenced by LDL concentration. The rate of PAI-1 release was similar in HAECs incubated with N-LDL (5.7 +/- 0.6 mu g/mg cell protein/24 h), G-LDL (5.7 +/- 0.7), MO-LDL (5.5 +/- 0.8), or MOG-LDL (5.7 +/- 0.9) and was not influenced by LDL concentration. In contrast, tPA release was significantly decreased in cells incubated with LDL (10 mu g/mL) modified extensively by oxidation, and averaged 45.2 +/- 5.0 and 43.7 +/- 9.9 ng/mg/24 h for HO-LDL and HOG-LDL, respectively, and was further decreased with increasing concentrations of the heavily oxidized LDL preparations. PAI-1 release was not significantly decreased relative to N-LDL in cells incubated with low concentrations (5 to 50 mu g/mL) of HO-LDL and HOG-LDL, but was decreased to 3.2 +/- 0.5 and 3.1 +/- 0.7 mu g/mg/24 h for HO-LDL and HOG-LDL at 200 mu g/mL, respectively. Results using in vivo glycated versus nonglycated LDL showed that tPA and PAI-1 release did not differ between subfractions. Release of tPA averaged 5.11 +/- 0.6 and 5.12 +/- 0.7 ng/mg/ 24 h, whereas release of PAI-1 averaged 666 +/- 27 ng/mg/24 h and 705 30 ng/ mg/24 h for nonglycated and glycated LDL subfractions, respectively. Using LDL of different density subclasses, tPA and PAI-1 release in response to LDL from diabetic patients compared with control subjects did not differ when HAECs were incubated with LDLs of increasing density isolated from each subject pair. We conclude that oxidation of LDL, but not glycation, may contribute to the altered fibrinolysis observed in diabetes. C1 Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Res Serv, Charleston, SC 29401 USA. Univ S Carolina, Dept Chem & Biochem, Columbia, SC 29208 USA. Univ Oklahoma, Hlth Sci Ctr, Endocrinol Sect, Oklahoma City, OK 73104 USA. Univ Melbourne, Dept Med, Parkville, Vic 3052, Australia. RP Klein, RL (reprint author), Med Univ S Carolina, Strom Thurmond Biomed Res Facil, Room 501,114 Doughty St, Charleston, SC 29403 USA. EM kleinrl@musc.edu RI Jenkins, Alicia/N-2482-2015 NR 12 TC 5 Z9 6 U1 0 U2 1 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-531-1 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2005 VL 1043 BP 379 EP 389 DI 10.1196/annals.1333.044 PG 11 WC Biochemistry & Molecular Biology; Chemistry, Applied; Multidisciplinary Sciences; Physiology SC Biochemistry & Molecular Biology; Chemistry; Science & Technology - Other Topics; Physiology GA BCY08 UT WOS:000231834100044 PM 16037259 ER PT J AU Collins, TC Petersen, NJ Suarez-Almazor, M Ashton, CM AF Collins, TC Petersen, NJ Suarez-Almazor, M Ashton, CM TI Ethnicity and peripheral arterial disease SO MAYO CLINIC PROCEEDINGS LA English DT Article ID ANKLE-ARM INDEX; VASCULAR-DISEASE; INTERMITTENT CLAUDICATION; DIABETES-MELLITUS; OCCLUSIVE DISEASE; INCOME INEQUALITY; LOWER-EXTREMITIES; UNITED-STATES; SOCIAL-CLASS; MORTALITY AB OBJECTIVE: To determine whether race/ethnicity is an independent risk factor for peripheral arterial disease (PAD). PATIENTS AND METHODS: From September 2000 through August 2001, we screened patients (age greater than or equal to55 years) for PAD within 4 primary care clinics located in the Houston, Tex, area. Variables that were bivariately associated with PAD (P less than or equal to .05) were selected for entry into a multivariate logistic regression model to determine the independent risk factors for PAD. RESULTS: Among 403 patients (136 white, 136 African American, and 131 Latino patients, 81 of whom were Spanish speaking), the prevalence of PAD was 22.8% among African American patients, 13.7% among Latino patients, and 13.2% among white patients (P = .06). Within the multivariate model, adjusting for age, smoking status (odds ratio [OR], 2.58; 95% confidence interval [CI] 1.27-5.25), diabetes mellitus (OR, 2.98; 95% CI, 1.58-5.63): hypertension (OR, 2.58; 95% CI, 1.12-5.95), and education, African American and Latino patients were not more likely than white patients to have a diagnosis of PAD (OR 1.89, 95% CI 0.89-3.99 and OR 1.54, 95% CI 0.59-4.06, respectively). CONCLUSION: After adjusting for atherosclerotic risk factors and level of education, ethnicity was not an independent risk factor for PAD. When determining ethnic variation in outcomes among patients with PAD, efforts are needed to better understand the role of the primary care setting to reduce the burden of social inequality on health. C1 Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. RP Collins, TC (reprint author), Dept Vet Affairs, 2002 Holcombe Blvd,152, Houston, TX 77030 USA. EM tcollins@bcm.tmc.edu NR 35 TC 16 Z9 16 U1 0 U2 1 PU MAYO CLINIC PROCEEDINGS PI ROCHESTER PA 660 SIEBENS BLDG MAYO CLINIC, ROCHESTER, MN 55905 USA SN 0025-6196 J9 MAYO CLIN PROC JI Mayo Clin. Proc. PD JAN PY 2005 VL 80 IS 1 BP 48 EP 54 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 884AM UT WOS:000226057000009 PM 15667029 ER PT B AU Gutkin, DW Metes, D Shurin, MR AF Gutkin, Dmitriy W. Metes, Diana Shurin, Michael R. BE Lotze, MT Thomson, AW TI Handling Sera and Obtaining Fluid from Different Compartments: Practical Considerations SO MEASURING IMMUNITY: BASIC BIOLOGY AND CLINICAL ASSESSMENT LA English DT Article; Book Chapter ID SYSTEMIC LUPUS-ERYTHEMATOSUS; IMMUNOGLOBULIN LIGHT-CHAINS; AMNIOTIC-FLUID; MULTIPLE-SCLEROSIS; CEREBROSPINAL-FLUID; RHEUMATOID-ARTHRITIS; PRETERM DELIVERY; SYNOVIAL-FLUID; PLEURAL FLUID; CLINICAL-FEATURES C1 [Gutkin, Dmitriy W.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Metes, Diana] Univ Pittsburgh, Med Ctr, Div Clin Immunopathol, Dept Surg, Pittsburgh, PA USA. [Shurin, Michael R.] Univ Pittsburgh, Med Ctr, Div Clin Immunopathol, Dept Pathol, Pittsburgh, PA USA. RP Gutkin, DW (reprint author), VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 59 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-047933-0; 978-0-12-455900-4 PY 2005 BP 121 EP 130 DI 10.1016/B978-012455900-4/50271-3 PG 10 WC Immunology; Medical Laboratory Technology SC Immunology; Medical Laboratory Technology GA BCN55 UT WOS:000310783900011 ER PT J AU Austad, SN AF Austad, SN TI Diverse aging rates in metazoans: targets for functional genomics SO MECHANISMS OF AGEING AND DEVELOPMENT LA English DT Article; Proceedings Paper CT 2nd International Conference on Functional Genomics of Ageing CY APR 28-MAY 01, 2004 CL Hersonissos, GREECE DE longevity; age-specific mortality; accelerated aging; slow-aging ID AGE-RELATED-CHANGES; DIETARY RESTRICTION; ANTECHINUS-STUARTII; BODY-COMPOSITION; LIFE-SPAN; LONGEVITY; DOG; METABOLISM; BREEDS; SIZE AB Aging, or senescence. has typically been measured by demographic analysis, which has its merits but is blind to key aspects of functional development and deterioration. If one uses demographic analyses, however, the approach providing most insight is the analysis of age-specific mortality. The continuing increase in DNA sequencing power combined with emerging computational techniques will allow in the near future detailed investigation of mechanisms of aging in diverse species beyond the typical laboratory bestiary. A comparative approach of this son needs to consider, in addition to simple longevity, the effects of phylogeny and body size on the species in question. Insight may be gained from the study of species exhibiting accelerated aging relative to more "typical" species. These naturally short-lived species. such as several small shrews and marsupials, avoid the worry inherent in "accelerated aging" genotypes of common models, which is that they are only short-lived because of some idiosyncratic pathology unrelated to general aging. A case of special interest that has yet to be seriously investigated is the domestic dog in which selective breeding has produced phenotypes within the same species that age at two-fold different rates. Exceptionally long-lived species offer exceptional opportunities to discover whether there are few or many ways to create long-lived organisms. Slow-aging species with the most to offer include bats and naked mole-rats. Perhaps no fundamental question in biology is more intriguing that why and how nature has produced such a dazzling array of aging rates. The development of functional genetics over the next several decades promises to lead us toward an answer. (C) 2004 Elsevier Ireland Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Barshop Inst Longev & Aging Studies, San Antonio, TX 78245 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78284 USA. RP Austad, SN (reprint author), Univ Texas, Hlth Sci Ctr, Barshop Inst Longev & Aging Studies, SCTBM Bldg,Room 3-100,15355 Lambda Dr, San Antonio, TX 78245 USA. EM austad@uthscsa.edu NR 32 TC 43 Z9 46 U1 0 U2 9 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0047-6374 J9 MECH AGEING DEV JI Mech. Ageing Dev. PD JAN PY 2005 VL 126 IS 1 SI SI BP 43 EP 49 DI 10.1016/j.mad.2004.09.022 PG 7 WC Cell Biology; Geriatrics & Gerontology SC Cell Biology; Geriatrics & Gerontology GA 891EL UT WOS:000226564000007 PM 15610761 ER PT J AU Ashton, CM Pietz, K AF Ashton, CM Pietz, K TI Setting a new standard for studies of geographic variation in hospital utilization rates SO MEDICAL CARE LA English DT Editorial Material ID PREVENTABLE HOSPITALIZATIONS; PRIMARY-CARE; HEALTH-CARE; CLINICS; ACCESS C1 VA Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. RP Ashton, CM (reprint author), VA Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM carol.ashton@med.va.gov NR 20 TC 3 Z9 3 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 2005 VL 43 IS 1 BP 1 EP 3 PG 3 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 883MQ UT WOS:000226017000001 PM 15626927 ER PT J AU Petersen, LA Pietz, K Woodard, LD Byrne, M AF Petersen, LA Pietz, K Woodard, LD Byrne, M TI Comparison of the predictive validity of diagnosis-based risk adjusters for clinical outcomes SO MEDICAL CARE LA English DT Article DE risk adjustment; Diagnostic Cost Groups; Adjusted Clinical Groups; capitation; predictive validity; mortality; long-term care; age ID LAST YEAR; MEDICARE; ADJUSTMENT; LIFE; CARE; PAYMENTS; SERVICES AB Objectives: Many possible methods of risk adjustment exist, but there is a dearth of comparative data on their performance. We compared the predictive validity of 2 widely used methods (Diagnostic Cost Groups [DCGs] and Adjusted Clinical Groups [ACGs]) for 2 clinical outcomes using a large national sample of patients. Methods: We studied all patients who used Veterans Health Administration (VA) medical services in fiscal year (FY) 2001 (n = 3,069,168) and assigned both a DCG and an ACG to each. We used logistic regression analyses to compare predictive ability for death or long-term care (LTC) hospitalization for age/gender models, DCG models, and ACG models. We also assessed the effect of adding age to the DCG and ACG models. Results: Patients in the highest DCG categories, indicating higher severity of illness, were more likely to die or to require LTC hospitalization. Surprisingly, the age/gender model predicted death slightly more accurately than the ACG model (c-statistic of 0.710 versus 0.700, respectively). The addition of age to the ACG model improved the c-statistic to 0.768. The highest c-statistic for prediction of death was obtained with a DCG/age model (0.830). The lowest c-statistics were obtained for age/gender models for LTC hospitalization (c-statistic 0.593). The c-statistic for use of ACGs to predict LTC hospitalization was 0.783, and improved to 0.792 with the addition of age. The c-statistics for use of DCGs and DCG/age to predict LTC hospitalization were 0.885 and 0.890, respectively, indicating the best prediction. Conclusions: We found that-risk adjusters based upon diagnoses predicted an increased likelihood of death or LTC hospitalization, exhibiting good predictive validity. In this comparative analysis using VA data, DCG models were generally superior to ACG models in predicting clinical outcomes, although ACG model performance was enhanced by the addition of age. C1 Houston Vet Affairs Med Ctr, Hlth Serv Res & Dev Ctr Excellence 152, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX USA. Univ Miami, Sch Med, Dept Epidemiol & Publ Hlth, Miami, FL USA. RP Petersen, LA (reprint author), Houston Vet Affairs Med Ctr, Hlth Serv Res & Dev Ctr Excellence 152, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 24 TC 77 Z9 77 U1 1 U2 2 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 JAN PY 2005 VL 43 IS 1 BP 61 EP 67 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 883MQ UT WOS:000226017000009 PM 15626935 ER PT J AU Turner, EH Blackwell, AD AF Turner, EH Blackwell, AD TI 5-Hydroxytryptophan plus SSRIs for interferon-induced depression: Synergistic mechanisms for normalizing synaptic serotonin SO MEDICAL HYPOTHESES LA English DT Article ID SEASONAL AFFECTIVE-DISORDER; HEPATITIS-C; ANTIDEPRESSANT ACTION; TRYPTOPHAN DEPLETION; LIGHT THERAPY; ALPHA; L-5-HYDROXYTRYPTOPHAN; METABOLISM; REMISSION; 5-HYDROXY-L-TRYPTOPHAN AB Interferon-α (IFN) is widely used in the treatment of certain cancers and viral infections, including hepatitis C (HCV). Unfortunately, depression is a common side effect of IFN therapy, affecting approximately a third of HCV patients receiving IFN therapy. Studies have shown that selective serotonin reuptake inhibitors (SSRIs) can effectively treat IFN-induced depression in only 63-75% of cases. For the remaining percentage, depression often necessitates dose reduction of or discontinuation from IFN therapy. Emerging evidence indicates that IFN may cause depression by affecting brain serotonin. IFN has been shown to increase serotonin reuptake and to decrease serotonin synthesis. We hypothesize that SSRIs are not fully effective because they affect only serotonin reuptake, not serotonin synthesis, and that effective treatment must address both uptake and synthesis. 5-Hydroxytryptophan (5-HTP) effectively increases central nervous system synthesis of serotonin. It is the immediate precursor of serotonin and is widely available as a dietary supplement, which is well absorbed after an oral dose. Several double-blind studies have shown 5-HTP to be effective in the treatment of nondrug-induced depression. We hypothesize that patients who become depressed on IFN will respond to the synergistic combination of SSRIs plus 5-HTP. © 2005 Elsevier Ltd. All rights reserved. C1 Portland VA Med Ctr, Mood Disorders Res Ctr, Mental Hlth Div, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Psychiat, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Pharmacol & Physiol, Portland, OR 97239 USA. Portland VA Med Ctr, NW Hepatitis C Resource Ctr, Portland, OR 97239 USA. RP Turner, EH (reprint author), Portland VA Med Ctr, Mood Disorders Res Ctr, Mental Hlth Div, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM Erick.turner@med.va.gov RI Blackwell, Aaron/B-5258-2008; Turner, Erick/A-4848-2008 OI Blackwell, Aaron/0000-0002-5871-9865; Turner, Erick/0000-0002-3522-3357 NR 55 TC 23 Z9 26 U1 0 U2 2 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0306-9877 J9 MED HYPOTHESES JI Med. Hypotheses PY 2005 VL 65 IS 1 BP 138 EP 144 DI 10.1016/j.mehy.2005.01.026 PG 7 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 932DW UT WOS:000229535400023 PM 15893130 ER PT J AU Sonnenberg, A AF Sonnenberg, A TI The inevitable rise of mediocrity in academic medicine SO MEDICAL HYPOTHESES LA English DT Article ID CREATIVITY; REQUIREMENTS; DEPARTMENTS; GUIDELINES; JOURNALS; FACULTY AB The present analysis addresses the question of how it has been possible for academic medicine to grow and lose its creative productivity at the same time. A mathematical model is developed to simulate the mechanisms that govern growth of medical systems over time. Time-dependent growth of system size increases the occurrence of statistical deviations of all system parameters. Deviations are correlated with costs and creative output. As deviation-induced costs start to strain the system's tolerance, means become implemented to restrict deviation, which ultimately also reduces its creative output. To maintain growth combined with high levels of creative output, an academic medical system would need to continuously branch off and nurture smaller subsystems, which pursue their own set of goals relatively independently of the overall academic structure. Published by Elsevier Ltd. C1 Portland VA Med Ctr, Gastroenterol Sect, Portland, OR 97239 USA. RP Sonnenberg, A (reprint author), Portland VA Med Ctr, Gastroenterol Sect, P3-G1,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM sonnenbe@ohsu.edu NR 22 TC 1 Z9 1 U1 0 U2 1 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0306-9877 J9 MED HYPOTHESES JI Med. Hypotheses PY 2005 VL 65 IS 2 BP 400 EP 404 DI 10.1016/j.mehy.2005.02.028 PG 5 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 935YI UT WOS:000229818900034 PM 15894430 ER PT J AU Bhidayasiri, R Bronstein, JM AF Bhidayasiri, R Bronstein, JM TI Improvement of cervical dystonia: possible role of transcranial magnetic stimulation simulating sensory tricks effect SO MEDICAL HYPOTHESES LA English DT Article ID SUBTHALAMIC NUCLEUS RESULT; EXCITOTOXIC ACID LESIONS; SENSORIMOTOR INTEGRATION; NEURONAL-ACTIVITY; FOCAL DYSTONIA; WRITERS CRAMP; MOTOR CORTEX; DEPRESSION; RESPONSES; HAND AB Idiopathic cervical dystonia (ICD) is the most common form of focal dystonia. A characteristic and unique diagnostic feature is the presence of "sensory tricks", for example, a finger placed on the chin to neutralize the spasm. Although approximately 70% of patients with ICD experience effective sensory tricks, the exact mechanism of these tricks is still unknown. However, recent evidence suggests that higher sensorimotor integration processes are involved. A study using H(2)(15)O positron emission tomography demonstrated that the application of sensory trick stimulus, resulting in a near-neutral head position, led to an increased activation mainly of the superior and inferior parietal lobules (ipsilateral to head turn) and bilateral occipital cortex and to a decreased activity of the supplementary motor area and the primary sensorimotor cortex (contralateral to head turn). Since transcranial magnetic stimulation (TMS) is an experimental device with the ability to excite or depress the neural circuits, we hypothesize that the use of TMS of specific parameters to specific brain areas (as above) may produce an effect similar to sensory tricks resulting in the relief of spasms and the improvement of cervical dystonia. (c) 2004 Elsevier Ltd. All rights reserved. C1 Univ Calif Los Angeles, Med Ctr, Dept Neurol, Geffen Sch Med, Los Angeles, CA 90095 USA. W Los Angeles Vet Affairs Med Ctr, Dept Neurol, PADRECC, Los Angeles, CA 90095 USA. RP Bhidayasiri, R (reprint author), Univ Calif Los Angeles, Med Ctr, Dept Neurol, Geffen Sch Med, Los Angeles, CA 90095 USA. EM rbh@ucla.edu OI Bhidayasiri, Roongroj/0000-0002-6901-2064 NR 30 TC 7 Z9 8 U1 0 U2 1 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0306-9877 J9 MED HYPOTHESES JI Med. Hypotheses PY 2005 VL 64 IS 5 BP 941 EP 945 DI 10.1016/j.mehy.2004.11.022 PG 5 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 912VH UT WOS:000228107500009 PM 15780489 ER PT J AU McFall, M Tackett, J Maciejewski, ML Richardson, RD Hunt, SC Roberts, L AF McFall, M Tackett, J Maciejewski, ML Richardson, RD Hunt, SC Roberts, L TI Predicting costs of Veterans Affairs health care in Gulf War veterans with medically unexplained physical symptoms SO MILITARY MEDICINE LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER; POPULATION-BASED SURVEY; SELF-REPORTED SYMPTOMS; PSYCHIATRIC-DISORDERS; VIETNAM VETERANS; SOMATIZATION; EXPOSURES; SEVERITY; SERVICES; OUTCOMES AB Measures of post-traumatic stress disorder (PTSD) and depression were used to predict Veterans Affairs outpatient treatment costs among Persian Gulf War veterans with medically unexplained physical symptoms. Patients (N=206) enrolled in a Veterans Affairs primary care clinic for Persian Gulf War veterans completed study assessments at the initial appointment or at a proximal follow-up visit. Costs of care for mental health, medical, and pharmacy services for these veterans were computed for the subsequent 6-month period. Depression and PTSD symptoms explained a significant share of variance in costs of mental health care and pharmacy services, after adjustment for covariates. None of the mental status measures was significantly related to costs of medical care. Models using global measures of mental health status were as robust as models using disorder-specific measures of PTSD and depression in predicting mental health care and pharmacy costs. The implications of these findings for anticipating costs of care for Persian Gulf War veterans are discussed. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Hlth Serv, Seattle, WA 98108 USA. Univ Washington, Dept Occupat & Environm Med, Seattle, WA 98108 USA. RP McFall, M (reprint author), VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. NR 40 TC 5 Z9 5 U1 0 U2 0 PU ASSN MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 J9 MIL MED JI Milit. Med. PD JAN PY 2005 VL 170 IS 1 BP 70 EP 75 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 019JG UT WOS:000235830800013 PM 15724858 ER PT J AU Sun, CP Liao, JC Zhang, YH Gau, V Mastali, M Babbitt, JT Grundfest, WS Churchill, BM McCabe, ERB Haake, DA AF Sun, CP Liao, JC Zhang, YH Gau, V Mastali, M Babbitt, JT Grundfest, WS Churchill, BM McCabe, ERB Haake, DA TI Rapid, species-specific detection of uropathogen 16S rDNA and rRNA at ambient temperature by dot-blot hybridization and an electrochemical sensor array SO MOLECULAR GENETICS AND METABOLISM LA English DT Article DE diagnosis; molecular; DNA probes; microbiology; molecular microbiology; nucleic acid hybridization/methods; oligonucleotide probes; RNA; ribosomal; 16S; urinary tract infections; molecular diagnosis ID BACTERIAL; PROBES; IDENTIFICATION; AMPLIFICATION; INFECTIONS; BIOSENSORS; SEQUENCES; GENE AB Development of rapid molecular approaches for pathogen detection is key to improving treatment of infectious diseases. For this study, the kinetics and temperature-dependence of DNA probe hybridization to uropathogen species-specific sequences were examined. A set of oligonucleotide probes were designed based on variable regions of the 16S gene of the Escherichia coli, Proteus mirabilis, Klebsiella oxytoca, and Pseudomonas aeruginosa. A universal bacterial probe and probes-specific for gram-positive and gram-negative organisms were also included. The oligonucleotide probes discriminated among 16S genes derived from I I different species of uropathogenic bacteria applied to nylon membranes in a dot-blot format. Significant binding of oligonucleotide probes to target DNA and removal of nonspecific binding by membrane washing could both be achieved rapidly, requiring as little as 10 min. An oligonucleotide probe from the same species-specific region of the E coli 16S gene was used as a capture probe in a novel electro-chemical 16-sensor array based on micro fabrication technology. Sequence-specific hybridization of target uropathogen 16S rDNA was detected through horseradish peroxidase acting as an electrochemical transducer via a second, detector probe. The sensor array demonstrated rapid, species-specific hybridization in a time course consistent with the rapid kinetics of the dot-blot hybridization studies. As in the dot-blot hybridization studies, species-specific detection of bacterial nucleic acids using the sensor array approach was demonstrated both at 65 degreesC and at room temperature. These results demonstrate that molecular hybridization approaches can be adapted to rapid, room temperature conditions ideal for an electrochemical sensor array platform. Published by Elsevier Inc. C1 Univ Calif Los Angeles, Dept Human Genet, David Geffen Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Biomed Engn, Henry Samueli Sch Engn & Appl Sci, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Urol, David Geffen Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Pediat, David Geffen Sch Med, Los Angeles, CA 90024 USA. GenFluid Inc, Monterey, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, Los Angeles, CA 90024 USA. RP Haake, DA (reprint author), Univ Calif Los Angeles, Dept Human Genet, David Geffen Sch Med, Los Angeles, CA USA. EM dhaake@ucla.edu RI Liao, Joseph/J-5874-2015 FU NIBIB NIH HHS [R01 EB000127-04, EB00127, R01 EB000127-01, R01 EB000127-02, R01 EB000127-03, R01 EB000127-05] NR 23 TC 30 Z9 32 U1 0 U2 7 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1096-7192 J9 MOL GENET METAB JI Mol. Genet. Metab. PD JAN PY 2005 VL 84 IS 1 BP 90 EP 99 DI 10.1016/j.ymgme.2004.11.006 PG 10 WC Endocrinology & Metabolism; Genetics & Heredity; Medicine, Research & Experimental SC Endocrinology & Metabolism; Genetics & Heredity; Research & Experimental Medicine GA 899VL UT WOS:000227173700012 PM 15639199 ER PT J AU Thurman, JM Kraus, DM Girardi, G Hourcade, D Kang, HJ Royer, PA Mitchell, LM Giclas, PC Salmon, J Gilkeson, G Holers, VM AF Thurman, JM Kraus, DM Girardi, G Hourcade, D Kang, HJ Royer, PA Mitchell, LM Giclas, PC Salmon, J Gilkeson, G Holers, VM TI A novel inhibitor of the alternative complement pathway prevents antiphospholipid antibody-induced pregnancy loss in mice SO MOLECULAR IMMUNOLOGY LA English DT Article DE complement; antigens/peptides/epitopes; antibodies; autoantibodies; rodent ID FACTOR-B; RENAL-DISEASE; COMPONENT C3; MRL/LPR MICE; DEFICIENT; GLOMERULONEPHRITIS; THERAPY; INNATE; SYSTEM; INJURY AB Studies in gene-targeted mice have demonstrated that factor B of the alternative complement pathway plays an important role in several disease models, but an exogenous inhibitor of factor B has not previously been available. We have developed an inhibitory monoclonal antibody directed against a critical epitope on mouse factor B and have tested it in a model of antiphospholipid (aPL) antibody (Ab)-induced fetal loss. Gene-targeted factor B-deficient mice (fB(-/-)) were injected with a fusion protein comprised of the second and third short consensus repeat (SCR) domains of mouse factor B linked to a mouse IgG(1) Fc domain. Hybridomas were made from splenocytes of the immunized mouse. One mAb, designated 1379, produced an IgG, antibody that inhibited alternative pathway activation in vitro and in vivo by preventing formation of the C3bBb complex. Strikingly, this mAb inhibited alternative pathway activation in serum from mice, rats, humans, monkeys, pigs and horses. Fab fragments made from this mAb also inhibited alternative pathway activation. Epitope mapping demonstrated that this antibody binds to factor B within the third SCR domain. When mAb 1379 was administered to mice that also received human IgG containing antiphospholipid antibodies, it provided significant protection from antiphospholipid antibody-induced complement activation and fetal loss. Thus, this mAb to factor B has broad species reactivity and effectively inhibits alternative pathway activation. The mAb protects mice in an in vivo model of antiphospholipid antibody syndrome, demonstrating the therapeutic potential for the inhibition of factor B in this disease. (C) 2004 Elsevier Ltd. All rights reserved. C1 Univ Colorado, Hlth Sci Ctr, Div Nephrol & Hypertens, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Div Rheumatol, Denver, CO 80262 USA. Weill Med Coll, Hosp Special Surg, Dept Med, New York, NY 10021 USA. Washington Univ, Sch Med, Dept Med, Div Rheumatol, St Louis, MO 63110 USA. Natl Jewish Med & Res Ctr, Dept Pediat, Div Allergy & Immunol, Denver, CO 80262 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Med Res Serv, Charleston, SC 29425 USA. RP Thurman, JM (reprint author), Univ Colorado, Hlth Sci Ctr, Div Nephrol & Hypertens, 4200 E 9th Ave,B-115, Denver, CO 80262 USA. EM joshua.thurman@uchsc.edu FU NIAID NIH HHS [R0-1 AI051436-01A1, R0-1 AI31105, R0-1 AI47469]; NIDDK NIH HHS [K08 DK064790-01] NR 26 TC 89 Z9 90 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0161-5890 J9 MOL IMMUNOL JI Mol. Immunol. PD JAN PY 2005 VL 42 IS 1 BP 87 EP 97 DI 10.1016/j.molimm.2004.07.043 PG 11 WC Biochemistry & Molecular Biology; Immunology SC Biochemistry & Molecular Biology; Immunology GA 875NR UT WOS:000225427800010 PM 15488947 ER PT J AU Yao, JK Reddy, RD AF Yao, JK Reddy, RD TI Metabolic investigation in psychiatric disorders SO MOLECULAR NEUROBIOLOGY LA English DT Article; Proceedings Paper CT Satellite Symposium on Oxidative Mechanisms in Neurodegenerative Disorder CY FEB 07-11, 2004 CL Guilin, PEOPLES R CHINA DE high-pressure liquid chromatography; coulometric multielectrode array system; metabolomics; psychiatric disorders; oxidative stress ID REDOX-ACTIVE COMPOUNDS; THERAPEUTIC IMPLICATIONS; SCHIZOPHRENIA; SEROTYPES; ARRAY; RATS; FEMALE; ACID AB A multiplicity of theories have been proposed over the years that aim to conceptualize the pathophysiology of neuropsychiatric disorders, including impaired neurotransmission, viral infections, genetic mutation, energy metabolism deficiency, excitotoxicity, oxidative stress, and others. It is likely that complex disorders such as schizophrenia, bipolar disorder, and major depression are associated with multiple etiologies and pathogenetic mechanisms. In light of the interwoven biochemistry of human organs, identifying a network of multiple interacting biochemical pathways that account for the constellation of clinical and biological features would advance our understanding of these disorders. One such approach is to evaluate simultaneously the multiple metabolites in order to uncover the dynamic relations in the relevant biochemical systems. These metabolites are a group of low-molecular-weight, redox-active compounds, such as antioxidants, amino acids, catecholamines vitamins, lipids, and nucleotides, which reflect the metabolic processes, including anabolism and catabolism as well as other related cellular processes (e.g., signal transduction, regulation, detoxification, etc.). Such an analytic approach has the potential to yield valuable insights into the likely complex pathophysiological mechanisms that affect multiple metabolic pathways and thereby offer multiple windows of therapeutic opportunities. C1 VA Pittsburgh Healthcare Syst, Med Res Serv, Pittsburgh, PA USA. Univ Pittsburgh, Med Ctr, WPIC, Dept Psychiat, Pittsburgh, PA USA. Univ Pittsburgh, Sch Pharm, Dept Pharmaceut Sci, Pittsburgh, PA 15261 USA. RP Yao, JK (reprint author), VA Pittsburgh Healthcare Syst, Med Res Serv, Pittsburgh, PA USA. EM jkyao@pitt.edu FU NIMH NIH HHS [MH58141, MH64118] NR 27 TC 17 Z9 18 U1 1 U2 3 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0893-7648 J9 MOL NEUROBIOL JI Mol. Neurobiol. PY 2005 VL 31 IS 1-3 BP 193 EP 203 DI 10.1385/MN:31:1-3:193 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 940BY UT WOS:000230119900015 PM 15953821 ER PT J AU Kelly, S Cheng, DY Steinberg, GK Yenari, MA AF Kelly, S Cheng, DY Steinberg, GK Yenari, MA TI Mild hypothermia decreases GSK3 beta expression following global cerebral ischemia SO NEUROCRITICAL CARE LA English DT Article DE global cerebral ischemia; mild hypothermia; GSK3 beta; phos-GSK3 beta; neuroprotection ID GLYCOGEN-SYNTHASE KINASE-3-BETA; RABBIT SKELETAL-MUSCLE; PHOSPHORYLASE-KINASE; FOREBRAIN ISCHEMIA; CARDIAC-ARREST; BRAIN-INJURY; RATS; LITHIUM; BCL-2 AB Introduction: The serine/threonine kinase glycogen synthase kinase 3 beta (GSK3 beta) is abundant in the central nervous system and is neuron-specific. GSK3 beta plays a pivotal role in the regulation of numerous cellular functions (including phosphorylation) and, thereby, regulation of many metabolic, signaling, and structural proteins as well as transcription factors that can influence cell survival. This article reports that GSK3 beta expression following global cerebral ischemia (GCI) is altered by the neuroprotectant, mild hypothermia (33 degrees C). Methods: Male Sprague-Dawley rats were anesthetized and subjected to GCI; arterial blood pressure was reduced to 30 mmHg by blood withdrawal via the jugular vein, and both common carotid arteries were occluded with aneurysm clips for 8 minutes. Hypothermia (33 degrees C) was induced in half the rats 10 minutes prior to GCI and was maintained for 3 hours. Rats were killed 24 or 72 hours later to assess cell death and GSK3 beta expression. Results: At 72 hours post-GCI, levels of GSK3 beta expression were significantly lower in hypothermic rats than in normothermic rats. This reduction in GSK3 beta correlated with marked neuroprotection and reduced terminal deoxynucleotidyl transferase-mediated uridine 5'-triphosphate-biotin nick end labeling staining in hippocampal CA1 neurons. No significant changes in phosphorylated GSK3 beta expression were observed. Conclusion: These data suggest that GSK3 beta plays a role in GCI pathology that can be altered by mild hypothermia. C1 Stanford Univ, Dept Neurosurg, Stanford, CA 94305 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. RP Yenari, MA (reprint author), UCSF & SF VAMC, Dept Neurol, 4150 Clement St,MC127, San Francisco, CA 94121 USA. EM yenari@alum.mit.edu RI Kelly, Stephen/A-8307-2010 FU NINDS NIH HHS [R01 NS40516]; PHS HHS [R01 27292] NR 27 TC 2 Z9 4 U1 0 U2 1 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 1541-6933 J9 NEUROCRIT CARE JI Neurocrit. Care PY 2005 VL 2 IS 2 BP 212 EP 217 DI 10.1385/Neurocrit.Care2005;2:212-217 PG 6 WC Critical Care Medicine; Clinical Neurology SC General & Internal Medicine; Neurosciences & Neurology GA 947JI UT WOS:000230639100018 PM 16159068 ER PT J AU Rosano, C Simonsick, EM Harris, TB Kritchevsky, SB Brach, J Visser, M Yaffe, K Newman, AB AF Rosano, C Simonsick, EM Harris, TB Kritchevsky, SB Brach, J Visser, M Yaffe, K Newman, AB CA Hlth ABC Collaborative Res Grp TI Association between physical and cognitive function in healthy elderly: The health, aging and body composition study SO NEUROEPIDEMIOLOGY LA English DT Article DE physical function; cognitive performance; gait speed; well-functioning elderly ID STROKE REHABILITATION; EXTRAPYRAMIDAL SIGNS; SENILE DEMENTIA; ALZHEIMER-TYPE; OLDER ADULTS; PERFORMANCE; IMPAIRMENT; WOMEN; MOTOR; DECLINE AB Performance measures of physical function ( gait speed, chair stands, standing balance) and cognitive function [Teng-modified Mini-Mental Status Exam (3MS) and digit symbol substitution test (DSST)] were assessed at baseline in 3,075 participants in the Health, Aging and Body Composition Study. Each physical function measure was examined for the strength and magnitude of association with cognitive function. All physical function measures were associated with both the 3MS and DSST scores (p < 0.001), and in multivariate analysis each relationship was independent of demographic characteristics, weight, physical activity and comorbid health conditions of participants. The association of motor performance was consistently greater for the DSST than the 3MS and, among the motor tests, gait speed retained a significant association with both cognitive measures independent of demographic, weight, physical activity and comorbid health conditions. In this large cohort of high-functioning older adults, the correlation between physical and cognitive function was not entirely explained by demographics. Longitudinal studies are needed to determine the direction of causality in this relationship. Copyright (C) 2005 S. Karger AG, Basel. C1 Univ Pittsburgh, Dept Med, Div Geriatr Med, Pittsburgh, PA 15260 USA. NIA, Intramural Res Program, Baltimore, MD 21224 USA. NIA, Epidemiol Demog & Biometry Program, Bethesda, MD 20892 USA. Univ Tennessee, Dept Prevent Med, Memphis, TN USA. Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Phys Therapy, Pittsburgh, PA USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. Vrije Univ Amsterdam, Inst Res Extramural Med, Amsterdam, Netherlands. RP Rosano, C (reprint author), Univ Pittsburgh, Dept Med, Div Geriatr Med, 930 Scaife Hall, Pittsburgh, PA 15260 USA. EM RosanoC@edc.pitt.edu RI Brach, Jennifer/A-6912-2009; Newman, Anne/C-6408-2013 OI Newman, Anne/0000-0002-0106-1150; Rosano, Caterina/0000-0002-0909-1506; Rosano, Caterina/0000-0002-4271-6010 NR 31 TC 116 Z9 118 U1 0 U2 9 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0251-5350 J9 NEUROEPIDEMIOLOGY JI Neuroepidemiology PY 2005 VL 24 IS 1-2 BP 8 EP 14 DI 10.1159/000081043 PG 7 WC Public, Environmental & Occupational Health; Clinical Neurology SC Public, Environmental & Occupational Health; Neurosciences & Neurology GA 883OC UT WOS:000226021500002 PM 15459503 ER PT J AU Lee, JK Won, JS Singh, AK Singh, I AF Lee, JK Won, JS Singh, AK Singh, I TI Adenosine kinase inhibitor attenuates the expression of inducible nitric oxide synthase in glial cells SO NEUROPHARMACOLOGY LA English DT Article DE adenosine; adenosine kinase inhibitor; adenosine receptor; C6 glioma cells; inducible nitric oxide synthase ID ACTIVATED PROTEIN-KINASE; RAT PRIMARY ASTROCYTES; MIDDLE CEREBRAL-ARTERY; KAPPA-B; ANTISEIZURE ACTIVITY; ENZYME-INHIBITION; NERVOUS-SYSTEM; RECEPTORS; INDUCTION; PHARMACOLOGY AB The present study demonstrates the anti-inflammatory effect of adenosine kinase inhibitor (ADKI) in glial cells. Treatment of glial cells with IC51, an ADKI. simulated the extracellular adenosine release and reduced the LPS/IFNgamma-mediated production of NO, and induction of iNOS and TNF-alpha gene expression. The recovery of IC51-mediated inhibition of iNOS expression by adenosine transport inhibitor. S-(4-nitrobenzyl)-6-thioinosine (NBTI), and (lie inhibition of LPS/IFNgamma-(-induced iNOS gene expression by exogenous adenosine indicate a role for adenosine release in IC51-mediated iNOS expression. The rescue of IC51-mediated inhibition of iNOS expression by adenosine receptor antagonist for A(2A). 8-(3-chlorostyryl)caffeine (CSC) and alloxazine for A(2B), further supports a role for interaction of adenosine and its receptors in anti-inflammatory, activity. The IC51-mediated induction of cAMP levels, downstream target of A(2A) and A(2B). and inhibition of LPS/IFNgamma-induced expression of iNOS by forskolin. a cAMP activator. document a role for cAMP mediated pathway in anti-inflammatory activity of IC51. Taken together, these studies document that IC51-mediated inhibition of iNOS expression is through activation of adenosine receptors, which activates A(2A) and A(2B) resulting in increased cAMP levels following LPS/IFNgamma stimulation. Moreover, the lack of effect of IC51 or adenosine on NFkappaB DNA binding activity and its transactivity indicates that the inhibition of iNOS expression mediated by IC51 may be through an NFkappaB independent pathway. (C) 2004 Elsevier Ltd. All rights reserved. C1 Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pathol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Singh, I (reprint author), Med Univ S Carolina, Dept Pediat, 96 Jonathan Lucas St,316 Clin Sci Bldg, Charleston, SC 29425 USA. EM singhi@musc.edu FU NINDS NIH HHS [NS-40144, NS-34741, NS-22576, NS-37766] NR 45 TC 10 Z9 10 U1 2 U2 3 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0028-3908 J9 NEUROPHARMACOLOGY JI Neuropharmacology PD JAN PY 2005 VL 48 IS 1 BP 151 EP 160 DI 10.1016/j.neuropharm.2004.09.006 PG 10 WC Neurosciences; Pharmacology & Pharmacy SC Neurosciences & Neurology; Pharmacology & Pharmacy GA 887RY UT WOS:000226324400014 PM 15617735 ER PT S AU Yenari, MA Liu, JL Zheng, Z Vexler, ZS Lee, JE Giffard, RG AF Yenari, MA Liu, JL Zheng, Z Vexler, ZS Lee, JE Giffard, RG BE Slikker, W Andrews, RJ Trembly, B TI Antiapoptotic and anti-inflammatory mechanisms of heat-shock protein protection SO NEUROPROTECTIVE AGENTS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT 7th International Conference on Neuroprotective Agents CY NOV 14-19, 2004 CL Pacific Grove, CA SP Cent Arkansas Chapter SIGMA XI, Natl Ctr Toxicol Res, FDA, US EPA DE heat-shock proteins; neuroprotection; apoptosis; cerebral ischemia; inflammation ID APOPTOSIS-INDUCING FACTOR; STRESS-INDUCED APOPTOSIS; KAPPA-B ACTIVATION; NITRIC-OXIDE; CEREBRAL-ISCHEMIA; FOCAL ISCHEMIA; RAT HEAT-SHOCK-PROTEIN-70; DIFFERENTIAL INDUCTION; TRANSCRIPTION FACTOR; APAF-1 APOPTOSOME AB We and others have previously shown that heat-shock proteins (HSPs) are involved in protecting the brain from a variety of insults including stroke, epilepsy, and other related insults. While the mechanism of this protection has largely been thought to be due to their chaperone functions (i.e., preventing abnormal protein folding or aggregation), recent work has shown that HSPs may also directly interfere with other cell death pathways such as apoptosis and inflammation. Using models of cerebral ischemic and ischemia-like injury, we overexpressed the 70-kDa heat-shock protein (HSP70) using gene transfer or by studying a transgenic mouse model. HSP70 protected neurons and astrocytes from experimental stroke and stroke-like insults. HSP70 transgenic mice also had better neurological scores following experimental stroke compared to their wild-type littermates. Overexpressing HSP70 was associated with less apoptotic cell death and increased expression of the antiapoptotic protein, Bcl-2. Furthermore, HSP70 suppressed microglial/monocyte activation following experimental stroke. HSP70 overexpression also led to the reduction of matrix metalloproteinases. We suggest that HSPs are capable of protecting brain cells from lethal insults through a variety of mechanisms and should be explored as a potential therapy against stroke and other neurodegenerative diseases. C1 Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Neurosurg, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Pediat, San Francisco, CA 94121 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Yonsei Univ, Dept Anat, Seoul 120749, South Korea. Yonsei Univ, Project BK21, Seoul 120749, South Korea. Stanford Univ, Dept Anesthesia, Sch Med, Stanford, CA 94305 USA. RP Yenari, MA (reprint author), Univ Calif San Francisco, Dept Neurol, 4150 Clement St, San Francisco, CA 94121 USA. EM yenari@alum.mit.edu RI Liu, Jialing/A-8627-2012 OI Liu, Jialing/0000-0003-4420-4382; Lee, Jong Eun/0000-0001-6203-7413 FU NIGMS NIH HHS [GM49831]; NINDS NIH HHS [NS35902, NS40469, NS40516, NS44025, P01 NS37520] NR 60 TC 170 Z9 197 U1 1 U2 19 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-578-8 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2005 VL 1053 BP 74 EP 83 DI 10.1196/annals.1344.007 PG 10 WC Multidisciplinary Sciences; Clinical Neurology; Neurosciences; Pharmacology & Pharmacy SC Science & Technology - Other Topics; Neurosciences & Neurology; Pharmacology & Pharmacy GA BDR63 UT WOS:000235109800010 PM 16179510 ER PT S AU Imam, SZ Duhart, HM Skinner, JT Ali, SF AF Imam, SZ Duhart, HM Skinner, JT Ali, SF BE Slikker, W Andrews, RJ Trembly, B TI Cocaine induces a differential dose-dependent alteration in the expression profile of immediate early genes, transcription factors, and caspases in PC12 cells: A possible mechanism of neurotoxic damage in cocaine addiction SO NEUROPROTECTIVE AGENTS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT 7th International Conference on Neuroprotective Agents CY NOV 14-19, 2004 CL Pacific Grove, CA SP Cent Arkansas Chapter SIGMA XI, Natl Ctr Toxicol Res, FDA, US EPA DE cocaine; psychostimulants; dopamine; immediate early genes; apoptosis; transcription ID DOPAMINE NEURONS; BRAIN; TRANSPORTERS; METABOLISM; EXPOSURE; ABUSERS; USERS AB Cocaine is a widely used drug of abuse and psychostimulant that acts on the central nervous system by blocking the dopamine reuptake sites. PC12 cells, a rat pheochromocytoma clonal line, in the presence of nerve growth factor (NGF), multiply and differentiate into competent neurons that can synthesize, store, and secrete the neurotransmitter dopamine (DA). In the present study, we evaluated the effect of increasing doses of cocaine on the expression of immediate early genes (IEGs), c-fos and c-jun, and closely related transcription factors, SP-1 and NF-k beta, at 24 h after the exposure to cocaine (50, 100, 200, 500, 1000, 2500 mu M) in NGF-differentiated PC12 cells. Cocaine (50-500 mu M) resulted in significant induction of the expression of c-jos, c-jun, SP-1, and NF-k beta. However, higher concentrations of cocaine (1000 and 2500 mu M) resulted in the downregulation of these expressions after 24 h. To further understand the role of dose-dependent changes in the mechanisms of cell death, we evaluated the protein expression of apoptotic markers. A concentration-dependent increase in the expression of caspase-9 and -3 was observed up to 500 mu M cocaine. However, the higher dose did not show any expression. We also evaluated the effect of increasing doses of cocaine on DA concentration and the expression of dopamine transporter (DAT). A significant dose-dependent decrease in the concentration of DA as well as the expression of DAT was observed 24 h after the exposure of PC12 cells to cocaine. Therefore, in the present study, we reported that cocaine has both upstream and downstream regulatory actions on some IEGs and transcription factors that can regulate the mechanism of cell death, and these effects on gene expression are independent of its action on the dopaminergic system. C1 S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. US FDA, Natl Ctr Toxicol Res, Div Neurotoxicol, Jefferson, AR 72079 USA. RP Imam, SZ (reprint author), S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. EM simam@satx.rr.com; sali@nctr.fda.gov NR 23 TC 19 Z9 19 U1 0 U2 1 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-578-8 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2005 VL 1053 BP 482 EP 490 DI 10.1196/annals.1344.042 PG 9 WC Multidisciplinary Sciences; Clinical Neurology; Neurosciences; Pharmacology & Pharmacy SC Science & Technology - Other Topics; Neurosciences & Neurology; Pharmacology & Pharmacy GA BDR63 UT WOS:000235109800049 PM 16179556 ER PT J AU Dackis, CA Kampman, KM Lynch, KG Pettinati, HM O'Brien, CP AF Dackis, CA Kampman, KM Lynch, KG Pettinati, HM O'Brien, CP TI A double-blind, placebo-controlled trial of modafinil for cocaine dependence SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE modafinil; cocaine; glutamate; pharmacotherapy; abstinence; addiction ID QUALITY-OF-LIFE; GLUTAMATE TRANSMISSION; WITHDRAWAL SYMPTOMS; NUCLEUS-ACCUMBENS; CONSCIOUS RAT; DRUG; NARCOLEPSY; ADDICTION; METHYLPHENIDATE; AMPHETAMINE AB Despite years of active research, there are still no approved medications for the treatment of cocaine dependence. Modafinil is a glutamate-enhancing agent that blunts cocaine euphoria under controlled conditions, and the current study assessed whether modafinil would improve clinical outcome in cocaine-dependent patients receiving standardized psychosocial treatment. This was a randomized, double-blind, placebo-controlled trial conducted at a university outpatient center (from 2002 to 2003) on a consecutive sample of 62 (predominantly African American) cocaine-dependent patients (aged 25-63) free of significant medical and psychiatric conditions. After screening, eligible patients were randomized to a single morning dose of modafinil (400 mg), or matching placebo tablets, for 8 weeks while receiving manual-guided, twice-weekly cognitive behavioral therapy. The primary efficacy measure was cocaine abstinence based on urine benzoylecgonine levels. Secondary measures were craving, cocaine withdrawal, retention, and adverse events. Modafinil-treated patients provided significantly more BE-negative urine samples (p = 0.03) over the 8-week trial when compared to placebos, and were more likely to achieve a protracted period (greater than or equal to3 weeks) of cocaine abstinence (p = 0.05). There were no serious adverse events, and none of the patients failed to complete the study as a result of adverse events. This study provides preliminary evidence, which should be confirmed by a larger study, that modafinil improves clinical outcome when combined with psychosocial treatment for cocaine dependence. C1 Univ Penn, Sch Med, Treatment Res Ctr, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Dackis, CA (reprint author), Univ Penn, Sch Med, Treatment Res Ctr, 3900 Chestnut St, Philadelphia, PA 19104 USA. EM dackis@mail.med.upenn.edu FU NIDA NIH HHS [DA P50-12756, DA P60-05186] NR 44 TC 219 Z9 223 U1 3 U2 14 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD JAN PY 2005 VL 30 IS 1 BP 205 EP 211 DI 10.1038/sj.npp.1300600 PG 7 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 880WD UT WOS:000225819700023 PM 15525998 ER PT J AU Diaz, N Bronstein, JM AF Diaz, N Bronstein, JM TI Parkinson's disease research education and Clinical Centers (PADRECC): Background and overview SO NEUROREHABILITATION LA English DT Article ID QUALITY-OF-LIFE; REHABILITATION; THERAPY AB Parkinson's disease (PD) afflicts more than 1,000,000 people in the United States and over 50,000 veterans obtain their medical care for PD within the Veterans Health Care System. In an effort to improve care for this growing population of veterans suffering from PD, the Veteran's Health Administration established 6 Parkinson's disease Research, Education, and Clinical Centers (PADRECC) based on merit. These 6 centers offer state of the art diagnosis and treatment of PD and other movement disorders. The PADRECC also provide education for both the professional community and patients not only at the 6 sites, but also throughout the VA system through the development of a national consortium. Improving veterans' health care through research is also a priority for the PADRECC. All 6 PADRECC are participating in the largest surgical trial for the treatment of PD ever performed. Heath service researchers have already identified quality of care indicators that are now being used to evaluate care for veterans with PD. Basic researchers at the PADRECC are studying the cause of PD and are developing new therapies including stem cells. The development of the PADRECC has created an important infrastructure and attracted expertise into the VA system. They have already made great improvements in caring for veterans with PD and promises to push the field further with their research efforts. C1 Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Dept Neurol, Los Angeles, CA USA. RP Bronstein, JM (reprint author), Univ Calif Los Angeles, Sch Med, Dept Neurol, 710 Westwood Blvd, Los Angeles, CA 90095 USA. EM jbronste@ucla.edu NR 15 TC 6 Z9 6 U1 0 U2 0 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1053-8135 J9 NEUROREHABILITATION JI Neurorehabilitation PY 2005 VL 20 IS 3 BP 153 EP 160 PG 8 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 005KB UT WOS:000234820000002 PM 16340096 ER PT J AU Protas, EJ Mitchell, K Williams, A Qureshy, H Caroline, K Lai, EC AF Protas, EJ Mitchell, K Williams, A Qureshy, H Caroline, K Lai, EC TI Gait and step training to reduce falls in Parkinson's disease SO NEUROREHABILITATION LA English DT Article DE Parkinson's disease; falls; gait training; rehabilitation ID BODY-WEIGHT SUPPORT; PHYSICAL-THERAPY; STROKE PATIENTS; CONTROLLED-TRIAL; TREADMILL; BALANCE; PEOPLE; INDIVIDUALS; STIMULATION; RELIABILITY AB Introduction: Frequent falls and risk of injury are evident in individuals with Parkinson's disease (PD) as the disease progresses. There have been no reports of any interventions that reduce the incidence of falls in idiopathic PD. Purpose: Assess the benefit of gait and step perturbation training in individuals with PD. Design: Randomized, controlled trial. Setting: Outpatient research, education and clinical center in a tertiary care Veterans Affairs Medical Center. Outcome measures: Gait parameters, 5-step test, report of falls Subjects: Eighteen men with idiopathic PD in stage 2 or 3 of the Hoehn and Yahr staging Methods: Subjects were randomly assigned to a trained or control group. They were asked about any falls 2 weeks prior to and after an 8 week period. Gait speed, cadence, and step length were tested on an instrumented walkway. Subjects were timed while stepping onto and back down from an 8.8 cm step for 5 consecutive steps. Gait training consisted of walking on a treadmill at a speed greater than over ground walking speed while walking in 4 directions and while supported in a harness for safety. Step training consisted of suddenly turning the treadmill on and off while the subject stood in the safety harness facing either forwards, backwards, or sideways. Training occurred 1 hour per day, three times per week for 8 weeks. A two-factor (time and group) analysis of variance with repeated measures was used to compare the groups. Results: Substantial reduction occurred in falls in the trained group, but not in the control group. Gait speed increased in the trained group from 1.28 +/- 0.33 meters/sec to 1.45 +/- 0.37 meters/sec, but not in the control group (from 1.26 to 1.27 m/s). The cadence increased for both groups: from 112.8 to 120.3 steps/min for the trained group and 117.7 to 124.3 steps/min for the control group. Stride lengths increased for the trained group, but not the control group. The 5- step test speed increased in the trained group from 0.40 +/- 0.08 steps/sec to 0.51 +/- 0.12 steps/sec, and in the control group (0.36 +/- 0.11 steps/sec to 0.42 +/- 0.11 steps/ sec). Conclusion: Gait and step perturbation training resulted in a reduction in falls and improvements in gait and dynamic balance. This is a promising approach to reduce falls for patients with PD. C1 Univ Texas, Med Branch, Dept Phys Therapy, Galveston, TX 77555 USA. Michael E DeBakey Vet Affairs Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Houston, TX USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Texas Womans Univ, Sch Phys Therapy, Houston, TX USA. RP Protas, EJ (reprint author), Univ Texas, Med Branch, Dept Phys Therapy, Galveston, TX 77555 USA. EM ejprotas@utmb.edu RI Nathalie, Zimmermann/M-2179-2014 FU NIA NIH HHS [P30 AG024832] NR 48 TC 149 Z9 154 U1 4 U2 27 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1053-8135 J9 NEUROREHABILITATION JI Neurorehabilitation PY 2005 VL 20 IS 3 BP 183 EP 190 PG 8 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 005KB UT WOS:000234820000005 PM 16340099 ER PT J AU Trail, M Fox, C Ramig, LO Sapir, S Howard, J Lai, EC AF Trail, M Fox, C Ramig, LO Sapir, S Howard, J Lai, EC TI Speech treatment for Parkinson's disease SO NEUROREHABILITATION LA English DT Review DE Parkinson's disease; speech and voice disorders; speech and voice treatment; hypokinetic dysarthria; hypophonia ID INTENSIVE VOICE TREATMENT; BASAL GANGLIA DISORDERS; OF-THE-LITERATURE; L-DOPA THERAPY; TREATMENT LSVT(R); BEHAVIORAL RECOVERY; FUNCTIONAL-ANATOMY; ACOUSTIC ANALYSIS; VOCAL INTENSITY; WRIST MOVEMENTS AB Researchers estimate that 89% of people with Parkinson's disease (PD) have a speech or voice disorder including disorders of laryngeal, respiratory, and articulatory function. Despite the high incidence of speech and voice impairment, studies suggest that only 3-4% of people with PD receive speech treatment. The authors review the literature on the characteristics and features of speech and voice disorders in people with PD, the types of treatment techniques available, including medical, surgical, and behavioral therapies, and provide recommendations for the current efficacy of treatment interventions and directions of future research. C1 Michael E DeBakey VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Natl Ctr Voice & Speech, Denver, CO USA. Univ Colorado, Dept Speech Language Hearing Sci, Boulder, CO 80309 USA. Univ Haifa, Dept Commun Sci & Disorders, Fac Social Welf & Hlth Sci, Haifa, Israel. Philadelphia VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA USA. RP Trail, M (reprint author), Michael E DeBakey VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, 2002 Holcombe Blvd,127 PD, Houston, TX 77030 USA. EM mtrail@bcm.tmc.edu NR 171 TC 41 Z9 42 U1 5 U2 30 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1053-8135 J9 NEUROREHABILITATION JI Neurorehabilitation PY 2005 VL 20 IS 3 BP 205 EP 221 PG 17 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 005KB UT WOS:000234820000007 PM 16340101 ER PT J AU Piper, M Abrams, GM Marks, WJ AF Piper, M Abrams, GM Marks, WJ TI Deep brain stimulation for the treatment of Parkinson's disease: Overview and impact on gait and mobility SO NEUROREHABILITATION LA English DT Article DE Parkinson's disease; gait; gait analysis; deep brain stimulation; rehabilitation ID SUBTHALAMIC NUCLEUS STIMULATION; HIGH-FREQUENCY STIMULATION; GLOBUS-PALLIDUS; PARS INTERNA; FOLLOW-UP; LEVODOPA AB Abnormality in gait is a cardinal feature of Parkinson's disease. Walking is characterized by relatively preserved sequencing of trunk and limb movements, but diminished velocity, shortened stride length, increased base, and diminished double stance support time. The principle problem producing the gait abnormalities is dopamine deficiency, which is hypothesized to disrupt pallido-thalamic modulation of cortical motor regions that automatically regulate walking. Deep brain stimulation currently is directed at either the globus pallidum internus (GPi) or subthalamic nucleus (STN) and improves many of the abnormal characteristics of parkinsonian gait with efficacy similar to dopamine replacement. The optimal target for stimulation remains uncertain and is currently being addressed in a large VA cooperative study. Our studies show that unilateral stimulation of GPi or STN improves gait to a similar extent. Functional and quantitative gait analyses confirm sustained improvement in gait dynamics with bilateral stimulation for periods for more than several years. Parkinsonian gait is also improved with rehabilitation training, primarily using external visual or auditory cues. The combination of deep brain stimulation, pharmacotherapy, and rehabilitation training may result in more effective comprehensive approaches to the reduced mobility associated with Parkinson's disease. C1 San Francisco VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. RP Abrams, GM (reprint author), San Francisco VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, 4150 Clement St, San Francisco, CA 94121 USA. EM abrams@itsa.ucsf.edu NR 22 TC 20 Z9 22 U1 0 U2 3 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1053-8135 J9 NEUROREHABILITATION JI Neurorehabilitation PY 2005 VL 20 IS 3 BP 223 EP 232 PG 10 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 005KB UT WOS:000234820000008 PM 16340102 ER PT J AU Song, B Marvizon, JCG AF Song, B Marvizon, JCG TI N-methyl-D-aspartate receptors and large conductance calcium-sensitive potassium channels inhibit the release of opioid peptides that induce mu-opioid receptor internalization in the rat spinal cord SO NEUROSCIENCE LA English DT Article DE dorsal horn; dynorphin; enkephalin; internalization; mu-opioid receptor; opioid ID DORSAL-HORN NEURONS; ENKEPHALIN-DEGRADING ENZYMES; EXTRASYNAPTIC NMDA RECEPTORS; MEDIAL PREOPTIC NUCLEUS; PRIMARY AFFERENT-FIBERS; NEUROPEPTIDE FF ANALOG; CORTICAL CELL-CULTURE; SMOOTH-MUSCLE-CELLS; MIXED INHIBITOR; SUBSTANCE-P AB Endogenous opioids in the spinal cord play an important role in nociception, but the mechanisms that control their release are poorly understood. To simultaneously detect all opiolds able to activate the mu-opioid receptor, we measured mu-opioid receptor internalization in rat spinal cord slices stimulated electrically or chemically to evoke opioid release. Electrical stimulation of the dorsal horn in the presence of peptidase inhibitors produced mu-opioid receptor internalization in half of the mu-opioid receptor neurons. This internalization was rapidly abolished by N-methyl-D-aspartate (IC50=2 mu M), and N-methyl-D-aspartate antagonists prevented this effect. mu-Opioid receptor internalization evoked by high K+ or veratridine was also inhibited by N-methyl-D-aspartate receptor activation. N-methyl-D-aspartate did not affect mu-opioid receptor internalization induced by exogenous endomorphins, confirming that the effect of N-methyl-D-aspartate was on opioid release. We hypothesized that this inhibition was mediated by large conductance Cal(2+)-sensitive K+ channels BK(Ca2+). Indeed, inhibition by N-methyl-D-aspartate was prevented by tetraethylammonium and by the selective BK(Ca2+) blockers paxilline, penitrem A and verruculogen. Paxilline did not increase mu-opiold receptor internalization in the absence of N-methyl-D-aspartate, indicating that it does not produce an increase in opioid release unrelated to the inhibition by h-methyl-D-aspartate. The BK(Ca2+) involved appears to be a subtype with slow association kinetics for iberiotoxin, which was effective only with long incubations. The BK(Ca2+) opener NS-1619 also inhibited the evoked mu-opioid receptor internalization, and iberiotoxin prevented this effect. We concluded that Ca2+ influx through N-methyl-D-aspartate receptors causes the opening of BK(Ca2+) and hyperpolarization in opioid-containing dorsal horn neurons, resulting in the inhibition of opioid release. Since g-opioid receptors in the dorsal horn mediate analgesia, inhibition of spinal opioid release could contribute to the hyperalgesic actions of spinal N-methyl-D-aspartate receptors. (c) 2005 Published by Elsevier Ltd on behalf of IBRO. C1 Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, CURE, Digest Dis Res Ctr, Div Digest Dis,Dept Med,David Geffen Sch Med, Los Angeles, CA 90073 USA. Vet Affairs greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Marvizon, JCG (reprint author), Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, Bldg 115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM marvizon@ucla.edu FU NIDA NIH HHS [1 R01 DA12609, R01 DA012609, P50 DA005010] NR 77 TC 16 Z9 16 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PY 2005 VL 136 IS 2 BP 549 EP 562 DI 10.1016/j.neuroscience.2005.08.032 PG 14 WC Neurosciences SC Neurosciences & Neurology GA 991RY UT WOS:000233832600018 PM 16203108 ER PT J AU Calcina, F Barocelli, E Bertoni, S Furukawa, O Kaunitz, J Impicciatore, M Sternini, C AF Calcina, F Barocelli, E Bertoni, S Furukawa, O Kaunitz, J Impicciatore, M Sternini, C TI Effect of N-methyl-D-aspartate receptor blockade on neuronal plasticity and gastromtestinal transit delay induced by ischemia/reperfusion in rats SO NEUROSCIENCE LA English DT Article DE ascending pathway; descending pathway; excitatory motor neurons; inhibitory motor neurons; nitric oxide ID NITRIC-OXIDE SYNTHASE; ISCHEMIA-REPERFUSION INJURY; GENE-RELATED PEPTIDE; VASOACTIVE INTESTINAL POLYPEPTIDE; ENTERIC NERVOUS-SYSTEM; FELINE SMALL-INTESTINE; SUBSTANCE-P; NECROTIZING ENTEROCOLITIS; INTERSTITIAL-CELLS; PROTEIN NITRATION AB intestinal ischemia impairs gastrointestinal motility. The aims of this study were to investigate the effect of intestinal ischemia on gastrointestinal transit and on the expression of enteric transmitters in the rat, and whether the glutamate N-methyl-D-aspartate receptors influence these effects. Ischemia (11 h), induced by occluding the superior mesenteric artery, was followed by 0 or 24 h of reperfusion. Normal and sham-operated rats served as controls. Serosal blood flow was measured with laser Doppler flow meter. Gastrointestinal transit was measured as time of appearance of a marker in fecal pellets. Immunohistochemistry was used to evaluate the number of neurons immunoreactive for neuronal nitric oxide synthase (NOS) or vasoactive intestinal polypeptide and the density of substance P immunoreactive fibers in the myenteric plexus. The N-methyl-D-aspartate receptors antagonist, (+)-5-methyl-10,11-dihydro-5HT-[a,b] cyclohepten-5,10-imine (MK-801) (1 mg/kg i.v.) or the NOS inhibitor, N-nitro-L-arginine (10 mg/kg i.v.) was administered prior to ischemia. Serosal blood flow was decreased by 70% during ischemia, but it was not altered in sham-operated rats. Gastrointestinal transit was significantly prolonged in ischemic/reper-fused rats compared with controls. There was a significant increase in the number of vasoactive intestinal polypeptide and neuronal nitric oxide synthase immunoreactive neurons, and a marked decrease of substance P immunoreactive fibers in ischemia followed by 24 h of reperfusion animals compared with controls. These alterations were not observed in ischemia without reperfusion. A significant delay of gastrointestinal transit and increase of vasoactive intestinal polypeptide neurons were also observed in sham-operated rats. The changes in transmitter expression and gastrointestinal transit in ischemic/reperfused rats were prevented by pre-treatment with the NOS inhibitor, N-nitro-L-arginine or the N-methyl-D-aspartate receptors antagonist, MK-801. This study suggests an involvement of the glutamatergic system and its interaction with nitric oxide in intestinal ischemia/reperfusion. Ischemia/reperfusion might induce local release of glutamate that activates N-methyl-D-aspartate receptors leading to increased production of nitric oxide and adaptive changes in enteric transmitters that might contribute to gastrointestinal dysmotility. (c) 2005 Published by Elsevier Ltd on behalf of IBRO. C1 Vet Adm Greater Los Angeles Hlth Syst, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. Univ Parma, Dept Pharmacol Biol & Appl Chem Sci, I-43100 Parma, Italy. RP Sternini, C (reprint author), Vet Adm Greater Los Angeles Hlth Syst, CURE Digest Dis Res Ctr, CURE Bldg 115,Room 224,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM csternin@ucla.edu RI Barocelli, Elisabetta/C-4509-2013 FU NIDDK NIH HHS [DK41301, DK54155, DK54221, DK57037] NR 60 TC 28 Z9 28 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PY 2005 VL 134 IS 1 BP 39 EP 49 DI 10.1016/j.neuroscience.2005.03.052 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 949SK UT WOS:000230808200005 PM 15939544 ER PT J AU Thompson, KW AF Thompson, KW TI Genetically engineered cells with regulatable GABA production can affect afterdischarges and behavioral seizures after transplantation into the dentate gyrus SO NEUROSCIENCE LA English DT Article DE transplantation; epilepsy; seizures; GAD; GABA; hippocampus ID TEMPORAL-LOBE EPILEPSY; KINDLING EPILEPSY; PIRIFORM CORTEX; NEURAL TRANSPLANTATION; NEURONS; GRAFTS; RATS; SUPPRESSION; MODEL; TERM AB Intractable seizures originating in the mesial temporal lobe can often be controlled by resection. An alternative to removing hippocampal tissue may be transplantation of GABA-producing cells. Neural cell transplantation has been performed in hundreds of patients, including some with temporal lobe epilepsy. This study evaluates the seizure-suppressing capabilities of engineered GABA-producing cells transplanted into the dentate gyrus. Immortalized neurons were engineered to produce GABA under the control of doxycycline. The cells were characterized for GABA production in vitro and for their ability to raise GABA concentrations in vivo. Cells were transplanted bilaterally into the dentate gyrus of rats and tested in two separate paradigms. Afterdischarge thresholds and durations were tested with granule cell stimulation, and the development of behavioral seizures, induced by daily electrical stimulation of the major excitatory input pathway into the dentate gyrus, was assessed in the presence, or the absence, of doxycycline. GABA production was under the tight control of doxycycline. Cells engineered to produce GABA raised tissue GABA concentrations in the hippocampus compared with non GABA-producing cells, and this was abolished when doxycycline was administered. GABA-producing cells raised the threshold, and shortened the duration of hippocampal afterdischarges elicited by granule cell stimulation. Lastly, the appearance of stage 5 seizures was slowed in the kindling paradigm, compared with a group that received non-GABA-producing cells, and compared with a group that received GABA-producing cells but was administered doxycycline. This study shows that targeted hippocampal implants of genetically engineered cells have the potential to raise GABA levels and to affect seizure development. The ability to suppress the production of GABA, and to modulate the physiological effects of the transplanted cells provides an important level of experimental control. These techniques, combined with stem cell technology, may advance cell-based therapies for epilepsy and other diseases of the CNS. (c) 2005 Published by Elsevier Ltd on behalf of IBRO. C1 Univ Calif Los Angeles, Dept Neurol, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Univ Calif Los Angeles, Dept Neurol, VA Greater Los Angeles Healthcare Syst, Bldg 114,Room 137,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM kthompso@ucla.edu NR 40 TC 46 Z9 50 U1 0 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 EI 1873-7544 J9 NEUROSCIENCE JI Neuroscience PY 2005 VL 133 IS 4 BP 1029 EP 1037 DI 10.1016/j.neuroscience.2005.03.003 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 942FO UT WOS:000230268500016 PM 15927406 ER PT J AU Lao, L Marvizon, JCG AF Lao, L Marvizon, JCG TI GABA(A) receptor facilitation of neurokinin release from primary afferent terminals in the rat spinal cord SO NEUROSCIENCE LA English DT Article DE C-fiber; dorsal horn; GABA; internalization; neurokinin 1 receptor; substance P ID GAMMA-AMINOBUTYRIC-ACID; PRIMARY SENSORY NEURONS; SUBSTANCE-P RELEASE; METHYL-D-ASPARTATE; CALCIUM-CHANNEL BLOCKERS; SUPERFICIAL DORSAL HORN; ROOT GANGLION NEURONS; BINDING-SITES; NMDA-RECEPTOR; N-TYPE AB Our goal was to test the following hypotheses: 1) GABA(A) receptors facilitate neurokinin release from primary afferent terminals; 2) they do this by suppressing an inhibitory effect of GABA(B) receptors; 3) the activation of these two receptors is controlled by the firing frequency of primary afferents. We evoked neurokinin release by stimulating the dorsal root attached to spinal cord slices, and measured it using neurokinin 1 receptor (NK1R) internalization. Internalization evoked by root stimulation at 1 Hz (but not at 100 Hz) was increased by the GABAA receptor agonists muscimol (effective concentration of drug for 50% of the increase [EC50] 3 muM) and isoguvacine (EC50 4.5 muM). Internalization evoked by root stimulation at 100 Hz was inhibited by the GABAA receptor antagonists bicuculline (effective concentration of drug for 50% of the inhibition [IC50] 2 muM) and picrotoxin (IC50 243 nM). Internalization evoked by incubating the root with capsaicin (to selectively recruit nociceptive fibers) was increased by isoguvacine and abolished by picrotoxin. Therefore, GABAA receptors facilitate neurokinin release. Isoguvacine-facilitated neurokinin release was inhibited by picrotoxin, low Cl-, low Ca2+, Ca2+ channel blockers and N-methyl-D-aspartate receptor antagonists. Bumetanide, an inhibitor of the Na+-K+-2Cl(-) cotransporter, inhibited isoguvacine-facilitated neurokinin release, but this could be attributed to a direct inhibition of GABAA receptors. The GABAB agonist baclofen inhibited NK1R internalization evoked by 100 Hz root stimulation (IC50 1.5 muM), whereas the GABAB receptor antagonist (2S)-3-[[(1S)-1-(3+ dichlorophenyl)ethyl]amino-2-hydroxypropyl](phenylmethyl) phosphinic acid (CGP-55845) increased NK1R internalization evoked by 1 Hz root stimulation (EC50 21 nM). Importantly, baclofen inhibited isoguvacine-facilitated neurokinin release, and CGP-55845 reversed the inhibition of neurokinin release by bicuculline. In conclusion, 1) GABAB receptors located presynaptically in primary afferent terminals inhibit neurakinin release; 2) GABAA receptors located in GABAergic interneurons facilitate neurokinin release by suppressing GABA release onto these GABA(B) receptors; 3) high frequency firing of C-fibers stimulates neurokinin release by activating GABA(A) receptors and inhibiting GABA(B) receptors, whereas low frequency firing inhibits neurokinin release by the converse mechanisms. (C) 2005 IBRO. Published by Elsevier Ltd. All rights reserved. C1 Univ Calif Los Angeles, David Geffen Sch Med,Dept Med,Div Digest Dis, CURE Digest Dis Res Ctr, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA USA. RP Marvizon, JCG (reprint author), VA Greater Los Angeles Healthcare Syst, Bldg 115,Room 119,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM marvizon@ucla.edu FU NIDA NIH HHS [R01-DA12609] NR 93 TC 16 Z9 16 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PY 2005 VL 130 IS 4 BP 1013 EP 1027 DI 10.1016/j.neuroscience.2004.10.019 PG 15 WC Neurosciences SC Neurosciences & Neurology GA 894BW UT WOS:000226766000018 PM 15652997 ER PT J AU Frazer, A Morilak, DA AF Frazer, A Morilak, DA TI What should animal models of depression model? SO NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS LA English DT Review ID GENERALIZED ANXIETY DISORDER; FORCED SWIMMING TEST; TRUE DRUG RESPONSE; MAJOR DEPRESSION; ANTIDEPRESSANT DRUGS; DOUBLE-BLIND; CLINICAL-TRIALS; MOOD DISORDERS; NEUROENDOCRINE RESPONSES; EARLY IMPROVEMENT AB In this article, we discuss what animal models of depression should be attempting to 'model'. One must first determine if the goal is to model the regulatory mechanisms by which antidepressant treatments alleviate the various symptoms of depression, or to model the dysregulatory mechanisms underlying the etiology of those symptoms. When modeling the mechanisms of antidepressant effects, a key feature that is often overlooked is the time course required for behavioral efficacy. Even in the clinical literature, there is considerable confusion and inconsistency in defining and identifying 'time of onset' of clinical effect. Although the 'therapeutic tag' may not be as long as has been commonly believed, it does occur. Observable improvement in either global symptomatology or specific symptoms becomes evident after 7-14 days of treatment, and more complete recovery takes considerably longer. Thus, any model addressing potential mechanisms of antidepressant action should exhibit a similar time-dependency. Second, whether attempting to address mechanisms underlying behavioral effects of antidepressants, or the neurobiological substrates underlying the development and manifestation of depression, it is essential to recognize that the syndrome of depression is a diagnostic construct that includes a variety of disparate symptoms, some of which may be related mechanistically, and others that may not be specific to depression, but may cut across categorical diagnostic schemes. Further, it is critical to recognize the close relationship of depression and anxiety. Psychological studies have suggested that the myriad symptoms of depression and anxiety may be subsumed within a more limited number of distinct behavioral dimensions, such as negative affect (neuroticism), positive affect, or physiologic hyperarousal. These dimensions may be related to the functioning of specific neurobiological systems. Thus, rather than trying to recreate or mimic the entire spectrum of symptoms comprising the syndrome of depression, it may be more informative to develop animal models for these behavioral dimensions. Such models may then provide access not only to the neural regulatory mechanisms underlying effective antidepressant treatment, but may also provide clues to the processes underlying the development and manifestation of depression. (c) 2005 Elsevier Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Frazer, A (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pharmacol, MC 7764,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM frazer@uthscsa.edu FU NIMH NIH HHS [MH53851] NR 88 TC 69 Z9 74 U1 3 U2 19 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0149-7634 J9 NEUROSCI BIOBEHAV R JI Neurosci. Biobehav. Rev. PY 2005 VL 29 IS 4-5 SI SI BP 515 EP 523 DI 10.1016/j.neubiorev.2005.03.006 PG 9 WC Behavioral Sciences; Neurosciences SC Behavioral Sciences; Neurosciences & Neurology GA 939JL UT WOS:000230068700003 PM 15893377 ER PT J AU Kliethermes, CL AF Kliethermes, CL TI Anxiety-like behaviors following chronic ethanol exposure SO NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS LA English DT Review DE ethanol withdrawal; anxiety; elevated plus maze; light/dark box; open field; locomotor activity; mice; rats ID ELEVATED PLUS-MAZE; CORTICOTROPIN-RELEASING-FACTOR; WITHDRAWAL-INDUCED ANXIETY; OPEN-FIELD BEHAVIOR; ONE-TRIAL TOLERANCE; PHYSICAL-DEPENDENCE; ALCOHOL-WITHDRAWAL; EXPLORATORY-BEHAVIOR; ANXIOGENIC RESPONSE; LOCOMOTOR-ACTIVITY AB Rodent models of ethanol withdrawal-induced anxiety have been used to explore the neurobiology underlying withdrawal and to evaluate the utility of therapeutic agents aimed at reducing withdrawal severity. Of the many tests of anxiety-like behavior, the elevated plus maze, light/dark box, and open field are the most commonly used. In general, ethanol withdrawal decreases most or all of the individual behaviors recorded in these tasks, indicating the occurrence of an anxiogenic-like effect of withdrawal in rodents, although these effects of withdrawal have not always been found. Potential problems with interpreting the effects of withdrawal as being indicative of an anxiety-like state include the effects of withdrawal on motivation to explore an apparatus, non-specific effects of withdrawal on locomotion, and the use of test parameters that have not been pharmacologically validated. For example, most of the published studies interpreted as having shown increased anxiety-like behavior during ethanol withdrawal have also observed concurrent decreases in locomotion. At a minimum, a given test of anxiety-like behavior during withdrawal should be responsive to the dose and duration of ethanol exposure that was used to produce physical dependence, and should not non-specifically decrease locomotion. In addition, standard anxiolytic drugs should ameliorate the anxiogenic-like effects of withdrawal, preferably in multiple tests of anxiety-like behavior. (C) 2004 Elsevier Ltd. All rights reserved. C1 Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland Alcohol Res Ctr, Dept Vet Affairs Med Ctr,Portland VA Med Ctr, Portland, OR 97239 USA. RP Kliethermes, CL (reprint author), Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland Alcohol Res Ctr, Dept Vet Affairs Med Ctr,Portland VA Med Ctr, R&D 12,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM kliether@ohsu.edu FU NIAAA NIH HHS [AA10760, AA015015]; NIDA NIH HHS [DA01762] NR 103 TC 96 Z9 97 U1 4 U2 10 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0149-7634 J9 NEUROSCI BIOBEHAV R JI Neurosci. Biobehav. Rev. PD JAN PY 2005 VL 28 IS 8 BP 837 EP 850 DI 10.1013/j.neubiorev.2004.11.001 PG 14 WC Behavioral Sciences; Neurosciences SC Behavioral Sciences; Neurosciences & Neurology GA 893FH UT WOS:000226704200005 PM 15642625 ER PT J AU Burgio, K Goode, P Urban, D Umlauf, M Locher, J Bueschen, A Redden, D AF Burgio, K Goode, P Urban, D Umlauf, M Locher, J Bueschen, A Redden, D TI Preoperative biofeedback-assisted behavioral training to reduce post-prostatectomy incontinence: A randomized controlled trial SO NEUROUROLOGY AND URODYNAMICS LA English DT Meeting Abstract CT 35th Annual Meeting of the International-Continence-Society CY AUG 28-SEP 02, 2005 CL Montreal, CANADA SP Int Continence Soc C1 Univ Alabama, Birmingham VA Med Ctr, Birmingham, AL USA. RI Umlauf, Mary/A-5021-2015 NR 0 TC 3 Z9 3 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0733-2467 J9 NEUROUROL URODYNAM JI Neurourol. Urodyn. PY 2005 VL 24 IS 5-6 MA 46 BP 477 EP 478 PG 2 WC Urology & Nephrology SC Urology & Nephrology GA 953CD UT WOS:000231052600047 ER PT J AU Keung, E Xue, Y AF Keung, Edmund Xue, Yang BE Wang, PJ TI Remote web-based device monitoring SO NEW ARRHYTHMIA TECHNOLOGIES LA English DT Article; Book Chapter ID IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS; PACEMAKER C1 [Keung, Edmund] VA Natl ICD Surveillance Ctr, San Francisco, CA 94121 USA. [Keung, Edmund] Western Pacemaker Surveillance Ctr, San Francisco, CA USA. [Keung, Edmund] San Francisco VA Med Ctr, Cardiol Sect, San Francisco, CA USA. [Xue, Yang] Univ Michigan, Sch Med, Fremont, CA USA. RP Keung, E (reprint author), VA Natl ICD Surveillance Ctr, San Francisco, CA 94121 USA. NR 11 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL SCIENCE PUBL PI OXFORD PA OSNEY MEAD, OXFORD OX2 0EL, ENGLAND BN 978-0-470-98872-5 PY 2005 BP 206 EP 218 DI 10.1002/9780470988725.ch22 D2 10.1002/9780470988725 PG 13 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA BYE83 UT WOS:000298280100022 ER PT J AU Meng, Z King, PH Nabors, LB Jackson, NL Chen, CY Emanuel, PD Blume, SW AF Meng, Z King, PH Nabors, LB Jackson, NL Chen, CY Emanuel, PD Blume, SW TI The ELAV RNA-stability factor HuR binds the 5 '-untranslated region of the human IGF-IR transcript and differentially represses cap-dependent and IRES-mediated translation SO NUCLEIC ACIDS RESEARCH LA English DT Article ID GROWTH-FACTOR-I; 5' UNTRANSLATED REGION; AU-RICH ELEMENT; CYTOPLASMIC SHUTTLING PROTEIN; CONTAINING MESSENGER-RNAS; RIBOSOME ENTRY SITES; TUMOR-SUPPRESSOR WT1; RECEPTOR GENE; PHOSPHATIDYLINOSITOL 3-KINASE; INITIATION-FACTOR AB The type I insulin-like growth factor receptor (IGF-IR) is an integral component in the control of cell proliferation, differentiation and apoptosis. The IGF-IR mRNA contains an extraordinarily long (1038 nt) 5'-untranslated region (5'-UTR), and we have characterized a diverse series of proteins interacting with this RNA sequence which may provide for intricate regulation of IGF-IR gene expression at the translational level. Here, we report the purification and identification of one of these IGF-IR 50-UTR- binding proteins as HuR, using a novel RNA crosslinking/ RNase elution strategy. Because HuR has been predominantly characterized as a 3'-UTR- binding protein, enhancing mRNAstability and generally increasing gene expression, we sought to determine whether HuR might serve a different function in the context of its binding the IGF-IR 5'-UTR. We found that HuR consistently repressed translation initiation through the IGF-IR 5'-UTR. The inhibition of translation by HuR was concentration dependent, and could be reversed in trans by addition of a fragment of the IGF-IR5'-UTR containing the HuR binding sites as a specific competitor, or abrogated by deletion of the third RNA recognition motif of HuR. We determined that HuR repressed translation initiation through the IGF-IR 5'-UTR in cells as well, and that siRNA knockdown of HuR markedly increased IGF-IR protein levels. Interestingly, we also found that HuR potently inhibited IGF-IR translation mediated through internal ribosome entry. Kinetic assays were performed to investigate the mechanism of translation repression by HuR and the dynamic interplay between HuR and the translation apparatus. We found that HuR, occupying a cap-distal position, significantly delayed translation initiation mediated by cap-dependent scanning, but was eventually displaced from its binding site, directly or indirectly, as a consequence of ribosomal scanning. However, HuR perpetually blocked the activity of the IGF-IR IRES, apparently arresting the IRES-associated translation preinitiation complex in an inactive state. This function of HuR as a 5'-UTR-binding protein and dual-purpose translation repressor may be critical for the precise regulation of IGF-IR expression essential to normal cellular homeostasis. C1 Univ Alabama, Dept Biochem & Mol Genet, Birmingham, AL 35294 USA. Univ Alabama, Dept Neurol, Birmingham, AL 35294 USA. Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Ctr Comprehens Canc, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL 35294 USA. RP Blume, SW (reprint author), Univ Alabama, Wallace Tumor Inst, 1824 6th Ave S,Room 508, Birmingham, AL 35294 USA. EM scott.blume@ccc.uab.edu OI Emanuel, Peter/0000-0002-9764-2434 FU NCI NIH HHS [CA80916, CA108886, K24 CA080916, R01 CA108886] NR 76 TC 71 Z9 72 U1 1 U2 2 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0305-1048 J9 NUCLEIC ACIDS RES JI Nucleic Acids Res. PY 2005 VL 33 IS 9 BP 2962 EP 2979 DI 10.1093/nar/gki603 PG 18 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 932HK UT WOS:000229544600028 PM 15914670 ER PT J AU Suswam, EA Li, YY Mahtani, H King, PH AF Suswam, EA Li, YY Mahtani, H King, PH TI Novel DNA-binding properties of the RNA-binding protein TIAR SO NUCLEIC ACIDS RESEARCH LA English DT Article ID SMALL NUCLEAR RIBONUCLEOPROTEIN; MAMMALIAN STRESS GRANULES; TUMOR-NECROSIS-FACTOR; FAR UPSTREAM ELEMENT; MESSENGER-RNA; TELOMERIC DNA; SPLICE-SITE; CRYSTAL-STRUCTURE; STABILITY FACTOR; POLYMERASE-II AB TIA-1 related protein binds avidly to uridine-rich elements in mRNA and pre-mRNAs of a wide range of genes, including interleukin (IL)-8 and vascular endothelial growth factor (VEGF). The protein has diverse regulatory roles, which in part depend on the locus of binding within the transcript, including translational control, splicing and apoptosis. Here, we observed selective and potent inhibition of TIAR-RNP complex formation with IL-8 and VEGF 3'-untranslated regions (3'-UTRs) using thymidine-rich deoxyoligonucleotide (ODN) sequences derived from the VEFG 3'-UTR. We show by ultraviolet crosslinking and electrophoretic mobility shift assays that TIAR can bind directly to single-stranded, thymidine-rich ODNs but not to double-stranded ODNs containing the same sequence. TIAR had a nearly 6-fold greater affinity for DNA than RNA (K(d app=)1.6x10(-9) M versus 9.4 x 10(-9) M). Truncation of TIAR indicated that the high affinity DNA-binding site overlaps with the RNA-binding site involving RNA recognition motif 2 (RRM2). However, RRM1 alone could also bind to DNA. Finally, we show that TIAR can be displaced from single-stranded DNA by active transcription through the binding site. These results provide a potential mechanism by which TIAR can shuttle between RNA and DNA ligands. C1 Univ Alabama, Dept Neurol, Birmingham, AL 35295 USA. Univ Alabama, Dept Physiol & Biophys, Birmingham, AL 35295 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL 35295 USA. RP King, PH (reprint author), Univ Alabama, Dept Neurol, Birmingham, AL 35295 USA. EM pking@uab.edu NR 60 TC 39 Z9 39 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0305-1048 J9 NUCLEIC ACIDS RES JI Nucleic Acids Res. PY 2005 VL 33 IS 14 BP 4507 EP 4518 DI 10.1093/nar/gki763 PG 12 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 957ID UT WOS:000231362600018 PM 16091628 ER PT B AU Kaunitz, JD Tanaka, S Akiba, Y AF Kaunitz, JD Tanaka, S Akiba, Y BE Ishii, H Suematsu, M Tanishita, K Suzuki, H TI Gastroduodenal microcirculatory response to luminal acid SO ORGAN MICROCIRCULATION: A GATEWAY TO DIAGNOSITC AND THERAPEUTIC INTERVENTIONS SE KEIO UNIVERSITY INTERNATIONAL SYMPOSIA FOR LIFE SCIENCES AND MEDICINE LA English DT Proceedings Paper CT 14th Keio-University International Symposium for Life Sciences and Medicine CY DEC 11-13, 2003 CL Keio Univ, Tokyo, JAPAN SP Keio Univ Med Sci Fund HO Keio Univ DE stomach; esophagus; duodenum; vanilloid receptor; blood flow ID GENE-RELATED PEPTIDE; MUCOSAL BLOOD-FLOW; SENSING PATHWAYS; RAT DUODENUM; HYPEREMIC RESPONSE; VAGAL AFFERENTS; PROTECTION; ESOPHAGUS; SENSITIVITY; MECHANISMS AB The hyperemic response to luminal acid, a key protective mechanism for upper gastrointestinal mucosa, occurs by different mechanisms in the distal esophagus, stomach, and duodenum. The esophagus is a stratified squamous mucosa of high electrical resistance. Although luminal acid permeates only into the superficial epithelial layer, luminal acid induces protective mucosal hyperemia and clinical symptoms. The stomach has a well-studied micro circulatory response to luminal acid. Blood flow is believed to play a prominent role in mucosal protection, since the abolition of the hyperemic response to luminal acid is associated with enhanced mucosal injury susceptibility. Infusion of pentagastrin, mimicking the endogenous secretory gastric response to food, unmasked this hyperemic response in undamaged mucosa and activates neurons in the vagal nucleus. The duodenum is a leaky, low-resistance, columnar epithelium. Unlike the stomach, duodenal hyperemia is readily produced by perfusion with acidic luminal solutions. We further studied the afferent pathways involved with this hyperemic response. The vanilloid receptor (VR) antagonist capsazepine (CPZ) dose-dependently inhibited capsaicin-induced hyperemia. Capsazepine dose-dependently inhibited acid-induced hyperemia. The gastric and intestinal mucosae are richly innervated with VR. Each segment of the gastrointestinal tract exposed to gastric acid appears to have a unique protective mechanisms to which regulation of mucosal blood flow plays an important role. C1 Greater Los Angeles Vet Affairs Healthcare Syst, WLAVA Med Ctr, Los Angeles, CA 90073 USA. RP Kaunitz, JD (reprint author), Greater Los Angeles Vet Affairs Healthcare Syst, WLAVA Med Ctr, Los Angeles, CA 90073 USA. NR 27 TC 1 Z9 1 U1 0 U2 0 PU SPRINGER-VERLAG TOKYO PI TOKYO PA 37-3, HONGO 3-CHOME BONKYO-KU, TOKYO, 113, JAPAN BN 4-431-22135-2 J9 KEIO U INT SYMP LIFE JI Keio Univ. Int. Symp. Life Sci. Med PY 2005 VL 13 BP 79 EP 88 PG 10 WC Engineering, Biomedical; Gastroenterology & Hepatology; Peripheral Vascular Disease SC Engineering; Gastroenterology & Hepatology; Cardiovascular System & Cardiology GA BBN74 UT WOS:000226302200010 ER PT B AU Takeuchi, T Zhang, LN Kaunitz, JD AF Takeuchi, T Zhang, LN Kaunitz, JD BE Ishii, H Suematsu, M Tanishita, K Suzuki, H TI Intracellular pH (pH(i)) measurement in rat duodenal epithelium in vivo using SNARF-1 SO ORGAN MICROCIRCULATION: A GATEWAY TO DIAGNOSITC AND THERAPEUTIC INTERVENTIONS SE KEIO UNIVERSITY INTERNATIONAL SYMPOSIA FOR LIFE SCIENCES AND MEDICINE LA English DT Proceedings Paper CT 14th Keio-University International Symposium for Life Sciences and Medicine CY DEC 11-13, 2003 CL Keio Univ, Tokyo, JAPAN SP Keio Univ Med Sci Fund HO Keio Univ DE SNARF-1; pH(i); duodenal epithelium; in vivo; acid C1 W Los Angeles Vet Affairs Med Ctr, Digest Dis Res Ctr, CURE, Los Angeles, CA 90073 USA. RP Takeuchi, T (reprint author), W Los Angeles Vet Affairs Med Ctr, Digest Dis Res Ctr, CURE, Bldg 114,Suite 217, Los Angeles, CA 90073 USA. NR 5 TC 1 Z9 1 U1 0 U2 0 PU SPRINGER-VERLAG TOKYO PI TOKYO PA 37-3, HONGO 3-CHOME BONKYO-KU, TOKYO, 113, JAPAN BN 4-431-22135-2 J9 KEIO U INT SYMP LIFE JI Keio Univ. Int. Symp. Life Sci. Med PY 2005 VL 13 BP 89 EP 91 PG 3 WC Engineering, Biomedical; Gastroenterology & Hepatology; Peripheral Vascular Disease SC Engineering; Gastroenterology & Hepatology; Cardiovascular System & Cardiology GA BBN74 UT WOS:000226302200011 ER PT J AU Rossi, MJ Sundararaj, K Koybasi, S Phillips, MS Szulc, ZM Bielawska, A Day, TA Obeid, LM Hannun, YA Ogretmen, B AF Rossi, MJ Sundararaj, K Koybasi, S Phillips, MS Szulc, ZM Bielawska, A Day, TA Obeid, LM Hannun, YA Ogretmen, B TI Inhibition of growth and telomerase activity by novel cationic ceramide analogs with high solubility in human head and neck squamous cell carcinoma cells SO OTOLARYNGOLOGY-HEAD AND NECK SURGERY LA English DT Article; Proceedings Paper CT 107th Annual Meeting of the American-Academy-of-Otolaryngology-Head-and-Neck-Surgery CY SEP 21-24, 2003 CL ORLANDO, FL SP Amer Acad Otolaryngol Head & Neck Surg ID CANCER; LINE; CHEMOTHERAPY; GEMCITABINE; MECHANISMS; CISPLATIN AB OBJECTIVES: Head and neck squamous cell carcinoma (HNSCC) is notoriously resistant to chemotherapy. The sphingolipid ceramide and its analogs have been demonstrated to exert antitumor activity in many cell types; however, the effectiveness of these analogs has been limited by potency and solubility. This study focuses on the effects of novel highly soluble cationic pyridinium-ceramides, alone and in combination with various chemotherapeutic agents, on cell survival, telomerase activity, and cell cycle arrest in HNSCC cell lines in vitro. METHODS: The concentration of pyridinium-ceramides and chemotherapeutic agents that inhibited cell growth by 50% (IC50) was determined by MTT cell survival assays. The cell cycle profiles were determined by flow cytometry. Telomerase activity was determined by telomerase repeat amplification protocol (TRAP) assay. RESULTS: Treatment of the human UM-SCC-22A (SCC of the hypopharynx) cells, as well as various other HNSCC cell lines, with C-6-Pyr-Cer resulted in the inhibition of cell survival with an IC50 concentration of approximately 250 to 300 nM at 96 hours, whereas its IC50 was greater than 1000 nM in non-cancerous Wi-38 human lung fibroblasts, and adult human epidermal keratinocytes. Moreover, treatment with C-6-Pyr-Cer also resulted in cell cycle arrest in G0/G1, which correlated with a significant inhibition of telomerase activity in UM-SCC-22A cells. Additional results demonstrated that the combination of C-6-Pyr-Cer with gemcitabine (GMZ) or doxorubicin (DOX), which have the lowest IC50 concentrations among various chemotherapeutic drugs in these cells, enhances the effects of these drugs in the inhibition of telomerase and cell growth. CONCLUSIONS: These data suggest that the novel C-6-Pyr-Cer with high solubility and bioavailability may lead to the development of new therapeutic strategies that target telomerase for the treatment of HNSCC. C1 Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Med Univ S Carolina, Coll Med, Charleston, SC 29425 USA. Med Univ S Carolina, Div Head & Neck Oncol Surg, Dept Otolaryngol Head & Neck Surg, Charleston, SC 29425 USA. Med Univ S Carolina, Hollings Canc Ctr, Charleston, SC 29425 USA. Ralph H Johnson Vet Adm, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. RP Ogretmen, B (reprint author), 173 Ashley Ave,BSB 518E, Charleston, SC 29425 USA. EM ogretmen@musc.edu OI Szulc, Zdzislaw M./0000-0003-1756-9028; obeid, lina/0000-0002-0734-0847 FU NCI NIH HHS [P01 CA097132, R01 CA88932]; NIA NIH HHS [AG16583] NR 21 TC 30 Z9 32 U1 0 U2 4 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0194-5998 J9 OTOLARYNG HEAD NECK JI Otolaryngol. Head Neck Surg. PD JAN PY 2005 VL 132 IS 1 BP 55 EP 62 DI 10.1016/j.otohns.2004.08.015 PG 8 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 886HA UT WOS:000226216300010 PM 15632910 ER PT J AU Dworkin, RH Turk, DC Farrar, JT Haythornthwaite, JA Jensen, MP Katz, NP Kerns, RD Stucki, G Allen, RR Bellamy, N Carr, DB Chandler, J Cowan, P Dionne, R Galer, BS Hertz, S Jadad, AR Kramer, LD Manning, DC Martin, S McCormick, CG McDermott, MP McGrath, P Quessy, S Rappaport, BA Robbins, W Robinson, JP Rothman, M Royal, MA Simon, L Stauffer, JW Stein, W Tollett, J Wernicke, J Witter, J AF Dworkin, RH Turk, DC Farrar, JT Haythornthwaite, JA Jensen, MP Katz, NP Kerns, RD Stucki, G Allen, RR Bellamy, N Carr, DB Chandler, J Cowan, P Dionne, R Galer, BS Hertz, S Jadad, AR Kramer, LD Manning, DC Martin, S McCormick, CG McDermott, MP McGrath, P Quessy, S Rappaport, BA Robbins, W Robinson, JP Rothman, M Royal, MA Simon, L Stauffer, JW Stein, W Tollett, J Wernicke, J Witter, J TI Core outcome measures for chronic pain clinical trials: IMMPACT recommendations SO PAIN LA English DT Review ID QUALITY-OF-LIFE; LOW-BACK-PAIN; RANDOMIZED CONTROLLED-TRIAL; PLACEBO-CONTROLLED TRIAL; CONSORT STATEMENT; HEALTH-STATUS; POSTHERPETIC NEURALGIA; NEUROPATHIC PAIN; INSTRUMENTS; SCORES C1 Univ Rochester, Sch Med & Dent, Dept Anesthesiol, Rochester, NY 14642 USA. Univ Washington, Seattle, WA 98195 USA. Univ Penn, Philadelphia, PA 19104 USA. Johns Hopkins Univ, Baltimore, MD 21218 USA. Harvard Univ, Boston, MA 02115 USA. Yale Univ, New Haven, CT USA. Univ Munich, D-80539 Munich, Germany. AstraZeneca, Wilmington, DE USA. Univ Queensland, Brisbane, Qld, Australia. Tufts Univ, Boston, MA 02111 USA. Merck & Co Inc, Blue Bell, PA USA. Amer Chron Pain Assoc, Rocklin, CA USA. Natl Inst Dent & Craniofacial Res, Bethesda, MD USA. Endo Pharmaceut Inc, Chadds Ford, PA USA. US FDA, Rockville, MD 20857 USA. Univ Toronto, Hlth Network, Toronto, ON, Canada. Purdue Pharma, Stamford, CT USA. Novartis Pharmaceut, E Hanover, NJ USA. Pfizer Global Res & Dev, Ann Arbor, MI USA. NINDS, Bethesda, MD 20892 USA. Univ Rochester, Rochester, NY 14627 USA. Dalhousie Univ, Halifax, NS B3H 3J5, Canada. GlaxoSmithKline Inc, Res Triangle Pk, NC USA. NeurogesX, San Carlos, CA USA. Johnson & Johnson Consumer Prod Inc, Raritan, NJ USA. Elan Pharmaceut, San Diego, CA USA. Abbott Labs, Lake Forest, IL USA. Univ Calif San Diego, San Diego, CA 92103 USA. US Dept Vet Affairs, Washington, DC USA. Eli Lilly & Co, Indianapolis, IN 46285 USA. RP Dworkin, RH (reprint author), Univ Rochester, Sch Med & Dent, Dept Anesthesiol, Rochester, NY 14642 USA. EM robert_dworkin@urmc.rochester.edu RI Farrar, John/A-1037-2007; Bellamy, Nicholas/G-3631-2010 OI Farrar, John/0000-0001-8656-5157; McGrath, Patrick/0000-0002-9568-2571 NR 85 TC 1124 Z9 1142 U1 12 U2 80 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0304-3959 J9 PAIN JI Pain PD JAN PY 2005 VL 113 IS 1-2 BP 9 EP 19 DI 10.1016/j.pain.2004.09.012 PG 11 WC Anesthesiology; Clinical Neurology; Neurosciences SC Anesthesiology; Neurosciences & Neurology GA 891PG UT WOS:000226592400005 PM 15621359 ER PT S AU Chatterjee, B Echchgadda, I Song, CS AF Chatterjee, B Echchgadda, I Song, CS BE Sies, H Packer, L TI Vitamin D receptor regulation of the steroid/bile acid sulfotransferase SULT2A1 SO PHASE II CONJUGATION ENZYMES AND TRANSPORT SYSTEMS SE Methods in Enzymology LA English DT Review; Book Chapter ID HUMAN HYDROXYSTEROID SULFOTRANSFERASE; HUMAN DEHYDROEPIANDROSTERONE SULFOTRANSFERASE; HUMAN CYTOSOLIC SULFOTRANSFERASES; FARNESOID X-RECEPTOR; MOLECULAR-CLONING; LITHOCHOLIC ACID; RAT-LIVER; BILE-ACID; TRANSCRIPTIONAL CONTROL; CRYSTAL-STRUCTURE AB SULT2A1 is a sulfo-conjugating phase 11 enzyme expressed at very high levels in the liver and intestine, the two major first-pass metabolic tissues, and in the steroidogenic adrenal tissue. SULT2A1 acts preferentially on the hydroxysteroids dehydroepiandrosterone, testosterone/ dihydrotestosterone, and pregnenolone and on cholesterol-derived amphipathic sterol bile acids. Several therapeutic drugs and other xenobiotics, which include xenoestrogens, are also sulfonated by this cytosolic steroid/ bile acid sulfotransferase. Nonsteroid nuclear receptors with key roles in the metabolism and detoxification of endobiotics and xenobiotics, such as bile acid-activated farnesoid X receptor, xenobiotic-activated pregnane X receptor and constitutive androstane receptor, and lipid-activated peroxisome proliferator-activated receptor-a, mediate transcription induction of SULT2A1 in the enterohepatic system. The ligand-activated vitamin D receptor (VDR) is another nuclear receptor that stimulates SULT2A1 transcription, and the regulatory elements in human, mouse, and rat promoters directing this induction have been characterized. Given that bile acid sulfonation is catalyzed exclusively by SULT2A1 and that the 3 alpha-sulfate of the highly toxic lithocholic acid is a major excretory metabolite in humans, we speculate that a role for the VDR pathway in SULT2A1 expression may have emerged to shield first-pass tissues from the cytotoxic effects of a bile acid overload arising from disrupted sterol homeostasis triggered by endogenous and exogenous factors. C1 Univ Texas, Hlth Sci Ctr, Dept Mol Med, Inst Biotechnol, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Chatterjee, B (reprint author), Univ Texas, Hlth Sci Ctr, Dept Mol Med, Inst Biotechnol, San Antonio, TX 78285 USA. FU NIA NIH HHS [R01-AG-10486, R01-AG-19660] NR 55 TC 36 Z9 36 U1 0 U2 3 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA SN 0076-6879 BN 0-12-182805-0 J9 METHOD ENZYMOL JI Methods Enzymol. PY 2005 VL 400 BP 165 EP 191 DI 10.1016/S0076-6879(05)00010-8 PG 27 WC Biochemical Research Methods; Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA BDO60 UT WOS:000234565000010 PM 16399349 ER PT J AU Wilkins, JN Majewska, MD Van Gorp, W Li, SH Hinken, C Plotkin, D Setoda, D AF Wilkins, JN Majewska, MD Van Gorp, W Li, SH Hinken, C Plotkin, D Setoda, D TI DHEAS and POMS measures identify cocaine dependence treatment outcome SO PSYCHONEUROENDOCRINOLOGY LA English DT Article DE cocaine; profile of mood states; dehydroepiandrosterone sulphate; DHEA; DHEAS; dehydroepiandrosterone; cortisol; abstinent; relapsed; dropped out ID CORTICOTROPIN-RELEASING-FACTOR; DEHYDROEPIANDROSTERONE-SULFATE; MAJOR DEPRESSION; ABSTINENCE SYMPTOMATOLOGY; SMOKING-CESSATION; SALIVARY CORTISOL; DRUG-ADDICTION; PLASMA-LEVELS; FOLLOW-UP; ABUSERS AB Early attrition is a significant problem in the treatment of cocaine dependence, but it is unclear why some patients succeed in treatment while others relapse or drop out of treatment without a demonstrated relapse. The goal of this study was to determine whether baseline levels of select hormones, including the adrenal hormone and excitatory neurosteroid dehydroepiandrosterone sulfate (DHEAS), would distinguish between treatment outcome groups. Based on the literature, completion of 90 days of treatment was established as a key outcome variable. Methods: Quantitative urine levels of the cocaine metabolite benzoylecgonine (BE) and other substance of abuse analytes, plasma levels of DHEAS, DHEA, cortisol., and prolactin, and the profile of mood states (POMS) were serially measured in 38 mate cocaine-dependent (DSM-IV) patients and in 28 controls of similar gender and age over a six month study. Exclusion criteria for the patients and controls included Axis I mood, anxiety or psychotic disorders. The patients could not manifest substance dependence except to cocaine. The patients and controls received remuneration for urine and blood collection. Blood samples for hormone levels were obtained between 8 and 10 a.m. on days 1, 14 and 21 of a 21-day inpatient treatment program and throughout 6 months of outpatient study visits at 45-day intervals. Results: Attrition from treatment and study appointments occurred predominately at the junction between inpatient and outpatient programs. Forty percent of patients made the transition to outpatient treatment and remained abstinent and in treatment for a median of 103 days (ABST). Forty-two percent of patients dropped out of treatment during the inpatient stay or never returned after completing the inpatient program (DO) and 18% had a documented relapse either during, or within the first week after, the inpatient stay (REL). POMS total scores were elevated at treatment entry for both the ABST and DO groups. Plasma DHEAS levels in the DO patients were decreased compared to controls and increased in the ABST patients. POMS total scores for the REL patients at baseline were at control levels. Baseline cortisol levels were not statistically different between the outcome groups, though they were elevated for all cocaine patient groups. When treatment outcome was collapsed into whether patients completed (ABST) or did not complete 90 days of treatment (90N), ABST plasma DHEAS and cortisol. were significantly elevated compared to the 90N patients and controls across the first 3 weeks of cocaine withdrawal. Conclusions: At treatment entry, each of the three patient outcome groups was identified by Levels of circulating DHEAS and distressed mood. In the ABST patients, distressed mood during withdrawal may have been mitigated through antidepressant-like actions of enhanced endogenous DHEAS activity, thus contributing to improved abstinence and treatment retention. Patients, such as the DO group, with high levels of distressed mood at treatment entry and low DHEAS levels may benefit from adjunctive pharmacotherapy that targets DHEAS and POMS measures. Patients, such as the REL group, who tack distressed mood at treatment entry, may require intense application of motivational approaches plus residential treatment. (C) 2004 Elsevier Ltd. All rights reserved. C1 Cedars Sinai Med Ctr, Dept Psychiat, Los Angeles, CA 90048 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90073 USA. Natl Inst Drug Abuse, Div Treatment Res & Dev, NIH, Bethesda, MD 20892 USA. Columbia Univ Coll Phys & Surg, Dept Psychiat, New York, NY 10032 USA. RP Wilkins, JN (reprint author), Cedars Sinai Med Ctr, Dept Psychiat, 8730 Alden Dr,Room C-301, Los Angeles, CA 90048 USA. EM wilkinsj@cshs.org NR 69 TC 27 Z9 27 U1 1 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 JAN PY 2005 VL 30 IS 1 BP 18 EP 28 DI 10.1016/j.psyneuen.2004.04.006 PG 11 WC Endocrinology & Metabolism; Neurosciences; Psychiatry SC Endocrinology & Metabolism; Neurosciences & Neurology; Psychiatry GA 858TL UT WOS:000224214700003 PM 15358439 ER PT J AU Egede, LE AF Egede, LE TI Effect of comorbid chronic diseases on prevalence and odds of depression in adults with diabetes SO PSYCHOSOMATIC MEDICINE LA English DT Article DE diabetes; depression; chronic disease; health survey; health service research; health psychology ID PRIMARY-CARE; MAJOR DEPRESSION; UNITED-STATES; METAANALYSIS; INDIVIDUALS; DISABILITY; MORTALITY; WORK; RISK AB Objective: The objective of this study was to determine the effect of coexisting chronic conditions on prevalence and odds of depression in individuals with diabetes. Methods: Data on 1794 adults with diabetes from the 1999 National Health Interview Survey were analyzed. Six chronic conditions were identified: hypertension, coronary artery disease, chronic arthritis, stroke, chronic obstructive pulmonary disease, and end-stage renal disease. Chronic conditions were counted and categorized into 4 groups: diabetes alone, diabetes + 1 condition, diabetes + 2 conditions, and diabetes + 3 or more conditions. Prevalence of depression was calculated by number of chronic conditions and for each condition. Adjusted odds of depression were calculated by number of chronic conditions and for each chronic condition while simultaneously controlling for covariates and for each chronic condition using multiple logistic regression. STATA was used for statistical analyses. Results: Using diabetes alone as reference, adjusted odds of major depression by number of conditions were: diabetes + 1 (1.31; 95% confidence interval [CI], 0.67-2.55), diabetes + 2 (2.09; 95% CI, 1.06-4.12), and diabetes + 3 or more (4.09; 95% CI, 2.04-8.17). Adjusted odds of major depression for each coexisting chronic conditions were: hypertension (1.22; 95% CI, 0.78-1.90), coronary artery disease (2.00; 95% CI, 1.27-3.14), chronic arthritis (2.02; 95% CI, 1.35-3.02), stroke (2.15; 95% CI, 1.10-4.31), chronic obstructive pulmonary disease (0.96; 95% CI, 0.52-1.81), and end-stage renal disease (1.19; 95% CI, 0.57-2.49). Conclusion: Odds of major depression are significantly increased among adults with diabetes in the presence of two or more coexisting chronic conditions, and coexistence of coronary artery disease, chronic arthritis, and stroke in particular, are associated with increased odds of major depression. C1 Med Univ S Carolina, Ctr Hlth Care Res, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Egede, LE (reprint author), Med Univ S Carolina, Ctr Hlth Care Res, 135 Cannon St,Suite 403,POB 250837, Charleston, SC 29425 USA. EM egedel@musc.edu FU AHRQ HHS [5K08HS11418] NR 26 TC 55 Z9 55 U1 3 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0033-3174 J9 PSYCHOSOM MED JI Psychosom. Med. PD JAN-FEB PY 2005 VL 67 IS 1 BP 46 EP 51 DI 10.1097/01.psy.0000149260.82006.fb PG 6 WC Psychiatry; Psychology; Psychology, Multidisciplinary SC Psychiatry; Psychology GA 892TU UT WOS:000226673700007 PM 15673623 ER PT J AU Anzueto, A Tashkin, D Menjoge, S Kesten, S AF Anzueto, A Tashkin, D Menjoge, S Kesten, S TI One-year analysis of longitudinal changes in spirometry in patients with COPD receiving tiotropium SO PULMONARY PHARMACOLOGY & THERAPEUTICS LA English DT Article DE chronic obstructive pulmonary disease; tiotropium; spirometry; lung function; FEV1 ID OBSTRUCTIVE PULMONARY-DISEASE; AIR-FLOW LIMITATION; LUNG HEALTH; DECLINE; SMOKERS; MILD AB Background: Airway medications have not been shown to reduce the loss of lung function in patients with COPD. We explored whether tiotropium 18 mug once daily could slow the rate of decline of lung function over a 1-year period. Methods: We performed a post-hoc analysis of data from 921 ambulatory COPD patients participating in two, 1-year, double-blind, tiotropium vs. placebo-controlled trials. Serial spirometry was obtained at baseline (before first dose of study drug), on day 8, at 6 weeks, and at 3, 6, 9 and 12 months after start of the study. Results: Baseline demographics and lung function were comparable. Baseline FEV1 was 1.01 +/- 0.41 (SD) L (39 +/-14% predicted). Mean decline in trough FEV1 (i.e. FEV1 23-24 h after prior use of medication) between days 8 and 344 was 58 ml/year in the placebo group and 12 ml/year in the tiotropium group (p=0.005 vs. placebo); and between days 50 and 344 was 59 ml/year in the placebo group and 19 ml/year in the tiotropium group (p=0.036 vs. placebo). Conclusions: Based on a retrospective analysis of 1-year, placebo-controlled clinical trials, tiotropium was associated with a reduced rate of loss of FEV1. Longer-term trials specifically designed to study this effect are required to confirm this observation.(C) 2004 Elsevier Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Pulm Crit Care, San Antonio, TX 78299 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78299 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Boehringer Ingelheim Pharmaceut Inc, Ridgefield, CT 06877 USA. RP Anzueto, A (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pulm Crit Care, 7400 Merton Minter Blvd,111E, San Antonio, TX 78299 USA. EM anzueto@uthcsa.edu NR 29 TC 76 Z9 82 U1 0 U2 0 PU ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1094-5539 J9 PULM PHARMACOL THER JI Pulm. Pharmacol. Ther. PY 2005 VL 18 IS 2 BP 75 EP 81 DI 10.1016/j.pupt.2004.10.003 PG 7 WC Pharmacology & Pharmacy; Respiratory System SC Pharmacology & Pharmacy; Respiratory System GA 893CR UT WOS:000226697400001 PM 15649848 ER PT J AU Soroush-Yari, A Burstein, S Hoo, GWS Santiago, SM AF Soroush-Yari, A Burstein, S Hoo, GWS Santiago, SM TI Pulmonary hypertension in men with thyrotoxicosis SO RESPIRATION LA English DT Article DE dyspnea; hyperthyroidism; pulmonary hypertension ID GRAVES-DISEASE; TRICUSPID REGURGITATION; HYPERTHYROIDISM; HEART AB Thyrotoxicosis has a myriad of respiratory symptoms including dyspnea. Pulmonary hypertension may contribute to the respiratory symptoms of thyrotoxicosis, but is often unrecognized. We describe 3 male patients with thyrotoxicosis and associated pulmonary hypertension. Case reports of an additional 15 patients are also reviewed. In patients with thyrotoxicosis and pulmonary hypertension, treatment of thyrotoxicosis alone is associated with improvement in pulmonary hypertension. Previous reports have consisted of mostly female patients, but we report 3 men. When all cases are considered, the typical patient is female (10/14 = 71%), middle-aged ( 48 years), with mean pulmonary artery systolic pressures improving from 56 to 32 mm Hg with treatment. Autoantibodies were detected in 10/14 ( 71%) patients. The response to treatment ( medical or surgical) of thyrotoxicosis supports the hypothesis that hyperthyroidism is either a cause of pulmonary hypertension, or a factor that may unmask pulmonary hypertension. Recognition is important since treatment and response are very different compared to other patients with pulmonary hypertension. This association may not be readily considered in men, since most reports have been of women. Copyright (C) 2005 S. Karger AG, Basel. C1 Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Healthcare Syst, Dept Med,Pulm & Crit Care Sect, Los Angeles, CA USA. RP Santiago, SM (reprint author), W Los Angeles Vet Affairs Med Ctr, Pulm & Crit Care Sect 111Q, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Silverio.santiago@med.va.gov NR 32 TC 12 Z9 12 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0025-7931 J9 RESPIRATION JI Respiration PY 2005 VL 72 IS 1 BP 90 EP 94 DI 10.1159/000083408 PG 5 WC Respiratory System SC Respiratory System GA 904ID UT WOS:000227488400017 PM 15753642 ER PT J AU Sarraf, D Jain, A Dubovy, S Kreiger, A Fong, D Paschal, J AF Sarraf, D Jain, A Dubovy, S Kreiger, A Fong, D Paschal, J TI Mucosa-associated lymphoid tissue lymphoma with intraocular involvement SO RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES LA English DT Article DE choroidal infiltrates; conjunctival MALT lymphoma; intraocular neoplasm; MALT lymphoma; mucosa-associated lymphoid tissue lymphoma ID B-CELL LYMPHOMA; MALT LYMPHOMA; HYPERPLASIA; CONJUNCTIVITIS; SCLERITIS AB Purpose: To report the clinicopathologic features of a patient with mucosa-associated lymphoid tissue (MALT) lymphoma of the conjunctiva and associated intraocular involvement. Methods: This study is a retrospective clinicopathologic correlative case report summarizing the clinical, radiologic, and histopathologic findings of a patient with conjunctival MALT lymphoma and associated intraocular involvement. Results: Ophthalmic examination and fluorescein angiography demonstrated progressive conjunctival infiltration bilaterally, marked uveal effusions in the left eye, and cellular white infiltrates of the choroid in the right eye. MRI of the orbit revealed a diffusely infiltrating intra- and extraocular lesion extending around the globe and optic nerve in the left eye without evidence of intracranial extension. Conjunctival biopsy showed low-grade tumor cells, consistent with the diagnosis of MALT lymphoma. The patient was successfully treated with external beam radiation with marked clinical improvement. Conclusion: Conjunctival MALT lymphomas, typically indolent and localized tumors, may extend into the orbit and invade local tissues such as the choroid with devastating consequences. A conjunctival biopsy can provide an easy diagnosis of this treatable entity. C1 Univ Calif Los Angeles, Sch Med, Jules Stein Eye Inst, Los Angeles, CA 90095 USA. Greater Los Angeles Vet Adm Healthcare Ctr, Los Angeles, CA USA. Kaiser Permanente, Baldwin Pk Woodland Hill, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Univ Miami, Bascom Palmer Eye Inst, Miami, FL 33152 USA. RP Sarraf, D (reprint author), Univ Calif Los Angeles, Sch Med, Jules Stein Eye Inst, 100 Stein Plaza, Los Angeles, CA 90095 USA. EM dsarraf@ucla.edu NR 23 TC 25 Z9 26 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0275-004X J9 RETINA-J RET VIT DIS JI Retin.-J. Retin. Vitr. Dis. PD JAN PY 2005 VL 25 IS 1 BP 94 EP 98 DI 10.1097/00006982-200501000-00018 PG 5 WC Ophthalmology SC Ophthalmology GA 891OG UT WOS:000226589800018 PM 15655452 ER PT J AU Clarke, P Richardson-Burns, SM DeBiasi, RL Tyler, KL AF Clarke, P Richardson-Burns, SM DeBiasi, RL Tyler, KL TI Mechanisms of apoptosis during reovirus infection SO ROLE OF APOPTOSIS IN INFECTION SE CURRENT TOPICS IN MICROBIOLOGY AND IMMUNOLOGY LA English DT Review ID NF-KAPPA-B; CENTRAL-NERVOUS-SYSTEM; ATTACHMENT PROTEIN SIGMA-1; SPINAL MUSCULAR-ATROPHY; CELL-CYCLE ARREST; STRUCTURAL BASIS; DEATH RECEPTORS; GENE-EXPRESSION; CANCER-CELLS; SIALIC-ACID AB Reovirus infection has proven to be an excellent experimental system for studying mechanisms of virus-induced pathogenesis. Reoviruses induce apoptosis in a wide variety of cultured cells in vitro and in target tissues in vivo, including the heart and central nervous system. In vivo, viral infection, tissue injury, and apoptosis colocalize, suggesting that apoptosis is a critical mechanism by which disease is triggered in the host. This review examines the mechanisms of reovirus-induced apoptosis and investigates the possibility that inhibition of apoptosis may provide a novel strategy for limiting virus-induced tissue damage following infection. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol B 182, Denver, CO 80262 USA. Denver VA Med Ctr, Denver, CO 80220 USA. RP Clarke, P (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol B 182, 4200 E 9th Ave, Denver, CO 80262 USA. EM Penny.Clarke@uchsc.edu OI Tyler, Kenneth/0000-0003-3294-5888 FU NINDS NIH HHS [R01 NS050138, R01 NS050138-04, R01 NS051403, R01 NS051403-03, R01NS050138] NR 48 TC 25 Z9 25 U1 0 U2 1 PU SPRINGER-VERLAG BERLIN PI BERLIN PA HEIDELBERGER PLATZ 3, D-14197 BERLIN, GERMANY SN 0070-217X J9 CURR TOP MICROBIOL JI Curr.Top.Microbiol.Immunol. PY 2005 VL 289 BP 1 EP 24 PG 24 WC Immunology; Microbiology SC Immunology; Microbiology GA BCT25 UT WOS:000231113700001 PM 15791949 ER PT J AU Sergi, MJ Kern, RS Mintz, J Green, MF AF Sergi, MJ Kern, RS Mintz, J Green, MF TI Learning potential and the prediction of work skill acquisition in schizophrenia SO SCHIZOPHRENIA BULLETIN LA English DT Article DE schizophrenia; learning potential; dynamic testing; neurocognition; work skills; vocational skills ID CARD SORTING TEST; NEUROCOGNITIVE DEFICITS; REHABILITATION; PERFORMANCE; DEMENTIA; CAPACITY AB This study examined whether a measure of learning potential could predict work skill acquisition in schizophrenia beyond the prediction offered by a single administration assessment. Fifty-seven outpatients with schizophrenia or schizoaffective disorder completed a test-train-test version of the Wisconsin Card Sorting Test as a measure of their learning potential. The outpatients were randomly assigned to training by errorless learning or conventional instruction on two work skills (index card filing and toilet tank assembly). Work skills were assessed both immediately and 3 months after training. Generally, patients with high learning potential performed better on the work skill tasks. Learning potential explained an additional 15 percent of variance beyond single administration assessment in participants' accuracy immediately after work skill training and an additional 13 percent of variance in participants' accuracy 3 months after training. These findings indicate that measures of learning potential contribute to the prediction of work skill acquisition, going beyond the predictive power of single administration assessments. C1 Calif State Univ Northridge, Dept Psychol, Northridge, CA 91330 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Sergi, MJ (reprint author), Calif State Univ Northridge, Dept Psychol, 18111 Nordhoff St, Northridge, CA 91330 USA. EM mark.sergi@csun.edu FU NIMH NIH HHS [MH-30911] NR 17 TC 39 Z9 44 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD JAN PY 2005 VL 31 IS 1 BP 67 EP 72 DI 10.1093/schbul/sbi007 PG 6 WC Psychiatry SC Psychiatry GA 915MV UT WOS:000228309200007 PM 15888426 ER PT J AU Bowie, CR Serper, MR Riggio, S Harvey, PD AF Bowie, CR Serper, MR Riggio, S Harvey, PD TI Neurocognition, symptomatology, and functional skills in older alcohol-abusing schizophrenia patients SO SCHIZOPHRENIA BULLETIN LA English DT Article DE schizophrenia; alcohol; cognition; adaptive functions ID GERIATRIC-PATIENTS; VOLUME DEFICITS; COMORBIDITY; DYSFUNCTION; IMPAIRMENT; INSTRUMENT; MEDICATION; DEPENDENCE; DISORDERS; DIAGNOSIS AB Deficits in neurocognitive functioning are common to both schizophrenia and alcoholism. Recent studies suggest that neurocognitive functioning is the most significant predictor of social-adaptive functioning in schizophrenia. Cognitive impairment induced by alcoholism may result in more impaired functional outcome for comorbid patients. Past research examining alcohol-abusing schizophrenia patients has not examined correlates with functional outcome and has generally been limited to relatively younger patients. This study examined neurocognitive functioning and its correlates in alcohol-abusing schizophrenia patients between the ages of 40 and 80. Outpatients with schizophrenia (SZ; n = 17) or both schizophrenia and alcohol abuse or dependence (SZ + ETOH; n = 18) were tested on a neurocognitive battery, rated for symptomatology, and assessed for functional abilities. The results suggest that alcohol abuse in schizophrenia is associated with more impaired functioning across many domains, including memory impairment, negative and general psychopathology symptoms, and adaptive functions. The only significant predictor of impaired functional status in the overall sample and the SZ + ETOH group was neurocognitive functioning. C1 Mt Sinai Sch Med, Dept Psychiat, Psychol Serv, New York, NY 10029 USA. Hofstra Univ, Dept Psychol, Hempstead, NY 11550 USA. NYU, Sch Med, New York, NY USA. Mt Sinai Sch Med, Schizophrenia Treatment & Res Program, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, New York, NY 10029 USA. RP Bowie, CR (reprint author), Mt Sinai Sch Med, Dept Psychiat, Psychol Serv, 1425 Madison Ave,4th Floor, New York, NY 10029 USA. EM christopher.bowie@mssm.edu RI Reis, Aline/G-9573-2012 FU NIMH NIH HHS [MH 36692, MH63116] NR 41 TC 32 Z9 32 U1 4 U2 9 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD JAN PY 2005 VL 31 IS 1 BP 175 EP 182 DI 10.1093/schbul/sbi001 PG 8 WC Psychiatry SC Psychiatry GA 915MV UT WOS:000228309200016 PM 15888435 ER PT J AU Yao, JK Thomas, EA Reddy, RD Keshavan, MS AF Yao, JK Thomas, EA Reddy, RD Keshavan, MS TI Association of plasma apolipoproteins D with RBC membrane arachidonic acid levels in schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE apolipoproteins D; arachidonic acid; schizophrenia; first-episode neuroleptic-naive ID PSYCHIATRIC-DISORDERS; HUMAN ERYTHROCYTES; OXIDATIVE-STRESS; RAT HIPPOCAMPUS; E EXPRESSION; BRAIN; DISEASE; FLUID; PATHOPHYSIOLOGY; PROGESTERONE AB Apolipoprotein D (apoD) is a member of the lipocalin superfamily of transporter proteins that bind small hydrophobic molecules, including arachidonic acid (AA). The ability of apoD to bind AA implicates it in pathways associated with membrane phospholipid signal transduction and metabolism. Recent findings of an increased expression of apoD in the mouse brain after clozapine treatment suggested a role for apoD in the pharmacological action of clozapine. Moreover, clozapine has been shown to increase membrane AA levels in RBC phospholipids from schizophrenic patients. ApoD levels have also been shown to be elevated in the CNS of subjects with chronic schizophrenia, a disorder associated with AA dysfunction. In this study, we examined whether plasma apoD levels are related to red blood cell membrane AA contents in the first episode neuroleptic-naive schizophrenic (FENNS) patients. Plasma apoD levels as measured by enzyme-linked immunosorbent (ELISA) were not significantly different (F = 0.51, df = 2,86, p = 0.60) among healthy controls (n = 36). FENNS patients (n = 33) and patients with other psychiatric disorders (n = 19). However, plasma apoD levels were significantly correlated with RBC-AA (p = 0.0022) and docosapentaenoic acid (p = 0.0008) in FENNS patients. There are several known mechanisms that can lead to the type of membrane fatty acid defects that have been identified in schizophrenia. Whether plasma apoD alone is a major determinant of reduced RBC membrane AA levels in FENNS patients remains to be determined, although these preliminary data appear not to support this prentise. Taken together with other in vitro studies, however, the present data support the view, that an increased expression of apoD such as induced by atypical neuroleptic drug, may facilitate incorporation of AA into membrane phospholipids by its selective binding to AA. (C) 2004 Elsevier B.V. All rights reserved. C1 VA Pittsburgh Healthcare Syst, Neurochem & Psychopharm Lab, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Ctr Med, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Pharm, Dept Pharmaceut Sci, Pittsburgh, PA 15213 USA. Scripps Res Inst, Dept Mol Biol, La Jolla, CA 92037 USA. RP Yao, JK (reprint author), VA Pittsburgh Healthcare Syst, Neurochem & Psychopharm Lab, Bldg 13,1780 Highland Dr, Pittsburgh, PA 15206 USA. EM jkyao@pitt.edu FU NIMH NIH HHS [MH-64118, MH-45203, MH-58141] NR 41 TC 13 Z9 15 U1 2 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD JAN 1 PY 2005 VL 72 IS 2-3 BP 259 EP 266 DI 10.1016/j.schres.2004.05.007 PG 8 WC Psychiatry SC Psychiatry GA 889FZ UT WOS:000226430200017 PM 15560970 ER PT J AU Reddy, GP Gotway, MB Araoz, PA AF Reddy, GP Gotway, MB Araoz, PA TI Imaging of chronic thromboembolic pulmonary hypertension SO SEMINARS IN ROENTGENOLOGY LA English DT Article ID CT FINDINGS; SPIRAL CT; HELICAL CT; EMBOLISM; ANGIOGRAPHY; DIAGNOSIS; CONTRAST; DISEASE C1 Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. San Francisco Gen Hosp, San Francisco, CA 94110 USA. Mayo Clin, Dept Radiol, Rochester, MN USA. RP Reddy, GP (reprint author), Univ Calif San Francisco, Dept Radiol, Box 0628,505 Parnassus Ave,Suite M396, San Francisco, CA 94143 USA. EM gautham.reddy@radiology.uscf.edu NR 20 TC 3 Z9 3 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 0037-198X J9 SEMIN ROENTGENOL JI Semin. Roentgenology PD JAN PY 2005 VL 40 IS 1 BP 41 EP 47 DI 10.1053/j.ro.2004.09.009 PG 7 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 889YT UT WOS:000226479500009 PM 15732560 ER PT J AU Mu, QW Nahas, Z Johnson, KA Yamanaka, K Mishory, A Koola, J Hill, S Horner, MD Bohning, DE George, MS AF Mu, QW Nahas, Z Johnson, KA Yamanaka, K Mishory, A Koola, J Hill, S Horner, MD Bohning, DE George, MS TI Decreased cortical response to verbal working memory following sleep deprivation SO SLEEP LA English DT Article DE verbal working memory; sleep deprivation; functional magnetic resonance imaging ID TERM RECOGNITION MEMORY; BRAIN-REGIONS; TASK; MAINTENANCE; PERFORMANCE; ACTIVATION; COMPONENTS; ATTENTION; BEHAVIOR; HUMANS AB Study Objective: To investigate the cerebral hemodynamic response to verbal working memory following sleep deprivation. Design: Subjects were scheduled for 3 functional magnetic resonance imaging scanning visits: an initial screening day (screening state), after a normal night of sleep (rested state), and after 30 hours of sleep deprivation (sleep-deprivation state). Subjects performed the Sternberg working memory task alternated with a control task during an approximate 13-minute functional magnetic resonance imaging scan. Setting: Inpatient General Clinical Research Center and outpatient functional magnetic resonance imaging center. Patients or Participants: Results from 33 men (mean age, 28.6 +/- 6.6 years) were included in the final analyses. Interventions: None. Measurements and Results: Subjects performed the same Sternberg working memory task at the 3 states within the magnetic resonance imaging scanner. Neuroimaging data revealed that, in the screening and rested states, the brain regions activated by the Sternberg working memory task were found in the left dorsolateral prefrontal cortex, Broca's area, supplementary motor area, right ventrolateral prefrontal cortex, and the bilateral posterior parietal cortexes. After 30 hours of sleep deprivation, the activations in these brain regions significantly decreased, especially in the bilateral posterior parietal cortices. Task performance also decreased. A repeated-measures analysis of variance revealed that subjects at the screening and rested states had similar activation patterns, with each having significantly more activation than during the sleep-deprivation state. Conclusions: These results suggest that human sleep-deprivation deficits are not caused solely or even predominantly by prefrontal cortex dysfunction and that the parietal cortex, in particular, and other brain regions involved in verbal working memory exhibit significant sleep-deprivation vulnerability. C1 Med Univ S Carolina, Brain Stimulat Lab, Charleston, SC 29425 USA. Med Univ S Carolina, Ctr Adv Imaging, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Mu, QW (reprint author), Med Univ S Carolina, Brain Stimulat Lab, IOP,502 N,67 President St, Charleston, SC 29425 USA. EM muq@musc.edu FU NIA NIH HHS [R01-AG40956] NR 34 TC 77 Z9 83 U1 1 U2 6 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 JAN 1 PY 2005 VL 28 IS 1 BP 55 EP 67 PG 13 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 911TN UT WOS:000228028000010 PM 15700721 ER PT J AU Littner, MR Kushida, C Wise, M Davila, DG Morgenthaler, T Lee-Chiong, T Hirshkowitz, M Loube, DL Bailey, D Berry, RB Kapen, S Kramer, M AF Littner, MR Kushida, C Wise, M Davila, DG Morgenthaler, T Lee-Chiong, T Hirshkowitz, M Loube, DL Bailey, D Berry, RB Kapen, S Kramer, M TI Practice Parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test - An American Academy of Sleep Medicine Report - Standards of practice committee of the American Academy of Sleep Medicine SO SLEEP LA English DT Article DE multiple sleep latency test; maintenance of wakefulness test; sleepiness; hypersomnia; daytime wakefulness ID EXCESSIVE DAYTIME SLEEPINESS; NARCOLEPSY; APNEA AB Characterization of excessive sleepiness is an important task for the sleep clinician, and assessment requires a thorough history and in many cases, objective assessment in the sleep laboratory. These practice parameters were developed to guide the sleep clinician on appropriate clinical use of the Multiple Sleep Latency Test (MSLT), and the Maintenance of Wakefulness Test (MWT). These recommendations replace those published in 1992 in a position paper produced by the American Sleep Disorders Association. A Task Force of content experts was appointed by the American Academy of Sleep Medicine to perform a comprehensive review of the scientific literature and grade the evidence regarding the clinical use of the MSLT and the MWT Practice parameters were developed based on this review and in most cases evidence based methods were used to support recommendations. When data were insufficient or inconclusive, the collective opinion of experts was used to support recommendations. These recommendations were developed by the Standards of Practice Committee and reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine. The MSLT is indicated as part of the evaluation of patients with suspected narcolepsy and may be useful in the evaluation of patients with suspected idiopathic hypersomnia. The MSLT is not routinely indicated in the initial evaluation and diagnosis of obstructive sleep apnea syndrome, or in assessment of change following treatment with nasal continuous positive airway pressure (CPAP). The MSLT is not routinely indicated for evaluation of sleepiness in medical and neurological disorders (other than narcolepsy), insomnia, or circadian rhythm disorders. The MWT may be indicated in assessment of individuals in whom the inability to remain awake constitutes a safety issue, or in patients with narcolepsy or idiopathic hypersomnia to assess response to treatment with medications. There is little evidence linking mean sleep latency on the MWT with risk of accidents in real world circumstances. For this reason, the sleep clinician should not rely solely on mean sleep latency as a single indicator of impairment or risk for accidents, but should also rely on clinical judgment. Assessment should involve integration of findings from the clinical history, compliance with treatment, and, in some cases, objective testing using the MWT These practice parameters also include recommendations for the MSLT and MWT protocols, a discussion of the normative data available for both tests, and a description of issues that need further study. C1 VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. David Geffen Sch Med, Sepulveda, CA USA. Stanford Univ, Ctr Excellence Sleep Disorders, Stanford, CA 94305 USA. Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Baptist Med Ctr, Sleep Disorders Ctr, Little Rock, AR USA. Mayo Sleep Disorders Ctr, Rochester, MN USA. Natl Jewish Med & Res Ctr, Sleep Clin, Denver, CO USA. Baylor Coll Med, VA Med Ctr, Houston, TX 77030 USA. Swedish Med Ctr, Sleep Med Inst, Seattle, WA USA. Univ Florida, Malcolm Randall VAMC, Gainesville, FL USA. Wayne State Univ, Detroit, MI USA. Maimonides Hosp, Dept Psychiat, Brooklyn, NY 11219 USA. NYU, Sch Med, New York, NY USA. RP Littner, MR (reprint author), VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. OI Morgenthaler, Timothy/0000-0002-2614-3793 NR 18 TC 377 Z9 383 U1 1 U2 11 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 JAN 1 PY 2005 VL 28 IS 1 BP 113 EP 121 PG 9 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 911TN UT WOS:000228028000016 PM 15700727 ER PT J AU Atwood, C Simpson, R Konermann, M Cramer-Borneman, M Shalaby, A Freedman, RA Fowler, J Hansen, C Neuzner, J Hartley, J AF Atwood, C Simpson, R Konermann, M Cramer-Borneman, M Shalaby, A Freedman, RA Fowler, J Hansen, C Neuzner, J Hartley, J TI Atrial overdrive pacing & sleep apnea in a bradycardia population SO SLEEP LA English DT Meeting Abstract CT 19th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 18-23, 2005 CL Denver, CO SP Associated Profess Sleep Soc C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Utah, Salt Lake City, UT USA. Klinikum Kassel, Kassel, Germany. Marien Hosp, Kassel, Germany. Hennepin Cty Med Ctr, Minneapolis, MN USA. Guidant Corp, CRM, St Paul, MN 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 PY 2005 VL 28 SU S MA 579 BP A195 EP A195 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 923JL UT WOS:000228906101088 ER PT J AU Fischer, ME Watson, NF Buchwald, D Vitek, M Goldberg, J AF Fischer, ME Watson, NF Buchwald, D Vitek, M Goldberg, J TI Sleep duration and self-reported illness in twins SO SLEEP LA English DT Meeting Abstract CT 19th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 18-23, 2005 CL Denver, CO SP Associated Profess Sleep Soc C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, VET Registry, Seattle ERIC, Seattle, WA USA. Hines VA Cooperat Studies Program, Hines, IL 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 PY 2005 VL 28 SU S MA 453 BP A154 EP A154 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 923JL UT WOS:000228906100455 ER PT J AU Hirshkowitz, M Roth, T Black, J Wesnes, K Arora, S Niebler, G White, D AF Hirshkowitz, M Roth, T Black, J Wesnes, K Arora, S Niebler, G White, D TI Armodafinil as adjunct therapy improves wakefulness and fatigue in patients with obstructive sleep apnea/hypopnea syndrome SO SLEEP LA English DT Meeting Abstract CT 19th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 18-23, 2005 CL Denver, CO SP Associated Profess Sleep Soc C1 VA Med Ctr, Sleep Disorders Ctr, Houston, TX USA. Henry Ford Hosp, Sleep Disorders & Res Ctr, Detroit, MI 48202 USA. Stanford Univ, Stanford Sleep Disorders Clin, Stanford, CA 94305 USA. Cognit Drug Res Ltd, Goring On Thames, England. Cephalon Inc, W Chester, PA USA. Brigham & Womens Hosp, Div Sleep Med, Boston, MA 02115 USA. NR 0 TC 1 Z9 1 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 PY 2005 VL 28 SU S MA 531 BP A180 EP A180 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 923JL UT WOS:000228906101040 ER PT J AU Lu, JW Mann, GL Volgin, DV Ross, RJ Morrison, AR Kubin, L AF Lu, JW Mann, GL Volgin, DV Ross, RJ Morrison, AR Kubin, L TI Perifornical hypothalamic microinjections of antisense oligodeoxynucleotides against beta 3 subunit of GABA(A) receptor reduce REM sleep SO SLEEP LA English DT Meeting Abstract CT 19th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 18-23, 2005 CL Denver, CO SP Associated Profess Sleep Soc C1 Univ Penn, Dept Biol Anim, Philadelphia, PA 19104 USA. Univ Penn, Ctr Sleep & Resp Neurobiol, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Behav Hlth Serv, Philadelphia, PA USA. RI Volgin, Denys/A-1041-2007 NR 0 TC 0 Z9 0 U1 1 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 PY 2005 VL 28 SU S MA 28 BP A10 EP A10 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 923JL UT WOS:000228906100030 ER PT J AU Martin, JL Webber, AP Harker, JO Josephson, KR Alessi, CA AF Martin, JL Webber, AP Harker, JO Josephson, KR Alessi, CA TI Diurnal cortisol is associated with functional improvement during post-acute rehabilitation in older adults SO SLEEP LA English DT Meeting Abstract CT 19th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 18-23, 2005 CL Denver, CO SP Associated Profess Sleep Soc C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Geriatr Res Educ & Clin Ctr, Sepulveda, CA 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 PY 2005 VL 28 SU S MA 328 BP A111 EP A112 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 923JL UT WOS:000228906100329 ER PT J AU Pawlyk, AC Ross, RJ Jha, SK Brennan, FX Morrison, AR AF Pawlyk, AC Ross, RJ Jha, SK Brennan, FX Morrison, AR TI The differential rapid eye movement sleep response to cued and contextual fear conditioning is suppressed by a shared response to fearful conditioned stimuli SO SLEEP LA English DT Meeting Abstract CT 19th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 18-23, 2005 CL Denver, CO SP Associated Profess Sleep Soc C1 Univ Penn, Ctr Sleep & Resp Neurobiol, Philadelphia, PA 19104 USA. Univ Penn, Lab Study Brain Sleep, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 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 PY 2005 VL 28 SU S MA 1020 BP A346 EP A346 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 923JL UT WOS:000228906101527 ER PT J AU Szymusiak, R Xi, X Kumar, S Shah, N McGinty, D AF Szymusiak, R Xi, X Kumar, S Shah, N McGinty, D TI Activation of arousal systems during sleep in rats exposed to intermittent hypoxia SO SLEEP LA English DT Meeting Abstract CT 19th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 18-23, 2005 CL Denver, CO SP Associated Profess Sleep Soc C1 VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 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 PY 2005 VL 28 SU S MA 79 BP A26 EP A26 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 923JL UT WOS:000228906100081 ER PT J AU Tucker, AM Gehrman, P Sanford, LD Morrison, AR Armitage, R Ross, RJ AF Tucker, AM Gehrman, P Sanford, LD Morrison, AR Armitage, R Ross, RJ TI Effect of anticipatory anxiety on sleep SO SLEEP LA English DT Meeting Abstract CT 19th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 18-23, 2005 CL Denver, CO SP Associated Profess Sleep Soc C1 Univ Sci Philadelphia, Philadelphia, PA USA. Univ Penn, Sch Med, Ctr Sleep & Resp Neurobiol, Philadelphia, PA 19104 USA. Eastern Virginia Med Sch, Norfolk, VA 23501 USA. Univ Penn, Sch Vet Med, Philadelphia, PA 19104 USA. Univ Michigan, Ann Arbor, MI 48109 USA. Philadelphia VA Med Ctr, Philadelphia, PA 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 PY 2005 VL 28 SU S MA 928 BP A314 EP A314 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 923JL UT WOS:000228906101436 ER PT J AU Uschakov, A McGinty, D Szymusiak, R AF Uschakov, A McGinty, D Szymusiak, R TI Sleep active neurons within the ventral lamina terminalis project to the bed nucleus of the stria terminalis and the lateral hypothalamus SO SLEEP LA English DT Meeting Abstract CT 19th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 18-23, 2005 CL Denver, CO SP Associated Profess Sleep Soc C1 VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Psychol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Neurobiol, Los Angeles, CA USA. NR 0 TC 1 Z9 1 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 PY 2005 VL 28 SU S MA 51 BP A17 EP A17 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 923JL UT WOS:000228906100053 ER PT J AU Weaver, EM AF Weaver, EM TI Self-identified sleep apnea is associated with subjective sleepiness SO SLEEP LA English DT Meeting Abstract CT 19th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 18-23, 2005 CL Denver, CO SP Associated Profess Sleep Soc C1 Univ Washington, Sleep Disorders Ctr, Seattle, WA 98195 USA. VA Puget Sound Healthcare Syst, Seattle, WA 98195 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 PY 2005 VL 28 SU S MA 620 BP A208 EP A208 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 923JL UT WOS:000228906101129 ER PT J AU Xi, X McGinty, D Szymusiak, R AF Xi, X McGinty, D Szymusiak, R TI Patterns of sleep disturbance in rats exposed to intermittent hypoxia SO SLEEP LA English DT Meeting Abstract CT 19th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 18-23, 2005 CL Denver, CO SP Associated Profess Sleep Soc C1 VA Greater Los Angeles, Res Serv, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 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 PY 2005 VL 28 SU S MA 47 BP A16 EP A16 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 923JL UT WOS:000228906100049 ER PT J AU Farmer, MM Ferraro, KF AF Farmer, MM Ferraro, KF TI Are racial disparities in health conditional on socioeconomic status? SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE race; socioeconomic status; health; disparities in health; USA ID SAMPLE SELECTION BIAS; QUALITY-OF-LIFE; UNITED-STATES; DOUBLE JEOPARDY; RISK-FACTORS; CONTINUING SIGNIFICANCE; CARDIOVASCULAR-DISEASE; PSYCHOLOGICAL DISTRESS; AFRICAN-AMERICANS; WHITE ADULTS AB Racial health inequality is related to socioeconomic status (SES), but debate ensues on the nature of the relationship. Using the US National Health and Nutrition Examination Survey I and the subsequent follow-up interviews, this research examines health disparities between white and black adults and whether the SES/health gradient differs across the two groups in the USA. Two competing mechanisms for the conditional or interactive relationship between race and SES on health are examined during a 20-year period for black and white Americans. Results show that black adults began the study with more serious illnesses and poorer self-rated health than white adults and that the disparity continued over the 20 years. Significant interactions were found between race and education as well as race and employment status on health outcomes. The interaction effect of race and education showed that the racial disparity in self-rated health was largest at the higher levels of SES, providing some evidence for the "diminishing returns" hypothesis; as education levels increased, black adults did not have the same improvement in self-rated health as white adults. Overall, the findings provide evidence for the continuing significance of both race and SES in determining health status over time. (C) 2004 Elsevier Ltd. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, Ctr Study Healthcare Provider Behav, HSR&D Ctr Excellence, Sepulveda, CA 91343 USA. VA Greater Los Angeles Healthcare Syst, VA Hlth Serv Res & Dev Ctr Excellence, Sepulveda Ambulatory & Nursing Home Ctr, VA Ctr Study Healthcare Provider Behav, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv,Johnson Comprehens Canc Ctr, Div Canc Prevent & Control Res, Los Angeles, CA 90024 USA. Purdue Univ, Dept Sociol, W Lafayette, IN 47907 USA. Purdue Univ, Ctr Aging & Life Course, W Lafayette, IN 47907 USA. RP Farmer, MM (reprint author), VA Greater Los Angeles Healthcare Syst, Ctr Study Healthcare Provider Behav, HSR&D Ctr Excellence, Bldg 25,Room B110,1611 Plummer St, Sepulveda, CA 91343 USA. EM farmermm@ucla.edu; ferraro@purdue.edu RI Ferraro, Kenneth/E-4811-2011 FU NIA NIH HHS [AG11705] NR 72 TC 178 Z9 180 U1 5 U2 37 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD JAN PY 2005 VL 60 IS 1 BP 191 EP 204 DI 10.1016/j.socscimed.2004.04.026 PG 14 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA 868XB UT WOS:000224945300017 PM 15482878 ER PT J AU Viktrup, L Koke, S Burgio, KL Ouslander, JG AF Viktrup, L Koke, S Burgio, KL Ouslander, JG TI Stress urinary incontinence in active elderly women SO SOUTHERN MEDICAL JOURNAL LA English DT Review DE elderly; quality of life; stress urinary incontinence; urinary incontinence ID QUALITY-OF-LIFE; COMMUNITY-DWELLING WOMEN; OVERACTIVE BLADDER; POSTMENOPAUSAL WOMEN; UNITED-STATES; DETRUSOR INSTABILITY; EPIDEMIOLOGIC SURVEY; REPLACEMENT THERAPY; PSYCHOSOCIAL IMPACT; URETHRAL PRESSURE AB Urinary incontinence in the elderly is a significant health problem fraught with isolation, depression, and an increased risk of institutionalization and medical complications. Stress urinary incontinence (SUI), the complaint of involuntary loss of urine during effort or exertion or during sneezing or coughing, is the most common type Of urinary incontinence. SUI can seriously degrade the quality of life for many active seniors, and has become an economic challenge for society. With the rapid increase in the active elderly worldwide, SUI is becoming a significant global problem. However, since only a fraction of women with SUI have consulted a physician, the clinical extent and public health impact of SUI are probably underestimated. The Mounting social, medical, and economic problem of SUI in active elderly women as a rapidly growing segment of the population worldwide is reviewed. We evaluate the age-related changes of the lower urinary tract, examine risk factors, and suggest different treatment options shown to be effective in reducing SUI in this population. C1 Emory Univ, Wesley Woods Ctr, Div Geriatr Med & Gerontol, Atlanta, GA 30329 USA. Lilly Res Labs, Indianapolis, IN USA. Indiana Univ, Dept Family Med, Bloomington, IN 47405 USA. Univ Alabama, Med Sch Birmingham, Birmingham, AL 35487 USA. Univ Alabama, Birmingham VA Med Ctr, Birmingham, AL 35487 USA. RP Ouslander, JG (reprint author), Emory Univ, Wesley Woods Ctr, Div Geriatr Med & Gerontol, 1841 Clifton Rd NE, Atlanta, GA 30329 USA. EM jouslan@emory.edu NR 123 TC 13 Z9 16 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0038-4348 J9 SOUTH MED J JI South.Med.J. PD JAN PY 2005 VL 98 IS 1 BP 79 EP 89 DI 10.1097/01.SMJ.0000146587.06656.98 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 888GA UT WOS:000226361000012 PM 15678640 ER PT J AU Johansen, KL AF Johansen, KL TI Exercise and chronic kidney disease - Current recommendations SO SPORTS MEDICINE LA English DT Review ID STAGE RENAL-DISEASE; QUALITY-OF-LIFE; HEMODIALYSIS-PATIENTS; DIALYSIS PATIENTS; SUBMAXIMAL EXERCISE; CARDIOVASCULAR COMPLICATIONS; MAINTENANCE HEMODIALYSIS; REHABILITATION PROGRAMS; FUNCTIONAL-CAPACITY; TRANSPLANT PATIENTS AB Patients with chronic kidney disease (CKD) are inactive and have reduced physical functioning and performance. Aerobic exercise interventions have been shown to increase maximal oxygen consumption in selected patients. In addition, preliminary evidence, although mixed, suggests that aerobic exercise training can improve blood pressure control, lipid profiles and mental health in this population. A few larger studies are now available showing that aerobic training can also improve physical functioning and performance. The impact on survival or hospitalisation has not been determined. Resistance exercise training, although less studied, appears to increase muscle strength and size and may also improve functioning. There have been several reports of successful combined exercise interventions, but the designs have not allowed evaluation of the relative benefits of aerobic and resistance training on physical functioning. Despite the evidence that exercise is safe and beneficial in patients with CKD, dialysis patients remain inactive, and exercise assessment, counselling and training is not widely offered to patients with CKD. Studies of the barriers to patient participation in exercise and to Provider assessment and recommendations are needed so that more widely generalisable interventions can be developed. However, in the interim, patients should be encouraged to participate in moderate physical activity to meet the US Surgeon General's recommendations. Patients who are weak can benefit from strength-training interventions. Resistance and aerobic exercise programmes should be initiated at relatively low intensity in patients with CKD and progressed as slowly as tolerated in order to avoid injury and discontinuation of exercise. For patients on haemodialysis, incorporation of exercise into the dialysis session may increase patient participation and tolerance of exercise. C1 San Francisco VA Med Ctr, Nephrol Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. RP Johansen, KL (reprint author), San Francisco VA Med Ctr, Nephrol Sect, 111J,4150 Clement St, San Francisco, CA 94121 USA. FU NIDDK NIH HHS [DK-56182] NR 69 TC 48 Z9 55 U1 4 U2 13 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 0112-1642 J9 SPORTS MED JI Sports Med. PY 2005 VL 35 IS 6 BP 485 EP 499 DI 10.2165/00007256-200535060-00003 PG 15 WC Sport Sciences SC Sport Sciences GA 945LD UT WOS:000230503100003 PM 15974634 ER PT J AU Livingston, EH Ko, CY AF Livingston, EH Ko, CY TI Effect of diabetes and hypertension on obesity-related mortality SO SURGERY LA English DT Article ID BODY-MASS INDEX; NUTRITION EXAMINATION SURVEY; CORONARY HEART-DISEASE; NATIONAL-HEALTH; BLOOD-PRESSURE; CARDIOVASCULAR MORTALITY; OLDER PERSONS; UNITED-STATES; 26-YEAR RISK; US ADULTS AB Background. Obesity is increasing and, along with it, greater mortality resulting from the overweight condition. Weight-reduction surgery is recommended for many obese patients based on a perceived risk of greater obesity-related mortality. However, many of the studies cited to justify this have aggregated patient groups together, making it difficult to apply their findings to individual patients. Methods. The,combined National Health Interview Survey database from the years 1986-1994 that has been linked to the National Death Index was analyzed. Patients were stratified for their body mass index (BMI) category, the presence or absence of diabetes and hypertension, gender, and race. The contribution of hypertension and diabetes to mortality was determined by Cox proportional hazards modeling. The absolute magnitude that the effect gender, race, BMI, hypertension, and diabetes had on mortality was determined by examination of stratified age adjusted death rates. Results. We analyzed 662,443 records from individuals interviewed between 1986 and 1994. Of these, 49,391 had died in the follow-up period (mean follow-up, 7.2 years; range, 1-14 years). Cox proportional hazards modeling-adjusting for age, race, and gender-revealed that hypertension (hazard ratio = 1.35 [95 % CI 1.34-1.35], P < .0001) and diabetes (hazard ratio = 2.29 [95 % CI 2.28-2.29], P < .0001) increased mortality independent of body weight. Serious obesity was associated with an increased mortality by Cox modeling (hazard ratio = 1.72 [95 % CI 1.71-1.73], P < .0001); however, when assessed by stratified age-adjusted mortality rates, this increase was numerically small because of the relatively low mortality rate for those without hypertension or diabetes. The presence of hypertension or diabetes substantially increased age-adjusted mortality rates. Much of the increased mortality observed in diabetic patients was attributable to complications of diabetes and not necessarily from atherosclerosis. Conclusion. Because weight-loss surgery successfully cures hypertension or diabetes in most obese patients, it should be considered for obese patients having these diseases. Based on the greatly elevated mortality associated with diabetes, surgery may be justified for obese diabetic patients with BMIs lower than the currently accepted criteria. In contrast, for the morbidly obese without diabetes or hypertension, mortality is only slightly increased from obesity alone. In terms of mortality, the benefits of weight reduction resulting from weight-loss surgery are less clear if there is no coexistent diabetes or hypertension. C1 Univ Texas, SW Med Ctr, SW Med Sch, Div Gastrointestinal & Endocrine Surg, Dallas, TX 75390 USA. VA N Texas Hlth Care Syst, Dallas, TX USA. VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. RP Livingston, EH (reprint author), Univ Texas, SW Med Ctr, SW Med Sch, Div Gastrointestinal & Endocrine Surg, 5323 Harry Hines Blvd,Room E7-126, Dallas, TX 75390 USA. NR 53 TC 28 Z9 28 U1 0 U2 3 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 JAN PY 2005 VL 137 IS 1 BP 16 EP 25 DI 10.1016/j.surg.2004.05.049 PG 10 WC Surgery SC Surgery GA 883JJ UT WOS:000226007100003 PM 15614276 ER PT J AU Brent, G Boyle, CA AF Brent, G Boyle, CA TI The impact of maternal thyroid diseases on the developing fetus: Implications for diagnosis, treatment, and screening. Summary of proceedings, workshop organization, program, and participants SO THYROID LA English DT Editorial Material C1 Ctr Dis Control & Prevent, Natl ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA. Univ Calif Los Angeles, Amer Thyroid Assoc, Los Angeles, CA USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Div Thyroid 1, Los Angeles, CA USA. RP Boyle, CA (reprint author), Ctr Dis Control & Prevent, Natl ctr Birth Defects & Dev Disabil, 1600 Clifton Rd,Mailstop E-87, Atlanta, GA 30333 USA. EM cboyle@cdc.gov NR 5 TC 2 Z9 3 U1 0 U2 0 PU MARY ANN LIEBERT INC PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1050-7256 J9 THYROID JI Thyroid PD JAN PY 2005 VL 15 IS 1 BP 36 EP 40 DI 10.1089/thy.2005.15.36 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 896FX UT WOS:000226921100007 PM 15687821 ER PT J AU Smallridge, RC Glinoer, D Hollowell, JG Brent, G AF Smallridge, RC Glinoer, D Hollowell, JG Brent, G TI Thyroid function inside and outside of pregnancy: What do we know and what don't we know? SO THYROID LA English DT Article; Proceedings Paper CT Workshop on the Impact of Maternal Thyroid Diseases on the Developing Fetus CY JAN 12-13, 2004 CL Atlanta, GA ID IODINE DEFICIENCY; POSTPARTUM THYROIDITIS; PEROXIDASE ANTIBODIES; DIABETES-MELLITUS; DYSFUNCTION; WOMEN; AUTOANTIBODIES; HYPOTHYROIDISM; REPERCUSSIONS; DEPRESSION AB A workshop entitled, "The Impact of Maternal Thyroid Diseases on the Developing Fetus: Implications for Diagnosis, Treatment, and Screening," was held in Atlanta, Georgia, January 12-13, 2004. This paper reports on the session that examined the prevalence of thyroid dysfunction in reproductive-age women and the factors associated with abnormal function. For this session the following papers were presented: "Thyroidal Economy in the Pregnant State: An Overview," "The Prevalence of Thyroid Dysfunction in Reproductive-Age Women-United States," and "Risk Factors for Thyroid Disease: Autoimmunity and Other Conditions." These presentations were formally discussed by invited respondents and by others in attendance. Salient points from this session about which there was agreement include the following: physiologic changes associated with pregnancy require an increased availability of thyroid hormones by 40% to 100% in order to meet the needs of mother and fetus during pregnancy. In the first trimester of gestation the fetus is wholly dependent on thyroxine from the mother for normal neurologic development. For the maternal thyroid gland to meet the demands of pregnancy it must be present, disease-free, and capable of responding with adequate stores of iodine. Thyroid autoimmunity is common and may contribute to miscarriages, as well as to hypothyroidism. With sufficient iodine nutrition, autoimmune thyroid disease (AITD) is the most common cause of hypothyroidism. As of 1994, iodine nutrition in the United States appeared to be adequate, but its continued monitoring is essential. C1 Univ Kansas, Med Ctr, Lawrence, KS 66049 USA. Mayo Clin Jacksonville, Jacksonville, FL 32224 USA. Free Univ Brussels, Hop Univ St Pierre, Thyroid Invest Clin, Brussels, Belgium. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Amer Thyroid Assoc, Los Angeles, CA USA. RP Hollowell, JG (reprint author), Univ Kansas, Med Ctr, 435 N 1400 Rd, Lawrence, KS 66049 USA. EM jgh3@mindspring.com NR 43 TC 37 Z9 42 U1 0 U2 0 PU MARY ANN LIEBERT INC PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1050-7256 J9 THYROID JI Thyroid PD JAN PY 2005 VL 15 IS 1 BP 54 EP 59 DI 10.1089/thy.2005.15.54 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 896FX UT WOS:000226921100010 PM 15687824 ER PT J AU Tiffany, NM Wersinger, EM Beer, TM Garzotto, M AF Tiffany, NM Wersinger, EM Beer, TM Garzotto, M TI Imatinib mesylate and zoledronic acid in androgen-independent prostate cancer - Reply SO UROLOGY LA English DT Letter C1 Oregon Hlth Sci Univ, Div Hematol & Med Oncol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Urol, Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. RP Tiffany, NM (reprint author), Oregon Hlth Sci Univ, Div Hematol & Med Oncol, Portland, OR 97201 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 0090-4295 J9 UROLOGY JI Urology PD JAN PY 2005 VL 65 IS 1 BP 212 EP 212 DI 10.1016/j.urology.2004.06.006 PG 1 WC Urology & Nephrology SC Urology & Nephrology GA 891AY UT WOS:000226554900047 ER PT J AU Musicant, SE Roullet, JB Edwards, JM Moneta, GL AF Musicant, Scott E. Roullet, Jean-Baptiste Edwards, James M. Moneta, Gregory L. BE White, RA Hollier, LH TI Physiology of vasospastic disorders SO VASCULAR SURGERY: BASIC SCIENCE AND CLINICAL CORRELATIONS, 2ND EDITION LA English DT Article; Book Chapter ID GENE-RELATED PEPTIDE; PRIMARY RAYNAUDS-PHENOMENON; HUMAN SAPHENOUS-VEIN; SERUM ENDOTHELIN-1 CONCENTRATIONS; COLD-INDUCED VASOCONSTRICTION; CORONARY ARTERIAL SPASM; HUMAN DIGITAL ARTERIES; SMOOTH-MUSCLE; ADRENERGIC-RECEPTORS; ALPHA-ADRENOCEPTORS C1 [Musicant, Scott E.; Roullet, Jean-Baptiste; Edwards, James M.; Moneta, Gregory L.] Oregon Hlth & Sci Univ, Div Vasc Surg, Portland, OR 97201 USA. [Edwards, James M.] Portland VA Med Ctr, Portland, OR USA. RP Musicant, SE (reprint author), Oregon Hlth & Sci Univ, Div Vasc Surg, Portland, OR 97201 USA. NR 145 TC 0 Z9 0 U1 0 U2 1 PU BLACKWELL SCIENCE PUBL PI OXFORD PA OSNEY MEAD, OXFORD OX2 0EL, ENGLAND BN 978-0-470-98709-4 PY 2005 BP 80 EP 91 DI 10.1002/9780470987094.ch7 D2 10.1002/9780470987094 PG 12 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA BYD13 UT WOS:000298080000008 ER PT S AU Filley, CM AF Filley, CM BE Ulmer, JL Parsons, L Moseley, M Gabrieli, J TI White matter and behavioral neurology SO WHITE MATTER IN COGNITIVE NEUROSCIENCE: ADVANCES IN DIFFUSION TENSOR IMAGING AND ITS APPLICATIONS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Workshop on White Matter in the Cognitive Neurosciences CY AUG 19-20, 2004 CL New York Acad Sci, New York, NY SP Gen Elect Hlth Care Syst, Mushett Family Fdn, Natl Inst Hlth, Natl Sci Fdn, New York Acad Sci, Siemens Med HO New York Acad Sci DE white matter; behavioral neurology; magnetic resonance imaging; dementia; diffusion tensor imaging ID MILD COGNITIVE IMPAIRMENT; CENTRAL-NERVOUS-SYSTEM; MULTIPLE-SCLEROSIS; DISEASE; DEMENTIA; EVOLUTION; BRAIN; MRI; LEUKOENCEPHALOPATHY; DYSFUNCTION AB Although the study of higher brain function has traditionally focused on the cortical gray matter, recent years have witnessed the recognition that white matter also makes an important contribution to cognition and emotion. White matter comprises nearly half the brain volume and plays a key role in development, aging, and many neurologic and psychiatric disorders across the life span. More than 100 disorders exist in which white matter neuropathology is the primary or a prominent feature. A variety of neurobehavioral syndromes may result from these disorders; the concept of white matter dementia has been introduced as characteristic of many patients with white matter involvement, and a wide range of focal neurobehavioral syndromes and psychiatric disorders can also be related to dysfunction of myelinated tracts. Understanding the neurobehavioral aspects of white matter disorders is important for clinical diagnosis, treatment, prognosis, and research on brain-behavior relationships. Central to these investigations is the use of modern neuroimaging techniques, which have already provided substantial information on the characterization of white matter and its disorders, and which promise to advance our knowledge further with continued innovation. Diffusion tensor imaging is an exciting method that will assist with the identification of critical white matter tracts in the brain, and the localization of specific lesions that can be correlated with neurobehavioral syndromes. A behavioral neurology of white matter is thus emerging in which clinical observation combined with sophisticated neuroimaging will enable elucidation of the role of white matter connectivity in the distributed neural networks subserving higher brain function. C1 Univ Colorado, Sch Med, Denver, CO 80202 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Filley, CM (reprint author), Univ Colorado, Hlth Sci Ctr, Behav Neurol Sect, 4200 E 9th Ave, Denver, CO 80262 USA. EM christopher.filley@uchsc.edu NR 67 TC 40 Z9 42 U1 2 U2 4 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-545-1 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2005 VL 1064 BP 162 EP + DI 10.1196/annals.1340.028 PG 23 WC Multidisciplinary Sciences; Clinical Neurology; Neurosciences; Neuroimaging SC Science & Technology - Other Topics; Neurosciences & Neurology GA BDU41 UT WOS:000235430200012 PM 16394155 ER PT J AU Hess, R Chang, CCJ Conigliaro, J McNeil, M AF Hess, R Chang, CCJ Conigliaro, J McNeil, M TI Understanding physicians' attitudes towards hormone therapy SO WOMENS HEALTH ISSUES LA English DT Article; Proceedings Paper CT 14th Annual Meeting of the North-American-Menopause-Society CY SEP 17-20, 2003 CL Miami Beach, FL SP N Amer Menopause Soc ID ESTROGEN-REPLACEMENT THERAPY; CORONARY-HEART-DISEASE; POSTMENOPAUSAL WOMEN; CARDIOVASCULAR-DISEASE; SECONDARY PREVENTION; PLUS PROGESTIN; BREAST-CANCER; TRIAL; RISK; HEALTH AB Objective: We sought to understand the relationship among components of residency education about hormone therapy (HT), knowledge about HT, and provider attitudes toward HT during a time of rapidly changing practice guidelines. Methods: We surveyed residents in the University of Pittsburgh Internal Medicine residency programs between February to April 2002 (after the release of the Heart Estrogen/Progestin Replacement Study and prior to the release of preliminary Women's Health Initiative data) regarding demographics, educational (didactic and experiential) exposures to HT and menopause management, knowledge about HT, and attitudes toward HT. Results: Sixty-nine of 92 (75%) eligible residents completed the survey; 38% were women. The race and gender of responders did not differ from nonresponders. Residents had significant didactic exposure to HT and menopause management with 80% reporting more than one didactic exposure. Despite this, HT knowledge was low (mean knowledge score 47 +/- 16%) and only 26% of residents felt prepared to counsel patients about HT. We identified four factors related to provider attitudes toward HT: "persistence" in universally recommending HT, confidence in "HT benefits," concern about "HT cardiac risks," and concern about "HT noncardiac risks." More appropriate attitudes were associated with attending a lecture, having a rotation with a discussion of menopause management (i.e., Women's Health), and a continuity practice including more than 30% women. Pharmaceutical detailing and self-directed study were associated with less appropriate attitudes. Knowledge did not influence attitudes. Strongly held beliefs about the benefits of HT, appropriate or inappropriate, were associated with increasing "persistence." Conclusions: In an area of rapidly changing information, such as the risks and benefits of HT, knowledge is low. Experiential learning appropriately influences attitudes, while pharmaceutical detailing was associated with inappropriate attitudes toward HT risks. C1 Univ Pittsburgh, Div Gen Internal Med, Pittsburgh, PA 15260 USA. VA Pittsburgh Hlth Care Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. RP Hess, R (reprint author), 230 McKee Pl,Suite 600, Pittsburgh, PA 15213 USA. EM hessr@umpc.edu NR 27 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 1049-3867 J9 WOMEN HEALTH ISS JI Womens Health Iss. PD JAN-FEB PY 2005 VL 15 IS 1 BP 31 EP 38 DI 10.1016/j.whi.2004.10.002 PG 8 WC Public, Environmental & Occupational Health; Women's Studies SC Public, Environmental & Occupational Health; Women's Studies GA 894HM UT WOS:000226781600005 PM 15661585 ER PT J AU Ran, QT Liang, HY Gu, MJ Qi, WB Walter, CA Roberts, LJ Herman, B Richardson, A Van Remmen, H AF Ran, QT Liang, HY Gu, MJ Qi, WB Walter, CA Roberts, LJ Herman, B Richardson, A Van Remmen, H TI Transgenic mice overexpressing glutathione peroxidase 4 are protected against oxidative stress-induced apoptosis SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID HYDROPEROXIDE GLUTATHIONE-PEROXIDASE; LIPID-PEROXIDATION; OXIDANT STRESS; CYTOCHROME-C; DAMAGE; CELLS; INJURY; GENE; DIQUAT; PHGPX AB Glutathione peroxidase 4 (Gpx4) is uniquely involved in the detoxification of oxidative damage to membrane lipids. Our previous studies showed that Gpx4 is essential for mouse survival and that Gpx4 deficiency makes cells vulnerable to oxidative injury. In the present study, we generated two lines of transgenic mice overexpressing Gpx4 (Tg(GPX4) mice) using a genomic clone containing the human GPX4 gene. Both lines of Tg(GPX4) mice, Tg5 and Tg6, had elevated levels of Gpx4 (mRNA and protein) in all tissues investigated, and overexpression of Gpx4 did not cause alterations in activities of glutathione peroxidase 1, catalase, Cu/Zn superoxide dismutase, and manganese superoxide dismutase. The human GPX4 transgene rescued the lethal phenotype of null mutation of the mouse Gpx4 gene, indicating that the transgene can replace the essential role of mouse Gpx4 in mouse development. Cell death induced by t-butylhydroperoxide and diquat was significantly less in murine embryonic fibroblasts from Tg(GPX4) mice compared with wild type mice. Liver damage and lipid peroxidation induced by diquat were reduced significantly in Tg(GPX4) mice. In addition, diquat-induced apoptosis was decreased in Tg(GPX4) mice, as evidenced by attenuated caspase-3 activation and reduced cytochrome c release from mitochondria. These data demonstrate that Gpx4 plays a role in vivo in the mechanism of apoptosis induced by oxidative stress that most likely occurs through oxidative damage to mitochondrial phospholipids such as cardiolipin. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Barshop Ctr Longev & Aging Studies, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, San Antonio Canc Inst, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. Vanderbilt Univ, Dept Pharmacol, Nashville, TN 37232 USA. Vanderbilt Univ, Dept Med, Nashville, TN 37232 USA. RP Van Remmen, H (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, GRECC 182, 7400 Merton Mintor Blvd, San Antonio, TX 78284 USA. EM vanremmen@uthscsa.edu RI Liang, Hanyu/A-1066-2010 FU NIA NIH HHS [1P30 AG 13319, K01 AG 22014, P01 AG 19316] NR 45 TC 122 Z9 126 U1 0 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 DEC 31 PY 2004 VL 279 IS 53 BP 55137 EP 55146 DI 10.1074/jbc.M410387200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 882TI UT WOS:000225960800020 PM 15496407 ER PT J AU McFalls, EO Ward, HB Moritz, TE Goldman, S Krupski, WC Littooy, F Pierpont, G Santilli, S Rapp, J Hattler, B Shunk, K Jaenicke, C Thottapurathu, L Ellis, N Reda, DJ Henderson, WG AF McFalls, EO Ward, HB Moritz, TE Goldman, S Krupski, WC Littooy, F Pierpont, G Santilli, S Rapp, J Hattler, B Shunk, K Jaenicke, C Thottapurathu, L Ellis, N Reda, DJ Henderson, WG TI Coronary-artery revascularization before elective major vascular surgery SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID NONCARDIAC SURGERY; BYPASS-SURGERY; CARDIAC RISK; MYOCARDIAL-INFARCTION; DISEASE; ANGIOPLASTY; GUIDELINE; MORTALITY; SURVIVAL; OUTCOMES AB BACKGROUND: The benefit of coronary-artery revascularization before elective major vascular surgery is unclear. METHODS: We randomly assigned patients at increased risk for perioperative cardiac complications and clinically significant coronary artery disease to undergo either revascularization or no revascularization before elective major vascular surgery. The primary end point was long-term mortality. RESULTS: Of 5859 patients scheduled for vascular operations at 18 Veterans Affairs medical centers, 510 (9 percent) were eligible for the study and were randomly assigned to either coronary-artery revascularization before surgery or no revascularization before surgery. The indications for a vascular operation were an expanding abdominal aortic aneurysm (33 percent) or arterial occlusive disease of the legs (67 percent). Among the patients assigned to preoperative coronary-artery revascularization, percutaneous coronary intervention was performed in 59 percent, and bypass surgery was performed in 41 percent. The median time from randomization to vascular surgery was 54 days in the revascularization group and 18 days in the group not undergoing revascularization (P<0.001). At 2.7 years after randomization, mortality in the revascularization group was 22 percent and in the no-revascularization group 23 percent (relative risk, 0.98; 95 percent confidence interval, 0.70 to 1.37; P=0.92). Within 30 days after the vascular operation, a postoperative myocardial infarction, defined by elevated troponin levels, occurred in 12 percent of the revascularization group and 14 percent of the no-revascularization group (P=0.37). CONCLUSIONS: Coronary-artery revascularization before elective vascular surgery does not significantly alter the long-term outcome. On the basis of these data, a strategy of coronary-artery revascularization before elective vascular surgery among patients with stable cardiac symptoms cannot be recommended. C1 Vet Adm Med Ctr, Div Cardiol, Minneapolis, MN 55417 USA. Univ Minnesota, Dept Med, Div Cardiol, Minneapolis, MN 55455 USA. Univ Minnesota, Dept Surg, Minneapolis, MN 55455 USA. Univ Minnesota, Div Cardiovasc & Thorac Surg, Minneapolis, MN 55455 USA. Vet Affairs Med Ctr, Cooperat Studies Program Coordinating Ctr, Hines, IL USA. Vet Affairs Med Ctr, Div Peripheral Vasc Surg, Hines, IL USA. So Arizona VA Hlth Care Syst, Tucson, AZ USA. Univ Arizona, Sarver Heart Ctr, Tucson, AZ USA. Denver VA Med Ctr, Denver, CO USA. Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Surg, San Francisco, CA 94143 USA. Univ Calif San Francisco, San Francisco VA Med Ctr, Div Cardiol, San Francisco, CA 94143 USA. Univ Colorado, Hlth Outcomes Program, Aurora, CO USA. Univ Colorado, Dept Prevent Med & Biometr, Denver, CO 80202 USA. RP McFalls, EO (reprint author), Vet Adm Med Ctr, Div Cardiol, 1 Vet Dr, Minneapolis, MN 55417 USA. EM mcfal001@tc.umn.edu NR 24 TC 567 Z9 593 U1 0 U2 9 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD DEC 30 PY 2004 VL 351 IS 27 BP 2795 EP 2804 DI 10.1056/NEJMoa041905 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 883IH UT WOS:000226004300004 PM 15625331 ER PT J AU Ritsher, JB Phelan, JC AF Ritsher, JB Phelan, JC TI Internalized stigma predicts erosion of morale among psychiatric outpatients SO PSYCHIATRY RESEARCH LA English DT Article; Proceedings Paper CT Biennial Congress of the World-Federation-for-Mental-Health CY FEB, 2003 CL Melbourne, AUSTRALIA SP World Federat Mental Hlth DE severe mental illness (SMI); mental disorders; stereotyping; social alienation; risk factors; depressive symptoms ID MENTAL-ILLNESS; PERCEIVED STIGMA; CONSEQUENCES; DISORDERS; REJECTION; PEOPLE; HEALTH AB Stigma in society causes harm to people with severe mental illness (SMI) and internalized stigma represents its psychological point of impact. We evaluated the extent of internalized stigma in a sample of outpatients with SMI, using the Internalized Stigma of Mental Illness (ISMI) scale, developed with consumer input. About a third of the sample reported high levels of internalized stigma. We tested whether internalized stigma predicted increased depressive symptoms and reduced self-esteem at 4-month follow-up, controlling for baseline levels. Depression was predicted by Alienation, Stereotype Endorsement, Social Withdrawal Scales and total ISMI score. Reduced self-esteem was predicted by Alienation. ISMI results were stronger than those for the widely used Devaluation-Discrimination Scale. The finding that alienation further reduces morale speaks to the difficulty of pulling oneself out of this type of vicious cycle without assistance. (C) 2004 Elsevier Ireland Ltd. All rights reserved. C1 Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, San Francisco, CA 94121 USA. Columbia Univ, Mailman Sch Publ Hlth, Dept Sociomed Sci, New York, NY 10032 USA. RP Ritsher, JB (reprint author), Univ Calif San Francisco, Dept Psychiat, 116A,4150 Clement St, San Francisco, CA 94121 USA. EM ritsher@itsa.ucsf.edu FU NIMH NIH HHS [K2MH65330] NR 27 TC 225 Z9 233 U1 4 U2 23 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 DEC 30 PY 2004 VL 129 IS 3 BP 257 EP 265 DI 10.1016/j.psychres.2004.08.003 PG 9 WC Psychiatry SC Psychiatry GA 897HA UT WOS:000226993400005 PM 15661319 ER PT J AU Chin, PS Branch, KR Becker, KJ AF Chin, PS Branch, KR Becker, KJ TI Myocardial infarction following brief convulsive seizures SO NEUROLOGY LA English DT Editorial Material ID REFRACTORY EPILEPSY C1 Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA. Univ Washington, Med Ctr, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Med Ctr, Dept Neurol Surg, Seattle, WA 98195 USA. Univ Washington, Med Ctr, Div Cardiol, Seattle, WA 98195 USA. Univ Calif Los Angeles, Dept Med, Robert Wood Johnson VA Clin Scholars Program, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Neurol, Robert Wood Johnson VA Clin Scholars Program, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Becker, KJ (reprint author), Univ Washington, Harborview Med Ctr, Box 359775,325 9th Ave, Seattle, WA 98104 USA. EM kjb@u.washington.edu NR 7 TC 24 Z9 24 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD DEC 28 PY 2004 VL 63 IS 12 BP 2453 EP 2454 PG 3 WC Clinical Neurology SC Neurosciences & Neurology GA 883KJ UT WOS:000226010000064 PM 15623737 ER PT J AU Yamanaka, M Shegogue, D Pei, HP Bu, SZ Bielawska, A Bielawski, J Pettus, B Hannun, YA Obeid, L Trojanowska, M AF Yamanaka, M Shegogue, D Pei, HP Bu, SZ Bielawska, A Bielawski, J Pettus, B Hannun, YA Obeid, L Trojanowska, M TI Sphingosine kinase 1 (SPHK1) is induced by transforming growth factor-beta and mediates TIMP-1 up-regulation SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID DERMAL FIBROBLASTS; GENE-EXPRESSION; TISSUE INHIBITOR; KINASE-ACTIVITY; ONCOSTATIN-M; PROTEIN; SPHINGOSINE-1-PHOSPHATE; ACTIVATION; INTERACTS; METALLOPROTEINASE-1 AB Transforming growth factor-beta(TGF-beta) signaling plays a pivotal role in extracellular matrix deposition by stimulating collagen production and other extracellular matrix proteins and by inhibiting matrix degradation. The present study was undertaken to define the role of sphingosine kinase (SphK) in TGF-beta signaling. TGF-beta markedly up-regulated SphK1 mRNA and protein amounts and caused a prolonged increase in SphK activity in dermal fibroblasts. Concomitantly, TGF-beta reduced sphingosine-1-phosphate phosphatase activity. Consistent with the changes in enzyme activity, corresponding changes in sphingolipid levels were observed such that sphingosine 1-phosphate (S1P) was increased (similar to2-fold), whereas sphingosine and ceramide were reduced after 24 h of TGF-beta treatment. Given the relatively early induction of SphK gene expression in response to TGF-beta, we examined whether SphK1 may be involved in the regulation of TGF-beta-inducible genes that exhibit compatible kinetics, e.g. tissue inhibitor of metalloproteinase-1 (TIMP-1). We demonstrate that decreasing SphK1 expression by small interfering RNA (siRNA) blocked TGF-beta-mediated up-regulation of TIMP-1 protein suggesting that up-regulation of SphK1 contributes to the induction of TIMP-1 in response to TGF-beta. The role of SphK1 as a positive regulator of TIMP-1 gene expression was further corroborated by using ectopically expressed SphK1 in the absence of TGF-beta. Adenovirally expressed SphK1 led to a 2-fold increase of endogenous S1P and to increased TIMP-1 mRNA and protein production. In addition, ectopic SphK1 and TGF-beta cooperated in TIMP-1 up-regulation. Mechanistically, experiments utilizing TIMP-1 promoter constructs demonstrated that the action of SphK1 on the TIMP-1 promoter is through the AP1-response element, consistent with the SphK1-mediated up-regulation of phospho-c-Jun levels, a key component of AP1. Together, these experiments demonstrate that SphK/S1P are important components of the TGF-beta signaling pathway involved in up-regulation of the TIMP-1 gene. C1 Med Univ S Carolina, Div Rheumatol & Immunol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Hosp, Div Gen Internal Med, Charleston, SC 29425 USA. RP Trojanowska, M (reprint author), Med Univ S Carolina, Div Rheumatol & Immunol, 96 Jonathan Lucas St,Ste 912, Charleston, SC 29425 USA. EM trojanme@musc.edu OI Trojanowska, Maria/0000-0001-9550-7178 FU NIA NIH HHS [AG16538]; NIAMS NIH HHS [P60 AR049459]; NIGMS NIH HHS [GM43825] NR 45 TC 76 Z9 81 U1 0 U2 4 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD DEC 24 PY 2004 VL 279 IS 52 BP 53994 EP 54001 DI 10.1074/jbc.M410144200 PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 880MJ UT WOS:000225793600014 PM 15485866 ER PT J AU Harper, GM Leff, B Thomas, PA AF Harper, GM Leff, B Thomas, PA TI Educational epidemiology SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. Johns Hopkins Univ, Baltimore, MD USA. RP Harper, GM (reprint author), Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. EM michael.harper3@med.va.gov NR 2 TC 1 Z9 1 U1 0 U2 1 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 DEC 22 PY 2004 VL 292 IS 24 BP 2970 EP 2970 DI 10.1001/jama.292.24.2970-a PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 881CV UT WOS:000225841900013 PM 15613652 ER PT J AU Lorberbaum, JP Kose, S Johnson, MR Arana, GW Sullivan, LK Hamner, MB Ballenger, JC Lydiard, BR Brodrick, PS Bohning, DE George, MS AF Lorberbaum, JP Kose, S Johnson, MR Arana, GW Sullivan, LK Hamner, MB Ballenger, JC Lydiard, BR Brodrick, PS Bohning, DE George, MS TI Neural correlates of speech anticipatory anxiety in generalized social phobia SO NEUROREPORT LA English DT Article DE anticipatory anxiety; anxiety; fear; fMRI; functional magnetic resonance imaging; public speaking; social anxiety; social anxiety disorder; social phobia ID CEREBRAL-BLOOD-FLOW; MEDIAL PREFRONTAL CORTEX; AMYGDALA ACTIVATION; PUBLIC SPEAKING; HUMANS; PAIN; FACES; PET AB Patients with generalized social phobia fear embarrassment in most social situations. Little is known about its functional neuroanatomy. We studied BOLD-fMRI brain activity while generalized social phobics and healthy controls anticipated making public speeches. With anticipation minus rest, 8 phobics compared to 6 controls showed greater subcortical, limbic, and lateral paralimbic activity (pons, striatum, amygdala/uncus/anterior parahippocampus, insula, temporal pole) - regions important in automatic emotional processing - and less cortical activity (dorsal anterior cingulate/prefrontal cortex) -regions important in cognitive processing. Phobics may become so anxious, they cannot think clearly or vice versa. C1 Med Univ S Carolina, Dept Psychiat, Charleston, SC 29425 USA. Med Univ S Carolina, Ctr Adv Imaging, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 29401 USA. RP Lorberbaum, JP (reprint author), Med Univ S Carolina, Dept Psychiat, Charleston, SC 29425 USA. EM lorberjp@musc.edu NR 25 TC 157 Z9 161 U1 1 U2 19 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0959-4965 J9 NEUROREPORT JI Neuroreport PD DEC 22 PY 2004 VL 15 IS 18 BP 2701 EP 2705 PG 5 WC Neurosciences SC Neurosciences & Neurology GA 886XQ UT WOS:000226266800003 PM 15597038 ER PT J AU Asch, SM McGlynn, EA Hogan, MM Hayward, RA Shekelle, P Rubenstein, L Keesey, J Adams, J Kerr, EA AF Asch, SM McGlynn, EA Hogan, MM Hayward, RA Shekelle, P Rubenstein, L Keesey, J Adams, J Kerr, EA TI Comparison of quality of care for patients in the Veterans Health Administration and patients in a national sample SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; STANDARDIZED PATIENTS; UNITED-STATES; SYSTEM; AFFAIRS; VA; MANAGEMENT; UNDERUSE; SURGERY; TOOL AB Background: The Veterans Health Administration (VITA) has introduced an integrated electronic medical record, performance measurement, and other system changes directed at improving care. Recent comparisons with other delivery systems have been limited to a small set of indicators. Objective: To compare the quality of VITA care with that of care in a national sample by using a comprehensive quality-of-care measure. Design: Cross-sectional comparison. Setting: 12 VITA health care systems and 12 communities. Patients: 596 VITA patients and 992 patients identified through random-digit dialing. All were men older than 35 years of age. Measurements: Between 1997 and 2000, quality was measured by using a chart-based quality instrument consisting of 348 indicators targeting 26 conditions. Results were adjusted for clustering, age, number of visits, and medical conditions. Results: Patients from the VITA scored significantly higher for adjusted overall quality (67% vs. 51%; difference, 16 percentage points [95% CI, 14 to 18 percentage points]), chronic disease care (72% vs. 59%; difference, 13 percentage points [CI, 10 to 17 percentage points]), and preventive care (64% vs. 44%; difference, 20 percentage points [CI, 12 to 28 percentage points]), but not for acute care. The VITA advantage was most prominent in processes targeted by VITA performance measurement (66% vs. 43%; difference, 23 percentage points [CI, 21 to 26 percentage points]) and least prominent in areas unrelated to VITA performance measurement (55% vs. 50%; difference, 5 percentage points [CI, 0 to 10 percentage points]). Limitations: Unmeasured residual differences in patient characteristics, a lower response rate in the national sample, and differences in documentation practices could have contributed to some of the observed differences. Conclusions: Patients from the VITA received higher-quality care according to a broad measure. Differences were greatest in areas where the VITA has established performance measures and actively monitors performance. C1 Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. RAND Hlth, Santa Monica, CA USA. Vet Affairs Ann Arbor Healthcare Syst, Ann Arbor, MI USA. Univ Michigan, Ann Arbor, MI 48109 USA. RP Asch, SM (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd,Mail Code 111G, Los Angeles, CA 90073 USA. EM Steven.Asch@med.va.gov FU AHRQ HHS [5U18HS09463-03] NR 42 TC 328 Z9 329 U1 2 U2 9 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 DEC 21 PY 2004 VL 141 IS 12 BP 938 EP 945 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 882EY UT WOS:000225923000005 PM 15611491 ER PT J AU Lindenfeld, J Miller, GG Shakar, SF Zolty, R Lowes, BD Wolfel, EE Mestroni, L Page, RL Kobashigawa, J AF Lindenfeld, J Miller, GG Shakar, SF Zolty, R Lowes, BD Wolfel, EE Mestroni, L Page, RL Kobashigawa, J TI Drug therapy in the heart transplant recipient - Part II: Immunosuppressive drugs SO CIRCULATION LA English DT Article DE transplantation; drugs; immune system; rejection ID MYCOPHENOLATE MOFETIL RS-61443; CARDIAC ALLOGRAFT-REJECTION; CYCLOSPORINE MICROEMULSION; RANDOMIZED MULTICENTER; RENAL-TRANSPLANTATION; RAPAMYCIN AY-22,989; CLINICAL-EXPERIENCE; COMBINATION THERAPY; TACROLIMUS FK506; LIVER-TRANSPLANT C1 Univ Colorado, Hlth Sci Ctr, Div Cardiol, Ctr Womens Hlth Res, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Clin Pharm, Denver, CO 80262 USA. Denver VA Med Ctr, Denver, CO USA. Vanderbilt Univ, Div Infect Dis, Nashville, TN USA. Univ Calif Los Angeles, Div Cardiol, Los Angeles, CA USA. RP Lindenfeld, J (reprint author), Univ Colorado, Hlth Sci Ctr, Div Cardiol, Ctr Womens Hlth Res, 4200 E 9th Ave,B-130, Denver, CO 80262 USA. EM joann.lindenfeld@UCHSC.edu OI Lowes, Brian/0000-0002-5919-2540; Mestroni, Luisa/0000-0003-1116-2286 NR 73 TC 80 Z9 82 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD DEC 21 PY 2004 VL 110 IS 25 BP 3858 EP 3865 DI 10.1161/01.CIR.0000150332.42276.69 PG 8 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 881CT UT WOS:000225841700018 PM 15611389 ER PT J AU Fan, HX Nicholls, J Chua, D Chan, KH Sham, J Lee, S Gulley, ML AF Fan, HX Nicholls, J Chua, D Chan, KH Sham, J Lee, S Gulley, ML TI Laboratory markers of tumor burden in nasopharyngeal carcinoma: A comparison of viral load and serologic tests for Epstein-Barr virus SO INTERNATIONAL JOURNAL OF CANCER LA English DT Article DE Epstein-Barr virus; viral load; serology; nasopharyngeal carcinoma; tumor marker ID BLOOD-PROCESSING PROTOCOLS; CIRCULATING EBV DNA; QUANTITATIVE-ANALYSIS; NPC PATIENTS; PLASMA; ANTIBODY; PROTEIN; QUANTIFICATION; DIAGNOSIS; INFECTION AB Epstein-Barr virus (EBV) is present within the tumor cells of most cases of nasopharyngeal carcinoma (NPC). Recent studies suggest that tumor burden is proportional to the level of EBV DNA in blood and that rapid blood testing can be used to guide therapeutic intervention. The relative utility of viral load vs. serology has been insufficiently studied. In our study, EBV viral load was measured by quantitative PCR using either real-time or end-point detection systems in serum samples from 124 NPC patients (93 pretreatment, 13 relapsed, 18 in remission) and 40 controls. Serologic titers against EBV early antigen were measured in the same serum samples. EBV DNA was detectable in 64 of 93 untreated NPC patients (69%; mean viral load 11,211 copies/ml), 11 of 13 relapsed NPC patients (85%; mean 53,039 copies/ml) and 0 of 18 remission patients. EBV DNA was detectable in only 1 of 40 non-NPC controls (3%). In 34 instances where paired plasma and serum samples were available for testing, both were effective sample types, and there was no significant difference between end-point and real-time methods for measuring viral load. Early antigen (EA) IgA and IgG titers were elevated in most NPC patients regardless of whether their disease was active or in remission. EBV viral load was more informative than was EA serology for distinguishing remission from relapsed disease. EBV DNA measurement appears to be a noninvasive way to monitor tumor burden after therapy. (C) 2004 Wiley-Liss, Inc. C1 Univ N Carolina, Dept Pathol, Chapel Hill, NC 27599 USA. Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China. South Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Gulley, ML (reprint author), Univ N Carolina, Dept Pathol, Brinkhous Bullitt Bldg, Chapel Hill, NC 27599 USA. EM margaret_gulley@med.unc.edu NR 47 TC 39 Z9 42 U1 1 U2 4 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0020-7136 J9 INT J CANCER JI Int. J. Cancer PD DEC 20 PY 2004 VL 112 IS 6 BP 1036 EP 1041 DI 10.1002/ijc.20520 PG 6 WC Oncology SC Oncology GA 870SJ UT WOS:000225077900017 PM 15386346 ER PT J AU Jackson, SL Boyko, EJ Scholes, D Abraham, L Gupta, K Fihn, SD AF Jackson, SL Boyko, EJ Scholes, D Abraham, L Gupta, K Fihn, SD TI Predictors of urinary tract infection after menopause: A prospective study SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; ESTROGEN PLUS PROGESTIN; HEALTH INITIATIVE MEMORY; POSTMENOPAUSAL WOMEN; RISK-FACTORS; DIABETES-MELLITUS; ASYMPTOMATIC BACTERIURIA; ESCHERICHIA-COLI; YOUNG-WOMEN; PREVALENCE AB PURPOSE: To describe the incidence of and risk factors for acute cystitis among nondiabetic and diabetic postmenopausal women. METHODS: We conducted a population-based, prospective cohort study of 1017 postmenopausal women, aged 55 to 75 years, who were enrolled in a health maintenance organization and followed for 2 years. A wide range of behavioral and physiologic exposures were assessed at baseline interview and follow-up clinic visits; the main outcome measure was microbiologically-confirmed acute symptomatic cystitis. Follow-up was 87% at 12 months and 81% at 24 months. RESULTS: During 1773 person-years of follow-up, 138 symptomatic urinary tract infections occurred (incidence, 0.07 per person-year). Independent predictors of infection included insulin-treated diabetes (hazard ratio [HR] = 3.4; 95% confidence interval [CI]: 1.7 to 7.0) and a lifetime history of Urinary tract infection (HR for six or more infections = 6.9; 95% CI: 3.5 to 13.6). Borderline associations included a history of vaginal estrogen cream use in the last month (HR = 1.3; 95% CI: 1.0 to 3.4), a history of kidney stories (HR = 1.9; 95% CI: 1.0 to 3.7), and asymptomatic bacteriuria at baseline (HR = 1.8, 95% CI: 0.9 to 3.5). Sexual activity, urinary incontinence, parity, postcoital urination, vaginal dryness, use of cranberry juice, vaginal bacterial flora, and postvoid residual bladder volume were not associated with incident acute cystitis after multivariable adjustment. CONCLUSION: Insulin-treated diabetes is a potentially modifiable risk factor for incident acute cystitis among postmenopausal women, whereas a lifetime history of urinary tract infection was the strongest predictor. Use of oral or vaginal estrogen was not protective, and a wide range of behavioral and physiologic factors was not associated with acute cystitis episodes in this generally healthy sample. (C) 2004 by Elsevier Inc. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98103 USA. NW Hlth Serv Res & Dev Program, Seattle, WA 98103 USA. Epidemiol Res & Informat Ctr, Seattle, WA 98103 USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. Yale Univ, Dept Med Infect Dis, West Haven, CT USA. RP Jackson, SL (reprint author), VA Puget Sound Hlth Care Syst, 1825 N 52nd St, Seattle, WA 98103 USA. EM sljack@u.washington.edu OI Boyko, Edward/0000-0002-3695-192X FU NIDDK NIH HHS [DK02660, DK43134] NR 32 TC 57 Z9 59 U1 1 U2 3 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 DEC 15 PY 2004 VL 117 IS 12 BP 903 EP 911 DI 10.1016/j.amjmed.2004.07.045 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 884SL UT WOS:000226106300002 PM 15629728 ER PT J AU Au, DH Bryson, CL Fan, VS Udris, EM Curtis, JR McDonell, MB Fihn, SD AF Au, DH Bryson, CL Fan, VS Udris, EM Curtis, JR McDonell, MB Fihn, SD TI Beta-blockers as single-agent therapy for hypertension and the risk of mortality among patients with chronic obstructive pulmonary disease SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; PHARMACY RECORDS; HEALTH; VALIDATION; VALIDITY; SMOKING; DECLINE; ASTHMA; TRIAL AB PURPOSE: To assess the association between the type of antihypertensive medication and all-cause mortality among patients with chronic obstructive pulmonary disease (COPD). METHODS: The cohort comprised 1.966 patients (mean [ +/- SD] age, 65.8 +/- 10.7 years) enrolled in general internal medicine clinics at seven Veterans Affairs medical centers between December 1996 and October 1999. Patients had a diagnosis of both COPD and hypertension and were receiving single-agent antihypertensive therapy. RESULTS: Compared with calcium channel blockers, beta-blockers were associated with a decrease in mortality from any cause after adjusting for propensity for having been prescribed a beta-blocker (hazard ratio = 0.57; 95% confidence interval: 0.33 to 0.89). The association was similar when beta-blockers were compared with all other antihypertensive medications and the decreased risk of mortality was apparent among patients with pre-existing cardiac disease. Restriction of analyses to long-acting calcium channel blockers or to patients who used beta-agonists did not affect the point estimates. Exposure to the remaining classes of antihypertensive agents was not associated with mortality. CONCLUSION: Beta-blockers may have beneficial effects in patients who have COPD, pre-existing cardiac disease, and hyper-tension. Beta-blockers may not be contraindicated among patients with COPD. (C) 2004 by Elsevier Inc. C1 VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, NW Ctr Excellence, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA USA. RP Au, DH (reprint author), VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, NW Ctr Excellence, 1660 S Columbian Way, Seattle, WA 98108 USA. EM dau@u.washington.edu NR 19 TC 33 Z9 36 U1 1 U2 3 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 DEC 15 PY 2004 VL 117 IS 12 BP 925 EP 931 DI 10.1016/j.amjmed.2004.07.043 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 884SL UT WOS:000226106300005 PM 15629731 ER PT J AU Yee, KWH Schittenhelm, M O'Farrell, AM Town, AR McGreevey, L Bainbridge, T Cherrington, JM Heinrich, MC AF Yee, KWH Schittenhelm, M O'Farrell, AM Town, AR McGreevey, L Bainbridge, T Cherrington, JM Heinrich, MC TI Synergistic effect of SU11248 with cytarabine or daunorubicin on FLT3 ITD-positive leukemic cells SO BLOOD LA English DT Article ID ACUTE MYELOID-LEUKEMIA; TYROSINE KINASE INHIBITOR; INTERNAL TANDEM DUPLICATION; CHRONIC MYELOGENOUS LEUKEMIA; ACUTE PROMYELOCYTIC LEUKEMIA; TRANS-RETINOIC ACID; IN-VITRO; BONE-MARROW; MYELOPROLIFERATIVE DISEASE; HEMATOLOGIC MALIGNANCIES AB Fetal liver tyrosine kinase 3 internal tandem duplication (FLT3 ITD) mutations are the most common molecular abnormality associated with adult acute myeloid leukemia (AML). To exploit this molecular target, a number of potent and specific FLT3 kinase inhibitors have been developed and are currently being tested in early phase clinical trials of patients with refractory AML. To explore the efficacy of combining a FLT3 inhibitor with standard AML chemotherapy drugs, we tested the effect of combining the FLT3 inhibitor SU11248 with cytarabine or daunorubicin on the proliferation and survival of cell lines expressing either mutant (FLT3 ITD or FLT3 D835V) or wild-type (WT) FLT3. SU11248 had additive-to-synergistic inhibitory effects on FLT3-dependent leukemic cell proliferation when combined with cytarabine or daunorubicin. The synergistic interaction of SU11248 and the traditional antileukemic agents was more pronounced for induction of apoptosis. SU11248 inhibited the proliferation of primary AML myeloblasts expressing mutant FLT3 ITD but not WT FLT3 protein. Combining SU11248 and cytarabine synergistically inhibited the proliferation of primary AML myeloblasts expressing FLT3 ITD but not WT FLT3 protein. These data suggest that the addition of potent FLT3 inhibitors such as SU11248 to AML chemotherapy regimens could result in improved treatment results. (C) 2004 by The American Society of Hematology. C1 Oregon Hlth Sci Univ, Inst Canc, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. Univ Tuebingen, Clin Internal Med, Dept Hematol Oncol Immunol & Rheumatol, Tubingen, Germany. SUGEN, Preclin Res & Exploratory Dev, San Francisco, CA USA. RP Heinrich, MC (reprint author), R&D-19 3710 SW US Vet Affairs Hosp Rd, Portland, OR 97201 USA. EM heinrich@ohsu.edu FU NCI NIH HHS [P30 CA69533] NR 51 TC 79 Z9 79 U1 0 U2 3 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 DEC 15 PY 2004 VL 104 IS 13 BP 4202 EP 4209 DI 10.1182/blood-2003-10-3381 PG 8 WC Hematology SC Hematology GA 877VC UT WOS:000225601000058 PM 15304385 ER PT J AU Polci, R Peng, AM Chen, PL Riley, DJ Chen, YM AF Polci, R Peng, AM Chen, PL Riley, DJ Chen, YM TI NIMA-related protein kinase 1 is involved early in the ionizing radiation-induced DNA damage response SO CANCER RESEARCH LA English DT Article ID POLYCYSTIC KIDNEY-DISEASE; EARLY PARTICIPANT; PROTEIN-KINASES; GENE; SEQUENCE; REGION; BRCA1; NEK1 AB Cellular functions of the NimA-related mammalian kinase Nek1 have not been demonstrated to date. Here we show that Nek1 is involved early in the DNA damage response induced by ionizing radiation (IR) and that Nek1 is important for cells to repair and recover from DNA damage. When primary or transformed cells are exposed to IR, Nek1 kinase activity is increased within 4 minutes, and Nek1 expression is up-regulated shortly thereafter and sustained for hours. At the same early time frame after IR that its kinase activity is highest, a portion of Nek1 redistributes in cells from cytoplasm to discrete nuclear foci at sites of DNA double-strand breaks. There it colocalizes with gamma-H2AX and NFBD1/MDC1, two key proteins involved very early in the response to IR-induced DNA double-strand breaks. Finally, Nek1-deficient fibroblasts are much more sensitive to the effects of IR-induced DNA damage than otherwise identical fibroblasts expressing Nek1. These results suggest that Nek1 may function as a kinase early in the DNA damage response pathway. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Mol Med, Inst Biotechnol, San Antonio, TX 78229 USA. Univ Roma La Sapienza, Dept Clin Sci, Div Nephrol, Policlin Umberto I, Rome, Italy. S Texas Vet Hlth Care Syst, Div Res, San Antonio, TX USA. RP Chen, YM (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, Mail Code 7882,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM cheny@uthscsa.edu FU NCI NIH HHS [R01-CA85605]; NIDDK NIH HHS [1P50-DK061597, R01-DK61626] NR 17 TC 29 Z9 29 U1 2 U2 3 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD DEC 15 PY 2004 VL 64 IS 24 BP 8800 EP 8803 DI 10.1158/0008-5472.CAN-04-2243 PG 4 WC Oncology SC Oncology GA 880SJ UT WOS:000225809200002 PM 15604234 ER PT J AU Freytes, CO Ratanatharathorn, V Taylor, C Abboud, C Chesser, N Restrepo, A Arango, J Odenheimer, D AF Freytes, CO Ratanatharathorn, V Taylor, C Abboud, C Chesser, N Restrepo, A Arango, J Odenheimer, D TI Phase I/II randomized trial evaluating the safety and clinical effects of repifermin administered to reduce mucositis in patients undergoing autologous hematopoietic stem cell transplantation SO CLINICAL CANCER RESEARCH LA English DT Article ID KERATINOCYTE GROWTH FACTOR-2; BONE-MARROW-TRANSPLANTATION; COMPLICATIONS; CHEMOTHERAPY; EFFICACY; KGF-2 AB Purpose: To evaluate the safety of repifermin (keratinocyte growth factor-2) administered before and after autologous hematopoietic stem cell transplantation (auto-HSCT). A preliminary analysis of the ability of keratinocyte growth factor-2 to prevent mucositis was also done. Experimental Design: Forty-two patients received intravenous repifermin (25 mug/kg or 50 mug/kg) or placebo for 3 days before their auto-HSCT conditioning regimen and for up to 10 days after auto-HSCT. Within each dose level, 14 patients were randomized to repifermin and 7 patients to placebo. Clinical evaluations of mucositis were scheduled before auto-HSCT conditioning regimen, on the day of transplant, and three times per week until mucositis resolved. Results: In general, the incidence of adverse events was similar for patients treated with repifermin and placebo. No clinically meaningful differences were noted among treatment groups for clinical laboratory variables. Treatment groups experienced similar time to engraftment. The frequency of Grade 2 to 4 mucositis was 100% for patients in the placebo group, 64% for patients in the 25 mug/kg group (P = 0.041 versus placebo), and 50% for patients in the 50 mug/kg group (P = 0.006 versus placebo). Results of other endpoints, including pain on swallowing and use of pain medication specifically for mucositis, suggested a better outcome for patients in the 50 mug/kg group compared with the placebo and 25 mug/kg groups. Conclusions: Repifermin was well tolerated. Repifermin given before and after auto-HSCT seems to be active in reducing mucositis, but a larger trial will be necessary to determine the efficacy of repifermin with this dose schedule. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. S Tex Vet Hlth Care Syst, San Antonio, TX USA. Univ Michigan, Ctr Canc, Ann Arbor, MI 48109 USA. Arizona Canc Ctr, Tucson, AZ USA. Univ Rochester, Med Ctr, Rochester, NY 14642 USA. Human Genome Sci, Rockville, MD USA. RP Freytes, CO (reprint author), Univ Texas, Hlth Sci Ctr, Mail Code 7880,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM freytes@uthscsa.edu NR 18 TC 39 Z9 42 U1 1 U2 1 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1078-0432 J9 CLIN CANCER RES JI Clin. Cancer Res. PD DEC 15 PY 2004 VL 10 IS 24 BP 8318 EP 8324 DI 10.1158/1078-0432.CCR-04-1118 PG 7 WC Oncology SC Oncology GA 882SE UT WOS:000225957800025 PM 15623608 ER PT J AU Connick, E Kane, MA White, IE Ryder, J Campbell, TB AF Connick, E Kane, MA White, IE Ryder, J Campbell, TB TI Immune reconstitution inflammatory syndrome associated with Kaposi sarcoma during potent antiretroviral therapy SO CLINICAL INFECTIOUS DISEASES LA English DT Editorial Material ID HERPESVIRUS; AIDS; INFECTION; GROWTH; CELLS AB Rapidly progressive Kaposi sarcoma (KS) lesions with lymphadenopathy and tissue swelling occurred in a patient during antiretroviral treatment, despite an increased CD4(+) lymphocyte count and decreased HIV-1 level and KS-associated herpesvirus replication, suggesting immune reconstitution inflammatory syndrome. Inflammation resolved coincident with decreases in the CD4(+) lymphocyte count during paclitaxel treatment, whereas KS cleared only after prolonged antiretroviral therapy and chemotherapy. C1 Univ Colorado, Hlth Sci Ctr, Div Infect Dis, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pathol, Denver, CO 80262 USA. Univ Colorado, Ctr Canc, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Med Oncol Sect, Denver, CO USA. RP Connick, E (reprint author), Univ Colorado, Hlth Sci Ctr, Div Infect Dis, Box B168,4200 E 9th Ave, Denver, CO 80262 USA. EM liz.connick@uchsc.edu FU NCI NIH HHS [CA79389]; NIAID NIH HHS [U01 AI 32770, AI054907] NR 12 TC 50 Z9 55 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD DEC 15 PY 2004 VL 39 IS 12 BP 1852 EP 1855 DI 10.1086/426078 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 904JJ UT WOS:000227492200019 PM 15578411 ER PT J AU Eron, JJ Bartlett, JA Santana, JL Bellos, NC Johnson, J Keller, A Kuritzkes, DR St Clair, MH Johnson, VA AF Eron, JJ Bartlett, JA Santana, JL Bellos, NC Johnson, J Keller, A Kuritzkes, DR St Clair, MH Johnson, VA TI Persistent antiretroviral activity of nucleoside analogues after prolonged zidovudine and lamivudine therapy as demonstrated by rapid loss of activity after discontinuation SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE antiretroviral therapy; lamivudine; zidovudine; resistance; discontinuation ID VIROLOGICAL FAILURE; VIREMIA; RESISTANCE; INFECTION; COHORT AB Antiretroviral (ARV) treatment decisions are difficult for HIV-1-infected patients on complex treatment regimens who have partial suppression of HIV-1 replication and limited treatment options. Information on the ARV activity of the components of a complex regimen would be useful. Sixteen subjects who had received prolonged therapy with zidovudine (ZDV) and lamivudine (3TC), with a median duration of 32.5 months, were discontinuing this dual-nucleoside regimen and volunteered to have plasma HIV-1 RNA levels monitored over the 2 weeks after discontinuation. All subjects experienced an increase in HIV-1 RNA after discontinuation, with a median increase of 0.54 log(10) copies/mL over 2 weeks (range: 0.31-1.71; P < 0.001). An inverse correlation existed between the decline in HIV-1 RNA levels over 2 to 3 years on nucleoside analogue therapy and the increase over the 10 to 14 days off therapy (Spearman r = -0.53; P = 0.036). Over the 2-week period, a subset of individuals who had genotype testing at multiple reverse transcriptase codons associated with ZDV and 3TC resistance had no changes in genotype off therapy. Nucleoside analogue reverse transcriptase inhibitors may have continued ARV activity despite long durations of partially suppressive therapy and the presence of resistant HIV-1. C1 Univ N Carolina, AIDS Clin Res Unit, Chapel Hill, NC USA. Duke Univ, Ctr AIDS Res, Durham, NC USA. Univ Puerto Rico, San Juan AIDS Project, San Juan, PR 00936 USA. SW Infect Dis Associates Dallas, Dallas, TX USA. GlaxoSmithKline, Infect Dis Med Dev Ctr, Res Triangle Pk, NC USA. Brigham & Womens Hosp, Sect Retroviral Therapeut, Boston, MA 02115 USA. Harvard Univ, Sch Med, Boston, MA 02115 USA. Univ Alabama, Sch Med, Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Univ Alabama, Sch Med, Div Infect Dis, Birmingham, AL USA. RP Eron, JJ (reprint author), Univ N Carolina, AIDS Clin Res Unit, 211A W Cameron Ave, Chapel Hill, NC USA. EM jeron@med.unc.edu FU NCRR NIH HHS [RR00046]; NIAID NIH HHS [AI50410, AI40876] NR 13 TC 30 Z9 30 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD DEC 15 PY 2004 VL 37 IS 5 BP 1581 EP 1583 DI 10.1097/00126334-200412150-00009 PG 3 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 881FY UT WOS:000225850000009 PM 15577413 ER PT J AU Maany, I AF Maany, I TI Antidepressants and the risk of suicidal behaviors SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Maany, I (reprint author), Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. EM Maany_I@mail.trc.upenn.edu NR 2 TC 1 Z9 1 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 DEC 15 PY 2004 VL 292 IS 23 BP 2833 EP 2833 DI 10.1001/jama.292.23.2833-b PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 879CR UT WOS:000225694500012 PM 15598909 ER PT J AU Houck, PR Mazuradar, S Koru-Sengul, T Tang, G Mulsant, BH Pollock, BG Reynolds, CF AF Houck, PR Mazuradar, S Koru-Sengul, T Tang, G Mulsant, BH Pollock, BG Reynolds, CF TI Estimating treatment effects from longitudinal clinical trial data with missing values: comparative analyses using different methods SO PSYCHIATRY RESEARCH LA English DT Article DE intent-to-treat; missing data; mixed model; multiple imputation; maximum likelihood; depression ID MULTIPLE IMPUTATION; PATIENT DATA; MODELS; DEPRESSION; PSYCHIATRY; PROTOCOL AB The selection of a method for estimating treatment effects in an intent-to-treat analysis from clinical trial data with missing values often depends on the field of practice. The last observation carried forward (LOCF) analysis assumes that the responses do not change after dropout. Such an assumption is often unrealistic. Analysis with completers only requires that missing values occur completely at random (MCAR). Ignorable maximum likelihood (IML) and multiple imputation (MI) methods require that data are missing at random (MAR). We applied these four methods to a randomized clinical trial comparing anti-depressant effects in an elderly depressed group of patients using a mixed model to describe the course of the treatment effects. Results from an explanatory approach showed a significant difference between the treatments using LOCF and IML methods. Statistical tests indicate violation of the MCAR assumption favoring the flexible IML and MI methods. IML and MI methods were repeated under the pragmatic approach, using data collected after termination of protocol treatment and compared with previously reported results using piecewise splines and rescue (treatment adjustment) pragmatic analysis. No significant treatment differences were found. We conclude that attention to the missing-data mechanism should be an integral part in analysis of clinical trial data. (C) 2004 Elsevier Ireland Ltd. All rights reserved. C1 UPMC, Hlth Syst, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Biostat, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Stat, Pittsburgh, PA 15260 USA. VA Pittsburgh Hlth Care Syst, Geriatr Res, Educ & Clin Ctr, Pittsburgh, PA 15213 USA. RP Houck, PR (reprint author), UPMC, Hlth Syst, Western Psychiat Inst & Clin, Dept Psychiat, Thomas Detre Hall,3811 O Hara St, Pittsburgh, PA 15213 USA. EM houckpr@upmc.edu FU NIMH NIH HHS [MH30915, MH52247] NR 34 TC 41 Z9 41 U1 0 U2 7 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 DEC 15 PY 2004 VL 129 IS 2 BP 209 EP 215 DI 10.1016/j.psychres.2004.08.001 PG 7 WC Psychiatry SC Psychiatry GA 887PY UT WOS:000226319200010 PM 15590048 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 Anterior cingulate dysfunction during choice anticipation in schizophrenia SO PSYCHIATRY RESEARCH-NEUROIMAGING LA English DT Article DE cognitive deficits; decision making; social functioning; foresight; fMRI; working memory ID POSITRON-EMISSION-TOMOGRAPHY; CEREBRAL-BLOOD-FLOW; EVENT-RELATED FMRI; STROOP TASK-PERFORMANCE; SPATIAL WORKING-MEMORY; PREFRONTAL CORTEX; RESPONSE CONFLICT; NEURAL CIRCUITRY; PARIETAL CORTEX; FRONTAL-CORTEX AB The anterior cingulate cortex (ACGC) participates in selective attention. working memory (WM)), anticipation, and behavioral monitoring. Subjects with schizophrenia exhibit deficits in these mechanisms during selective attention and WM tasks. However, ACGC dysfunctions have not been specifically investigated during behavioral anticipation. whose deficits may relate to salient schizophrenic features such as foresight abnormalities and impaired social functioning and behavior. We thus studied ACGC function in relation to two aspects of WM, remembering information and anticipating responses. in control and schizophrenic subjects. We measured brain activation in eight subjects with schizophrenia and eight healthy volunteers using functional magnetic resonance imaging. All subjects performed stimulus-response delay tasks with color dots or facial expression diagrams as cues and either 50% or 100% response predictability. which emphasized demands on remembering the cues or anticipating the response for correct performance, respectively. We found a double dissociation of ACGC activtion between subject groups and task type. In controls, the ACGC became intensely activated during response anticipation (more extensively and bilaterally when the cues were colors than when they were facial diagrams) but remained at restin.. activity levels during remembering. In schizophrenic patients, significant ACGC activation was seen only when remembering a percept (more extensively and bilaterally when it was a facial diagram than when it was a color) but not when anticipating a response. These results reveal an ACGC dysfunction during choice anticipation in schizophrenia and suggest that it might underlie the foresight deficits seen in schizophrenic patients. Published by Elsevier Ireland Ltd. C1 Univ Calif Los Angeles, Neuropsychiat Inst & Hosp, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Greater Los Angeles VA Hlth Care Syst, Los Angeles, CA 90073 USA. MIRECC, VA Mental Illness VISN22, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Radiol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Pharmacol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Brain Mapping Ctr, Los Angeles, CA 90095 USA. RP Quintana, J (reprint author), Univ Calif Los Angeles, Neuropsychiat Inst & Hosp, Dept Psychiat & Biobehav Sci, Room C8-222,760 Westwood Plaza, Los Angeles, CA 90024 USA. EM xquintan@ucla.edu FU NCRR NIH HHS [RR12169] NR 75 TC 25 Z9 26 U1 5 U2 6 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0925-4927 J9 PSYCHIAT RES-NEUROIM JI Psychiatry Res. Neuroimaging PD DEC 15 PY 2004 VL 132 IS 2 BP 117 EP 130 DI 10.1016/j.psychresns.2004.06.005 PG 14 WC Clinical Neurology; Neuroimaging; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 893WX UT WOS:000226752700003 PM 15598546 ER PT J AU Caetano, SC Hatch, JP Brambilla, P Sassi, RB Nicoletti, M Mallinger, AG Frank, E Kupfer, DJ Keshavan, MS Soares, JC AF Caetano, SC Hatch, JP Brambilla, P Sassi, RB Nicoletti, M Mallinger, AG Frank, E Kupfer, DJ Keshavan, MS Soares, JC TI Anatomical MRI study of hippocampus and amygdala in patients with current and remitted major depression SO PSYCHIATRY RESEARCH-NEUROIMAGING LA English DT Article DE depression; amygdala; hippocampus; superior temporal gyrus; temporal lobe; MRI; neuroimaging ID TEMPORAL-LOBE STRUCTURES; MOOD DISORDERS; BIPOLAR DISORDER; GERIATRIC DEPRESSION; VOLUME LOSS; ABNORMALITIES; UNIPOLAR; EPISODE; SCHIZOPHRENIA; ATROPHY AB Morphometric MRI studies suggest decreased hippocampal volumes in currently depressed patients. with conflicting findings for the amygdala. We studied these temporal lobe structures and superior temporal gyrus (STG) in patients with current and remitted major depression. We scanned 31 unmedicated depressed patients (21 currently depressed, 10 remitted) and 31 matched healthy controls with a 3D SPGR sequence in a 1.5 Tesla GE Signa Imaging System. There was a trend towards smaller left amygdala volumes in all depressed patients compared with healthy controls. We found significantly smaller hippocampal volumes bilaterally in currently depressed patients than in remitted patients. Furthermore. we found a statistically significant inverse correlation between length of illness and left hippocampus volumes and fight superior temporal gyrus volumes. Our finding of smaller hippocampi in currently depressed patients is consistent with the hypothesis that hypercortisolism could result in hippocampal neurotoxicity in major depression. A smaller hippocampal size may be more characteristic of the depressive state and not be present in remitted patients. (C) 2004 Elsevier Ireland Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, San Antonio, TX 78229 USA. Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15260 USA. Univ Sao Paulo, Sch Med, Inst Psychiat, Dept Psychiat, BR-05508 Sao Paulo, Brazil. Univ Udine, Sect Psychiat, Dept Pathol, I-33100 Udine, Italy. Univ Pittsburgh, Sch Med, Dept Pharmacol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Psychol, Pittsburgh, PA 15260 USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78284 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. EM soares@uthscsa.edu RI brambilla, paolo/B-4184-2010; Caetano, Sheila/H-5010-2012 OI brambilla, paolo/0000-0002-4021-8456; Caetano, Sheila/0000-0001-8403-7078 FU NIMH NIH HHS [MH 01736, MH 30915] NR 41 TC 128 Z9 136 U1 1 U2 13 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0925-4927 J9 PSYCHIAT RES-NEUROIM JI Psychiatry Res. Neuroimaging PD DEC 15 PY 2004 VL 132 IS 2 BP 141 EP 147 DI 10.1016/j.psychresns.2004.08.002 PG 7 WC Clinical Neurology; Neuroimaging; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 893WX UT WOS:000226752700005 PM 15598548 ER PT J AU Green, MF Nuechterlein, KH AF Green, MF Nuechterlein, KH TI The MATRICS initiative: developing a consensus cognitive battery for clinical trials SO SCHIZOPHRENIA RESEARCH LA English DT Editorial Material C1 Univ Calif Los Angeles, Inst Neuropsychiat, Dept Psychiat & Biobehav Sci, Geffen Sch Med, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA USA. RP Green, MF (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, Dept Psychiat & Biobehav Sci, Geffen Sch Med, 300 Med Plaza, Los Angeles, CA 90095 USA. EM mgreen@ucla.edu; keithn@ucla.edu NR 10 TC 134 Z9 144 U1 7 U2 14 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD DEC 15 PY 2004 VL 72 IS 1 BP 1 EP 3 DI 10.1016/j.schres.2004.09.006 PG 3 WC Psychiatry SC Psychiatry GA 886FI UT WOS:000226211900001 PM 15531401 ER PT J AU Marder, SR Fenton, W AF Marder, SR Fenton, W TI Measurement and Treatment Research to Improve Cognition in Schizophrenia: NIMH MATRICS initiative to support the development of agents for improving cognition in schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE functional outcome; functional capacity; cognition; schizophrenia ID NEUROCOGNITIVE DEFICITS AB The impairments in social and vocational outcome that are common in schizophrenia are strongly related to the severity of impaired neurocognition. This observation led to the initiation of The NIMH's Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative, which supports the development of pharmacological agents to improve cognition in schizophrenia. MATRICS addresses barriers to drug development through a number of activities, including the development of a consensus battery for measuring cognition in schizophrenia; the development of a consensus regarding the most promising molecular targets that should be the focus of drug development; the use of a joint meeting with representatives from the industry, academia, NIMH, and the U.S. Food and Drug Administration (FDA) to clarify guidelines for the design of clinical trials for cognition enhancing agents; and finally, to assist NIMH in developing its research agenda in this area. (C) 2004 Published by Elsevier B.V. C1 Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90073 USA. W Los Angeles VA Healthcare Ctr, MIRECC 210A, VISN 22, Mental Illness Res Educ & Clin Ctr, Los Angeles, CA 90073 USA. NIH, Bethesda, MD 20892 USA. RP Marder, SR (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM marder@ucla.edu NR 20 TC 203 Z9 214 U1 2 U2 11 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD DEC 15 PY 2004 VL 72 IS 1 BP 5 EP 9 DI 10.1016/j.schres.2004.09.010 PG 5 WC Psychiatry SC Psychiatry GA 886FI UT WOS:000226211900002 PM 15531402 ER PT J AU Kern, RS Green, MF Nuechterlein, KH Deng, BH AF Kern, RS Green, MF Nuechterlein, KH Deng, BH TI NIMH-MATRICS survey on assessment of neurocognition in schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE NIMH-MATRICS; neurocognition; schizophrenia AB The NIMH-Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative requires, among other things, the establishment of a reliable, valid, and consensus-derived method of assessing cognition. The derived battery will provide a standardized way to assess the effects of cognition-enhancing agents across clinical trials. To this end, the first of six consensus-oriented conferences was held April 2003. The goals were twofold: (a) To select which cognitive constructs to measure in a consensus battery, and (b) to select which criteria to use in evaluating tests for inclusion in the battery. Based on consultation with experts on the RAND Panel Method, 74 experts were invited to participate in a pre-meeting survey to provide information relevant to decisions on the cognitive battery. The survey included sections on reliability, validity, test administration, norms and interpretation of tests, cognitive domains and their integration, battery duration, and overall importance of test qualities. For selection of cognitive targets, the results showed that experts ranked executive functions, attention/vigilance, memory processes, and problem-solving ability highest. For test qualities, the experts ranked test-retest reliability, good coverage of key individual cognitive constructs, and comparable alternate forms highest. This article presents the results of the pre-conference survey that was the first step in the RAND process towards development of the NIMH-MATRICS consensus battery to assess cognition in schizophrenia. (C) 2004 Elsevier B.V. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, MIRECC 210A, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. RP Kern, RS (reprint author), VA Greater Los Angeles Healthcare Syst, MIRECC 210A, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM rkern@ucla.edu FU NIMH NIH HHS [MH22006] NR 10 TC 53 Z9 57 U1 10 U2 16 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD DEC 15 PY 2004 VL 72 IS 1 BP 11 EP 19 DI 10.1016/j.schres.2004.09.004 PG 9 WC Psychiatry SC Psychiatry GA 886FI UT WOS:000226211900003 PM 15531403 ER PT J AU Nuechterlein, KH Barch, DM Gold, JM Goldberg, TE Green, MF Heaton, RK AF Nuechterlein, KH Barch, DM Gold, JM Goldberg, TE Green, MF Heaton, RK TI Identification of separable cognitive factors in schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE cognition; schizophrenia; factor analysis; neuropsychology; psychopharmacology ID CONTINUOUS PERFORMANCE-TEST; WORKING-MEMORY IMPAIRMENTS; NEUROPSYCHOLOGICAL DEFICITS; SOCIAL COGNITION; INFORMATION; DYSFUNCTION; DISORDERS; ATTENTION; BATTERY; 1ST-EPISODE AB One of the primary goals in the NIMH initiative to encourage development of new interventions for cognitive deficits in schizophrenia, Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS), has been to develop a reliable and valid consensus cognitive battery for use in clinical trials. Absence of such a battery has hampered standardized evaluation of new treatments and, in the case of pharmacological agents, has been an obstacle to FDA approval of medications targeting cognitive deficits in schizophrenia. A fundamental step in developing such a battery was to identify the major separable cognitive impairments in schizophrenia. As part of this effort, we evaluated the empirical evidence for cognitive performance dimensions in schizophrenia, emphasizing factor analytic studies. We concluded that seven separable cognitive factors were replicable across studies and represent fundamental dimensions of cognitive deficit in schizophrenia: Speed of Processing, Attention/Vigilance, Working Memory, Verbal Learning and Memory, Visual Learning and Memory, Reasoning and Problem Solving, and Verbal Comprehension. An eighth domain, Social Cognition, was added due to recent increased interest in this area and other evidence of its relevance for clinical trials aiming to evaluate the impact of potential cognitive enhancers on cognitive performance and functional outcome. Verbal Comprehension was not considered appropriate for a cognitive battery intended to be sensitive to cognitive change, due to its resistance to change. The remaining seven domains were recommended for inclusion in the MATRICS-NIMH consensus cognitive battery and will serve as the basic structure for that battery. These separable cognitive dimensions also have broader relevance to future research aimed at understanding the nature and structure of core cognitive deficits in schizophrenia. (C) 2004 Elsevier B.V. All rights reserved. C1 Univ Calif Los Angeles, Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA USA. Washington Univ, Dept Psychol, St Louis, MO USA. Univ Maryland Baltimore Cty, Sch Med, Dept Psychiat, Maryland Psychiat Res Ctr, Baltimore, MD 21228 USA. NIMH, Intramural Program, Clin Brain Disorders Branch, Bethesda, MD 20892 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. RP Nuechterlein, KH (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, 300 Med Plaza,Rm 2251, Los Angeles, CA 90095 USA. EM keithn@ucla.edu RI Barch, Deanna/G-8638-2013 FU NIMH NIH HHS [MH22006, MH66286] NR 67 TC 595 Z9 614 U1 13 U2 77 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD DEC 15 PY 2004 VL 72 IS 1 BP 29 EP 39 DI 10.1016/j.schres.2004.09.007 PG 11 WC Psychiatry SC Psychiatry GA 886FI UT WOS:000226211900005 PM 15531405 ER PT J AU Green, MF Kern, RS Heaton, RK AF Green, MF Kern, RS Heaton, RK TI Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS SO SCHIZOPHRENIA RESEARCH LA English DT Article DE cognition; schizophrenia; MATRICS ID PERSISTENT MENTAL-ILLNESS; QUALITY-OF-LIFE; NEUROCOGNITIVE DEFICITS; FOLLOW-UP; NEUROPSYCHOLOGICAL IMPAIRMENT; SCHIZOAFFECTIVE DISORDER; SOCIAL-BEHAVIOR; 1ST EPISODE; SCALE; SYMPTOMS AB It is generally accepted that cognitive deficits in schizophrenia are related to functional outcome. However, support for longitudinal relationships between cognition and functional outcome has not been as well documented. The current paper presents a review of 18 recently published longitudinal studies (minimum 6-month follow up) of the relationships between cognition and community outcome in schizophrenia. Results from these studies reveal considerable support for longitudinal associations between cognition and community outcome in schizophrenia. These studies demonstrate that cognitive assessment predict later functional outcome and provide a rationale for psychopharmacological interventions for cognitive deficits in schizophrenia. Although the relationships between cognition and community outcome are well-supported, it is clear that community functioning is also affected by a host of factors apart from cognition that are usually not considered in clinical trial studies (e.g., psychosocial rehabilitation and educational/vocational opportunities). In the second part of the paper, we consider intervening steps between cognitive performance measures and community outcome. These steps are apt to have important implications for clinical trials of cognition-enhancing agents in schizophrenia. (C) 2004 Elsevier B.V. All rights reserved. C1 Univ Calif Los Angeles, Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. RP Green, MF (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, 300 Med Plaza,Rm 2263, Los Angeles, CA 90095 USA. EM mgreen@ucla.edu FU NIMH NIH HHS [MH22006] NR 48 TC 659 Z9 674 U1 2 U2 47 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD DEC 15 PY 2004 VL 72 IS 1 BP 41 EP 51 DI 10.1016/j.schres.2004.09.009 PG 11 WC Psychiatry SC Psychiatry GA 886FI UT WOS:000226211900006 PM 15531406 ER PT J AU Schnickel, GT Whiting, D Hsieh, GR Yun, JJ Fischbein, MP Fishbein, MC Yao, W Shfizadeh, A Ardehali, A AF Schnickel, GT Whiting, D Hsieh, GR Yun, JJ Fischbein, MP Fishbein, MC Yao, W Shfizadeh, A Ardehali, A TI CD8 lymphocytes are sufficient for the development of chronic rejection SO TRANSPLANTATION LA English DT Article DE transplantation; chronic rejection; CD8 lymphocyte ID CARDIAC ALLOGRAFT-REJECTION; PERFORIN-DEFICIENT MICE; NONOBESE DIABETIC MICE; T-CELL SUBSETS; IFN-GAMMA; IN-VIVO; FAS; ARTERIOSCLEROSIS; VASCULOPATHY; ACTIVATION AB Background. The role of CD8 lymphocytes, in chronic rejection or cardiac allograft vasculopathy (CAV), is incompletely understood. The purposes of this study were to determine whether CD8 lymphocytes, in the absence of CD4 lymphocytes, are capable of causing the intimal lesions of CAV; and if so, to define the effector mechanism(s) of CD8 lymphocytes. Methods. We modified a previously characterized major histocompatibility complex class II mismatched murine model of CAV. Wild-type CD8 lymphocytes were transferred to nude mice followed by heterotopic heart transplantation. Recipient mice were then treated with a CD40 activating antibody, which is known to provide help for CD8 lymphocyte activation, in the absence of CD4 lymphocytes. Donor hearts were harvested on day 40 posttransplantation and analyzed for cellular infiltrates and intimal thickening. In separate experiments, isolated perforin -/-, Fas ligand (FasL) -/-, and interferon (IFN)-gamma -/- CD8 lymphocytes were transferred to nude mice followed by identical experimented protocol. Results. With adaptive transfer of wild-type CD8 lymphocytes, the donor hearts were infiltrated with activated CD8 lymphocytes and displayed significant intimal lesions. Adoptive transfer of perforin -/- and FasL -/- CD8 lymphocytes to nude mice resulted in similar patterns of CD8 lymphocyte infiltration and similar severity of intimal lesions. The donor hearts from IFN-gamma -/- CD8 lymphocyte reconstituted recipients displayed minimal intimal lesions, although CD8 lymphocytes were present in the allografts. Conclusions. Unprimed CD8 lymphocytes in the absence of CD4 lymphocytes can cause intimal lesions of CAV. CD8 lymphocytes production of IFN-gamma, but not the perforin or the FasL-mediated cytotoxicity, is the critical step in the development of intimal lesions. C1 Univ Calif Los Angeles, Ctr Med, Div Cardiothorac Surg, David Geffen Sch Med,Dept Surg, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Dept Surg, Div Cardiac Surg, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA USA. RP Ardehali, A (reprint author), Univ Calif Los Angeles, Ctr Med, Div Cardiothorac Surg, David Geffen Sch Med,Dept Surg, 62-18c CHS,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM aardehali@mednet.ucla.edu OI Schnickel, Gabriel/0000-0003-4392-2200 NR 34 TC 15 Z9 18 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0041-1337 J9 TRANSPLANTATION JI Transplantation PD DEC 15 PY 2004 VL 78 IS 11 BP 1634 EP 1639 DI 10.1097/01.TP.0000141362.33931.40 PG 6 WC Immunology; Surgery; Transplantation SC Immunology; Surgery; Transplantation GA 879FQ UT WOS:000225702200010 PM 15591952 ER PT J AU Lindenfeld, JA Miller, GG Shakar, SF Zolty, R Lowes, BD Wolfel, EE Mestroni, L Page, RL Kobashigawa, J AF Lindenfeld, JA Miller, GG Shakar, SF Zolty, R Lowes, BD Wolfel, EE Mestroni, L Page, RL Kobashigawa, J TI Drug therapy in the heart transplant recipient - Part I: Cardiac rejection and immunosuppressive drugs SO CIRCULATION LA English DT Article DE transplantation; immune system; rejection ID RENAL-ALLOGRAFT RECIPIENTS; MONOCLONAL-ANTIBODY OKT3; ACUTE CELLULAR REJECTION; ANTITHYMOCYTE GLOBULIN; HUMORAL REJECTION; ORGAN-TRANSPLANTATION; INTERNATIONAL-SOCIETY; LUNG-TRANSPLANTATION; INDUCTION THERAPY; CONTROLLED TRIAL C1 Univ Colorado, Hlth Sci Ctr, Div Cardiol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Ctr Womens Hlth Res, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Clin Pharm, Denver, CO 80262 USA. Denver VA Med Ctr, Denver, CO USA. Vanderbilt Univ, Div Infect Dis, Nashville, TN USA. Univ Calif Los Angeles, Div Cardiol, Los Angeles, CA USA. RP Lindenfeld, JA (reprint author), Univ Colorado, Hlth Sci Ctr, Div Cardiol, 4200 E 9th Ave B-130, Denver, CO 80262 USA. EM joann.lindenfeld@UCHSC.edu OI Lowes, Brian/0000-0002-5919-2540; Mestroni, Luisa/0000-0003-1116-2286 NR 50 TC 65 Z9 67 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 DEC 14 PY 2004 VL 110 IS 24 BP 3734 EP 3740 DI 10.1161/01.CIR.0000149745.83186.89 PG 7 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 879HI UT WOS:000225706600019 PM 15596559 ER PT J AU Schilling, LM Kelly, DP Drake, AL Heilig, LF Hester, EJ Dellavalle, RP AF Schilling, LM Kelly, DP Drake, AL Heilig, LF Hester, EJ Dellavalle, RP TI Digital information archiving policies in high-impact medical and scientific periodicals SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Dermatol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Dermatol Serv, Denver, CO USA. RP Schilling, LM (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. EM lisa.schilling@uchsc.edu RI Dellavalle, Robert/L-2020-2013 OI Dellavalle, Robert/0000-0001-8132-088X FU NCI NIH HHS [K-07 CA92550-01A1]; NIAMS NIH HHS [T32 AR07411]; PHS HHS [5 D14HP00153] NR 5 TC 8 Z9 8 U1 1 U2 2 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 DEC 8 PY 2004 VL 292 IS 22 BP 2724 EP 2726 DI 10.1001/jama.292.22.2724 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 877CY UT WOS:000225546600020 PM 15585731 ER PT J AU Chen, RW Zhang, YQ Rose, ME Graham, SH AF Chen, RW Zhang, YQ Rose, ME Graham, SH TI Cyclooxygenase-2 activity contributes to neuronal expression of cyclin D1 after anoxia/ischemia in vitro and in vivo SO MOLECULAR BRAIN RESEARCH LA English DT Article DE ischemia; cyclooxygenase; cell cycle; cyclin d1 ID AMYOTROPHIC-LATERAL-SCLEROSIS; CELL-CYCLE; ALZHEIMERS-DISEASE; DEPENDENT KINASES; ANTIINFLAMMATORY DRUGS; CEREBRAL-ISCHEMIA; DEATH; APOPTOSIS; BRAIN; INHIBITORS AB Cyclooxygenase-2 (COX-2) activity has been implicated in the pathogenesis of neuronal cell death in ischemia and other diseases, but the mechanism by which COX-2 exacerbates cell death is unknown. COX-2 activity, is known to induce expression of cyclin D I in neoplastic cells, and cyclin D1 expression can induce cell death in postmitotic neurons. In the present study, the role of COX-2 and cyclin D1 in neuronal cell death induced by anoxia and ischemia was examined. Treatment with the COX-2 specific inhibitor (NS 398 25 muM) and cyclin D1 inhibitor (flavopiridol 1 muM) increased neuronal survival and inhibited DNA fragmentation after anoxia. NS-398 suppressed anoxia-induced expression of cyclin D1. Flavopiridol inhibited the anoxia-induced increased expression of cyclin D1, but had no effect on COX-2 expression. Treatment with the selective COX-2 inhibitor, SC58125, had no affect on COX-2 expression but partially suppressed cyclin D1 expression in the cortex following middle cerebral artery occlusion in vivo. These results show that COX-2 activity is required for cyclin D I expression after ischemia in vivo and anoxia in vitro. These data provide support for the hypothesis that cyclin D1 expression is an important mechanism by which COX-2 activity exacerbates ischemic neuronal death. (C) 2004 Elsevier B.V. All rights reserved. C1 VA Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr, Res Serv 151, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. RP Graham, SH (reprint author), VA Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr, Res Serv 151, Univ Dr C, Pittsburgh, PA 15240 USA. EM sgra@pitt.edu NR 42 TC 4 Z9 4 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0169-328X J9 MOL BRAIN RES JI Mol. Brain Res. PD DEC 6 PY 2004 VL 132 IS 1 BP 31 EP 37 DI 10.1016/j.molbrainres.2004.08.020 PG 7 WC Neurosciences SC Neurosciences & Neurology GA 876LX UT WOS:000225499500004 ER PT J AU Musher, DM Musher, BL AF Musher, DM Musher, BL TI Medical progress - Contagious acute gastrointestinal infections SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Review ID DAY-CARE-CENTERS; HEMOLYTIC-UREMIC-SYNDROME; ASTROVIRUS-ASSOCIATED GASTROENTERITIS; CAMPYLOBACTER-JEJUNI INFECTION; POLYMERASE CHAIN-REACTION; ESCHERICHIA-COLI 0157-H7; ROUND-STRUCTURED VIRUS; NORWALK-LIKE VIRUS; TYPHOID-FEVER; UNITED-STATES C1 Michael E DeBakey Vet Affairs Med Ctr, Infect Dis Sect, Med Serv, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol Virol & Microbiol, Houston, TX 77030 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. RP Musher, DM (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Infect Dis Sect, Med Serv, Houston, TX 77030 USA. EM daniel.musher@med.va.gov NR 132 TC 83 Z9 87 U1 1 U2 3 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD DEC 2 PY 2004 VL 351 IS 23 BP 2417 EP 2427 DI 10.1056/NEJMra041837 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 875OC UT WOS:000225429000011 PM 15575058 ER PT J AU Janssen, WJ Dhaliwal, G Collard, HR Saint, S AF Janssen, WJ Dhaliwal, G Collard, HR Saint, S TI Clinical problem-solving - Why "why'' matters SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID HEMOLYTIC-ANEMIA; GLUCOSE-6-PHOSPHATE-DEHYDROGENASE DEFICIENCY; INDUCED METHEMOGLOBINEMIA C1 Univ Colorado, Hlth Sci Ctr, Dept Med, Div Pulm Sci & Crit Care Med, Denver, CO 80262 USA. San Francisco Vet Affairs Med Ctr, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, Sch Med, San Francisco, CA USA. Ann Arbor Vet Affairs Med Ctr, Patient Safety Enhancement Program, Ann Arbor Vet Affairs Hlth Serv Res & Dev Ctr Exc, Ann Arbor, MI USA. Univ Michigan Hlth Syst, Dept Internal Med, Ann Arbor, MI USA. RP Janssen, WJ (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Med, Div Pulm Sci & Crit Care Med, 4200 E 9th Ave,Box C-272, Denver, CO 80262 USA. EM janssen@uchsc.edu FU AHRQ HHS [P20-HS11540] NR 15 TC 11 Z9 12 U1 0 U2 2 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD DEC 2 PY 2004 VL 351 IS 23 BP 2429 EP 2434 DI 10.1056/NEJMcps040669 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 875OC UT WOS:000225429000014 PM 15575060 ER PT J AU Yerevanian, BI Koek, RJ Feusner, JD Hwang, S Mintz, J AF Yerevanian, BI Koek, RJ Feusner, JD Hwang, S Mintz, J TI Antidepressants and suicidal behaviour in unipolar depression SO ACTA PSYCHIATRICA SCANDINAVICA LA English DT Article DE depressive disorder; dysthymic disorder; suicide; suicide, attempted; antidepressants; antidepressive agents, tricyclic; serotonin reuptake inhibitors ID AFFECTIVE-DISORDERS; PREVENTION; SWEDEN; RISK; FLUOXETINE; PAROXETINE; MORTALITY; EFFICACY; PLACEBO; LITHIUM AB Objective: To compare the rates of suicidal behaviour during vs. after discontinuation of treatment with antidepressants, and to determine the comparative rates of suicidal behaviour for patients maintained on tricyclic (TCA) vs. selective serotonin reuptake inhibitor (SSRI) antidepressants. Method: Charts were reviewed for 521 patients with major depressive disorder and/or dysthymic disorder. Periods of active treatment or discontinuation with SSRIs or TCAs were determined. Rates of completed suicide, suicide attempts, and hospitalization for suicidality were analyzed. Results: There was greater than a five-fold increase in risk for suicidal behaviour after discontinuation of antidepressant treatment (P < 0.0001). The rates of suicidal behavior during treatment with SSRIs or TCAs were similar. Conclusion: Suicidal behaviour in unipolar depressed patients treated with antidepressants increases substantially after medication discontinuation. This effect occurred in both patients who were maintained on SSRIs and TCAs. The findings support a possible protective effect on suicidal behaviour for both SSRIs and TCAs. C1 LA Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. W Los Angeles Vet Affairs Med Ctr, Biostat Consultat Unit, Los Angeles, CA 90073 USA. RP Yerevanian, BI (reprint author), 16111 Plummer St 116A, North Hills, CA 91343 USA. EM byerevan@ucla.edu RI Feusner, Jamie/K-2312-2012 OI Feusner, Jamie/0000-0002-0391-345X NR 33 TC 37 Z9 37 U1 1 U2 5 PU BLACKWELL MUNKSGAARD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 0001-690X J9 ACTA PSYCHIAT SCAND JI Acta Psychiatr. Scand. PD DEC PY 2004 VL 110 IS 6 BP 452 EP 458 DI 10.1111/j.1600-0447.2004.00437.x PG 7 WC Psychiatry SC Psychiatry GA 867TL UT WOS:000224865200008 PM 15521830 ER PT J AU Becker, HC Lopez, MF AF Becker, HC Lopez, MF TI Increased ethanol drinking after repeated chronic ethanol exposure and withdrawal experience in C57BL/6 mice SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE ethanol drinking; ethanol dependence; withdrawal sensitization; C57BL/6J mice ID LIMITED ACCESS PARADIGM; PREFERRING P RAT; ALCOHOL-WITHDRAWAL; ANIMAL-MODEL; REPEATED DEPRIVATIONS; CONSUMPTION; PREFERENCE; DEPENDENCE; SEIZURES; EPISODES AB Background: The development of dependence may have significant motivational consequences regarding continued use and abuse of ethanol. We have developed a mouse model of ethanol dependence and repeated withdrawals that demonstrates sensitization of seizures and other symptoms of withdrawal. It is unclear whether such experience influences ethanol drinking behavior. The present series of experiments were designed to examine whether repeated cycles of chronic ethanol exposure and withdrawal has an impact on subsequent motivation to voluntarily self-administer ethanol. Methods: With the use of a modified sucrose-fading procedure, adult male C57BL/6J mice were trained to drink 15% (v/v) ethanol in a limited access procedure (2 hr/day). The animals were not food or water deprived at any time during the experiments. Once stable baseline intake was established, mice were exposed to four cycles of 16 hr of ethanol vapor (or air) in inhalation chambers separated by 8-hr periods of withdrawal. At 32 hr after the last cycle of ethanol exposure, all mice were tested for ethanol intake under limited access conditions for 5 consecutive days. The animals then received a second series of chronic ethanol exposure and withdrawal followed by another 5-day test period for ethanol drinking. Results: Stable daily baseline intake was established in mice that drank 15% ethanol combined with 5% sucrose (experiment 1), 15% ethanol alone (experiment 2), 5% sucrose alone (experiment 3), or 15% ethanol when presented as a choice with water (experiment 4). After repeated cycles of chronic ethanol exposure and withdrawal experience, consumption of ethanol solutions increased over baseline levels and in comparison with control (air-exposed) groups. However, sucrose consumption did not change in mice that were trained to drink 5% sucrose. The increase in ethanol consumption after chronic ethanol exposure and withdrawal experience resulted in a significant increase in resultant blood ethanol levels. Conclusions: Once the positive reinforcing properties of ethanol were established, chronic ethanol exposure and withdrawal experience resulted in a significant increase in voluntary ethanol drinking that yielded a >2-fold increase in resultant blood ethanol levels. This increase in ethanol intake occurred whether ethanol was presented in combination with sucrose, alone (unadulterated), or as a choice with tap water. Furthermore, this effect seems to be selective for ethanol in that animals that were trained to drink a sucrose solution did not exhibit a change in their intake after similar chronic ethanol exposure. As such, this model may be useful in studying the mechanisms and conditions in which chronic ethanol treatment influences motivation to resume drinking after a period of abstinence (relapse). C1 Med Univ S Carolina, Dept Psychiat & Behav Sci, Ralph H Johnson VA Med Ctr, Chareston Alcohol Res Ctr,Ctr Drug & Alcohol Prog, Charleston, SC 29425 USA. RP Becker, HC (reprint author), Med Univ S Carolina, Dept Psychiat & Behav Sci, Ralph H Johnson VA Med Ctr, Chareston Alcohol Res Ctr,Ctr Drug & Alcohol Prog, IOP 456N,67 President St, Charleston, SC 29425 USA. EM beckerh@musc.edu FU NIAAA NIH HHS [AA013885, AA014095, P50-AA014095] NR 50 TC 161 Z9 162 U1 4 U2 9 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 DEC PY 2004 VL 28 IS 12 BP 1829 EP 1838 DI 10.1097/01.ALC.0000149977.95306.3A PG 10 WC Substance Abuse SC Substance Abuse GA 881KI UT WOS:000225866000007 PM 15608599 ER PT J AU Pisegna, J Holtmann, G Howden, CW Katelaris, PH Sharma, P Spechler, S Triadafilopoulos, G Tytgat, G AF Pisegna, J Holtmann, G Howden, CW Katelaris, PH Sharma, P Spechler, S Triadafilopoulos, G Tytgat, G TI Review article: oesophageal complications and consequences of persistent gastro-oesophageal reflux disease SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Review ID HELICOBACTER-PYLORI INFECTION; DUODENAL-ULCER DISEASE; GASTRIC-ACID SECRETION; BARRETTS-ESOPHAGUS; ATROPHIC GASTRITIS; CHANGING PATTERNS; TREATING PATIENTS; THERAPY; GERD; RISK AB The major oesophageal complications associated with persistent gastro-oesophageal reflux disease (GERD) include erosive oesophagitis, ulceration, strictures and gastrointestinal (GI) bleeding. Although the causes of these complications are uncertain, studies indicate that erosive oesophagitis may progress to the development of ulcers, strictures and GI bleeding. Pharmacological treatment with proton pump inhibitors is favoured over that with H-2-receptor antagonists for the treatment of strictures. The treatment of strictures is accomplished with dilation and many favour the concomitant use of proton pump inhibitors. Most gastroenterologists are seeing far fewer oesophageal strictures these days since the introduction of proton pump inhibitors. In addition, research has shown that oesophageal complications have a greater impact on patients suffering from night-time GERD than on those suffering from daytime GERD. Barrett's oesophagus is a significant complication associated with persistent GERD and those at risk generally experience a longer duration of symptoms, especially those with a high degree of severity. In addition, there is a strong relationship between Barrett's oesophagus and oesophageal adenocarcinoma. This is in part due to the association of obesity and the development of hiatal hernias. Furthermore, endoscopic screening is being used to detect Barrett's oesophagus and oesophageal adenocarcinoma in persons suffering from chronic GERD, even though screening may not have an impact on outcomes (Sharma P, McQuaid K, Dent J, et al. A critical review of the diagnosis and management of Barrett's esophagus: The AGA Chicago Workshop. Gastroenterology 2004; 127: 310-30.). C1 VA Greater Los Angeles Healthcare Syst, Div Gastroenterol & Hepatol, Los Angeles, CA 90073 USA. Royal Adelaide Hosp, Dept Gastroenterol Hepatol & Gen Med, Adelaide, SA 5000, Australia. Northwestern Univ, Feinberg Sch Med, Div Gastroenterol, Chicago, IL 60611 USA. Univ Sydney, Dept Gastroenterol, Concord Hosp, Sydney, NSW 2006, Australia. Univ Kansas, Sch Med, VA Med Ctr, Kansas City, MO USA. Univ Texas, SW Med Ctr, Div Gastroenterol, Dallas, TX USA. Stanford Univ, Med Ctr, Div Gastroenterol & Hepatol, Menlo Pk, CA USA. Univ Amsterdam, Acad Med Ctr, Dept Gastroenterol, NL-1105 AZ Amsterdam, Netherlands. RP VA Greater Los Angeles Healthcare Syst, Div Gastroenterol & Hepatol, 691-111C, Los Angeles, CA 90073 USA. EM jpisegna@ucla.edu NR 81 TC 24 Z9 27 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0269-2813 EI 1365-2036 J9 ALIMENT PHARM THER JI Aliment. Pharmacol. Ther. PD DEC PY 2004 VL 20 SU 9 BP 47 EP 56 DI 10.1111/j.1365-2036.2004.02240.x PG 10 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 868NU UT WOS:000224921100006 PM 15527464 ER PT J AU Baruch, L Glazer, RD Aknay, N Vanhaecke, J Heywood, JT Anand, I Phil, D Krum, H Hester, A Cohn, JN AF Baruch, L Glazer, RD Aknay, N Vanhaecke, J Heywood, JT Anand, I Phil, D Krum, H Hester, A Cohn, JN TI Morbidity, mortality, physiologic and functional parameters in elderly and non-elderly patients in the Valsartan Heart Failure Trial (Val-HeFT) SO AMERICAN HEART JOURNAL LA English DT Article ID ANGIOTENSIN-RECEPTOR BLOCKER; CONVERTING ENZYME-INHIBITORS; HOSPITALIZATION; HYPERTENSION; ALDOSTERONE; POPULATION; GUIDELINES; SURVIVAL AB Background The Valsartan Heart Failure Trial (Val-HeFT) demonstrated the favorable effects of the addition of valsartan to prescribed heart failure (HF) therapy on HF hospitalization, and functional and physiological parameters. As the prevalence of HF morbidity and mortality are increased in the elderly, the effect of valsartan in the elderly is oil clinical significance. Methods In this post-hoc analysis, morbidity, mortality, left ventricular (LV) size and function, brain natriuretic peptide (BNP), aldosterone, norepinephrine (NE), quality of life, and treatment effect with valsartan were examined by subgroups of 2350 elderly (greater than or equal to65 years) and 2660 non-elderly (<65 years) patients enrolled in Val-HeFT. Results while the overall incidence of morbidity and mortality was higher in the elderly, valsartan produced beneficial effects in reducing risk of morbidity in the elderly by 11.8% (P = .07), and the non-elderly by 14.6% (P = .09). Valsartan had no effect on mortality compared to placebo in the non-elderly, 15.2% vs 15.0% (P = .87), and elderly,, 25.1% vs 24.0%, (P = .64). Valsartan had statistically significant beneficial effects in both the elderly and non-elderly or, LV size and function, BNP, aldosterone and quality of life. Beneficial effects on NE were also observed with valsartan, in both subgroups with statistically significant reductions produced in the non-elderly. Conclusions Val-HeFT demonstrated that elderly patients present with more advanced HF as evidenced by higher morbidity and mortality along with greater neurohormonal activation. In Val-HeFT, valsartan produced G consistent beneficial effect on morbidity, LV function and size, quality of life, and neurohormonal levels in both the elderly and non-elderly. C1 Bronx Vet Adm Med Ctr, Bronx, NY 10468 USA. Novartis Pharmaceut Corp, E Hanover, NJ USA. UZ Gasthuisberg, Louvain, Belgium. Loma Linda Univ, Med Ctr, Loma Linda, CA USA. Vet Affairs Med Ctr, Minneapolis, MN USA. Monash Univ, Sch Med, Alfred Hosp, Melbourne, Vic 3004, Australia. Univ Minnesota, Minneapolis, MN USA. RP Baruch, L (reprint author), Bronx Vet Adm Med Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM baruchlarry@att.net NR 22 TC 14 Z9 22 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 DEC PY 2004 VL 148 IS 6 BP 951 EP 957 DI 10.1016/j.ahj.2004.06.001 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 882WF UT WOS:000225970400006 PM 15632877 ER PT J AU Wang, PL Meyer, MM Orloff, SL Anderson, S AF Wang, PL Meyer, MM Orloff, SL Anderson, S TI Bone resorption and "relative" immobilization hypercalcemia with prolonged continuous renal replacement therapy and citrate anticoagulation SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE continuous renal replacement therapy (CRRT); immobilization hypercalcemia; citrate; osteoporosis ID CRITICALLY ILL PATIENT; CALCIUM HOMEOSTASIS; ELDERLY-PATIENTS; HEMOFILTRATION; OSTEOPOROSIS; METABOLISM AB Regional citrate anticoagulation is an alternative to heparin in patients with bleeding diatheses who require continuous renal replacement therapy (CRRT). The short-term metabolic consequences that occur with citrate anticoagulation are well described and usually manageable if established protocols are followed vigilantly. Because of its customary short-term nature, the long-term consequences of CRRT with citrate are less often considered and have not been reported. The authors present the case of a woman with multisystem organ failure and prolonged acute renal failure who required CRRT for 120 days. Throughout her hospital course, adequate regional anticoagulation was achieved by blocking the coagulation cascade via the chelation of calcium by citrate. Despite an appropriate drop in the postfilter ionized calcium level, by 8 weeks after the initiation of CRRT, the patient was able to normalize serum calcium levels without the customary calcium infusion. Bone resorption owing to prolonged immobilization leading to hypercalcemia is a known complication of critically ill patients. This problem is more pronounced in patients with high bone turnover rates owing to conditions such as secondary hyperparathyroidism. In this particular case, the chelation of calcium by citrate masked the ensuing immobilization hypercalcemia, resulting in marked bone loss and bilateral spontaneous femoral fractures in the context of normal calcium levels. In critically ill patients sustained with prolonged CRRT with citrate anticoagulation, bone resorption and "relative" immobilization hypercalcemia may manifest as normal serum calcium levels in the face of failing calcium infusion rate requirements. Am J Kidney Dis 44:1110-1114. (C) 2004 by the National Kidney Foundation, Inc. C1 Oregon Hlth & Sci Univ, Div Nephrol & Hypertens, Dept Med, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Surg, Div Liver Pancreas Transplantat, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR USA. RP Anderson, S (reprint author), Oregon Hlth & Sci Univ, Div Nephrol & Hypertens PP262, 3314 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM anderssh@ohsu.edu NR 17 TC 7 Z9 10 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 DEC PY 2004 VL 44 IS 6 BP 1110 EP 1114 DI 10.1053/j.ajkd.2004.09.001 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 877SO UT WOS:000225590700019 PM 15558534 ER PT J AU Landefeld, CS AF Landefeld, CS TI Commercial support and bias in pharmaceutical research SO AMERICAN JOURNAL OF MEDICINE LA English DT Editorial Material ID CONFLICTS-OF-INTEREST; DRUG TRIALS; INDUSTRY; ASSOCIATION; PHYSICIANS; INTERESTS; COMPANIES; QUALITY; EVENTS C1 Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94118 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Landefeld, CS (reprint author), Univ Calif San Francisco, Div Geriatr, Box 1265,Suite 380,3333 Calif St, San Francisco, CA 94118 USA. NR 23 TC 5 Z9 5 U1 1 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 DEC 1 PY 2004 VL 117 IS 11 BP 876 EP 878 DI 10.1016/j.amjmed.2004.10.001 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 879GH UT WOS:000225703900013 PM 15589496 ER PT J AU Chang, E Barbosa, E Singh, I Singh, A Paintilia, M AF Chang, E Barbosa, E Singh, I Singh, A Paintilia, M TI The effects of treatment with N-acetylcysteine (NAC) in a rat model of preeclampsia SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Meeting Abstract CT 25th Annual Meeting of the Society-for-Maternal-Fetal-Medicine CY FEB 09-12, 2005 CL Reno, NV SP Soc Maternal Fetal Med C1 Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Neurol, Charleston, SC 29425 USA. Ralph Johnson VA Med Ctr, Dept Pathol & Lab Med, Charleston, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 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 DEC PY 2004 VL 191 IS 6 SU S MA 12 BP S6 EP S6 DI 10.1016/j.ajog.2004.09.047 PG 1 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 882FW UT WOS:000225925500014 ER PT J AU Polanczyk, MJ Jones, RE Subramanian, S Afentoulis, M Rich, C Zakroczymski, M Cooke, P Vandenbark, AA Offner, H AF Polanczyk, MJ Jones, RE Subramanian, S Afentoulis, M Rich, C Zakroczymski, M Cooke, P Vandenbark, AA Offner, H TI T lymphocytes do not directly mediate the protective effect of estrogen on experimental autoimmune encephalomyelitis SO AMERICAN JOURNAL OF PATHOLOGY LA English DT Article ID EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; MULTIPLE-SCLEROSIS; ANTIGEN PRESENTATION; LEUKOCYTE ADHESION; MICE; CELLS; EXPRESSION; RECEPTORS; PREGNANCY; INJURY AB Gender influences mediated by 17beta-estradiol (E2) have been associated with susceptibility to and severity of autoimmune diseases such as diabetes, arthritis, and multiple sclerosis. in this regard, we have shown that estrogen receptor-alpha (Esr1) is crucial for the protective effect of 17beta-estradiol (E2) in murine experimental autoimmune encephalitis (EAE), an animal model of multiple sclerosis. The expression of estrogen receptors among various immune cells (eg, T and B lymphocytes, antigen-presenting cells) suggests that the therapeutic effect of E2 is likely mediated directly through specific receptor binding. However, the target immune cell populations responsive to E2 treatment have not been identified. in the current study, we induced EAE in T-cell-deficient, severe combined immunodeficient mice or in immunocompetent mice with encephalitogenic T cells from wildtype Esr1 +/+ or Esr1 knockout (Esr1 -/-) donors and compared the protective E2 responses. The results showed that E2-responsive, Esr1] +/+ disease-inducing encephalitogenic T cells were neither necessary nor sufficient for E2-mediated protection from EAE. Instead, the therapeutic response appeared to be mediated through direct effects on nonlymphocytic, E2-responsive cells and down-regulation of the inflammatory response in the central nervous system. These results provide the first demonstration that the protective effect of E2 on EAE is not mediated directly through E2-responsive T cells and raise the alternative possibility that nonlymphocytic cells such as macrophages, dendritic cells, or other nonlymphocytic cells are primarily responsive to E2 treatment in EAE. C1 Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR 97201 USA. Univ Illinois, Urbana, IL 61801 USA. Agr Univ Warsaw, Fac Med Vet, Dept Food Hyg, Warsaw, Poland. RP Offner, H (reprint author), Portland VA Med Ctr, 3710 SW US Vet Hosp Rd,R&D-31, Portland, OR 97239 USA. EM offnverva@ohsu.edu FU NIEHS NIH HHS [R01 ES011590, ES11590]; NINDS NIH HHS [R01 NS045445, NS39122, R01 NS023221, NS23221, R01 NS023444, NS45445, NS23444, R01 NS039122] NR 36 TC 39 Z9 42 U1 0 U2 1 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3993 USA SN 0002-9440 J9 AM J PATHOL JI Am. J. Pathol. PD DEC PY 2004 VL 165 IS 6 BP 2069 EP 2077 DI 10.1016/S0002-9440(10)63257-9 PG 9 WC Pathology SC Pathology GA 874WL UT WOS:000225381100021 PM 15579449 ER PT J AU Wisse, BE Ogimoto, K Morton, GJ Wilkinson, CW Frayo, RS Cummings, DE Schwartz, MW AF Wisse, BE Ogimoto, K Morton, GJ Wilkinson, CW Frayo, RS Cummings, DE Schwartz, MW TI Physiological regulation of hypothalamic IL-1 beta gene expression by leptin and glucocorticoids: implications for energy homeostasis SO AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM LA English DT Article DE interleukin-1 beta; cytokine; corticosterone; food intake; appetite; obesity; anorexia ID CENTRAL-NERVOUS-SYSTEM; MESSENGER-RNA; FOOD-INTAKE; RAT-BRAIN; INTERLEUKIN-1-BETA; MECHANISMS; RECEPTORS; CORTICOSTERONE; ACTIVATION; CYTOKINES AB Interleukin-1beta (IL-1beta) is synthesized in a variety of tissues, including the hypothalamus, where it is implicated in the control of food intake. The current studies were undertaken to investigate whether hypothalamic IL-1beta gene expression is subject to physiological regulation by leptin and glucocorticoids (GCs), key hormones involved in energy homeostasis. Adrenalectomy (ADX) increased hypothalamic IL-1beta mRNA levels twofold, measured by real-time PCR (P < 0.05 vs. sham-operated controls), and this effect was blocked by subcutaneous infusion of a physiological dose of corticosterone. Conversely, hypothalamic IL-1β mRNA levels were reduced by 30% in fa/fa (Zucker) rats, a model of genetic obesity caused by leptin receptor mutation (P = 0.01 vs. lean littermates), and the effect of ADX to increase hypothalamic IL-1β mRNA levels in fa/fa rats (P = 0.02) is similar to that seen in normal animals. Moreover, fasting for 48 h (which lowers leptin and raises corticosterone levels) reduced hypothalamic IL-1β mRNA levels by 30% (P = 0.02), and this decrease was fully reversed by refeeding for 12 h. Thus leptin and GCs exert opposing effects on hypothalamic IL-1β gene expression, and corticosterone plays a physiological role to limit expression of this cytokine in both the presence and absence of intact leptin signaling. Consistent with this hypothesis, systemic leptin administration to normal rats (2 mg/kg ip) increased hypothalamic IL-1β mRNA levels twofold (P < 0.05 vs. vehicle), an effect similar to that of ADX. These data support a model in which expression of hypothalamic IL-1beta is subject to opposing physiological regulation by corticosterone and leptin. C1 Univ Washington, Harborview Med Ctr, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98104 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Seattle, WA 98108 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. RP Wisse, BE (reprint author), Univ Washington, Harborview Med Ctr, Dept Med, Div Metab Endocrinol & Nutr, 325 9th Ave,Box 359757, Seattle, WA 98104 USA. EM bewisse@u.washington.edu RI Schwartz, Michael/H-9950-2012 FU NIDDK NIH HHS [DK 12819, DK 52989, DK 61384, DK 61516, P30 DK 035816, P30 DK 17047]; NINDS NIH HHS [NS 32273] NR 30 TC 28 Z9 28 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1849 J9 AM J PHYSIOL-ENDOC M JI Am. J. Physiol.-Endocrinol. Metab. PD DEC PY 2004 VL 287 IS 6 BP E1107 EP E1113 DI 10.1152/ajpendo.00038.2004 PG 7 WC Endocrinology & Metabolism; Physiology SC Endocrinology & Metabolism; Physiology GA 867WP UT WOS:000224873800010 PM 15304373 ER PT J AU Fischer, L Gukovskaya, AS Young, SH Gukovsky, I Lugea, A Buechler, P Penninger, JM Friess, H Pandol, SJ AF Fischer, L Gukovskaya, AS Young, SH Gukovsky, I Lugea, A Buechler, P Penninger, JM Friess, H Pandol, SJ TI Phosphatidylinositol 3-kinase regulates Ca2+ signaling in pancreatic acinar cells through inhibition of sarco(endo)plasmic reticulum Ca2+-ATPase SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE pancreas; cholecystokinin; carbachol ID ADENINE-DINUCLEOTIDE PHOSPHATE; CASEIN KINASE-II; INOSITOL 1,4,5-TRISPHOSPHATE; CYTOSOLIC CALCIUM; HUMAN PLATELETS; MAST-CELLS; ACTIVATION; STORES; ENTRY; CHOLECYSTOKININ AB Calcium is a key mediator of hormone-induced enzyme secretion in pancreatic acinar cells. At the same time, abnormal Ca2+ responses are associated with pancreatitis. We have recently shown that inhibition of phosphatidylinositol 3-kinase (PI3-kinase) by LY-294002 and wortmannin, as well as genetic deletion of PI3-kinase-gamma, regulates Ca2+ responses and the Ca2+-sensitive trypsinogen activation in pancreatic acinar cells. The present study sought to determine the mechanisms of PI3-kinase involvement in Ca2+ responses induced in these cells by CCK and carbachol. The PI3-kinase inhibitors inhibited both Ca2+ influx and mobilization from intracellular stores induced by stimulation of acini with physiological and pathological concentrations of CCK, as well as with carbachol. PI3-kinase inhibition facilitated the decay of cytosolic free Ca2+ concentration ([Ca2+](i)) oscillations observed in individual acinar cells. The PI3-kinase inhibitors decreased neither CCK-induced inositol 1,4,5-trisphosphate [Ins(1,4,5) P-3] production nor Ins(1,4,5) P-3-induced Ca2+ mobilization, suggesting that the effect of PI3-kinase inhibition is not through Ins( 1,4,5) P3 or Ins( 1,4,5) P3 receptors. PI3-kinase inhibition did not affect Ca2+ mobilization induced by thapsigargin, a specific inhibitor of sarco(endo) plasmic reticulum Ca2+-ATPase (SERCA). Moreover, SERCA blockade with thapsigargin abolished the effects of pharmacological and genetic PI3-kinase inhibition on [Ca2+](i) signals, suggesting SERCA as a downstream target of PI3-kinase. Both pharmacological PI3-kinase inhibition and genetic deletion of PI3-kinase-gamma increased the amount of Ca2+ in intracellular stores during CCK stimulation. Finally, addition of the PI3-kinase product phosphatidylinositol 3,4,5-trisphosphate to permeabilized acini significantly attenuated Ca2+ reloading into the endoplasmic reticulum. The results indicate that PI3-kinase regulates Ca2+ signaling in pancreatic acinar cells through its inhibitory effect on SERCA. C1 Vet Affairs Greater Los Angeles Healthcare Syst, W Los Angeles Vet Affairs Healthcare Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90073 USA. Univ Heidelberg, Dept Surg, D-69120 Heidelberg, Germany. Austrian Acad Sci, Inst Mol Biotechnol, A-1030 Vienna, Austria. RP Gukovskaya, AS (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, W Los Angeles Vet Affairs Healthcare Ctr, 11301 Wilshire Blvd,Bldg 258,Rm 340, Los Angeles, CA 90073 USA. EM agukovsk@ucla.edu RI Penninger, Josef/I-6860-2013 OI Penninger, Josef/0000-0002-8194-3777 FU NIAAA NIH HHS [P50-AA-11999]; NIDDK NIH HHS [DK-59508, DK-59936] NR 58 TC 18 Z9 19 U1 0 U2 3 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD DEC PY 2004 VL 287 IS 6 BP G1200 EP G1212 DI 10.1152/ajpgi.00212.2004 PG 13 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 869MI UT WOS:000224987400013 PM 15271649 ER PT J AU Najib, A Lorberbaum, JP Kose, S Bohning, DE George, MS AF Najib, A Lorberbaum, JP Kose, S Bohning, DE George, MS TI Regional brain activity in women grieving a romantic relationship breakup SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article; Proceedings Paper CT 57th Annual Meeting of the Society-of-Biological-Psychiatry CY MAY 16-18, 2002 CL PHILADELPHIA, PA SP Soc Biol Psychiat ID CEREBRAL-BLOOD-FLOW; CHILDHOOD SEXUAL-ABUSE; FUNCTIONAL NEUROANATOMY; MOOD DISORDERS; MAJOR DEPRESSION; PANIC DISORDER; HUMAN AMYGDALA; ANXIETY; SADNESS; FMRI AB Objective: Separation from loved ones commonly leads to grief reactions. In some individuals, grief can evolve into a major depressive episode. The brain regions involved in grief have not been specifically studied. The authors studied brain activity in women actively grieving a recent romantic relationship breakup. It was hypothesized that while remembering their ex-partner, subjects would have altered brain activity in regions identified in sadness imaging studies: the cerebellum, anterior temporal cortex, insula, anterior cingulate, and prefrontal cortex. Method: Nine right-handed women whose romantic relationship ended within the preceding 4 months were studied. Subjects were scanned using blood-oxygen-level-dependent functional magnetic resonance imaging while they alternated between recalling a sad, ruminative thought about their loved one (grief state) and a neutral thought about a different person they knew an equally long time. Results: Acute grief (grief minus neutral state) was associated with increased group activity in posterior brain regions, including the cerebellum, posterior brainstem, and posterior temporoparietal and occipital brain regions. Decreased activity was more prominent anteriorly and on the left and included the anterior brainstem, thalamus, striatum, temporal cortex, insula, and dorsal and ventral anterior cingulate/prefrontal cortex. When a more lenient statistical threshold for regions of interest was used, additional increases were found in the lateral temporal cortex, supragenual anterior cingulate/medial prefrontal cortex, and right inferomedial dorsolateral prefrontal cortex, all of which were adjacent to spatially more prominent decreases. in nearly all brain regions showing brain activity decreases with acute grief, activity decreases were greater in women reporting higher grief levels over the past 2 weeks. Conclusions: During acute grief, subjects showed brain activity changes in the cerebellum, anterior temporal cortex, insula, anterior cingulate, and prefrontal cortex, consistent with the hypothesis. Subjects with greater baseline grief showed greater decreases in all these regions except for the cerebellum. Further imaging studies are needed to understand the relationship between normal sadness, grief, and depression. C1 Med Univ S Carolina, Dept Psychiat, Charleston, SC 29425 USA. Med Univ S Carolina, Ctr Adv Imaging Res, Charleston, SC 29425 USA. Univ Tubingen, Med Ctr, Tubingen, Germany. Ralph H Johnson VA Med Ctr, Mental Hlth Serv, Charleston, SC USA. RP Najib, A (reprint author), Krokusweg 21, D-72622 Nurtingen, Germany. EM arif.najib@web.de; lorberjp@musc.edu NR 56 TC 56 Z9 60 U1 7 U2 22 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD DEC PY 2004 VL 161 IS 12 BP 2245 EP 2256 DI 10.1176/appi.ajp.161.12.2245 PG 12 WC Psychiatry SC Psychiatry GA 876NJ UT WOS:000225503500016 PM 15569896 ER PT J AU Thomas, SB Fine, MJ Ibrahim, SA AF Thomas, SB Fine, MJ Ibrahim, SA TI Health disparities: The importance of culture and health communication SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Editorial Material C1 Univ Pittsburgh, Grad Sch Publ Hlth, Ctr Minor Hlth, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, VA Ctr Hlth Equit Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Dept Med, Pittsburgh, PA USA. RP Thomas, SB (reprint author), Univ Pittsburgh, Grad Sch Publ Hlth, Ctr Minor Hlth, Pittsburgh, PA 15260 USA. NR 0 TC 52 Z9 54 U1 0 U2 1 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 DEC PY 2004 VL 94 IS 12 BP 2050 EP 2050 DI 10.2105/AJPH.94.12.2050 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 877IF UT WOS:000225560800006 PM 15612166 ER PT J AU Casas-Zamora, JA Ibrahim, SA AF Casas-Zamora, JA Ibrahim, SA TI Confronting health inequity: The global dimension SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Editorial Material ID EQUITY C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. World Hlth Org, European Union, Brussels, Belgium. RP Ibrahim, SA (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C,11-E,130 A-U, Pittsburgh, PA 15240 USA. EM said.ibrahim2@med.va.gov NR 37 TC 12 Z9 12 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 DEC PY 2004 VL 94 IS 12 BP 2055 EP 2058 DI 10.2105/AJPH.94.12.2055 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 877IF UT WOS:000225560800009 PM 15569950 ER PT J AU Kressin, NR Chang, BH Whittle, J Peterson, ED Clark, JA Rosen, AK Orner, M Collins, TC Alley, LG Petersen, LA AF Kressin, NR Chang, BH Whittle, J Peterson, ED Clark, JA Rosen, AK Orner, M Collins, TC Alley, LG Petersen, LA TI Racial differences in cardiac catheterization as a function of patients' beliefs SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID CORONARY-REVASCULARIZATION PROCEDURES; INVASIVE CARDIOVASCULAR PROCEDURES; HEALTH-CARE UTILIZATION; MEDICAL-CARE; ETHNIC-DIFFERENCES; VETERANS; ACCESS; ANGIOGRAPHY; RACE/ETHNICITY; ASSOCIATION AB Objectives. We examined racial differences in cardiac catheterization rates and reviewed whether patients' beliefs or other variables were associated with observed disparities. Methods. We did a prospective observational cohort study of 1045 White and African American patients at 5 Veterans Affairs (VA) medical centers whose nuclear imaging studies indicated reversible cardiac ischemia. Results. There were few demographic differences between White and African American patients in our sample. African Americans were less likely than Whites to undergo cardiac catheterization. African Americans were more likely than Whites to indicate a strong reliance on religion and to report racial and social class discrimination and were less likely to indicate a generalized trust in people but did not differ from White patients on numerous other attitudes about health and health care. Neither sociodemographic or clinical characteristics nor patients' beliefs explained the observed disparities, but physicians' assessments of the procedure's importance and patients' likelihood of coronary disease seemed to account for differences not otherwise explained. Conclusions. Patients' preferences are not the likely source of racial disparities in the use of cardiac catheterization among veterans using VA care, but physicians' assessments warrant further attention. C1 VA Med Ctr, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA 01730 USA. Boston Univ, Sch Publ Hlth, Dept Hlth Serv, Boston, MA 02215 USA. Univ Kansas, Med Ctr, Div Gen & Geriatr Med, Kansas City, KS 66103 USA. Kansas City Vet Affairs Med Ctr, Kansas City, MO USA. Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA. Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Baylor Coll Med, Dept Med, Div Hlth Serv Res, Houston, TX 77030 USA. Atlanta Vet Affairs Med Ctr, Rehabil R&D Ctr, Atlanta, GA USA. Emory Univ, Nell Hodgson Woodruff Sch Nursing, Atlanta, GA 30322 USA. RP Kressin, NR (reprint author), VA Med Ctr, Ctr Hlth Qual Outcomes & Econ Res, 200 Springs Rd,Bldg 70 152, Bedford, MA 01730 USA. EM nkressin@bu.edu NR 35 TC 47 Z9 47 U1 2 U2 4 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 DEC PY 2004 VL 94 IS 12 BP 2091 EP 2097 DI 10.2105/AJPH.94.12.2091 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 877IF UT WOS:000225560800018 PM 15569959 ER PT J AU Woodard, LD Kressin, NR Petersen, LA AF Woodard, LD Kressin, NR Petersen, LA TI Is lipid-lowering therapy underused by African Americans at high risk of coronary heart disease within the VA health care system? SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; OF-VETERANS-AFFAIRS; INVASIVE CARDIOVASCULAR PROCEDURES; NUTRITION EXAMINATION SURVEY; SERUM-CHOLESTEROL; ARTERY-DISEASE; BLOOD-PRESSURE; SECONDARY PREVENTION; RACIAL-DIFFERENCES; NATIONAL-HEALTH AB Objectives. We examined whether racial differences exist in cholesterol monitoring, use of lipid-lowering agents, and achievement of guideline-recommended low-density lipoprotein (LDL) levels for secondary prevention of coronary heart disease. Methods. We reviewed charts for 1045 African American and White patients with coronary heart disease at 5 Veterans Affairs (VA) hospitals. Results. Lipid levels were obtained in 67.0% of patients. Whites and African Americans had similar screening rates and mean lipid levels. Among the 544 ideal candidates for therapy, rates of treatment and achievement of target LDL levels were similar. Conclusions. We found no disparities in cholesterol management. This absence of disparities may be the result of VA quality improvement initiatives or prescription coverage through the VA health care system. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat, Houston, TX USA. Baylor Coll Med, Dept Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Bedford Vet Affairs Med Ctr, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. Boston Univ, Sch Publ Hlth, Dept Hlth Serv, Boston, MA 02215 USA. RP Woodard, LD (reprint author), Houston Vet Affairs Med Ctr, Hlth Serv Res & Dev 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM lwoodard@bcm.tmc.edu FU BHP HRSA HHS [1 T32 PE 10031-01] NR 44 TC 6 Z9 6 U1 0 U2 1 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 DEC PY 2004 VL 94 IS 12 BP 2112 EP 2117 DI 10.2105/AJPH.94.12.2112 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 877IF UT WOS:000225560800021 PM 15569962 ER PT J AU Mustillo, S Krieger, N Gunderson, EP Sidney, S McCreath, H Kiefe, CI AF Mustillo, S Krieger, N Gunderson, EP Sidney, S McCreath, H Kiefe, CI TI Self-reported experiences of racial discrimination and black-white differences in preterm and low-birthweight deliveries: The CARDIA study SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID BODY-MASS INDEX; BACTERIAL VAGINOSIS; BLOOD-PRESSURE; RISK-FACTORS; PREGNANCY; WOMEN; HEALTH; VALIDITY; STRESS; GAIN AB Objectives. We examined the effects of self-reported experiences of racial discrimination on Black-White differences in preterm (less than 37 weeks gestation) and low-birthweight (less than 2500 g) deliveries. Methods. Using logistic regression models, we analyzed data on 352 births among women enrolled in the Coronary Artery Risk Development in Young Adults Study. Results. Among Black women, 50% of those with preterm deliveries and 61% of those with low-birthweight infants reported having experienced racial discrimination in at least 3 situations; among White women, the corresponding percentages were 5% and 0%. The unadjusted odds ratio for preterm delivery among Black versus White women was 2.54 (95% confidence interval [Cl] = 1.33, 4.85), but this value decreased to 1.88 (95% Cl = 0.85, 4.12) after adjustment for experiences of racial discrimination and to 1.11 (95% Cl = 0.51, 2.41) after additional adjustment for alcohol and tobacco use, depression, education, and income. The corresponding odds ratios for low birthweight were 4.24 (95% Cl = 1.31, 13.67), 2.11 (95% Cl = 0.75, 5.93), and 2.43 (95% Cl = 0.79, 7.42). Conclusions. Self-reported experiences of racial discrimination were associated with preterm and low-birthweight deliveries, and such experiences may contribute to Black-White disparities in perinatal outcomes. C1 Duke Univ, Sch Med, Dept Psychiat & Behav Sci, Durham, NC 27710 USA. Harvard Univ, Sch Publ Hlth, Dept Soc Human Dev & Hlth, Boston, MA 02115 USA. Kaiser Permanente, Med Care Program, Div Res, Oakland, CA USA. Univ Alabama Birmingham, Div Prevent Med, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Duke Univ, Sch Med, Dept Psychiat & Behav Sci, Box 3454, Durham, NC 27710 USA. EM smustillo@psych.duhs.duke.edu FU NHLBI NIH HHS [N01 HC-95095, N01 HC048050, N01-HC-48047, N01-HC-48048, N01-HC-48049, N01-HC-48050, N01HC48047, N01HC48048, N01HC48049, N01HC48050, N01HC95095]; NIDDK NIH HHS [K01 DK059944, K01 DK059944-03] NR 52 TC 157 Z9 158 U1 3 U2 12 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 800 I STREET, NW, WASHINGTON, DC 20001-3710 USA SN 0090-0036 EI 1541-0048 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD DEC PY 2004 VL 94 IS 12 BP 2125 EP 2131 DI 10.2105/AJPH.94.12.2125 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 877IF UT WOS:000225560800023 PM 15569964 ER PT J AU Lin, PH Bush, RL Yao, QZ Lam, R Paladugu, R Zhou, W Chen, CY Lumsden, AB AF Lin, PH Bush, RL Yao, QZ Lam, R Paladugu, R Zhou, W Chen, CY Lumsden, AB TI Abdominal aortic surgery in patients with human immunodeficiency virus infection SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 56th Annual Meeting of the Southwestern Surgical Congress CY APR 18-21, 2004 CL Monterey, CA DE human immunodeficiency virus; aortic bypass; aortoiliac occlusive disease; abdominal aortic aneurysm; complications ID QUALITY-OF-LIFE; HIV-INFECTION; HEMODIALYSIS ACCESS; SERUM-ALBUMIN; COMPLICATIONS; DISEASE; WOMEN; AIDS; SURVIVAL; COUNTS AB Purpose: Human immunodeficiency virus (HIV) infection is known to cause acquired immune deficiency syndrome, which has been associated with a wide array of cardiovascular pathologies. This report examined the clinical outcome of patients infected with HIV who underwent abdominal aortic reconstruction for aneurysm or occlusive disease. Methods: Hospital and clinic records of all patients with HIV infection who underwent an abdominal aortic operation were reviewed during an 11-year period. Relevant risk factors and clinical variables were assessed for surgical outcome. Results: Forty-eight HIV patients (mean age 54 +/- 13 years) were identified who underwent abdominal aortic bypass grafting during the study period. Indications for aortic operation included aneurysm (n = 20) and aortoiliac occlusive disease (n = 28). All patients underwent successful aortic reconstructions without intraoperative mortality. Postoperative complications and in-hospital mortality occurred in 16 patients (33%) and 7 patients (15%), respectively. The mean follow-up period was 41 months. Life-table survival rates in aneurysm and occlusive patients at 60 months were 43.2% +/- 5.3% and 46.3% +/- 7.4% (not significant), respectively. Multivariate analysis showed that low CD4 lymphocyte counts (<200/muL, P- <0.05) and hypoalbuminemia (<3.5 g/dL, P <0.05) were risk factors for postoperative complications. Conclusion: Perioperative morbidity and mortality rates are high in HIV patients undergoing an abdominal aortic operation. Low CD4 lymphocyte counts and hypoalbumine'mia are associated with poor clinical outcomes in HIV patients undergoing abdominal aortic reconstruction. (C) 2004 Excerpta Medica Inc. All rights reserved. C1 Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg, Houston, TX 77030 USA. Methodist Hosp, Houston VAMC, Houston, TX 77030 USA. RP Lin, PH (reprint author), Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg, 2002 Holcomb Blvd 112, Houston, TX 77030 USA. EM plin@bcm.tmc.edu NR 35 TC 24 Z9 26 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD DEC PY 2004 VL 188 IS 6 BP 690 EP 696 DI 10.1016/j.amjsurg.2004.08.054 PG 7 WC Surgery SC Surgery GA 885UW UT WOS:000226183600020 PM 15619485 ER PT J AU Watts, K Lin, PH Bush, RL Awad, S McCoy, SA Felkai, D Zhou, W Nguyen, L Guerrero, MA Shenaq, SA Lumsden, AB AF Watts, K Lin, PH Bush, RL Awad, S McCoy, SA Felkai, D Zhou, W Nguyen, L Guerrero, MA Shenaq, SA Lumsden, AB TI The impact of anesthetic modality on the outcome of carotid endarterectomy SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 56th Annual Meeting of the Southwestern Surgical Congress CY APR 18-21, 2004 CL Monterey, CA DE carotid endarterectomy; local anesthesia; complications ID GENERAL-ANESTHESIA; LOCAL-ANESTHESIA; COMPLICATIONS; INSUFFICIENCY; OPERATIONS; ISCHEMIA; SURGERY AB Background: Carotid endarterectomy (CEA) reduces the risk of stroke in patients with high-grade carotid artery stenosis. This study evaluates the clinical outcome of CEA performed under local anesthesia (LA) versus general anesthesia (GA). Methods: Clinical variables and treatment outcomes were analyzed in 548 CEAs performed under either LA or GA during a 30-month period. Factors associated with morbidity were also analyzed. Results: A total of 263 CEAs under LA and 285 CEA under GA were analyzed. The LA group was associated with a lower incidence of shunt placement, operative time, and perioperative hemodynamic instability compared to the. GA group. No differences in neurologic complications or mortality were found between the 2 groups. Hyperlipidemia was a risk factor for postoperative morbidity in both the LA and GA groups, while age greater than 75 years was associated with increased overall morbidity in the GA group but not the LA group. Conclusions: This study demonstrates that increased age is associated with increased morbidity in CEA under GA, while hyperlipidemia is associated with increased morbidity in CEA regardless of the anesthetic choice. (C) 2004 Excerpta Medica Inc. All rights reserved. C1 Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg, Houston, TX 77030 USA. Methodist Hosp, Houston VAMC, Houston, TX 77030 USA. Baylor Coll Med, Dept Anesthesiol, Houston, TX 77030 USA. RP Lin, PH (reprint author), Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg, 2002 Holcomb Blvd 112, Houston, TX 77030 USA. EM plin@bcm.tmc.edu NR 25 TC 24 Z9 26 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD DEC PY 2004 VL 188 IS 6 BP 741 EP 746 DI 10.1016/j.amjsurg.2004.08.048 PG 6 WC Surgery SC Surgery GA 885UW UT WOS:000226183600036 PM 15619493 ER PT J AU Weigelt, J Kaafarani, HMA Itani, KMF Swanson, RN AF Weigelt, J Kaafarani, HMA Itani, KMF Swanson, RN TI Linezolid eradicates MRSA better than vancomycin from surgical-site infections SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 56th Annual Meeting of the Southwestern Surgical Congress CY APR 18-21, 2004 CL Monterey, CA DE Staphylococcus aureus; gram-positive bacteria; surgical wound infection; linezolid; vancomycin ID SOFT-TISSUE INFECTIONS; ANTIMICROBIAL SUSCEPTIBILITY PATTERNS; RESISTANT STAPHYLOCOCCUS-AUREUS; PROGRAM UNITED-STATES; METHICILLIN-RESISTANT; BACTEREMIA; MORTALITY; SKIN; CANADA AB Background: The purpose of this analysis was to compare the efficacy of linezolid versus vancomycin in patients with suspected or proven gram-positive methicillin-resistant Staphylococcus aureus (MRSA) surgical-site infections. Methods: An open-label, randomized, comparator-controlled, multicenter, multinational study was conducted in hospitalized patients. Patients were randomized 1: 1 to receive linezolid 600 mg (intravenous [IV] or oral) every 12 hours (n = 66) or vancomycin I g every 12 hours IV (n = 69) for 7 to 21 days. Patients were assessed at the test-of-cure (TOC) visit, 7 days after completing therapy. Results: Clinical success at TOC was documented in similar proportions of patients treated with linezolid or vancomycin. Of those with MRSA isolated, significantly more patients who received linezolid compared with those who received vancomycin were microbiologically cured (87% vs 48%, respectively; 95% confidence interval 16.51 to 60.27; P = 0.0022. Conclusion: Intravenous or oral linezolid was well tolerated and superior to vancomycin in treating patients with MRSA-infected surgical-site infections. (C) 2004 Excerpta Medica Inc. All rights reserved. C1 Med Coll Wisconsin, Dept Surg, Milwaukee, WI 53226 USA. Baylor Coll Med, Michael E DeBakey Dept Surg, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Houston, TX USA. Pfizer Inc, New York, NY USA. RP Weigelt, J (reprint author), Med Coll Wisconsin, Dept Surg, 9200 W Wisconsin Ave, Milwaukee, WI 53226 USA. EM jweigelt@mail.mcw.edu NR 25 TC 94 Z9 106 U1 0 U2 3 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD DEC PY 2004 VL 188 IS 6 BP 760 EP 765 DI 10.1016/j.amsjurg.2004.08.045 PG 6 WC Surgery SC Surgery GA 885UW UT WOS:000226183600041 PM 15619496 ER PT J AU Weeratunge, CN Roldan, J Anstead, GM AF Weeratunge, CN Roldan, J Anstead, GM TI Jaccoud arthropathy: A rarity in the spectrum of HIV-associated arthropathy SO AMERICAN JOURNAL OF THE MEDICAL SCIENCES LA English DT Article DE Jaccoud arthropathy; AIDS; HIV-associated arthropathy ID ACQUIRED IMMUNODEFICIENCY; RHEUMATIC MANIFESTATIONS; REITERS-SYNDROME; ARTHRITIS; INFECTION AB In studies comparing HIV-infected patients with HIV-negative patients, rheumatic manifestations, including reactive arthritis, psoriatic arthritis, myalgia, tendinitis, fibromyalgia, necrotizing vasculitis, polymyositis, Sjogren syndrome, were shown to occur more frequently in the HIV-positive group. Uncommon clinical features and the demonstration of HIV antigens in the synovial membranes suggest a direct role of HIV in the pathogenesis of HIV-associated rheumatic disease. Jaccoud arthropathy is a nonerosive deforming arthropathy reported to occur in cases of chronic rheumatic fever and systemic lupus erythematosus. Only two cases of HIV-associated Jaccoud arthropathy has been reported in the literature thus far, both in patients with features of reactive arthritis. We report a case of HIV-associated Jaccoud arthropathy in a patient without features of reactive arthropathy. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Div Clin Immunol & Rheumatol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Weeratunge, CN (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, 7703 Floyd Curl Dr,Mail Code 7881, San Antonio, TX 78229 USA. EM cnamalw@hotmail.com NR 15 TC 9 Z9 9 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-9629 J9 AM J MED SCI JI Am. J. Med. Sci. PD DEC PY 2004 VL 328 IS 6 BP 351 EP 353 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 880SD UT WOS:000225808600008 PM 15599332 ER PT J AU Graves, MC Fiala, M Dinglasan, LAV Liu, NQ Sayre, J Chiappelli, F van Kooten, C Vinters, HV AF Graves, MC Fiala, M Dinglasan, LAV Liu, NQ Sayre, J Chiappelli, F van Kooten, C Vinters, HV TI Inflammation in amyotrophic lateral sclerosis spinal cord and brain is mediated by activated macrophages, mast cells and T cells SO AMYOTROPHIC LATERAL SCLEROSIS AND OTHER MOTOR NEURON DISORDERS LA English DT Article DE immunopathogenesis of ALS; innate immunity; adaptive immunity; inflammation; mast cells ID TRANSGENIC MOUSE MODEL; PROTECTS MOTOR-NEURONS; UP-REGULATION; SUPEROXIDE-DISMUTASE; ALZHEIMERS-DISEASE; TNF-ALPHA; CYCLOOXYGENASE-2; ALS; CD40; INHIBITION AB Recent studies have shown inflammatory markers in affected neural tissues of amyotrophic lateral sclerosis (ALS) patients. We examined immunocytochemically spinal cord tissues of six patients with ALS, two with corticospinal tract degeneration secondary to cerebral infarcts and three control subjects without neuropathologic abnormalities. ALS spinal cords had dense macrophage infiltration ( one log greater than control spinal cords) involving the white and gray matter, with heaviest infiltration of lateral and ventral columns and, in one patient, prefrontal gyrus and the occipital lobes of the brain. Macrophages in ALS spinal cord showed strong expression of cyclooxygenase-2 (COX-2) ( one log greater than control tissues) and inducible nitric oxide synthase. In the gray matter, macrophages surrounded and appeared to phagocytize neurons (NeuN-positive) that appeared to be dying. Vessels showed damage to the tight junction protein ZO-1 in relation to perivascular CD40 receptor-positive macrophages and CD40 ligand-positive T lymphocytes. ALS spinal cords, but not control cords, were sparsely infiltrated with mast cells. In control cases with corticospinal tract degeneration following hemispheric cerebral infarction, macrophage infiltration of the white matter was COX-2-negative and restricted to lateral and anterior corticospinal tracts. Our data suggest that inflammation in ALS spinal cord and cortex is based on innate immune responses by macrophages and mast cells and adaptive immune responses by T cells. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Greater Los Angeles VA Med Ctr, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Biostat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Radiol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Dent, Div Oral Biol & Med, Los Angeles, CA 90024 USA. Leiden Univ, Med Ctr, Dept Nephrol, Leiden, Netherlands. Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med Neuropathol, Los Angeles, CA USA. RP Fiala, M (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, 63-090, Los Angeles, CA 90095 USA. EM fiala@ucla.edu FU NIA NIH HHS [P50 AG16570] NR 37 TC 83 Z9 83 U1 0 U2 3 PU TAYLOR & FRANCIS AS PI OSLO PA CORT ADELERSGT 17, PO BOX 2562, SOLLI, 0202 OSLO, NORWAY SN 1466-0822 J9 AMYOTROPH LATERAL SC JI Amyotroph. Lateral. Scler. Mot. Neuron Disord. PD DEC PY 2004 VL 5 IS 4 BP 213 EP 219 DI 10.1080/14660820410020286 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 881ON UT WOS:000225876900004 PM 15799549 ER PT J AU Finegold, SA Molitoris, D Vaisanen, ML Song, YL Liu, CX Bolanos, M AF Finegold, SA Molitoris, D Vaisanen, ML Song, YL Liu, CX Bolanos, M TI In vitro activities of OPT-80 and comparator drugs against intestinal bacteria SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID GLYCOPEPTIDE RESISTANCE; CLOSTRIDIUM-DIFFICILE; DIARRHEA AB The activities of OPT-80 against 453 intestinal bacteria were compared with those of seven other drugs. OPT-80 showed good activity against most clostridia, staphylococci, and enterococci, but streptococci, aerobic and facultative gram-negative rods, anaerobic gram-negative rods, and Clostridium ramosum were resistant. Poor activity against anaerobic gram-negative rods may maintain colonization resistance. C1 VA Greater Los Angeles Healthcare Syst, Med Serv, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Microbiol Mol Genet & Immunol, Los Angeles, CA 90024 USA. RP Finegold, SA (reprint author), W Los Angeles Vet Affairs Med Ctr, Infect Dis Sect 111F, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM sidfinegol@aol.com NR 19 TC 85 Z9 90 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 DEC PY 2004 VL 48 IS 12 BP 4898 EP 4902 DI 10.1128/AAC.48.12.4898-4902.2004 PG 5 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 876CW UT WOS:000225474500061 PM 15561877 ER PT J AU Schwartz, DL Rajendran, J Yueh, B Coltrera, MD LeBlanc, M Eary, J Krohn, K AF Schwartz, DL Rajendran, J Yueh, B Coltrera, MD LeBlanc, M Eary, J Krohn, K TI FDG-PET prediction of head and neck squamous cell cancer outcomes SO ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY LA English DT Article ID POSITRON-EMISSION-TOMOGRAPHY; GROWTH-FACTOR RECEPTOR; BREAST-CANCER; GLUCOSE-METABOLISM; F-18-FDG PET; CARCINOMA; RADIOTHERAPY; THERAPY; IMPACT; TUMORS AB Objective: To confirm that high pretreatment uptake of 2-deoxy-2[F-18]fluoro-D-glucose (FDG) detected by positron emission tomography (PET) measured at the primary head and neck squamous cell carcinoma (HNSCC) and at metastatic nodal disease predicts poor outcomes for HNSCC. Design and Patients: We enrolled 63 consecutive patients with a histological diagnosis of HNSCC (including tumors of the oral cavity, oropharynx, larynx, and hypopharynx) from September 2000 through June 2003, into a prospective institutional imaging trial. Fifty-four patients (86%) underwent a baseline FDG-PET scan before curative treatment and were eligible for analysis. Results: A primary tumor standardized uptake value (SUV) of greater than 9.0 predicted inferior local recurrence-free survival (P = .02) and disease-free survival (P = .03). Nodal SUV dichotomized according to the cohort median of 6.1 did not predict for either disease outcome (P = .71 and P = .98, respectively). On proportional hazards analysis, local recurrence and disease event hazard ratios for a primary tumor SUV of 9.0 or greater remained significant or at borderline significance when adjusted for nodal SUV or other clinical covariates. Conclusions: Our findings support an association between baseline primary tumor FDG SUV and HNSCC outcomes. In contrast, nodal FDG SUV was not predictive. Primary tumor FDG SUV is a promising prognostic factor and may establish the need for intensified locoregional therapy in individual patients. Multi-institutional imaging trials and further characterization of the biology responsible for elevated FDG uptake in HNSCC will be necessary to confirm the prognostic utility of FDG-labeled PET. C1 Univ Washington, Radiat Oncol Serv, Seattle, WA 98195 USA. Univ Washington, Surg & Perioperat Care Serv, Seattle, WA 98195 USA. Univ Washington, Hlth Serv Res & Dev Serv, Seattle, WA 98195 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Radiat Oncol, Seattle, WA 98195 USA. Univ Washington, Dept Radiol, Div Nucl Med, Seattle, WA 98195 USA. Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Dept Radiol, Seattle, WA 98195 USA. RP Schwartz, DL (reprint author), Univ Texas, MD Anderson Canc Ctr, Dept Radiat Oncol, 1515 Holcombe Blvd,Unit 97, Houston, TX 77030 USA. EM docdls@mdanderson.org OI Yueh, Bevan/0000-0003-1380-1053 FU NCI NIH HHS [CA42045] NR 30 TC 112 Z9 115 U1 0 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 DEC PY 2004 VL 130 IS 12 BP 1361 EP 1367 DI 10.1001/archotol.130.12.1361 PG 7 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 877WT UT WOS:000225606400001 PM 15611393 ER PT J AU Goldstein, JL Eisen, G Lewis, B Gralnek, L Zlotnick, S AF Goldstein, JL Eisen, G Lewis, B Gralnek, L Zlotnick, S TI Small bowel mucosal breaks associated with ibuprofen plus omeprazole, celecoxib, or placebo in healthy subjects as determined by video capsule endoscopy: Results from a multicenter, double-blind, randomized, controlled trial. SO ARTHRITIS AND RHEUMATISM LA English DT Meeting Abstract CT 68th Annual Scientific Meeting of the American-College-of-Rheumatology CY OCT 16-21, 2004 CL San Antonio, TX SP Amer Coll Rheumatol C1 Univ Illinois, Chicago, IL USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Mt Sinai Med Ctr, New York, NY 10029 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Pfizer Inc, New York, NY USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0004-3591 J9 ARTHRITIS RHEUM JI Arthritis Rheum. PD DEC PY 2004 VL 50 IS 12 BP 4099 EP 4099 PG 1 WC Rheumatology SC Rheumatology GA 879WP UT WOS:000225750200104 ER PT J AU Shin, JM Sachs, G AF Shin, JM Sachs, G TI Differences in binding properties of two proton pump inhibitors on the gastric H+,K+-ATPase in vivo SO BIOCHEMICAL PHARMACOLOGY LA English DT Article DE the proton pump inhibitor; the residence time; the gastric H plus ,K plus -ATPase; binding sites; glutathione; stoichiometry ID ACID-SECRETION; COMPETITIVE INHIBITOR; OMEPRAZOLE ANALOGS; CHEMICAL-REACTIONS; CALCIUM-PUMP; H,K-ATPASE; ATPASE; PANTOPRAZOLE; MECHANISM; SCH28080 AB Restoration of acid secretion after treatment with covalently-bound proton pump inhibitors may depend on protein turnover and on reversal of inhibition by reducing agents such as glutathione. Glutathione incubation of the H+,K+-ATPase isolated from omeprazole or pantoprazole-treated rats reversed 88% of the omeprazole inhibition but none of the pantoprazole inhibition. The present study was designed to measure binding properties of omeprazole or pantoprazole in vivo. Rats were injected with C-14-omeprazole or C-14- pantoprazole after acid stimulation. The specific binding to the gastric H+,K+-ATPase was measured at timed intervals as well as reversal of binding by glutathione reduction. The stoichiometry of omeprazole and pantoprazole binding to the catalytic subunit of the H+,KATPase was 2 moles of inhibitor per mole of the H+,K+-ATPase phosphoenzyme. Omeprazole bound to one cysteine between transmembrane segments 5/6 and one between 7/8, pantoprazole only to the two cysteines in the TM5/6 domain. Loss of drug from the pump was biphasic, the fast component accounted for 84% of omeprazole binding and 51% of pantoprazole binding. Similarly, only 16% of omeprazole binding but 40% of pantoprazole binding was not reversed by glutathione. The residence time of omeprazole and pantoprazole on the ATPase in vivo depends on the reversibility of binding. Binding of pantoprazole at cysteine 822 is irreversible whereas that of omeprazole at cysteine 813 and 892 is reversible both in vivo and in vitro. This is consistent with the luminal exposure of cysteine 813 and 892 and the intra-membranal location of cysteine 822 in the 3D structure of the H+,K+-ATPase. (C) 2004 Elsevier Inc. All rights reserved. C1 Univ Calif Los Angeles, Dept Physiol & Med, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Sachs, G (reprint author), Univ Calif Los Angeles, Dept Physiol & Med, Los Angeles, CA 90073 USA. EM gsachs@ucla.edu FU NIDDK NIH HHS [DK46917]; PHS HHS [53462, 41301] NR 47 TC 33 Z9 35 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0006-2952 J9 BIOCHEM PHARMACOL JI Biochem. Pharmacol. PD DEC 1 PY 2004 VL 68 IS 11 BP 2117 EP 2127 DI 10.1016/j.bcp.2004.07.035 PG 11 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 868ZP UT WOS:000224952200003 PM 15498502 ER PT J AU Lui, KJ Zhou, XH Lin, CD AF Lui, KJ Zhou, XH Lin, CD TI Testing equality between two diagnostic procedures in paired-sample ordinal data SO BIOMETRICAL JOURNAL LA English DT Article DE type I error; equality; ordinal scale; sensitivity; specificity; paired-sample data ID OPERATING CHARACTERISTIC CURVES; MAXIMUM-LIKELIHOOD ESTIMATION; SIGNAL-DETECTION THEORY; EQUIVALENCE; PARAMETERS AB When a new diagnostic procedure is developed, it is important to assess whether the diagnostic accuracy of the new procedure is different from that of the standard procedure. For paired-sample ordinal data, this paper develops two test statistics for testing equality of the diagnostic accuracy between two procedures without assuming any parametric models. One is derived on the basis of the probability of correctly identifying the case for a randomly selected pair of a case and a non-case over all possible cutoff points, and the other is derived on the basis of the sensitivity and specificity directly. To illustrate the practical use of the proposed test procedures, this paper includes an example regarding the use of digitized and plain films for screening breast cancer. This paper also applies Monte Carlo simulation to evaluate the finite sample performance of the two statistics developed here and notes that they can perform well in a variety of situations. C1 San Diego State Univ, Dept Math & Stat, San Diego, CA 92182 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, HSR D Ctr Excellence, Seattle, WA 98108 USA. RP Lui, KJ (reprint author), San Diego State Univ, Dept Math & Stat, San Diego, CA 92182 USA. EM kjl@rohan.sdsu.edu NR 14 TC 2 Z9 2 U1 0 U2 1 PU AKADEMIE VERLAG GMBH PI BERLIN PA PALISADENSTR 40, D-10243 BERLIN, GERMANY SN 0323-3847 J9 BIOMETRICAL J JI Biom. J. PD DEC PY 2004 VL 46 IS 6 BP 642 EP 652 DI 10.1002/bimj.200410062 PG 11 WC Mathematical & Computational Biology; Statistics & Probability SC Mathematical & Computational Biology; Mathematics GA 884KJ UT WOS:000226083300002 ER PT J AU Means, RT AF Means, RT TI Hepcidin and anaemia SO BLOOD REVIEWS LA English DT Review DE anaemia of chronic disease; cytokines; ferritin; inflammation; hepcidin; inflammation; iron ID TUMOR-NECROSIS-FACTOR; ANTIMICROBIAL PEPTIDE HEPCIDIN; MACROPHAGE IRON-METABOLISM; COLONY-FORMING-UNITS; CHRONIC DISEASE; TRANSFERRIN RECEPTOR; NITRIC-OXIDE; HEREDITARY HEMOCHROMATOSIS; RHEUMATOID-ARTHRITIS; BONE-MARROW AB The anaemia of chronic disease (ACD) is a common haematologic syndrome characterized by hypoferraemia with adequate reticuloendothetial iron stores. Frequently, serum ferritin concentration in these patients is elevated. The pathogenesis of ACD involves abnormalities in red cell survival, the erythropoietic response to anaemia, and in iron metabolism. Hepcidin is an antibacterial protein produced in the liver which can be found in blood or urine, and which participates in host defense. Recent studies have demonstrated that hepcidin is a key regulator of iron balance in the intestinal mucosa, and that abnormalities in hepcidin gene expression are associated with clinical abnormalities in iron parameters and, in some cases, with anaemia. Hepcidin is an acute-phase reacting protein, and it has been suggested that hepcidin is the key mediator of ACD. Investigation of hepcidin production in either serum or urine demonstrates a strong correlation with serum ferritin concentration. Differences between the hepcidin concentrations observed in ACD (or syndromes resembling ACD) and those observed in iron deficiency may depend on the definition used for the anaemia syndrome. It seems very likely that hepcidin is a major contributor to iron abnormalities characteristic of ACD; whether it contributes to the pathogenesis of the syndrome in a broader sense remains to be determined by further investigation. Published by Elsevier Ltd. C1 Ralph H Johnson VA Med Ctr, Dept Med, Div Hematol Oncol, Charleston, SC 29425 USA. Med Univ S Carolina, Charleston, SC 29425 USA. RP Means, RT (reprint author), Ralph H Johnson VA Med Ctr, Dept Med, Div Hematol Oncol, 903 CSB,96 Jonathan Lucas St, Charleston, SC 29425 USA. EM meansr@musc.edu RI Means, Robert/A-4454-2008 FU NHLBI NIH HHS [HL-69418] NR 48 TC 38 Z9 41 U1 0 U2 4 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0268-960X J9 BLOOD REV JI Blood Rev. PD DEC PY 2004 VL 18 IS 4 BP 219 EP 225 DI 10.1016/S0268-960X9(03)00066-3 PG 7 WC Hematology SC Hematology GA 867ZY UT WOS:000224882800001 PM 15501550 ER PT J AU Walsh, T Morris, AK Holle, LM Callander, N Bradshaw, P Valley, AW Clark, G Freytes, CO AF Walsh, T Morris, AK Holle, LM Callander, N Bradshaw, P Valley, AW Clark, G Freytes, CO TI Granisetron vs ondansetron for prevention of nausea and vomiting in hematopoietic stem cell transplant patients: results of a prospective, double-blind, randomized trial SO BONE MARROW TRANSPLANTATION LA English DT Article DE hematopoietic stem cell transplantation; nausea; vomiting; granisetron; ondansetron ID HIGH-DOSE CHEMOTHERAPY; BONE-MARROW-TRANSPLANTATION; CISPLATIN-INDUCED EMESIS; TOTAL-BODY IRRADIATION; ANTIEMETIC EFFICACY; INTRAVENOUS ONDANSETRON; DOLASETRON MESILATE; ORAL GRANISETRON; PROPHYLAXIS; CYCLOPHOSPHAMIDE AB The serotonin type- 3 ( 5- HT3) antagonists represent a significant advance in the prevention of acute nausea and vomiting ( N/ V) from highly emetogenic chemotherapy. We sought to determine if any differences in efficacy or adverse effects exist between two such agents, ondansetron and granisetron, during conditioning therapy for hematopoietic stem cell transplantation ( HSCT). Patients were randomized to receive either ondansetron 0.15 mg/ kg intravenously every 8 h or granisetron 10 mug/ kg intravenously daily. Additionally, all patients received scheduled dexamethasone and lorazepam. Prophylaxis was continued until 24 h after completion of chemotherapy. Nausea and distress were measured subjectively with visual analog scales and emetic episodes were quantified. Of the 110 randomized patients, 96 were evaluable for efficacy and safety. No significant differences in efficacy were observed between the ondansetron- and granisetron- treated patients, evaluated by comparing the degree of nausea and distress, number of emetic episodes and overall control of emesis. The adverse effects were also comparable and no patients were removed from study because of severe toxicities. This trial demonstrates that ondansetron and granisetron are equally effective at preventing acute N/ V associated with conditioning therapy frequently used for HSCT. The agent of choice should be based on drug acquisition cost or preference. C1 S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78229 USA. Duke Univ, Med Ctr, Durham, NC USA. Syntaxx Commun Inc, Storrs, CT USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Pharm Healthcare Solut, San Antonio, TX USA. OSI Pharmaceut Inc, Boulder, CO USA. RP Walsh, T (reprint author), S Texas Vet Hlth Care Syst, Audie L Murphy Div, 7400 Merton Minter Blvd,Dept 119, San Antonio, TX 78229 USA. EM dveblu@aol.com NR 23 TC 12 Z9 14 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0268-3369 J9 BONE MARROW TRANSPL JI Bone Marrow Transplant. PD DEC PY 2004 VL 34 IS 11 BP 963 EP 968 DI 10.1038/sj.bmt.1704714 PG 6 WC Biophysics; Oncology; Hematology; Immunology; Transplantation SC Biophysics; Oncology; Hematology; Immunology; Transplantation GA 871UQ UT WOS:000225159800007 PM 15489869 ER PT J AU Zook, NA Davalos, DB DeLosh, EL Davis, HP AF Zook, NA Davalos, DB DeLosh, EL Davis, HP TI Working memory, inhibition, and fluid intelligence as predictors of performance on Tower of Hanoi and London tasks SO BRAIN AND COGNITION LA English DT Article; Proceedings Paper CT 73rd Annual Convention of the Rocky-Mountain-Psychological-Association CY APR 11-13, 2003 CL Denver, CO SP Rocky Mt Psychol Assoc DE executive function; Tower of London; Tower of Hanoi; working memory; inhibition; fluid intelligence; matrix reasoning ID CARD SORTING TEST; FRONTAL-LOBE; INTERFERENCE; INFORMATION AB The contributions of working memory, inhibition, and fluid intelligence to performance on the Tower of Hanoi (TOH) and Tower of London (TOL) were examined in 85 undergraduate participants. All three factors accounted for significant variance on the TOH, but only fluid intelligence accounted for significant variance on the TOL. When the contribution of fluid intelligence was accounted for, working memory and inhibition continued to account for significant variance on the TOH. These findings support Duncan, Burgess, and Emslie's (1995) argument that fluid intelligence contributes to executive functioning, but also show that the executive processes elicited by tasks vary according to task structure. (C) 2004 Elsevier Inc. All rights reserved. C1 Colorado State Univ, Dept Psychol, Ft Collins, CO 80543 USA. Univ Colorado, Hlth Sci Ctr, Boulder, CO 80309 USA. Denver VA Med Ctr, Denver, CO USA. Univ Colorado, Dept Psychol, Colorado Springs, CO 80907 USA. RP Zook, NA (reprint author), Colorado State Univ, Dept Psychol, Ft Collins, CO 80543 USA. EM nazook@lamar.colostate.edu NR 30 TC 51 Z9 58 U1 8 U2 20 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0278-2626 J9 BRAIN COGNITION JI Brain Cogn. PD DEC PY 2004 VL 56 IS 3 BP 286 EP 292 DI 10.1016/j.bandc.2004.07.003 PG 7 WC Neurosciences; Psychology, Experimental SC Neurosciences & Neurology; Psychology GA 872LT UT WOS:000225209400002 PM 15522766 ER PT J AU Etzioni, DA Ponce, NA Babey, SH Spencer, BA Brown, ER Ko, CY Chawla, N Breen, N Klabunde, CN AF Etzioni, DA Ponce, NA Babey, SH Spencer, BA Brown, ER Ko, CY Chawla, N Breen, N Klabunde, CN TI A population-based study of colorectal cancer test use - Results from the 2001 California Health Interview Survey SO CANCER LA English DT Article DE colorectal neoplasms; prevention and control; mass screening; ethnic; groups; statistics and numeric data; endoscopy; utilization; occult blood; California ID PRIMARY-CARE; LOW-INCOME; UNITED-STATES; BARRIERS; ACCESS; WOMEN; ASSOCIATION; PREDICTORS; INSURANCE; PROGRESS AB BACKGROUND. Recent research has supported the use of colorectal cancer (CRC) tests to reduce disease incidence, morbidity, and mortality. A new health survey has provided an opportunity to examine the use of these tests in California's ethnically diverse population. The authors used the 2001 California Health Interview Survey (CHIS 2001) to evaluate 1) rates of CRC test use, 2) predictors of the receipt of tests, and 3) reasons for nonuse of CRC tests. METHODS. The CHIS 2001 is a random-digit dial telephone survey that was conducted in California. Responses were analyzed from 22,343 adults age greater than or equal to 50 years. CRC test use was defined as receipt of a fecal occult blood test in the past year and/or receipt of an endoscopic examination in the past 5 years. RESULTS. Nearly 54% of California adults reported receipt of a recent CRC test. Insurance coverage and having a usual source of care were the most important predictors of CRC testing. Latinos age < 65 years were less likely to be tested than whites (relative risk [RR], 0.84; 95% confidence interval [95% CI], 0.77-0.92). Men were more likely to be tested than women, an effect that was greater among individuals age 50-64 years (RR, 1.28; 95% CI, 1.23-1.32) than among individuals age 65 years (RR, 1.19; 95% CI, 1.15-1.23). Women were more likely than men to say that their physician did not inform them the test was needed and that CRC tests were painful or embarrassing. CONCLUSIONS. Results of the current study indicate a need for physicians to recommend CRC testing to their patients. Assuring that all individuals have both health insurance and a usual source of care would help address gaps in the receipt of CRC tests. (C) 2004 American Cancer Society. C1 Univ Calif Los Angeles, Ctr Hlth Policy Res, Dept Hlth Serv, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Robert Wood Johnson Clin Scholars Program, Los Angeles, CA 90024 USA. Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Dept Med, Los Angeles, CA USA. RAND, Santa Monica, CA USA. NCI, Hlth Serv & Econ Branch, Appl Res Program, Bethesda, MD 20892 USA. RP Ponce, NA (reprint author), Univ Calif Los Angeles, Ctr Hlth Policy Res, Dept Hlth Serv, 10911 Weyburn Ave,Suite 300, Los Angeles, CA 90024 USA. EM nponce@ucla.edu OI Ponce, Ninez/0000-0001-5151-6718 FU NCI NIH HHS [N02PC95057] NR 31 TC 80 Z9 81 U1 1 U2 4 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER JI Cancer PD DEC 1 PY 2004 VL 101 IS 11 BP 2523 EP 2532 DI 10.1002/cncr.20692 PG 10 WC Oncology SC Oncology GA 873ZS UT WOS:000225321300005 PM 15505783 ER PT J AU Ziv, E Tice, J Smith-Bindman, R Shepherd, J Cummings, S Kerlikowske, K AF Ziv, E Tice, J Smith-Bindman, R Shepherd, J Cummings, S Kerlikowske, K TI Mammographic density and estrogen receptor status of breast cancer SO CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION LA English DT Article ID UNITED-STATES; POSTMENOPAUSAL WOMEN; RISK; TAMOXIFEN; MENOPAUSE; PATTERNS; BRCA1; AGE; MUTATIONS; CARCINOMA AB Background: The density of breast tissue on a mammogram is a strong predictor of breast cancer risk and may reflect cumulative estrogen effect on breast tissue. Endogenous and exogenous estrogen exposure increases the risk of estrogen receptor (ER)-positive breast cancer. We determined if mammographic density is associated more strongly with ER-positive breast cancer than with ER-negative breast cancer. Methods: We analyzed data from 44,811 participants in the San Francisco Mammography Registry of whom 701 developed invasive breast cancer. Mammographic density was measured using the Breast Imaging Reporting and Data System (BI-RADS) classification system (1 = almost entirely fat, 2 = scattered fibroglandular, 3 = heterogeneously dense, 4 = extremely dense). We tested for associations between mammographic density and ER-positive and ER-negative breast cancer separately. Analyses were adjusted for age, body mass index, postmenopausal hormone use, family history of breast cancer, menopausal status, parity, and race/ethnicity. Results: Mammographic density was strongly associated with both ER-positive and ER-negative breast cancers. Compared with women with BI-RADS 2, women with BI-RADS 1 (lowest density) had a lower risk of ER-positive cancer [adjusted hazard ratio (HR), 0.28; 95% confidence interval (95% CI), 0.16-0.50] and ER-negative cancer (adjusted HR, 0.17; 95% CI, 0.04-0.70). Women with BI-RADS 4 (highest density) had an increased risk of ER-positive breast cancer (adjusted HR, 2.21; 95% CI, 1.64-3.04) and an increased risk of ER-negative breast cancer (adjusted HR, 2.21; 95% CI, 1.16-4.18). Conclusion: Surprisingly, women with high mammographic density have an increased risk of both ER-positive and ER-negative breast cancers. The association between mammographic density and breast cancer may be due to factors besides estrogen exposure. C1 Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Dept Med, San Francisco, CA 94115 USA. Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Dept Radiol, San Francisco, CA 94115 USA. Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Dept Epidemiol & Biostat, San Francisco, CA 94115 USA. Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA 94115 USA. Calif Pacific Med Ctr, Inst Res, San Francisco, CA USA. RP Ziv, E (reprint author), Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Dept Med, 1635 Divisadero St,Suite 600, San Francisco, CA 94115 USA. EM eziv@itsa.ucsf.edu RI Ziv, Elad/L-5396-2014 FU NCI NIH HHS [K22 CA109351, U01CA63740]; NIAMS NIH HHS [K12 AR47659] NR 30 TC 67 Z9 68 U1 0 U2 2 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1055-9965 J9 CANCER EPIDEM BIOMAR JI Cancer Epidemiol. Biomarkers Prev. PD DEC PY 2004 VL 13 IS 12 BP 2090 EP 2095 PG 6 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 884IC UT WOS:000226077100017 PM 15598766 ER PT J AU Beer, TM Myrthue, A Garzotto, M O'Hara, MF Chin, R Lowe, BA Montalto, MA Corless, CL Henner, WD AF Beer, TM Myrthue, A Garzotto, M O'Hara, MF Chin, R Lowe, BA Montalto, MA Corless, CL Henner, WD TI Randomized study of high-dose pulse calcitriol or placebo prior to radical prostatectomy SO CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION LA English DT Article ID VITAMIN-D-RECEPTOR; GROWTH-FACTOR-BETA; PROSTATIC INTRAEPITHELIAL NEOPLASIA; BREAST-CANCER CELLS; MESSENGER-RNA EXPRESSION; C-MYC; 1,25-DIHYDROXYVITAMIN D-3; HUMAN KERATINOCYTES; GENE-EXPRESSION; DOWN-REGULATION AB Background: Cancer chemoprevention trials require enormous resources due to the large numbers of patients and the years of follow-up needed to achieve sufficient statistical power. Examination of candidate prevention agents using biomarkers as surrogate end points has been proposed as a method to rapidly identify promising agents for prevention trials. Treatment of patients with candidate agents prior to scheduled biopsy or surgical resection of malignancy allows for direct examination of the treatment effects on tumor tissue. In this study, we selected this approach to test several hypotheses about the effect of calcitriol (1,25-dihydroxycholecalciferol), the active form of vitamin D, on early-stage human prostate cancer. Methods: After selection of surgical treatment for histologically confirmed adenocarcinoma of the prostate, patients were randomized to either calcitriol 0.5 mug/kg or placebo weekly for 4 weeks. The expression levels of the vitamin D receptor (VDR), proliferating cell nuclear antigen, PTEN (MMAC1/TEP1), c-Myc, transforming growth factor (TGF) beta receptor type II (TGFbeta RII), and Bcl-2 were quantified using immunohistochemistry in the patients' prostate specimens post surgery. Results: Thirty-seven of 39 prostate tumors were evaluable for molecular end points. VDR expression was reduced in patients treated with calcitriol (mean, 75.3% of cells) compared with those that received placebo (mean, 98.6%; P = 0.005). Calcitriol treatment did not result in a statistically significant change in the fraction of cells expressing TGFbeta RII, PTEN, or proliferating cell nuclear antigen. Bcl-2 and c-Myc expression was at the lower limits of detection in both the calcitriol group and the placebo group; therefore, we were unable to determine whether drug treatment induced a significant change in these biomarkers. Conclusions: High-dose calcitriol down-regulates VDR expression in human prostate cancer. Further study is needed to determine the biological consequences of VDR down-regulation in prostate cancer. This study shows that the use of the preprostatectomy model is feasible and can be used to test the effect of candidate chemopreventive agents on prostate cancer. C1 Oregon Hlth Sci Univ, Div Hematol & Med Oncol, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Pathol, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Div Urol, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR USA. RP Beer, TM (reprint author), Oregon Hlth Sci Univ, Div Hematol & Med Oncol, 3181 SW Sam Jackson Pk Rd,CR-145, Portland, OR 97239 USA. EM beert@ohsu.edu FU NCI NIH HHS [5R21 CA82504-02]; NCRR NIH HHS [5 M01 RR00334] NR 73 TC 25 Z9 27 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1055-9965 J9 CANCER EPIDEM BIOMAR JI Cancer Epidemiol. Biomarkers Prev. PD DEC PY 2004 VL 13 IS 12 BP 2225 EP 2232 PG 8 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 884IC UT WOS:000226077100035 PM 15598784 ER PT J AU Anstead, GM Owens, AD AF Anstead, GM Owens, AD TI Recent advances in the treatment of infections due to resistant Staphylococcus aureus SO CURRENT OPINION IN INFECTIOUS DISEASES LA English DT Review DE dalbavancin; daptomycin; linezolid; oritavancin; tigecycline ID VENTILATOR-ASSOCIATED PNEUMONIA; SKIN-STRUCTURE INFECTIONS; IN-VITRO; GLYCOPEPTIDE ANTIBIOTICS; RETROSPECTIVE ANALYSIS; COMPLICATED SKIN; VANCOMYCIN; EXPERIENCE; SUSCEPTIBILITY; MULTICENTER AB Purpose of review This paper reviews recent data on the treatment of infections caused by drug-resistant Staphylococcus aureus, particularly methicillin-resistant S. aureus (MRSA). This review will focus on new findings reported in the English-language medical literature from June 2003 to September 2004. Recent findings Despite the emergence of resistant and multidrug-resistant S. aureus, we have three effective drugs in clinical use for which little resistance has been observed: quinupristin-dalfopristin, linezolid, and daptomycin. Linezolid looks particularly promising in the treatment of MRSA pneumonia. Daptomycin displays rapid bactericidal activity in vitro, but, so far, clinical trials have only been conducted for the treatment of skin and soft-tissue infections. There are three drugs with broad-spectrum activity against Gram-positive organisms at an advanced stage of testing: two new glycopeptides with potent bacteriocidal activity and long half-lives (oritavancin and dalbavancin), and tigecycline, a minocycline derivative. These drugs have also shown efficacy in the treatment of skin and soft-tissue infections. Summary The promising data that have emerged in the last year indicate that we may have six available drugs to treat resistant S. aureus infections within the next few years. The next goal is to determine the appropriate indications and cost-effectiveness of each of these drugs in our treatment strategy against S. aureus and other Gram-positive pathogens. C1 Dept Vet Affairs Med Ctr, S Texas Vet Hlth Care Syst, Med Serv, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Div Infect Dis, Dept Med, San Antonio, TX 78229 USA. RP Anstead, GM (reprint author), Univ Texas, Hlth Sci Ctr, Div Infect Dis, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM anstead@uthscsa.edu NR 45 TC 42 Z9 43 U1 0 U2 0 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 DEC PY 2004 VL 17 IS 6 BP 549 EP 555 DI 10.1097/00001432-200412000-00007 PG 7 WC Infectious Diseases SC Infectious Diseases GA 879HB UT WOS:000225705900006 PM 15640709 ER PT J AU Zinman, B Kahn, SE Haffner, SM O'Neill, MC Heise, MA Freed, MI AF Zinman, B Kahn, SE Haffner, SM O'Neill, MC Heise, MA Freed, MI CA ADOPT Study Grp TI Phenotypic characteristics of GAD antibody-positive recently diagnosed patients with type 2 diabetes in North America and Europe SO DIABETES LA English DT Article ID GLUTAMIC-ACID DECARBOXYLASE; BETA-CELL FUNCTION; INSULIN-RESISTANCE; MELLITUS; PREDICTION; ADULTS; SENSITIVITY; SECRETION; PROGRAM; DISEASE AB A number of patients with type 2 diabetes are GAD antibody positive. A Diabetes Outcome Progression Trial (ADOPT) is a randomized, double-blind clinical trial in recently diagnosed drug-naive patients with type 2 diabetes that allows for the evaluation of GAD positivity in the context of anthropometric and biochemical characteristics. Of the 4,134 subjects enrolled in ADOPT for whom GAD status was obtained, 174 (4.2%) were GAD positive, with the prevalence of GAD antibodies being similar in North America (4.7%) and Europe (3.7%). Although BMI and age were similar, GAD-positive patients had a lower fasting insulin level, compatible with them being more insulin sensitive. The lower fasting insulin concentration was accompanied by a decreased early insulin response to oral glucose. However, when this insulin response was corrected for the degree of insulin sensitivity, GAD-positive and -negative patients had similar beta-cell function. Consistent with the difference in insulin sensitivity, GAD-positive patients had higher HDL cholesterol and lower triglyceride levels. In the GAD-positive individuals, the prevalence of the metabolic syndrome as defined by NCEP ATP III (National Cholesterol Education Program Adult Treatment Panel III) was also lower (74.1 vs. 83.7%, P = 0.0009). These phenotypic differences may underlie a potential difference in the natural history of hyperglycemia and its clinical outcomes. C1 Mt Sinai Hosp, Samuel Lunenfeld Res Inst, Toronto, ON M5G 1X5, Canada. Univ Toronto, Toronto, ON, Canada. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. GlaxoSmithKline, King Of Prussia, PA USA. RP Kahn, SE (reprint author), VA Med Ctr 151, 1660 S Columbia Way, Seattle, WA 98108 USA. EM skahn@u.washington.edu RI Zinman, Bernard/E-7266-2013; Hegele, Robert/G-3301-2011 OI Kahn, Steven/0000-0001-7307-9002 NR 22 TC 65 Z9 68 U1 0 U2 4 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD DEC PY 2004 VL 53 IS 12 BP 3193 EP 3200 DI 10.2337/diabetes.53.12.3193 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 874CI UT WOS:000225328100020 PM 15561950 ER PT J AU Roder, ME Kahn, SE AF Roder, ME Kahn, SE TI Suppression of beta-cell secretion by sontatostatin does not fully reverse the disproportionate proinsulinemia of type 2 diabetes SO DIABETES LA English DT Article; Proceedings Paper CT 5th Servier-IGIS Symposium CY MAR 18-20, 2004 CL St Jean Cap Ferrat, FRANCE ID C-PEPTIDE; INSULIN-RESISTANCE; ELEVATED PROINSULIN; NIDDM; HYPERPROINSULINEMIA; MECHANISM; ANTISERA; CAPACITY; MELLITUS; RELEASE AB Disproportionate hyperproinsulinemia is a feature of beta-cell dysfunction in type 2 diabetes. It has been hypothesized that this abnormality represents an intrinsic abnormality of the beta-cell and/or may result from an increase in beta-cell secretory demand. To address this, six patients with type 2 diabetes and six age- and BMI-matched normal subjects received a combined 3-h insulin and somatostatin clamp to decrease beta-cell secretory demand. An arginine stimulation test was performed before and at the end of the clamp to measure beta-cell peptide release. In keeping with the reduction in secretory demand, C-peptide levels were suppressed by 60-80% during the clamp, as were proinsulin (PI) levels. The arginine-stimulated PI/C-peptide ratio decreased in the diabetic subjects from 4.4 +/- 1.5% before to 1.8 +/- 0.5% after the clamp (P < 0.01). This latter ratio was similar to that observed in the normal subjects before the somatostatin infusion (1.5 +/- 0.3%). In the normal subjects, after the clamp the PI/C-peptide ratio had decreased to 0.8 +/- 0.3% (P < 0.01). Thus, the postclamp PI/C-peptide ratio in the subjects with type 2 diabetes was elevated compared with that in the normal subjects (P < 0.05). Based on these observations, while relief of secretory demand on beta-cells by somatostatin decreases the disproportionate elevation in PI levels in patients with type 2 diabetes, the failure to normalize this measure suggests that an intrinsic abnormality of beta-cell function exists in subjects with type 2 diabetes that may be aggravated by increased secretory demand. C1 Univ Copenhagen, Bispebjerg Hosp, Clin Internal Med 1, Endocrine Sect, DK-2400 Copenhagen NV, Denmark. Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Roder, ME (reprint author), Univ Copenhagen, Bispebjerg Hosp, Clin Internal Med 1, Endocrine Sect, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark. EM mir@dadlnet.dk FU NCRR NIH HHS [RR-37] NR 22 TC 4 Z9 4 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 DEC PY 2004 VL 53 SU 3 BP S22 EP S25 DI 10.2337/diabetes.53.suppl_3.S22 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 875YU UT WOS:000225460000004 PM 15561914 ER PT J AU Maciejewski, ML Reiber, G Boyko, EJ AF Maciejewski, ML Reiber, G Boyko, EJ TI Effectiveness of diabetic therapeutic footwear in preventing reulceration - Response to Chantelau SO DIABETES CARE LA English DT Letter C1 Dept Vet Affairs, Hlth Serv Res & Dev 152, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98101 USA. Univ Washington, Dept Hlth Sci, Seattle, WA 98195 USA. Dept Vet Affairs, Seattle Epidemiol Res & Informat Ctr, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98101 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. RP Maciejewski, ML (reprint author), Dept Vet Affairs, Hlth Serv Res & Dev 152, Vet Affairs Puget Sound Hlth Care Syst, Met Pk W,Suite 1400,1100 Olive Way, Seattle, WA 98101 USA. EM mlmaciej@u.washington.edu NR 5 TC 0 Z9 0 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 DEC PY 2004 VL 27 IS 12 BP 3025 EP 3026 DI 10.2337/diacare.27.12.3025 PG 2 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 874DU UT WOS:000225331900056 ER PT J AU Craig, WA Bhavnani, SM Ambrose, PG AF Craig, WA Bhavnani, SM Ambrose, PG TI The inoculum effect: Fact or artifact? SO DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE LA English DT Editorial Material ID ESCHERICHIA-COLI; PNEUMONIAE; CEFEPIME C1 William S Middleton Mem Vet Adm Med Ctr, Clin Pharmacol Sect, Dept Med, Madison, WI USA. Ordway Res Inst Inc, Inst Clin Pharmacodynam, Albany, NY USA. SUNY Buffalo, Sch Pharm & Pharmaceut Sci, Buffalo, NY 14260 USA. RP Craig, WA (reprint author), William S Middleton Mem Vet Adm Med Ctr, Clin Pharmacol Sect, Dept Med, Madison, WI USA. EM pgambrose@aol.com NR 12 TC 34 Z9 35 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0732-8893 J9 DIAGN MICR INFEC DIS JI Diagn. Microbiol. Infect. Dis. PD DEC PY 2004 VL 50 IS 4 BP 229 EP 230 DI 10.1016/j.diagmicrobio.2004.07.006 PG 2 WC Infectious Diseases; Microbiology SC Infectious Diseases; Microbiology GA 880WQ UT WOS:000225821100001 PM 15582294 ER PT J AU O'Connell, JB Maggard, MA Liu, JH Etzioni, DA Ko, CY AF O'Connell, JB Maggard, MA Liu, JH Etzioni, DA Ko, CY TI Are survival rates different for young and older patients with rectal cancer? SO DISEASES OF THE COLON & RECTUM LA English DT Article; Proceedings Paper CT 37th Annual Meeting of the Association-for-Academic-Surgery CY NOV 13-15, 2003 CL Sacramento, CA SP Assoc Acad Surg DE rectal; cancer; young; survival; population-based; SEER ID COLORECTAL-CANCER; PATIENTS LESS; COLON; AGE; CARCINOMA; ADENOCARCINOMA; PROGNOSIS; DECADES; ADULTS AB PURPOSE: Although it is generally believed that young patients with rectal cancer have worse survival rates, no comprehensive analysis has been reported. This study uses a national-level, population-based cancer registry to compare rectal cancer outcomes between young vs. older populations. METHODS: All patients with rectal carcinoma in the Surveillance, Epidemiology, and End Results cancer database from 1991 to 1999 were evaluated. Young (range, 2040 years; n = 466) and older groups (range, 60-80 years; n = 11,312) were compared for patient and tumor characteristics, treatment patterns, and five-year overall and stage-specific survival. Cox multivariate regression analysis was performed to identify predictors of survival. RESULTS: Mean ages for the groups were 34.1 and 70 years. The young group was comprised of more black and Hispanic patients compared with the older group (P < 0.001). Young patients were more likely to present with late-stage disease (young vs. older: Stage 111, 27 vs. 20 percent respectively, P < 0.001; Stage IV, 17.4 vs. 13.6 percent respectively, P < 0.02). The younger group also had worse grade tumors (poorly differentiated 24.3 vs. 14 percent respectively, P < 0.001). Although the majority of both groups received surgery (85 percent for each), significantly more young patients received radiation (P < 0.001). Importantly, overall and stage-specific, five-year survival rates were similar for both groups (P = not significant). CONCLUSIONS: Although previous studies have found young rectal cancer patients to have poorer survival compared with older patients, this population-based study shows that young rectal cancer patients seem to have equivalent overall and stage-specific survival. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP O'Connell, JB (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, 10833 Le Conte Ave,Room 73-215, Los Angeles, CA 90095 USA. EM jbocjboc@hotmail.com NR 29 TC 71 Z9 78 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0012-3706 J9 DIS COLON RECTUM JI Dis. Colon Rectum PD DEC PY 2004 VL 47 IS 12 BP 2064 EP 2069 DI 10.1007/s10350-004-0738-1 PG 6 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 878MD UT WOS:000225650000011 PM 15657655 ER PT J AU Weiss, T Miltner, WHR Liepert, J Meissner, W Taub, E AF Weiss, T Miltner, WHR Liepert, J Meissner, W Taub, E TI Rapid functional plasticity in the primary somatomotor cortex and perceptual changes after nerve block SO EUROPEAN JOURNAL OF NEUROSCIENCE LA English DT Review DE human; magnetic source imaging; magnetoencephalography; transcranial magnetic stimulation ID HUMAN MOTOR CORTEX; TRANSCRANIAL MAGNETIC STIMULATION; PHANTOM-LIMB PAIN; PRIMARY SOMATOSENSORY CORTEX; AMYOTROPHIC-LATERAL-SCLEROSIS; TACTILE SPATIAL-RESOLUTION; INDUCED MOVEMENT THERAPY; SHORT-TERM PLASTICITY; SPINAL-CORD-INJURY; CORTICAL REORGANIZATION AB The mature human primary somatosensory cortex displays a striking plastic capacity to reorganize itself in response to changes in sensory input. Following the elimination of afferent return, produced by either amputation, deafferentation by dorsal rhizotomy, or nerve block, there is a well-known but little-understood 'invasion' of the deafferented region of the brain by the cortical representation zones of still-intact portions of the brain adjacent to it. We report here that within an hour of abolishing sensation from the radial and medial three-quarters of the hand by pharmacological blockade of the radial and median nerves, magnetic source imaging showed that the cortical representation of the little finger and the skin beneath the lower lip, whose intact cortical representation zones are adjacent to the deafferented region, had moved closer together, presumably because of their expansion across the deafferented area. A paired-pulse transcranial magnetic stimulation procedure revealed a motor cortex disinhibition for two muscles supplied by the unaffected ulnar nerve. In addition, two notable perceptual changes were observed: increased two-point discrimination ability near the lip and mislocalization of touch of the intact ulnar portion of the fourth finger to the neighbouring third finger whose nerve supply was blocked. We suggest that disinhibition within the somatosensory system as a functional correlate for the known enlargement of cortical representation zones might account for not only the 'invasion' phenomenon, but also for the observed behavioural correlates of the nerve block. C1 Univ Jena, Dept Biol & Clin Psychol, D-07743 Jena, Germany. Univ Jena, Dept Neurol, D-6900 Jena, Germany. Univ Jena, Dept Anaesthesiol & Intens Care Med, D-6900 Jena, Germany. Univ Alabama, Dept Psychol, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Res Serv, Birmingham, AL USA. RP Weiss, T (reprint author), Univ Jena, Dept Biol & Clin Psychol, Steiger 3 Haus 1, D-07743 Jena, Germany. EM weiss@biopsy.uni-jena.de NR 121 TC 51 Z9 53 U1 3 U2 11 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0953-816X J9 EUR J NEUROSCI JI Eur. J. Neurosci. PD DEC PY 2004 VL 20 IS 12 BP 3413 EP 3423 DI 10.1111/j.1460-9568.2004.03790.x PG 11 WC Neurosciences SC Neurosciences & Neurology GA 878ZK UT WOS:000225686000021 PM 15610174 ER PT J AU Won, JS Im, YB Singh, AK Singh, I AF Won, JS Im, YB Singh, AK Singh, I TI Dual role of cAMP in iNOS expression in glial cells and macrophages is mediated by differential regulation of p38-MAPK/ATF-2 activation and iNOS stability SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Article DE ATF-2; p38-MAPK; iNOS; proteasome; cAMP; forskolin; glial cells; macrophages; free radicals ID NITRIC-OXIDE SYNTHASE; NF-KAPPA-B; NECROSIS-FACTOR-ALPHA; SMOOTH-MUSCLE CELLS; RAT MESANGIAL CELLS; CYCLIC-AMP; GENE-EXPRESSION; PROTEIN-KINASE; BINDING-PROTEIN; TRANSCRIPTION AB We reported previously that cAMP analogues or cAMP synthesis activator (forskolin; FSK) inhibit lipopolysaccharide (LPS)-induced inducible nitric-oxide systase (NOS) gene expression in astrocytes, while they enhance that in macrophages. Here, we report that the FSK-mediated inhibition of iNOS expression in C6 glial cells is due to its reduced transcriptional activity, while the FSK-mediated enhancement of iNOS expression in RAW264.7 macrophages is a result of increased stability of iNOS protein without transcriptional enhancement. The LPS/interferon-gamma (IFN)-induced iNOS transcription was inhibited by FSK via inhibition of p38-MAPK/ATF-2 activity in glial cells while it was not affected in macrophages. In both cell types, proteasome activities were required for the spontaneous degradation of NOS protein, and the inhibition of proteasome activity by MG132 after maximum increase of iNOS protein levels further enhanced iNOS protein induction by LPS/IFN, suggesting the involvement of proteasome in iNOS degradation. More importantly, the iNOS protein levels were equalized by the MG132 posttreatment in macrophages treated with LPS/IFN alone and along with FSK, and ubiquitinated iNOS protein levels were reduced by FSK posttreatment, suggesting that the FSK-mediated inhibition of ubiquitination of NOS protein and the following increased stability of iNOS protein are one of the mechanisms of cAMP-pathway-mediated enhancement of iNOS gene expression in macrophages. To our knowledge, this is the first evidence that cAMP regulates NOS expression at the posttranslational level in macrophages. (C) 2004 Elsevier Inc. All rights reserved. C1 Med Univ S Carolina, Dept Pediat, Div Dev Neurogenet, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pathol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Singh, I (reprint author), Med Univ S Carolina, Dept Pediat, Div Dev Neurogenet, 316 CSB, Charleston, SC 29425 USA. EM singhi@musc.edu FU NINDS NIH HHS [NS-37766, NS-22576, NS-34741, NS-40810] NR 46 TC 26 Z9 27 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0891-5849 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PD DEC 1 PY 2004 VL 37 IS 11 BP 1834 EP 1844 DI 10.1016/j.freeradbiomed.2004.08.017 PG 11 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 874RC UT WOS:000225366500016 PM 15528042 ER PT J AU Khalid, A Finkelstein, S McGrath, K AF Khalid, A Finkelstein, S McGrath, K TI Molecular diagnosis of solid and cystic lesions of the pancreas SO GASTROENTEROLOGY CLINICS OF NORTH AMERICA LA English DT Article ID K-RAS MUTATIONS; DETECTING TELOMERASE ACTIVITY; POLYMERASE-CHAIN-REACTION; INTRAEPITHELIAL NEOPLASIA; DUCTAL ADENOCARCINOMA; GENE-MUTATIONS; PREOPERATIVE DIAGNOSIS; BRUSH CYTOLOGY; IMMUNOHISTOCHEMICAL EVALUATION; HER-2/NEU EXPRESSION AB Pancreatic cancer is associated with a poor prognosis, and long-term survival has not changed significantly over the last several decades. Significant efforts are focused on improved diagnosis and earlier detection of pancreatic cancer through identification of specific biomarkers. This article reviews clinical applications of molecular diagnosis of solid and cystic pancreatic neoplasia. C1 Univ Pittsburgh, Med Ctr, Div Gastroenterol Hepatol & Nutr, Pittsburgh, PA 15213 USA. Univ Dr, Vet Affairs Pittsburgh Hlth Care Syst, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Med Ctr, Dept Pathol, Pittsburgh, PA 15213 USA. RP McGrath, K (reprint author), Univ Pittsburgh, Med Ctr, Div Gastroenterol Hepatol & Nutr, M2,C Wing,A6163,200 Lothrop St, Pittsburgh, PA 15213 USA. EM mcgrathkm@upmc.edu NR 86 TC 8 Z9 8 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 0889-8553 J9 GASTROENTEROL CLIN N JI Gastroenterol. Clin. North Am. PD DEC PY 2004 VL 33 IS 4 BP 891 EP + DI 10.1016/j.gtc.2004.07.007 PG 17 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 873SZ UT WOS:000225302600012 PM 15528024 ER PT J AU Peabody, JW Tozija, F Munoz, JA Nordyke, RJ Luck, J AF Peabody, JW Tozija, F Munoz, JA Nordyke, RJ Luck, J TI Using vignettes to compare the quality of clinical care variation in economically divergent countries SO HEALTH SERVICES RESEARCH LA English DT Article DE benchmarking/methods; quality indicators; health care; quality of health care; cross-national comparative study; clinical vignettes ID PRIMARY-HEALTH-CARE; STANDARDIZED PATIENTS; MEDICAL-RECORD; CHART ABSTRACTION; CASE-MANAGEMENT; SERVICES; VALIDATION; PERCEPTIONS; PERFORMANCE; GUIDELINES AB Objective. To determine whether clinical vignettes can measure variations in the quality of clinical care in two economically divergent countries. Data Source/Study Setting. Primary data collected between February 1997 and February 1998 at two Veterans Affairs facilities in the United States and four government-run outpatient facilities in Macedonia. Study Design. Randomly selected, eligible Macedonian and U.S. physicians (>97 percent participation rate) completed vignettes for four common outpatient conditions. Responses were judged against a master list of explicit quality criteria and scored as percent correct. Data Collection/Extraction. An ANOVA model and two-tailed t-tests were used to compare overall scores by case, study site, and country. Principal Findings. The mean score for U.S. physicians was 67 percent (+/-11 percent) compared to 48 percent (+/-11 percent) for Macedonian physicians. The quality of clinical practice, which emphasizes basic skills, varied greatly in both sites, but more so in Macedonia. However, the top Macedonian physicians in all sites approached or-in one case-exceeded the median score in the U.S. sites. Conclusions. Vignettes are a useful method for making cross-national comparisons of the quality of care provided in very different settings. The vignette measurements revealed that some physicians in Macedonia performed at a standard comparable to that of their counterparts in the United States, despite the disparity of the two health systems. We infer that in poorer countries, policy that promotes improvements in the quality of clinical practice-not just structural inputs-could lead to rapid improvements in health. C1 Univ Calif San Francisco, Inst Global Hlth, San Francisco, CA 94105 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA 90406 USA. Univ St Cyril & Methudius, Cathedra Social Med Med Fac, Skopje 91000, Macedonia. Escuela Super Econ & Negocios, San Salvador, El Salvador. Vet Affiars Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. RP Peabody, JW (reprint author), Univ Calif San Francisco, Inst Global Hlth, 74 New Montgomery,Suite 508, San Francisco, CA 94105 USA. NR 53 TC 30 Z9 30 U1 3 U2 5 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD DEC PY 2004 VL 39 IS 6 BP 1951 EP 1970 DI 10.1111/j.1475-6773.2004.00327.x PN 2 PG 20 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 893TZ UT WOS:000226743500003 PM 15544639 ER PT J AU Jowers, C Shih, R James, J Deloughery, TG Holden, WE AF Jowers, C Shih, R James, J Deloughery, TG Holden, WE TI Effects of Ginkgo biloba on exhaled nasal nitric oxide during normobaric hypoxia in humans SO HIGH ALTITUDE MEDICINE & BIOLOGY LA English DT Article DE vasodilation; acute mountain sickness; high altitude pulmonary edema; nose; altitude ID ACUTE MOUNTAIN-SICKNESS; EXTRACT AB Jowers, Casey, Richard Shih, Jim James, Thomas Deloughery, and William Holden. Effects of Ginkgo biloba on exhaled nasal nitric oxide during normobaric hypoxia in humans. High Alt. Med. Biol. 5:445-449, 2004.-Ginkgo biloba, an extract of the ginkgo tree, may prevent or lessen symptoms of acute mountain sickness in humans. The mechanism of this effect is poorly understood. One hypothesis is that ginkgo alters nitric oxide (NO) metabolism, possibly by scavenging NO or altering nitric oxide synthase expression and thereby lessening the vasodilatory effects of NO. To date, an effect of Ginkgo biloba on NO metabolism has not been demonstrated in humans. We measured exhaled nasal NO output in humans (n = 9) during normoxia and then during acute normobaric hypoxia (goal oxyhemoglobin saturation 75% to 85%) before and after administration of a standardized extract of Ginkgo biloba (120 mg twice daily for 5 days). Oxygen saturation, heart rate, and minute ventilation were similar before and after Ginkgo biloba administration. Exhaled nasal NO output was increased during normoxia following ginkgo (p < 0.02) and reduced during normobaric hypoxia both before (p < 0.02) and following (p < 0.003) ginkgo. Exhaled nasal NO output during normobaric hypoxia was lowest following ginkgo (p < 0.003). We conclude that Ginkgo biloba increases exhaled nasal NO output during normoxia and enhances reduced exhaled nasal NO output during normobaric hypoxia. Our results suggest that Ginkgo biloba may act to reduce AMS through an effect on NO metabolism. C1 Portland VA Med Ctr, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Holden, WE (reprint author), Portland VA Med Ctr, 3710 SW U-S Vet Hosp Rd,P3-PULM, Portland, OR 97201 USA. EM william.holden@med.va.gov NR 12 TC 2 Z9 2 U1 0 U2 0 PU MARY ANN LIEBERT INC PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1527-0297 J9 HIGH ALT MED BIOL JI High Alt. Med. Biol. PD WIN PY 2004 VL 5 IS 4 BP 445 EP 449 DI 10.1089/ham.2004.5.445 PG 5 WC Biophysics; Public, Environmental & Occupational Health; Sport Sciences SC Biophysics; Public, Environmental & Occupational Health; Sport Sciences GA 890GR UT WOS:000226500200007 PM 15671634 ER PT J AU Lim, HK Lee, DC McKay, WB Protas, EJ Holmes, SA Priebe, MM Sherwood, A AF Lim, HK Lee, DC McKay, WB Protas, EJ Holmes, SA Priebe, MM Sherwood, A TI Analysis of sEMG during voluntary movement - Part II: Voluntary response index sensitivity SO IEEE TRANSACTIONS ON NEURAL SYSTEMS AND REHABILITATION ENGINEERING LA English DT Article DE electromyography (EMG); motor control; spinal-cord injuries ID SPINAL-CORD INJURY; SURFACE EMG; GAIT AB In this paper, a method for analyzing surface electromyographic (sEMG) data recorded from the lower-limb muscles of incomplete spinal-cord injured (iSCI) subjects is evaluated. sEMG was recorded bilaterally from quadriceps, adductor, hamstring, tibialis anterior, and triceps surae muscles during voluntary ankle dorsillexion performed in the supine position as part of a comprehensive motor control assessment protocol. Analysis of the sEMG centered on two features, the magnitude of activation and the degree of similarity [similarity index (SI)] of the sEMG distribution to that of healthy subjects performing. the same maneuver (n = 10). The analysis calculations resulted in response vectors (RV) that were compared to healthy-subject-derived prototype response vectors resulting in a voluntary response index (VRI) [1]. Incomplete SCI subjects (n = 9) were used to test the sensitivity of this analysis method. They were given supported-weight treadmill ambulation training, which is expected to improve or at least not cause a deterioration of voluntary motor control. The VRI provided evidence that the quantitative sEMG analysis method used was able to differentiate between healthy subjects and those with iSCI, characterize individual differences among iSCI subjects, and track motor control changes occurring over time. C1 Baylor Coll Med, Houston, TX 77030 USA. Michael E DeBakey Med Ctr, Houston, TX 77030 USA. Methodist Rehabil Ctr, Jackson, MS 39216 USA. Univ Texas, Med Branch, Galveston, TX 77555 USA. Edward Hines Jr Vet Affairs Hosp, Hines, IL 60141 USA. RP Lim, HK (reprint author), Baylor Coll Med, Houston, TX 77030 USA. OI Sherwood, Arthur/0000-0002-0110-4317 NR 22 TC 8 Z9 8 U1 0 U2 0 PU IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC PI PISCATAWAY PA 445 HOES LANE, PISCATAWAY, NJ 08855 USA SN 1534-4320 J9 IEEE T NEUR SYS REH JI IEEE Trans. Neural Syst. Rehabil. Eng. PD DEC PY 2004 VL 12 IS 4 BP 416 EP 421 DI 10.1109/TNSRE.2004.838445 PG 6 WC Engineering, Biomedical; Rehabilitation SC Engineering; Rehabilitation GA 879UN UT WOS:000225744500006 PM 15614997 ER PT J AU Thrupp, L Bradley, S Smith, P Simor, A Gantz, N Crossley, K Loeb, M Strausbaugh, L Nicolle, L Bradley, S Crossley, K Gainer, RB Gantz, N Loeb, M Nicolle, L Quiros, R Simor, A Smith, P Steele, L Stevenson, K Strausbaugh, L Thrupp, L AF Thrupp, L Bradley, S Smith, P Simor, A Gantz, N Crossley, K Loeb, M Strausbaugh, L Nicolle, L Bradley, S Crossley, K Gainer, RB Gantz, N Loeb, M Nicolle, L Quiros, R Simor, A Smith, P Steele, L Stevenson, K Strausbaugh, L Thrupp, L CA SHEA Long-Term-Care Comm TI Tuberculosis prevention and control in long-term-care facilities for older adults SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Review ID MULTIDRUG-RESISTANT TUBERCULOSIS; BACTEC MGIT 960; PULMONARY TUBERCULOSIS; MYCOBACTERIUM-TUBERCULOSIS; SKIN-TEST; ISONIAZID CHEMOPROPHYLAXIS; MILIARY TUBERCULOSIS; CLINICAL SPECIMENS; DRUG-RESISTANCE; ELDERLY PERSONS AB In the United States, older adults comprise 22% of cases of tuberculous disease but only 12% of the population. Most cases of tuberculosis (TB) occur in community dwellers, but attack rates are highest among frail residents of long-term-care facilities. The detection and treatment of latent TB infection and TB disease can pose special challenges in older adults. Rapid recognition of possible disease, diagnosis, and implementation of airborne precautions are essential to prevent spread. It is the intent of this evidence-based guideline to assist healthcare providers in the prevention and control of TB, specifically in skilled nursing facilities for the elderly. C1 Univ Calif Irvine, Ctr Med, Infect Control Dept, Orange, CA 92868 USA. Univ Michigan, Dept Internal Med, Med Sch, Ann Arbor, MI 48109 USA. Univ Michigan, Vet Affairs Ann Arbor Healthcare Syst, Ann Arbor, MI 48109 USA. Univ Nebraska, Med Ctr, Dept Internal Med Infect Dis, Omaha, NE USA. Sunnybrook & Womens Coll, Hlth Sci Ctr, Dept Microbiol, Toronto, ON, Canada. Boulder Community Hosp, Dept Infect Dis, Boulder, CO USA. Univ Minnesota, Sch Med, Minneapolis, MN 55455 USA. Minneapolis VA Med Ctr, Dept Educ, Minneapolis, MN USA. Minneapolis VA Med Ctr, Dept Internal Med, Minneapolis, MN USA. McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada. Hamilton Reg Lab Program, Hamilton, ON, Canada. Oregon Hlth Sci Univ, Sch Med, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. Hlth Sci Ctr, Dept Med, Winnipeg, MB, Canada. RP Thrupp, L (reprint author), Univ Calif Irvine, Ctr Med, Infect Control Dept, Bldg 53,Rm 220,101 City Dr, Orange, CA 92868 USA. NR 104 TC 20 Z9 20 U1 0 U2 1 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD DEC PY 2004 VL 25 IS 12 BP 1097 EP 1108 DI 10.1086/502350 PG 12 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 879NS UT WOS:000225725100016 PM 15636299 ER PT J AU Dominguez, S Cooper, D Torriani, F Rodriguez-Torres, M Brau, N Sulkowski, W Sola, R Katlama, C Clumeck, N Nelson, MR Correa, MC Godofsky, EW Dieterich, D Duff, F Passe, S Lissen, E AF Dominguez, S Cooper, D Torriani, F Rodriguez-Torres, M Brau, N Sulkowski, W Sola, R Katlama, C Clumeck, N Nelson, MR Correa, MC Godofsky, EW Dieterich, D Duff, F Passe, S Lissen, E TI HCV-related factors but not HIV-related factors at baseline predict the response to treatment with peginterferon alfa-2a (40 kd) (pegasys) plus ribavirin (copegus) in patients with HIV-HCV co-infection: predictor analysis from the APRICOT study SO INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS LA English DT Meeting Abstract CT 6th European Congress of Chemotherapy and Infection/24th Interdisciphinary Meeting of Chimiotherapie Anit-Infections CY DEC 01-03, 2004 CL Paris, FRANCE C1 Univ New S Wales, Sydney, NSW, Australia. CHU St Pierre, Brussels, Belgium. HCFMUSP, Casa AIDS, Sao Paulo, Brazil. Hop La Pitie Salpetriere, Paris, France. Diego Res Fdn, Santurce, PR USA. Hosp del Mar, Barcelona, Spain. Virgen Rocio Univ Hosp, Seville, Spain. Chelsea & Westminster Hosp, London, England. Johns Hopkins Univ, Sch Med, Baltimore, MD USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. Mt Sinai Sch Med, New York, NY USA. Roche, Nutley, NJ USA. Univ Calif, San Diego, CA USA. Univ S Florida, Sch Med, Tampa, FL 33620 USA. RI mendes correa, maria cassia /A-6779-2013 NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0924-8579 J9 INT J ANTIMICROB AG JI Int. J. Antimicrob. Agents PD DEC PY 2004 VL 24 SU 2 BP S117 EP S117 PG 1 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 879RD UT WOS:000225734000127 ER PT J AU Yerevanian, BI Feusner, JD Koek, RJ Mintz, J AF Yerevanian, BI Feusner, JD Koek, RJ Mintz, J TI The dexamethasone suppression test as a predictor of suicidal behavior in unipolar depression SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE dexamethasone; depressive disorder; dysthymic disorder; suicide; attempted; suicide ID CEREBROSPINAL-FLUID; AMINE METABOLITES; METAANALYSIS; DISORDERS AB Background: Non-suppression on the dexamethasone suppression test (DST) in unipolar depression has been found to be associated with completed suicide, with less consistent data for attempted suicide and hospitalizations for suicidality. The purpose of this study was to examine DST non-suppression as a predictor of these three aspects of suicidal behaviour. Methods: Records were reviewed for 101 patients who met criteria for major depressive disorder and/or dysthymic disorder and had a DST performed. All patients were treated naturalistically and were followed for an average of 2 years. DST suppressors and non-suppressors were compared with respect to three outcomes: (1) completed suicide; (2) attempted suicide; and (3) hospitalizations for suicidality. Results: DST non-suppressors were significantly more likely to have completed suicide or be hospitalized for suicidality than DST suppressors, with a non-significant trend for attempts. Total suicidal events were also significantly more frequent in the non-suppressor group. Limitations: Axis II diagnoses and,severity of illness were not assessed. Knowledge of DST results may have influenced the decision to hospitalize patients. Conclusions: DST non-suppression identifies unipolar depressed patients with a higher risk for future suicide completion or hospitalization for suicidality. Performance of DST upon initiation of treatment may be a useful adjunct in identifying suicidal risk. Published by Elsevier B.V. C1 VA Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Biostat Consultat Unit, Los Angeles, CA 90073 USA. RP Yerevanian, BI (reprint author), 16111 Plummer St,116A-11, North Hills, CA 91343 USA. EM byerevan@ucla.edu RI Feusner, Jamie/K-2312-2012 OI Feusner, Jamie/0000-0002-0391-345X NR 32 TC 50 Z9 51 U1 0 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD DEC PY 2004 VL 83 IS 2-3 BP 103 EP 108 DI 10.1016/j.jad.2004.08.009 PG 6 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 880XA UT WOS:000225822100001 PM 15555702 ER PT J AU Yan, LJ Hammen, C Cohen, AN Daley, SE Henry, RM AF Yan, LJ Hammen, C Cohen, AN Daley, SE Henry, RM TI Expressed emotion versus relationship quality variables in the prediction of recurrence in bipolar patients SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE bipolar disorder; social support; recurrence; expressed emotion; perceived criticism; polarity-specificity ID SOCIAL SUPPORT; PSYCHIATRIC-PATIENTS; PERCEIVED CRITICISM; DISORDER; RELAPSE; DEPRESSION; MANIA AB Background: The expressed emotion (EE) construct has predicted clinical outcomes in schizophrenia and depression, but few studies have been conducted with bipolar patients. Moreover, there is a particular dearth of information regarding the prediction of depressive versus manic episodes in bipolar patients. Questions also remain about the utility of EE compared to other variables (perceived criticism, relationship negativity, and chronic strain in close relationships) that more directly evaluate interpersonal stress and about specific predictions of mania or depression. Methods: Forty-seven outpatients with bipolar I disorder participated in a 1-year longitudinal study. A close collateral of the patient completed the Five Minute Speech Sample (FMSS) to assess EE, and participants completed perceived criticism and negativity ratings of collaterals. Clinical outcomes and chronic interpersonal stress were assessed by interview at 3-month intervals. Results: High EE predicted depressive, but not manic recurrence. Other variables of close interpersonal relationships were not significant predictors of recurrence. Limitations: Participants nominated collaterals, and those who did not have such a confidant were excluded. Conclusions: The FMSS was sensitive to even mild negativity by the collateral that predicted later depressive episodes. This is the first study to demonstrate polarity-specific effects of EE on the prediction of recurrence in bipolar disorder. (C) 2004 Elsevier B.V. All rights reserved. C1 Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA. W Los Angeles VA Healthcare Ctr, Los Angeles, CA USA. MIRECC, Los Angeles, CA USA. Univ So Calif, Dept Psychol, Los Angeles, CA 90089 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Yan, LJ (reprint author), Univ Calif Los Angeles, Dept Psychol, 1285 Franz Hall,POB 951563,405 Hilgard Ave, Los Angeles, CA 90095 USA. EM ljyan@ucla.edu NR 25 TC 62 Z9 63 U1 2 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD DEC PY 2004 VL 83 IS 2-3 BP 199 EP 206 DI 10.1016/j.jad.2004.08.006 PG 8 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 880XA UT WOS:000225822100013 PM 15555714 ER PT J AU Bartzokis, G Lu, PH Mintz, J AF Bartzokis, G Lu, PH Mintz, J TI Quantifying age-related myelin breakdown with MRI: Novel therapeutic targets for preventing cognitive decline and Alzheimer's disease SO JOURNAL OF ALZHEIMERS DISEASE LA English DT Article DE myelin; oligodendrocyte; white matter; degeneration; dementia; development; aging; Alzheimer's disease; amyloid; beta; tau; MRI; relaxation rate; cholesterol; iron; metal; chelation; nicotine; MCI; AAMI; cognitive; memory; impairment; medications; treatment; brain; neurons ID WHITE-MATTER; NERVE-FIBERS; BRAIN; VOLUMES; MONKEY; MODEL; RAT AB Myelin plays an essential role in brain structure and function and the human brain is uniquely dependent on the elaboration of this late invention of evolution. Our brain has the most extensive and protracted process of myelination that extends to approximately age 50 in cortical regions that have the highest risk for developing Alzheimer's disease (AD) pathology. This myelin-centered model of the human brain asserts that unique vulnerabilities of myelin, especially late-developed myelin, and the oligodendrocytes that produce it are directly pertinent to many uniquely human neuropsychiatric diseases including late-life neurodegenerative disorders such as AD. Magnetic resonance imaging (MRI) technology permits the in vivo assessment of the roughly quadratic (inverted U) lifelong trajectory of human myelin development and its subsequent breakdown. There is close agreement between neuropsychology, neuropathology, and imaging measures suggesting that the process of myelin breakdown begins in adulthood, accelerates as aging progresses, and underlies both age-related cognitive declines and the most powerful risk factor of dementia-causing disorders such as AD: age. This myelin-centered model together with the technology that makes it possible to measure the trajectory of myelin breakdown provide a framework for developing novel treatments, as well as assessing efficacy of currently available treatments, intended to slow or reverse the breakdown process in both clinically healthy as well as symptomatic populations. Such treatments can be expected to have a wide spectrum of efficacy and impact multiple human disease processes including potentially slowing brain aging and thus provide opportunities for primary prevention of age-related degenerative disorders such as AD. C1 Univ Calif Los Angeles, Alzheimers Dis Ctr, David Gheffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Gheffen Sch Med, Dept Neurol, Div Brain Mapping,Lab Neuroimaging, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90073 USA. Charles R Drew Univ Med & Sci, Dept Psychiat, Los Angeles, CA 90043 USA. Univ Calif Los Angeles, David Gheffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, Alzheimers Dis Ctr, David Gheffen Sch Med, Dept Neurol, 710 Westwood Plaza,Room 2-238, Los Angeles, CA 90095 USA. EM gbar@ucla.edu RI Bartzokis, George/K-2409-2013 FU NIA NIH HHS [AG16570]; NIMH NIH HHS [MH0266029] NR 19 TC 41 Z9 42 U1 0 U2 7 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1387-2877 J9 J ALZHEIMERS DIS JI J. Alzheimers Dis. PD DEC PY 2004 VL 6 IS 6 SU S BP S53 EP S59 PG 7 WC Neurosciences SC Neurosciences & Neurology GA 900JT UT WOS:000227211900010 PM 15665415 ER PT J AU Longo, FM Massa, SM AF Longo, FM Massa, SM TI Neurotrophin-based strategies for neuroprotection SO JOURNAL OF ALZHEIMERS DISEASE LA English DT Article ID NERVE GROWTH-FACTOR; AMYLOID-BETA-PEPTIDE; INDUCED NEURONAL APOPTOSIS; SMALL-MOLECULE MIMETICS; ALZHEIMERS-DISEASE; CORTICAL-NEURONS; GENE-THERAPY; CELL-DEATH; RECEPTOR; P75 AB Neurotrophins activate a number of signaling pathways relevant to neuroprotection; however, their poor pharmacological properties and their pleiotropic effects resulting from interaction with the p75(NTR)-Trk-sortilin three-receptor signaling system limit therapeutic application. While local application of neurotrophin proteins addresses some of the pharmacological challenges, selective targeting of neurotrophin receptors might allow for more selective application of neurotrophin receptor signaling modulation. Recent studies have supported the feasibility of developing non-peptidyl small molecules that mimic specific domains of neurotrophins and modulate signaling of specific neurotrophin receptors. The expression of p75(NTR) by populations of neurons most vulnerable in Alzheimer's disease and the linkage of p75(NTR) signaling to aberrant signaling mechanisms occurring in this disorder, point to potential applications for p75(NTR)-based small molecule strategies. Small molecules targeted to p75(NTR) in the settings of neurodegenerative disease and other forms of neural injury might serve to inhibit death signaling, block proNGF-mediated degenerative signaling and minimize deleterious effects promoted by pharmacologically upregulated Trk signaling. C1 Univ N Carolina, Sch Med, Dept Neurol, Chapel Hill, NC 27599 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Longo, FM (reprint author), Univ N Carolina, Sch Med, Dept Neurol, CB7025, Chapel Hill, NC 27599 USA. EM longof@glial.med.unc.edu FU NIA NIH HHS [R01 AG09873] NR 47 TC 18 Z9 18 U1 0 U2 0 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1387-2877 J9 J ALZHEIMERS DIS JI J. Alzheimers Dis. PD DEC PY 2004 VL 6 IS 6 SU S BP S13 EP S17 PG 5 WC Neurosciences SC Neurosciences & Neurology GA 900JT UT WOS:000227211900004 PM 15665408 ER PT J AU Ledoux, WR Meaney, DF Hillstrom, HJ AF Ledoux, WR Meaney, DF Hillstrom, HJ TI A quasi-linear, viscoelastic, structural model of the plantar soft tissue with frequency-sensitive damping properties SO JOURNAL OF BIOMECHANICAL ENGINEERING-TRANSACTIONS OF THE ASME LA English DT Article DE foot; biomechanics; heel; metatarsals ID HUMAN HEEL PAD; MECHANICAL-PROPERTIES; FAT PAD; RESPONSES; FOOT; COMPRESSION; THICKNESS; BEHAVIOR; LIGAMENT; SOLE AB Little is known about the structural properties of plantar soft-tissue areas other than the heel; nor is it known whether the structural properties vary depending on location. Furthermore, although the quasi-linear viscoelastic (QLV) theory, has been used to model many soft-tissue types, it has not been employed to model the plantar soft tissue. The structural properties of the plantar soft tissue were quantified via stress relaxation experiments at seven regions (subcolcaneal, five submetatarsal, and subhallucal) across eight codaveric feet. The cadaveric feet were 36.9+/-17.4 (mean+/-S.D.) Years of age, all free front vascular diseases and orthopedics disorders. All tests were performed at a constant environmental temperature of 35degreesC. Stress relaxation experiments it ere performed: different loads were employed for different areas based on normative gait data. A modification of the relaxation spectrum employed within the QLV theory allowed for the inclusion of frequency-sensitive relaxation properties in addition to nonlinear elastic behavior The tissue demonstrated frequency-dependent damping properties that made the QLV theory ill suited to model the relaxation. There was a significant difference between the elastic structural properties (A) of the subcalcaneal tissue and all other areas (p=0.004), and a trend (p=0.067) for the fifth submetatarsal to have less viscous damping (cl) than the subhallucal, or first. second, or third submetatarsal areas. Thus, the data demonstrate that the structural properties of the foot can van: across regions, but careful consideration must be given to the applied loads and the manner in which the loads were applied. C1 VA Puget Sound Hlth Care Syst, Dept Vet Affairs, RR&D Ctr Excellence Limb Loss Prevent & Prosthet, Seattle, WA 98108 USA. Univ Washington, Dept Mech Engn, Seattle, WA 98195 USA. Univ Washington, Dept Orthopaed & Sports Med, Seattle, WA 98195 USA. Univ Penn, Dept Bioengn, Philadelphia, PA 19104 USA. Temple Univ, Sch Med, Gait Study Ctr, Philadelphia, PA 19107 USA. RP Ledoux, WR (reprint author), VA Puget Sound Hlth Care Syst, Dept Vet Affairs, RR&D Ctr Excellence Limb Loss Prevent & Prosthet, Seattle, WA 98108 USA. EM wrledoux@u.washington.edu RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 NR 29 TC 14 Z9 14 U1 1 U2 2 PU ASME-AMER SOC MECHANICAL ENG PI NEW YORK PA THREE PARK AVE, NEW YORK, NY 10016-5990 USA SN 0148-0731 J9 J BIOMECH ENG-T ASME JI J. Biomech. Eng.-Trans. ASME PD DEC PY 2004 VL 126 IS 6 BP 831 EP 837 DI 10.1115/1.1824133 PG 7 WC Biophysics; Engineering, Biomedical SC Biophysics; Engineering GA 901XD UT WOS:000227314700017 PM 15796342 ER PT J AU Mann, DL AF Mann, DL TI Basic mechanisms of left ventricular remodeling: The contribution of wall stress SO JOURNAL OF CARDIAC FAILURE LA English DT Article DE left ventricular remodeling; stretch; signal transduction; heart failure ID CONGESTIVE-HEART-FAILURE; SIGNAL-TRANSDUCTION PATHWAYS; BETA-ADRENERGIC-BLOCKADE; ACTIVATED ION CHANNELS; GTP-BINDING PROTEINS; CARDIAC MYOCYTES; DILATED CARDIOMYOPATHY; STRETCH; HYPERTROPHY; DISEASE AB Heart failure may be viewed as a progressive disorder that is impelled, at least in part, by progressive left ventricular (LV) remodeling. In the present discussion we will review the role of LV remodeling in the pathogenesis of heart failure, with a focus on the contribution that increased wall stress plays in the development and progression of LV remodeling. The clinical implication of this review is that existing neurohormonal strategies may not completely prevent disease progression in the failing heart, and that adjunctive strategies that are designed to specifically prevent or attenuate LV remodeling may play an important role in the clinical treatment of heart failure. C1 Baylor Coll Med, Winters Ctr Heart Failure Res, Dept Med, Houston, TX 77030 USA. Houston Vet Adm Med Ctr, Houston, TX USA. RP Mann, DL (reprint author), Baylor Coll Med, Winters Ctr Heart Failure Res, Dept Med, 6565 Fannin,MS 524, Houston, TX 77030 USA. FU NHLBI NIH HHS [P50 HL-O6H, R01 HL58081-01] NR 46 TC 24 Z9 26 U1 0 U2 2 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 DEC PY 2004 VL 10 IS 6 SU S BP S202 EP S206 DI 10.1016/j.cardfail.2004.09.008 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 885FL UT WOS:000226142400003 PM 15803551 ER PT J AU Yarbrough, WM Mukherjee, R Squires, CE Reese, ES Leiser, JS Stroud, RE Sample, JA Hendrick, JW Mingoia, JT McLean, JE Hardin, AE Dowdy, KB Spinale, FG AF Yarbrough, WM Mukherjee, R Squires, CE Reese, ES Leiser, JS Stroud, RE Sample, JA Hendrick, JW Mingoia, JT McLean, JE Hardin, AE Dowdy, KB Spinale, FG TI Caspase inhibition attenuates contractile dysfunction following cardioplegic arrest and Rewarming in the setting of left ventricular failure SO JOURNAL OF CARDIOVASCULAR PHARMACOLOGY LA English DT Article DE caspase; myocyte; LV failure; contractility ID MYOCARDIAL INFARCT SIZE; POTASSIUM CARDIOPLEGIA; RECEPTOR BLOCKADE; HEART-FAILURE; IN-VIVO; ISCHEMIA; ACTIVATION; APOPTOSIS; RECOVERY; TARGET AB Hyperkalemic cardioplegic arrest (HCA) and rewarming evokes postoperative myocyte contractile dysfunction, a phenomenon of particular importance in settings of preexisting left ventricular (LV) failure. Caspases are intracellular proteolytic enzymes recently demonstrated to degrade myocardial contractile proteins. This study tested the hypothesis that myocyte contractile dysfunction induced by HCA could be ameliorated with caspase inhibition in the setting of compromised myocardial function. LV myocytes were isolated from control pigs (n = 9, 30 kg) or pigs with LV failure induced by rapid pacing (n = 6, 240 bpm for 21 days) and were randomized to the following: (1) normothermia (2003 myocytes), incubation in cell culture medium for 2 hours at 37degreesC; (2) HCA only (506 myocytes), incubation for 2 hours in hypothermic HCA solution (4degreesC, 24 mEq K+); or (3) HCA + z-VAD, incubation in hypothermic HCA solution supplemented with 10 muM of the caspase inhibitor z-VAD (z-Val-Ala-Asp-fluoromethyl-ketone, 415 myocytes). Inotropic responsiveness was examined using beta-adrenergic stimulation (25 nM isoproterenol). Ambient normothermic myocyte shortening velocity (mum/s) was reduced with LV failure compared with control values (54 +/- 2 versus 75 +/- 2, respectively, P < 0.05). Following HCA, shortening velocity decreased in the LV failure and control groups (27 +/- 5 and 45 +/- 3, P < 0.05). Institution of z-VAD increased myocyte shortening velocity following HCA in both the LV failure and control groups (49 +/- 5 and 65 +/- 5, P < 0.05). Moreover, HCA supplementation with z-VAD increased beta-adrenergic responsiveness in both groups compared with HCA-only values. This study provides proof of concept that caspase activity contributes to myocyte contractile dysfunction following simulated HCA. Pharmacologic caspase inhibition may hold particular relevance in the execution of cardiac surgical procedures requiring HCA in the context of preexisting LV failure. C1 Med Univ S Carolina, Div Cardiothorac Surg, Charleston, SC 29425 USA. Ralph Johnson Vet Assoc Med Ctr, Charleston, SC 29425 USA. RP Spinale, FG (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, Strom Thurmond Res Bldg,770 MUSC Complex,Suite 62, Charleston, SC 29425 USA. EM wilburnm@musc.edu FU NHLBI NIH HHS [HL-07260, HL-56603, HL-48788] NR 24 TC 2 Z9 2 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0160-2446 J9 J CARDIOVASC PHARM JI J. Cardiovasc. Pharmacol. PD DEC PY 2004 VL 44 IS 6 BP 645 EP 650 DI 10.1097/00005344-200412000-00004 PG 6 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA 877HR UT WOS:000225559200004 PM 15550782 ER PT J AU Singh, BN AF Singh, BN TI Pursuit of sinus rhythm in patients with atrial fibrillation: Is the effort worth it? SO JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS LA English DT Editorial Material ID QUALITY-OF-LIFE; CARDIOVERSION; PREVENTION; IMPAIRMENT; MANAGEMENT; DISEASE; RISK C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Singh, BN (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Cardiol 111E, Los Angeles, CA 90073 USA. EM bsingh@ucla.edu NR 17 TC 2 Z9 2 U1 0 U2 0 PU WESTMINSTER PUBL INC PI GLEN HEAD PA 708 GLEN COVE AVE, GLEN HEAD, NY 11545 USA SN 1074-2484 J9 J CARDIOVASC PHARM T JI J. Cardiovasc. Pharmacol. Ther. PD DEC PY 2004 VL 9 IS 4 BP 219 EP 221 DI 10.1177/107424840400900401 PG 3 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA 890EY UT WOS:000226495700001 PM 15678240 ER PT J AU Ebrahimi, R Saleh, JR Toggart, EJ Hayatdavoudi, B Wolf, CJ Wadhani, NN Shah, AP AF Ebrahimi, R Saleh, JR Toggart, EJ Hayatdavoudi, B Wolf, CJ Wadhani, NN Shah, AP TI Lipid-lowering therapy in patients with peripheral arterial disease SO JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS LA English DT Article DE peripheral arterial disease; hypocholesterolemic drugs; HMG-CoA inhibitors; lipid therapy ID ANKLE-BRACHIAL INDEX; FEMORAL ATHEROSCLEROSIS; VASCULAR-DISEASE; INTERMITTENT CLAUDICATION; CHOLESTEROL REDUCTION; LEG SYMPTOMS; TRIAL; PREDICTOR; EVENTS; PROGRESSION AB Peripheral arterial disease (PAD) is a prevalent, chronic, and progressive atherosclerotic disease process involving the conduit vessels of the extremities. Most patients who present with objective signs of PAD are asymptomatic. These patients are at an increased risk of dying from cardiovascular events. Lipid management is the mainstay of risk-factor modification for patients with cardiovascular disease. Some evidence suggests that hypocholesterolemic drugs may halt the progression of atherosclerotic peripheral vascular disease. More recently, treatment with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) inhibitors have demonstrated improved function in patients with symptomatic peripheral vascular disease. This paper reviews the role of lipid therapy in patients with peripheral arterial disease with focus on functional improvement and symptomatic relief based on the available data. C1 Greater Los Angeles VA Med Ctr, Div Cardiol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. RP Ebrahimi, R (reprint author), Greater Los Angeles VA Med Ctr, Div Cardiol, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM rami.ebrahimi@med.va.gov NR 35 TC 4 Z9 4 U1 1 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1074-2484 EI 1940-4034 J9 J CARDIOVASC PHARM T JI J. Cardiovasc. Pharmacol. Ther. PD DEC PY 2004 VL 9 IS 4 BP 271 EP 277 DI 10.1177/107424840400900407 PG 7 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA 890EY UT WOS:000226495700007 PM 15678246 ER PT J AU Collins, TC Suarez-Almazor, M Petersen, NJ O'Malley, KJ AF Collins, TC Suarez-Almazor, M Petersen, NJ O'Malley, KJ TI A Spanish translation of the Walking Impairment Questionnaire was validated for patients with peripheral arterial disease SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE peripheral arterial disease; Walking Impairment; Hispanic Americans; questionnaires ID IQOLA PROJECT APPROACH; SCALING ASSUMPTIONS; GENERAL-POPULATION; PHYSICAL-ACTIVITY; DATA QUALITY; RELIABILITY; PREVALENCE; WOMEN AB Objectives: Walking impairment is a common manifestation of peripheral arterial disease (PAD). In this study we present evidence for the validity of our Spanish translation of the Walking Impairment Questionnaire (WIQ). Methods: The WIQ was translated into Spanish by our team of researchers. Spanish-speaking patients in the Houston. TX. area completed Spanish versions of the WIQ and the SF-36. Evidence for convergent and discriminant validity of the WIQ was obtained from correlations between the WIQ and other measures. Spanish or English as the primary language defined language-swaking status. Results: Amon- 403 patients, convergent validity evidence was strong for both English- and Spanish-speaking patients. For patients with PAD, the correlation between walking distance and physical functioning was 0.55 (P <.01) for English-speaking patients and 0.85 (P <.01) for Spanish-speaking patients. The correlations of walking impairment with emotional health measures ranged from 0.26 to 0.44 for English-speaking patients (P <.01) and from 0.34 to 0.78 for Spanish-speaking patients. Conclusions: The WIQ scores Correlated well with SF-36 components for both English- and SpaniSh-speaking patients. Our findings, suggested that our translation process did not limit our ability to capture good-quality data. Further research is needed to deteirniine what specific items in the WIQ or the SF-36 questionnaire warrant restructuring to increase their validity for use in diverse populations. (C) 2004 Elsevier Inc. All rights reserved. C1 Baylor Coll Med, Micael E DeBakey VA Med Ctr, Houston, TX 77030 USA. Houston Va Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. RP Collins, TC (reprint author), Baylor Coll Med, Micael E DeBakey VA Med Ctr, 2002 Holcombe Blvd,152, Houston, TX 77030 USA. EM tcollins@bcm.tmc.edu NR 31 TC 19 Z9 19 U1 11 U2 11 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 DEC PY 2004 VL 57 IS 12 BP 1305 EP 1315 DI 10.1016/j.jclinepi.2004.03.005 PG 11 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 885KA UT WOS:000226154300012 PM 15617957 ER PT J AU Burn, AK Fothergill, AW Kirkpatrick, WR Coco, BJ Patterson, TF McCarthy, DI Rinaldi, MG Redding, SW AF Burn, AK Fothergill, AW Kirkpatrick, WR Coco, BJ Patterson, TF McCarthy, DI Rinaldi, MG Redding, SW TI Comparison of antifungal susceptibilities to fluconazole and voriconazole of oral Candida glabrata isolates from head and neck radiation patients SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID PATIENTS RECEIVING RADIATION; RESISTANCE; RAVUCONAZOLE; COLONIZATION; INFECTIONS; CANCER; AGENTS AB The antifungal susceptibilities of 79 oral Candida glabrata isolates to fluconazole and voriconazole were compared. The MICs at which 90% of the isolates tested were inhibited were 1 mug of voriconazole/ml and 32 mug of fluconazole/ml. Oral C. glabrata isolates for which the fluconazole MICs are elevated are commonly those for which the voriconazole MICs are elevated, but these increases may be transient for voriconazole, as they are for fluconazole. C1 Univ Texas, Hlth Sci Ctr, Dept Gen Dent, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Healthcare Syst, San Antonio, TX USA. RP Burn, AK (reprint author), Univ Texas, Hlth Sci Ctr, Dept Gen Dent, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM burn@uthscsa.edu NR 16 TC 6 Z9 6 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 DEC PY 2004 VL 42 IS 12 BP 5846 EP 5848 DI 10.1128/JCM.42.12.5846-5848.2004 PG 3 WC Microbiology SC Microbiology GA 883SK UT WOS:000226035800061 PM 15583322 ER PT J AU Montori, VM Saha, S Clarke, M AF Montori, VM Saha, S Clarke, M TI A call for systematic reviews SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material ID RANDOMIZED CONTROLLED-TRIALS; HEALTH-CARE; QUALITY; METAANALYSES; ARTICLE; SCIENCE C1 Mayo Clin, Coll Med, Rochester, MN 55905 USA. Portland VA Med Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Portland, OR USA. UK Cochrane Ctr, Oxford, England. RP Montori, VM (reprint author), Mayo Clin, Coll Med, Rochester, MN 55905 USA. OI Montori, Victor/0000-0003-0595-2898 NR 16 TC 5 Z9 5 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 DEC PY 2004 VL 19 IS 12 BP 1240 EP 1241 DI 10.1111/j.1525-1497.2004.41001.x PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 882XF UT WOS:000225973000010 PM 15610335 ER PT J AU Mendez, ME O'Connor, SM Lim, GTH AF Mendez, ME O'Connor, SM Lim, GTH TI Hypersexuality after right pallidotomy for Parkinson's disease SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article ID SEXUAL-BEHAVIOR; DOPAMINE AB The authors describe hypersexuality following atypical right pallidotomy for intractable Parkinson's disease (PD). This patient and literature review suggest important roles for the pallidum in sexual behavior and dopamine in sexual arousal. C1 Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Mendez, ME (reprint author), VA Greater LA Healthcare Syst, Neurobehav Unit 116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@UCLA.edu NR 16 TC 29 Z9 29 U1 0 U2 3 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 WIN PY 2004 VL 16 IS 1 BP 37 EP 40 DI 10.1176/appi.neuropsych.16.1.37 PG 4 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 777PM UT WOS:000189186800005 PM 14990757 ER PT J AU Offner, H AF Offner, H TI Neuroimmunoprotective effects of estrogen and derivatives in experimental autoimmune encephalomyelitis: Therapeutic implications for multiple sclerosis SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Review DE estrogen; estrogen receptors; immunoregulation; neuroprotection; EAE; multiple sclerosis ID REGULATORY T-CELLS; EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; CENTRAL-NERVOUS-SYSTEM; IMMUNOLOGICAL SELF-TOLERANCE; MYELIN PROTEOLIPID PROTEIN; CD4(+)CD25(+) TREG CELLS; RECEPTOR-ALPHA; ER-BETA; CYTOKINE PRODUCTION; GENE-EXPRESSION AB The extensive literature and the work from our laboratory illustrate the large number of complex processes affected by estrogen that might contribute to the striking ability of 17beta-estradiol (E2) and its derivatives to inhibit clinical and histological signs of experimental autoimmune encephalomyelitis (EAE) in mice. These effects require sustained exposure to relatively low doses of exogenous hormone and offer better protection when initiated prior to induction of EAE. However, oral ethinyl estradiol (EE) and fluasterone, which lacks estrogenic side effects, could partially reverse clinical EAE when given after the onset of disease. The three main areas discussed in this review include E2-mediated inhibition of encephalitogenic T cells, inhibition of cell migration into central nervous system tissue, and neuroprotective effects that promote axon and myelin survival. E2 effects on EAE were mediated through Esrl (alpha receptor for E2) but not Esr2 (beta receptor for E2), as were its antiinflammatory and neuroprotective effects. A novel finding is that E2 up-regulated the expression of Foxp3 and CTLA-4 that contribute to the activity of CD4(+)CD25(+) Treg cells. The protective effects of E2 in EAE suggest its use as therapy for MS, although the risk of cardiovascular disease may complicate treatment in postmenopausal women. This risk could be minimized by using subpregnancy levels of exogenous E2 that produced synergistic effects when used in combination another immunoregulatory therapy. Alternatively, one might envision using EE or fluasterone metabolites alone or in combination therapies in both male and female MS patients. (C) 2004 Wiley-Liss, Inc. C1 Portland VA Med Ctr, Neuroimmunol Res R&D 31, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. RP Offner, H (reprint author), Portland VA Med Ctr, Neuroimmunol Res R&D 31, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM offnerva@ohsu.edu FU NIAID NIH HHS [AI42376]; NINDS NIH HHS [NS23444] NR 162 TC 58 Z9 61 U1 0 U2 2 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0360-4012 J9 J NEUROSCI RES JI J. Neurosci. Res. PD DEC 1 PY 2004 VL 78 IS 5 BP 603 EP 624 DI 10.1002/jnr.20330 PG 22 WC Neurosciences SC Neurosciences & Neurology GA 875JS UT WOS:000225417000001 PM 15515048 ER PT J AU Takesaka, J Crowley, R Casarett, D AF Takesaka, J Crowley, R Casarett, D TI What is the risk of distress in palliative care survey research? SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article DE distress; end-of-life care; research methods ID GOOD DEATH; FAMILY MEMBERS; PERCEPTIONS; EXPERIENCE; QUALITY; HOSPICE; LIFE AB To determine whether caregivers believe that interviews about end-of-life care are distressing and to identify patient and respondent characteristics associated with an increased risk of distress, distress was assessed in four studies that used family interviews. The setting was four rhledicare certified hospice organizations, the University of Pennsylvania Memory Disorders Clinic, and two nursing homes, and participants included 296 family members of seriously ill or recently deceased patients. For three of the studies, respondents described their distress on, a 5-point scale. Distress was reported as either present or absent in the fourth study. Sixty-four respondents (22%) reported experiencing distress. Intensity of distress was higher for younger respondents (Spearman rho -0.16; P = 0.013), younger patients (Spearman rho -0.28; P < 0.001), and family members of patients with cancer (mean. 0.55 vs. 0.24; Rank sum test P < 0.001). In a multivariable model, after adjusting for study population, younger patient age and cancer diagnosis were independently associated with the severity of distress. Sensitive questions about death and dying are unlikely to cause distress for family members. Although the likelihood of distress is low overall, investigators recruiting from these populations may improve the research by incorporating methods to assess and manage distress. (C) 2004 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved. C1 Univ Penn, Div Geriatr Med, Philadelphia, PA 19104 USA. Univ Penn, VA Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. Univ Penn, Ctr Bioeth, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Casarett, D (reprint author), 3615 Chestnut St, Philadelphia, PA 19104 USA. NR 25 TC 21 Z9 21 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0885-3924 J9 J PAIN SYMPTOM MANAG JI J. Pain Symptom Manage. PD DEC PY 2004 VL 28 IS 6 BP 593 EP 598 DI 10.1016/j.jpainsymman.2004.03.006 PG 6 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 885IJ UT WOS:000226150000012 PM 15589084 ER PT J AU Maldonado, A He, L Game, BA Nareika, A Sanders, JJ London, SD Lopes-Virella, MF Huang, Y AF Maldonado, A He, L Game, BA Nareika, A Sanders, JJ London, SD Lopes-Virella, MF Huang, Y TI Pre-exposure to high glucose augments lipopolysaccharide-stimulated matrix metalloproteinase-1 expression by human U937 histiocytes SO JOURNAL OF PERIODONTAL RESEARCH LA English DT Article DE diabetes mellitus; gene expression; glucose; lipopolysaccharide; macrophages; matrix metalloproteinases; periodontal diseases; signal transduction ID ACTIVATED PROTEIN-KINASES; DIABETES-MELLITUS; GENE-EXPRESSION; P38; PERIODONTITIS; INDUCTION; COMPLICATIONS; COLLAGENASE; INHIBITOR; CYTOKINE AB Background and objectives: It has been well established that patients with diabetes have increased prevalence and severity of periodontal diseases. However, the underlying mechanisms are not well understood. Given that bacterial infection is the primary cause of periodontal disease, we postulated that hyperglycemia may interplay with bacterial virulence factors such as lipopolysaccharide to up-regulate matrix metalloproteinase (MMP), leading to increased periodontal tissue destruction. Methods and results: We showed that prolonged pre-exposure of U937 histiocytes to high glucose markedly increased lipopolysaccharide-stimulated MMP-1 secretion and mRNA expression. Our results also showed that the effect of high glucose on lipopolysaccharide-induced MMP-1 expression is cell type-specific because no similar response was observed in human gingival fibroblasts. In addition to MMP-1, high glucose also augments lipopolysaccharide-stimulated MMP-7, -8, and -9 mRNA expression. In the investigation of the signaling pathways involved in the enhancement of lipopolysaccharide-induced MMP-1 expression by high glucose, we found that both high glucose and lipopolysaccharide regulate MMP-1 expression through the nuclear factor kappaB (NFkappaB) and mitogen-activated protein kinase (MAPK) cascades. Conclusions: The present study has shown that pre-exposure to high glucose and subsequent lipopolysaccharide treatment synergistically stimulates MMP-1 expression by mononuclear phagocytes through the NFkappaB and MAPK signaling pathways. This study has thus delineated a pathogenic mechanism that may be involved in the exacerbated periodontal disease in diabetic patients. C1 Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Charleston, SC 29425 USA. Med Univ S Carolina, Coll Dent Med, Charleston, SC 29425 USA. Ralph H Johnson Vet AFfairs Med Ctr, Charleston, SC 29401 USA. RP Huang, Y (reprint author), Ralph H Johnson Vet Affairs Med Ctr, 114 Doughty St, Charleston, SC 29403 USA. EM huangyan@musc.edu NR 29 TC 20 Z9 23 U1 1 U2 5 PU BLACKWELL MUNKSGAARD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 0022-3484 J9 J PERIODONTAL RES JI J. Periodont. Res. PD DEC PY 2004 VL 39 IS 6 BP 415 EP 423 DI 10.1111/j.1600-0765.2004.00756.x PG 9 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 871VK UT WOS:000225164500007 PM 15491346 ER PT J AU Shores, MM Moceri, VM Gruenewald, DA Brodkin, KI Matsumoto, AM Kivlahan, DR AF Shores, MM Moceri, VM Gruenewald, DA Brodkin, KI Matsumoto, AM Kivlahan, DR TI Low testosterone is associated with decreased function and increased mortality risk: A preliminary study of men in a geriatric rehabilitation unit SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE testosterone; elderly; function; mortality; rehabilitation ID SEX-HORMONE LEVELS; OLDER MEN; CRITICAL ILLNESS; HYPOGONADAL MEN; NURSING-HOMES; ELDERLY MEN; REPLACEMENT; HYPOPITUITARISM; MOOD; AGE AB OBJECTIVES: To evaluate whether low testosterone levels are associated with greater depression or poorer function in a geriatric rehabilitation unit. DESIGN: Retrospective review. SETTING: Geriatric rehabilitation unit. MEASUREMENTS: Low testosterone levels were defined as total testosterone of 3.0 ng/mL or less or free testosterone of 9.0 pg/mL or less. Age, ethnicity, weight, depression, ambulation, length of rehabilitation, and 6-month rehospitalization and mortality rates were obtained. Overall illness severity was determined using the Cumulative Illness Rating Scale for Geriatrics. RESULTS: Low testosterone levels were present in 29 of 44 (65.9%) men. There were no significant differences between men with low and normal testosterone levels in ethnicity, age, weight, depression, and overall illness severity. Lower testosterone levels were correlated with decreased ability to ambulate and transfer (Spearman P>.34; P<.05). There were no significant differences between men with low and normal testosterone in length of stay on the rehabilitation unit (mean+/-standard deviation= 19.6+/-11.6 vs 17.7+/-17.5 days, P=.68) or rehospitalization rates (41.4% vs 26.7%; P=.34). Men with low testosterone had a trend toward increased 6-month mortality (31.0% vs 6.7%; chi(2)=3.3, P=.07) and shorter survival time (log rank=3.2; df 1, P=.07). After entering testosterone and variables with potential prognostic significance for mortality in a stepwise manner in a Cox regression analysis, there was a significant mortality risk associated with low testosterone (hazard ratio=27.9, 95% confidence interval=2.0-384.0; P=.01). CONCLUSION: Low testosterone levels were correlated with decreased physical function and increased risk for 6-month mortality. Prospective studies with larger sample sizes and better standardized testosterone measures are needed to confirm these findings. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. RP Shores, MM (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,S-182 GRECC, Seattle, WA 98108 USA. EM molly.shores@med.va.gov NR 30 TC 40 Z9 42 U1 1 U2 3 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 DEC PY 2004 VL 52 IS 12 BP 2077 EP 2081 DI 10.1111/j.1532-5415.2004.52562.x PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 872DT UT WOS:000225188300017 PM 15571546 ER PT J AU Vig, EK Hopley, EK Taylor, JS Fryer-Edwards, K Starks, H AF Vig, EK Hopley, EK Taylor, JS Fryer-Edwards, K Starks, H TI Cognitive screening raises fears of identity theft SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Letter ID MENTAL STATUS QUESTIONNAIRE; DWELLING ELDERLY PERSONS; DECLINE C1 Univ Washington, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Geriatr & Extended Care, Seattle, WA USA. Univ Washington, Dept Anthropol, Seattle, WA 98195 USA. Univ Washington, Dept Med Hist & Eth, Seattle, WA 98195 USA. Univ Washington, Dept Med Educ & Biomed Informat, Seattle, WA 98195 USA. RP Vig, EK (reprint author), Univ Washington, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. NR 8 TC 0 Z9 0 U1 0 U2 1 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 DEC PY 2004 VL 52 IS 12 BP 2147 EP 2148 DI 10.1111/j.1532-5415.2004.52579_7.x PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 872DT UT WOS:000225188300036 PM 15571565 ER PT J AU Katz, IR AF Katz, IR TI Optimizing atypical antipsychotic treatment strategies in the elderly SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article ID PLACEBO-CONTROLLED-TRIAL; DRUG-INDUCED PSYCHOSIS; HEALTH PLAN DATABASE; PARKINSONS-DISEASE; BEHAVIORAL DISTURBANCES; TARDIVE-DYSKINESIA; DIABETES-MELLITUS; OLDER PATIENTS; DOUBLE-BLIND; FOLLOW-UP C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Katz, IR (reprint author), Univ Penn, Dept Psychiat, VISN 4 MIRECC Med Ctr,3535 Market St,Room 3001, Philadelphia, PA 19104 USA. EM katzi@mail.med.upenn.edu NR 35 TC 11 Z9 11 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 DEC PY 2004 VL 52 IS 12 SU S BP S272 EP S277 DI 10.1111/j.1532-5415.2004.52604.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 870MH UT WOS:000225060700005 PM 15541168 ER PT J AU Fried, L Solomon, C Shlipak, M Seliger, S Stehman-Breen, C Bleyer, AJ Chaves, P Furberg, C Kuller, L Newman, A AF Fried, L Solomon, C Shlipak, M Seliger, S Stehman-Breen, C Bleyer, AJ Chaves, P Furberg, C Kuller, L Newman, A TI Inflammatory and prothrombotic markers and the progression of renal disease in elderly individuals SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID CHRONIC KIDNEY-DISEASE; C-REACTIVE PROTEIN; CARDIOVASCULAR HEALTH; VASCULAR-DISEASE; RISK-FACTORS; ATHEROSCLEROSIS; INSUFFICIENCY; FAILURE; POPULATION; PREVALENCE AB Inflammatory and prothrombotic markers are elevated in individuals with mild to moderate renal disease. It was hypothesized that these markers may also be determinants of the progression of renal disease. The association of six markers-serum C-reactive protein (CRP), white blood cell (WBC) count, fibrinogen, factor VII, albumin, and hemoglobin-with subsequent elevations of creatinine and decline in estimated GFR in the Cardiovascular Health Study, a community-based cohort of elderly individuals, was analyzed. Linear regression was used to determine predictors of an annualized change in serum creatinine as the main outcome. Duration of follow-up was 7 yr for the original cohort and 4 yr for the more recently recruited black cohort. A total of 588 (12.7%) individuals had a decline in estimated GFR of at least 3 ml/min per yr per 1.73 m(2). Higher CRP (P < 0.001), WBC count (P < 0.001), fibrinogen (P < 0.001), and factor VII (P < 0.001) levels and lower albumin (P < 0.001) and hemoglobin levels (P < 0.001) were associated with a rise in creatinine, after adjusting for age. With additional adjustments for race, gender, baseline creatinine, systolic and diastolic BP, lipid levels, weight, and packyears smoking, higher CRP, factor VII, fibrinogen, WBC count, and lower albumin and hemoglobin levels remained associated with a rise in creatinine. Similar results were found for decline in estimated GFR. The decline in GFR was greater with increasing number of inflammatory or prothrombotic markers that were above the median (below for hemoglobin and albumin). Inflammatory and prothrombotic markers are predictors for a change in kidney function in elderly individuals. Interventions that reduce inflammation might confer significant cardiovascular and renal benefits. C1 Univ Pittsburgh, Sch Med, VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Med, Renal Electrolyte Div, Pittsburgh, PA 15240 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Calif San Francisco, Med Serv, Vet Affairs Med Ctr, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Univ Washington, Div Nephrol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Renal Sect, Seattle, WA USA. Wake Forest Univ, Nephrol Sect, Sch Med, Winston Salem, NC 27109 USA. Johns Hopkins Univ, Dept Med, Baltimore, MD USA. Johns Hopkins Univ, Dept Epidemiol, Baltimore, MD USA. Wake Forest Univ, Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27109 USA. Univ Pittsburgh, Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Div Geriatr Med, Pittsburgh, PA 15260 USA. RP Fried, L (reprint author), Univ Pittsburgh, Sch Med, VA Pittsburgh Healthcare Syst, Renal Sect, Univ Dr C,Mailstop 111F-U, Pittsburgh, PA 15240 USA. EM Linda.Fried@med.va.gov RI Newman, Anne/C-6408-2013 OI Newman, Anne/0000-0002-0106-1150 FU NHLBI NIH HHS [N01 HC 15103, N01 HC 35129, N01 HC 85079, N01 HC 85086] NR 28 TC 128 Z9 129 U1 0 U2 3 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 DEC PY 2004 VL 15 IS 12 BP 3184 EP 3191 DI 10.1097/01.ASN.0000146422.45434.35 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 876NW UT WOS:000225504800027 PM 15579522 ER PT J AU O'Toole, TP Conde-Martel, A Gibbon, JL Hanusa, BH Freyder, PJ Fine, MJ AF O'Toole, TP Conde-Martel, A Gibbon, JL Hanusa, BH Freyder, PJ Fine, MJ TI Substance-abusing urban homeless in the late 1990s: How do they differ from non-substance-abusing homeless persons? SO JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE LA English DT Article DE comorbidities; homelessness; needs; substance abuse ID DRUG-ABUSE; HEALTH; CARE; DISORDERS; ALCOHOL; POVERTY; ADULTS AB Much of our understanding of substance abuse and homelessness comes from data from the 1980s and may not necessarily reflect issues or trends prevalent during the 1990s. We report data from a two-city, community-based, populations-proportionate sample of 531 randomly selected homeless adults; the study was conducted in 1997 and compared substance-abusing to non-substance-abusing respondents. Most (78.3%) met criteria for substance abuse/dependence and were abusing either cocaine or alcohol and cocaine (68.5%). In the multiple logistic regression model, male gender (odds ratio [OR] 2.94, 95% confidence interval [CI] 1.70-5.09), less than a 12th grade education (OR 1.96, 95% CI 1.11-3.46), bustling or stealing for sustenance (OR 3.14, 95% CI 1.15-8.55), and identifying a need to learn bow to manage one's money (OR 2.41, 95% CI 1.45-3.98) were independently associated with substance abuse/dependence. Drug abuse/dependence and polysubstance use among urban homeless persons became a more prevalent issue in the late 1990s. These individuals have unique needs that will require tailored interventions. C1 Georgetown Univ, Sch Med, Washington, DC 20007 USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA 15260 USA. Pittsburgh Salvat Army Publ Inebriate Program, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. RP O'Toole, TP (reprint author), Georgetown Univ, Sch Med, 1111 NE Med Dent Bldg,3900 Reservoir Rd NW, Washington, DC 20007 USA. EM Tpo6@georgetown.edu NR 21 TC 17 Z9 17 U1 2 U2 5 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1099-3460 J9 J URBAN HEALTH JI J. Urban Health PD DEC PY 2004 VL 81 IS 4 BP 606 EP 617 DI 10.1093/jurban/jth144 PG 12 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 862PU UT WOS:000224504000007 PM 15466842 ER PT J AU Sylvestre, DL Loftis, JM Hauser, P Genser, S Cesari, H Borek, N Kresina, TF Seeff, L Francis, H AF Sylvestre, DL Loftis, JM Hauser, P Genser, S Cesari, H Borek, N Kresina, TF Seeff, L Francis, H TI Co-occurring hepatitis C, substance use, and psychiatric illness: Treatment issues and developing integrated models of care SO JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE LA English DT Article DE comorbidities; HIV; HCV; psychiatric illness; treatment ID ALCOHOL-USE DISORDERS; IDENTIFICATION TEST AUDIT; SEVERE MENTAL-ILLNESS; METHADONE-MAINTENANCE PATIENTS; SEROTONIN REUPTAKE INHIBITORS; INJECTING DRUG-USERS; INTERFERON-ALPHA; SCREENING-TEST; RATING-SCALE; DEPRESSIVE DISORDER AB Hepatitis C virus (HCV) infection is transmitted by injection drug use and associated with psychiatric conditions. Patients with drug use or significant psychiatric illness have typically been excluded from HCV treatment trials noting the 1997 National Institutes of Health Consensus Statement on HCV that indicated active drug use and major depressive illness were contraindications to treatment of HCV infection. However, the 2002 NIH Consensus Statement recognized that these patients could be effectively treated for HCV infection and recommended that treatment be considered on a case-by-case basis. Treating HCV infection in these patients is challenging, with drug use relapse possibly leading to psychosocial instability, poor adherence, and HCV reinfection. Interferon therapy may exacerbate preexisting psychiatric symptoms. Co-occurring human immunodeficiency virus or hepatitis B virus provide additional challenges, and access to ancillary medical and psychiatric services may be limited. Patients with co-occurring HCV infection, substance use, and psychiatric illness can complete interferon treatment with careful monitoring and aggressive intervention. Clinicians must integrate early interventions for psychiatric conditions and drug use into their treatment algorithm. Few programs or treatment models are designed to manage co-occurring substance use, psychiatric illness, and HCV infection and therapy. The National Institute on Drug Abuse convened a panel of experts to address the current status and the long-range needs through a 2-day workshop, Co-occurring Hepatitis C, Substance Abuse, and Psychiatric Illness: Addressing the Issues and Developing Integrated Models of Care. This conference report summarizes current data, medical management issues, and strategies discussed. C1 Natl Inst Drug Abuse, Ctr AIDS & Other Med Consequences Drug Abuse, NIH, Bethesda, MD 20892 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Oregon Hlth Sci Univ, Sch Med, Portland, OR 97201 USA. Portland VA Med Ctr, NW Hepatitis C Resource Ctr, Portland, OR USA. NIDDKD, NIH, Bethesda, MD 20892 USA. RP Hauser, P (reprint author), Natl Inst Drug Abuse, Ctr AIDS & Other Med Consequences Drug Abuse, NIH, 6001 Execut Blvd,MSC 9593, Bethesda, MD 20892 USA. EM peter.hauser2@med.va.gov NR 89 TC 61 Z9 61 U1 0 U2 5 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1099-3460 J9 J URBAN HEALTH JI J. Urban Health PD DEC PY 2004 VL 81 IS 4 BP 719 EP 734 DI 10.1093/jurban/jth153 PG 16 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 862PU UT WOS:000224504000016 PM 15466851 ER PT J AU Spencer, BA Fung, CH Wang, MM Rubenstein, LV Litwin, MS AF Spencer, BA Fung, CH Wang, MM Rubenstein, LV Litwin, MS TI Geographic variation across veterans affairs medical centers in the treatment of early stage prostate cancer SO JOURNAL OF UROLOGY LA English DT Article DE prostatic neoplasms; cluster analysis; United States Department of Veterans Affairs ID DATA-BASE REPORT; RADICAL PROSTATECTOMY; DEMOGRAPHIC VARIATION; RADIATION-THERAPY; TIME TRENDS; NEW-HAVEN; RATES; AGE; BENEFICIARIES; CARCINOMA AB Purpose: We investigated geographic variation in the treatment of early stage prostate cancer in a national sample of veterans after widespread adoption of the prostate specific antigen test. Materials and Methods: Our sample consisted of 16,352 cases from the Veterans Affairs Central Cancer Registry that were diagnosed between January 1997 and December 1999 with stage I or II prostate cancer. We used a 2-stage nested logit model to compare surgery, radiation therapy and noncurative treatment among 4 geographic regions of the United States. Results: Multivariate analysis showed that patients in the West (referent group) had a higher OR of undergoing surgery than radiation compared with the Northeast, South or Midwest (OR 0.77, 95% CI 0.67 to 0.87, OR 0.86, 95% CI 0.76 to 0.98 and OR 0.75, 95% CI 0.64 to 0.87, respectively. Black men, men with lower grade and higher stage tumors, and unmarried men were less likely to undergo curative treatment and less likely to undergo surgery than radiation. Conclusions: Geographic variation persists in patterns of care in men with early stage prostate cancer. However, this variation is limited to the choice between surgery and radiation rather than to the choice between curative and noncurative treatment. C1 Univ Calif Los Angeles, Dept Urol, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Robert Wood Johnson Clin Scholars Program, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90095 USA. RAND Hlth Sci Program, Santa Monica, CA USA. RP Spencer, BA (reprint author), Univ Calif Los Angeles, Dept Urol, David Geffen Sch Med, Box 951738, Los Angeles, CA 90095 USA. EM benjspencel@hotmail.com NR 18 TC 12 Z9 12 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 DEC PY 2004 VL 172 IS 6 BP 2362 EP 2365 DI 10.1097/01.ju.0000144064.54670.7b PN 1 PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 872GE UT WOS:000225194900055 PM 15538268 ER PT J AU Clarke, P Meintzer, SM Wang, YB Moffitt, LA Richardson-Burns, SM Johnson, GL Tyler, KL AF Clarke, P Meintzer, SM Wang, YB Moffitt, LA Richardson-Burns, SM Johnson, GL Tyler, KL TI JNK regulates the release of proapoptotic mitochondrial factors in reovirus-infected cells SO JOURNAL OF VIROLOGY LA English DT Article ID INDUCED APOPTOSIS REQUIRES; JUN NH2-TERMINAL KINASE; BAX-DEPENDENT APOPTOSIS; CYTOCHROME-C RELEASE; BCL-2 FAMILY-MEMBERS; VIRAL PROTEIN-R; SIGNAL-TRANSDUCTION; NEURONAL APOPTOSIS; INDUCE APOPTOSIS; VIRUS-INFECTION AB Reovirus-induced apoptosis is associated with activation of the proapoptotic mitogen-activated protein kinase c-Jun N-terminal kinase (JNK) and the JNK-associated transcription factor c-Jun. Here we show that reovirus-induced apoptosis and activation of caspase 3 are inhibited in cells deficient in MEK kinase 1, an upstream activator of JNK in reovirus-infected cells. Inhibition of JNK activity following reovirus infection delays the release of proapoptotic mitochondrial factors and the subsequent onset of apoptosis. In contrast, reovirus-induced apoptosis is not blocked by infection with adenovirus expressing dominant-negative c-Jun, and c-Jun activation does not correlate with apoptosis in reovirus-infected cells. This is the first report demonstrating that JNK is associated with regulation of mitochondrial pathways of apoptosis following viral infection. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol B182, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Immunol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Neurosci, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med & Microbiol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Univ N Carolina, Sch Med, Dept Pharmacol, Chapel Hill, NC USA. Univ N Carolina, Lineberger Comprehens Canc Ctr, Sch Med, Chapel Hill, NC 27599 USA. RP Clarke, P (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol B182, 4200 E 9th Ave, Denver, CO 80262 USA. EM penny.clarke@uchsc.edu OI Tyler, Kenneth/0000-0003-3294-5888 FU NIA NIH HHS [1R01AG14071] NR 44 TC 43 Z9 45 U1 0 U2 1 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 DEC PY 2004 VL 78 IS 23 BP 13132 EP 13138 DI 10.1128/JVI.78.23.13132-13138.2004 PG 7 WC Virology SC Virology GA 870VT UT WOS:000225087500041 PM 15542665 ER PT J AU Steinhauer, K Grayhack, JP Smiley-Oyen, AL Shaiman, S McNeil, MR AF Steinhauer, K Grayhack, JP Smiley-Oyen, AL Shaiman, S McNeil, MR TI The relationship among voice onset, voice quality, and fundamental frequency: A dynamical perspective SO JOURNAL OF VOICE LA English DT Article; Proceedings Paper CT 29th Annual Symposium: Care of the Professional Voice CY JUN, 2000 CL PHILADELPHIA, PA DE voice-register-dynamical systems; voice motor control; nonlinear dynamics ID INTRINSIC LARYNGEAL MUSCLES; COORDINATION DYNAMICS; REGISTERS; PHONATION AB In dynamical motor theory, skill acquisition occurs as a modification of preexisting coordination patterns or attractor states. The purpose of this study was to assess how different levels of voice onset, voice quality, and fundamental frequency (F-0) combine to form the attractor states common to voice motor control. Three levels of voice onset (glottal, simultaneous, and breathy), voice quality (modal speech, mixed, and falsetto), and fundamental frequency (low, mid, and high) were manipulated by vocally untrained, female subjects. Percent correct of acquisition trials and self-report of effort were used as measures of stable phonations indicative of an attractor state. Using intensity as a covariate, the results provided support for two of the three predicted triads representing attractor states in female speakers: (1) glottal onset/modal speech quality/low F-0; and (2) breathy onset/falsetto quality/high F-0. The results of this study suggest that certain parameters of voice motor control, such as onset, quality, and F-0, exist as part of a dynamical system that can be identified and manipulated in voice motor acquisition and learning. C1 Univ Pittsburgh, Voice Ctr, Pittsburgh, PA 15214 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Dept Commun Sci & Disorders, Pittsburgh, PA USA. Iowa State Univ, Dept Hlth & Human Performance, Ames, IA USA. RP Steinhauer, K (reprint author), Univ Pittsburgh, Voice Ctr, 200 Lothrop St, Pittsburgh, PA 15214 USA. EM tkstein@adelphia.net NR 30 TC 7 Z9 8 U1 2 U2 4 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0892-1997 J9 J VOICE JI J. Voice PD DEC PY 2004 VL 18 IS 4 BP 432 EP 442 DI 10.1016/j.jvoice.2004.01.006 PG 11 WC Otorhinolaryngology SC Otorhinolaryngology GA 880VI UT WOS:000225817400002 PM 15567045 ER PT J AU Ibrahim, SA Zhang, A Mercer, MB Baughman, M Kwoh, CK AF Ibrahim, SA Zhang, A Mercer, MB Baughman, M Kwoh, CK TI Inner city African-American elderly patients' perceptions and preferences for the care of chronic knee and hip pain: Findings from focus groups SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID HEALTH-CARE; ETHNIC-DIFFERENCES; DECISION-MAKING; CLINICAL CARE; OSTEOARTHRITIS; PHYSICIANS; CULTURE; COMMUNICATION; GENDER; ARTHROPLASTY AB Background. African Americans undergo joint replacement less often than do white persons. The authors studied African-Arnerican perceptions and preferences for the care of knee and hip pain. Methods. 10 focus groups Were conducted in an inner city community. Participants, older persons with chronic knee or hip pain, were asked to discuss their perceptions and preferences for the care of knee and hip pain. Transcripts were coded for thematic structure using NUD*ST software. Results. Cultural preferences and perceptions for care emerged as a major theme. Important subcategories of this theme included respect for the patient's faith and religiosity and perceptions of physician ethnicity, race, and sex. Conclusions. This sample of older inner city African Americans expressed unique cultural perceptions and preferences for the care of their knee and hip pain. Respect for patients' faith was important, whereas physicians' race, ethnicity, and religious background were not. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Case Western Reserve Univ, Sch Med, Cleveland, OH USA. RP Ibrahim, SA (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. EM said.ibrahim2@med.va.gov NR 51 TC 17 Z9 17 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 DEC PY 2004 VL 59 IS 12 BP 1318 EP 1322 PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 896WF UT WOS:000226964200012 PM 15699532 ER PT J AU Kurella, M Luan, J Yaffe, K Chertow, GM AF Kurella, M Luan, J Yaffe, K Chertow, GM TI Validation of the kidney disease quality of life (KDQOL) cognitive function subscale SO KIDNEY INTERNATIONAL LA English DT Article DE chronic kidney disease; cognitive impairment; end-stage renal disease ID CHRONIC-HEMODIALYSIS; ELDERLY POPULATION; ALZHEIMERS-DISEASE; NORMATIVE DATA; IMPAIRMENT; HEALTH; DIALYSIS; PERFORMANCE; PREVALENCE; INSTRUMENT AB Background. Formal cognitive function testing is cumbersome, and no self- administered instruments for estimating cognitive function in persons with chronic kidney disease (CKD) and end- stage renal disease (ESRD) have been validated. The goal of this study was to determine the validity of the Kidney Disease Quality of Life Cognitive Function scale (KDQOL-CF) for the assessment of cognitive impairment in persons with kidney disease. Methods. We administered the KDQOL- CF to 157 subjects, 79 with ESRD and 78 with CKD participating in a cross-sectional study of cognitive function. Scores on the Modified Mini- Mental State Exam (3MS) were considered the gold standard measure of global cognitive function. Performance characteristics of the KDQOL- CF were assessed using correlation coefficients, Bland- Altman plots, and receiver operating characteristic curves. Results. Median scores on the KDQOL- CF were 73 (interquartile range 60- 87) for subjects with ESRD and 87 (interquartile range 73- 100) for subjects with CKD (P < 0.0001). Scores on the KDQOL- CF were directly correlated with scores on the 3MS (r = 0.31, P = 0.0001). Defining global cognitive impairment as a 3MS score < 80, a cut- point of 60 on the KDQOL- CF accurately classified 76% of subjects, with 52% sensitivity and 81% specificity. On multivariable analysis, cerebral and peripheral vascular disease, benzodiazepine use, and higher serum phosphorus concentrations were associated with lower KDQOL- CF scores, while beta blocker use, education, and higher serum albumin concentrations were associated with higher KDQOL- CF scores. Conclusion. The KDQOL- CF is a valid instrument for estimating cognitive function in patients with CKD and ESRD. KDQOL- CF screening followed by 3MS testing in selected individuals may prove to be an effective and efficient strategy for identifying cognitive impairment in patients with kidney disease. C1 Univ Calif San Francisco, Dept Med, Div Nephrol, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, Div Psychiat, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, Div Neurol, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, Div Epidemiol, San Francisco, CA USA. Univ Calif San Francisco, Mt Zion Med Ctr, Moffitt Long Hosp, San Francisco, CA 94120 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. RP Chertow, GM (reprint author), Univ Calif San Francisco, Dept Med Res, UCSF Laurel Hts Suite 430,3333 Calif St, San Francisco, CA 94118 USA. EM chertowg@medicine.ucsf.edu RI Kurella Tamura, Manjula/C-8284-2014 OI Kurella Tamura, Manjula/0000-0001-5227-2479 FU NIDDK NIH HHS [R01 DK01005, R01 DK58411] NR 25 TC 31 Z9 32 U1 2 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD DEC PY 2004 VL 66 IS 6 BP 2361 EP 2367 DI 10.1111/j.1523-1755.2004.66024.x PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 870AK UT WOS:000225026200028 PM 15569327 ER PT J AU Hirano, S Bless, DM del Rio, AM Connor, NP Ford, CN AF Hirano, S Bless, DM del Rio, AM Connor, NP Ford, CN TI Therapeutic potential of growth factors for aging voice SO LARYNGOSCOPE LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 02-03, 2003 CL NASHVILLE, TN SP Amer Laryngol Assoc DE presbyphonia; basic fibroblast growth factor; hepatocyte growth factor; fibroblast; vocal fold; hyaluronic acid; collagen; age ID HUMAN VOCAL FOLD; AGE-RELATED-CHANGES; FIBROBLASTS; MANAGEMENT; EXPRESSION; COLLAGEN AB Objectives/Hypothesis: It has been reported that in aged vocal folds, dense collagen deposition takes place and hyaluronic acid decreases in the lamina propria, which are thought to contribute to the vocal problems occurring with age (presbyphonia). To restore aged vocal folds to their younger state, it seems crucial to address these age-related lamina propria changes. Intervention that might increase hyaluronic acid and decrease collagen would appear to be a potentially useful approach. The present study examined the effects of growth factors on aged fibroblasts in terms of the production of hyaluronic acid and collagen type I. Study Design: In vitro study using animal model. Methods: Fibroblasts were harvested from young and aged rat vocal folds and cultured with or without hepatocyte growth factor and/or basic fibroblast growth factor at different concentrations. Subsequently, the production of hyaluronic acid and collagen type I was examined in the supernatant culture media using enzyme-linked immunosorbent assay. Results: Aged fibroblasts produced less hyaluronic acid than younger fibroblasts. When aged and young fibroblasts were cultured with basic fibroblast growth factor, hyaluronic acid production increased and collagen type I production decreased regardless of the concentration, whereas the effects of hepatocyte growth factor appeared to vary with concentration. The basic fibroblast growth factor also was associated with stimulation of growth of aged fibroblasts. Conclusion: The present results suggest that growth factors, especially basic fibroblast growth factor, may have therapeutic potential in restoration of aged vocal fold. C1 Kyoto Natl Hosp, Dept Bronchoesophagol, Kyoto 6128555, Japan. Univ Wisconsin, Dept Surg, Div Otolaryngol Head & Neck Surg, Madison, WI USA. William S Middleton Mem Vet Adm Med Ctr, Dept Otolaryngol Head & Neck Surg, Madison, WI USA. RP Hirano, S (reprint author), Kyoto Natl Hosp, Dept Bronchoesophagol, 1-1 Fukakusa Mukaihata, Kyoto 6128555, Japan. EM chiraka@aol.com FU NIDCD NIH HHS [R01 DC 4428] NR 18 TC 52 Z9 57 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0023-852X J9 LARYNGOSCOPE JI Laryngoscope PD DEC PY 2004 VL 114 IS 12 BP 2161 EP 2167 DI 10.1097/01.mlg.0000149450.37640.db PG 7 WC Medicine, Research & Experimental; Otorhinolaryngology SC Research & Experimental Medicine; Otorhinolaryngology GA 878IE UT WOS:000225639300014 PM 15564837 ER PT J AU Didenko, VV Minchew, CL Shuman, S Baskin, DS AF Didenko, VV Minchew, CL Shuman, S Baskin, DS TI Semi-artificial fluorescent molecular machine for DNA damage detection SO NANO LETTERS LA English DT Article ID TOPOISOMERASE-I; LIVING ORGANISMS; RAT THYMOCYTES; APOPTOSIS; CLEAVAGE; FRAGMENTATION; DEGRADATION; SUBSTRATE; CELLS AB The design of artificial molecular machines is complicated because the mechanics used in macromachines is not readily adaptable for nano environments. We constructed a semi-artificial molecular device, which contains a naturally occurring molecular machine-a vaccinia virus encoded protein-linked with an artificial part. The self-assembled construct makes two fluorescently labeled detector units. It is the first sensor capable of selectively detecting different types of DNA breaks, exemplifying a practical approach to the design of molecular devices. C1 Baylor Coll Med, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Sloan Kettering Inst, New York, NY USA. RP Didenko, VV (reprint author), 2002 Holcombe Blvd,Bldg 109,Rm 204, Houston, TX 77030 USA. EM vdidenko@bcm.tmc.edu FU NIA NIH HHS [R03 AG022664-01, R03 AG022664-01, R03 AG022664] NR 41 TC 6 Z9 6 U1 1 U2 4 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 1530-6984 J9 NANO LETT JI Nano Lett. PD DEC PY 2004 VL 4 IS 12 BP 2461 EP 2466 DI 10.1021/nl048357e PG 6 WC Chemistry, Multidisciplinary; Chemistry, Physical; Nanoscience & Nanotechnology; Materials Science, Multidisciplinary; Physics, Applied; Physics, Condensed Matter SC Chemistry; Science & Technology - Other Topics; Materials Science; Physics GA 878XS UT WOS:000225681300029 PM 17330146 ER PT J AU Zhang, F Yin, W Chen, J AF Zhang, F Yin, W Chen, J TI Apoptosis in cerebral ischemia: executional and regulatory signaling mechanisms SO NEUROLOGICAL RESEARCH LA English DT Review DE apoptosis; cerebral ischemia; caspase; AIF; calpain; bcl-xL ID ENDOPLASMIC-RETICULUM STRESS; NEURONAL CELL-DEATH; CYTOCHROME-C RELEASE; MEDIATED HEPATOCYTE APOPTOSIS; TRANSIENT FOREBRAIN ISCHEMIA; PERMANENT FOCAL ISCHEMIA; BAX-DEPENDENT APOPTOSIS; TRAUMATIC BRAIN-INJURY; RAT-BRAIN; ARTERY OCCLUSION AB Programmed cell death, often in the form of apoptosis, is an important contributing mechanism in the pathogenesis of ischemic brain injury. Depending on the severity of the insult and the stage of the injury, the executional pathways that are directly responsible for cell death and the signaling mechanisms that participate in the regulation of these death pathways may vary. It is likely that molecular or pharmacological targeting of the upstream signaling mechanisms that control the death executional pathways may offer opportunities for more complete and longterm neuroprotection. This review summarizes the recent advancements in the understanding of the executional and regulatory signaling mechanisms in ischemic brain injury. C1 Univ Pittsburgh, Dept Neurol, Sch Med, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Inst Neurodegenerat Disorders, Pittsburgh, PA 15213 USA. Vet Affairs Pittsburgh Hlth Care Syst, Educat & Clin Ctr, Pittsburgh, PA 15261 USA. RP Chen, J (reprint author), Univ Pittsburgh, Dept Neurol, Sch Med, S-507 Biomed Sci Tower, Pittsburgh, PA 15213 USA. EM chenj2@msx.upmc.edu FU NINDS NIH HHS [NS45048, NS43802, NS36736, NS38560] NR 135 TC 60 Z9 65 U1 0 U2 5 PU MANEY PUBLISHING PI LEEDS PA HUDSON RD, LEEDS LS9 7DL, ENGLAND SN 0161-6412 J9 NEUROL RES JI Neurol. Res. PD DEC PY 2004 VL 26 IS 8 BP 835 EP 845 DI 10.1179/016164104X3824 PG 11 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 879NX UT WOS:000225725600006 PM 15727267 ER PT J AU Mazarati, AM AF Mazarati, AM TI Galanin and galanin receptors in epilepsy SO NEUROPEPTIDES LA English DT Review DE neuropeptides; galanin; G-protein coupled receptors; hippocampus; epilepsy; neuronal injury; neurogenesis; transgenic mice; antisense; viral vector ID SUSTAINING STATUS EPILEPTICUS; RAT VENTRAL HIPPOCAMPUS; GALR1 KNOCKOUT MICE; MESSENGER-RNA; PHOSPHOINOSITIDE TURNOVER; ACETYLCHOLINE-RELEASE; KAINATE RECEPTORS; PYRAMIDAL NEURONS; PERFORANT PATH; SPINAL-CORD AB The shift in the balance between the inhibition and the excitation in favor of the latter is a major mechanism of the evolvement of epileptic seizures. On the neurotransmitter level two major players contribute to such misbalance: an inhibitory transmitter gamma-aminobutyric acid, and an excitatory amino acid glutamate. Neuropeptides are powerful modulators of classical neurotransmitters, and thus represent an intriguing too] for restoring the balance between the inhibition and the excitation, through either blocking or activating peptide receptors depending on whether a peptide is pro- or anticonvulsant. Galanin, a 29-amino acid residues neuropeptide which inhibits glutamate release in the hippocampus, is a likely member of the anticonvulsant peptide family. During the past decade growing evidence has been suggesting that galanin is in fact a powerful inhibitor of seizure activity. This review summarizes the state of research of galanin in epilepsy, beginning with the first simple experiments which showed that central injection of galanin agonists inhibited seizures, and that seizures themselves affected galanin signaling in the hippocampus; exploring the impact of active manipulation with the expression of galanin and galanin receptors on seizures, using transgenic animals, antisense and pepticle-expressing vector approaches; and concluding with the recent advances in pharmacology, which led to the synthesis of non-peptide galanin receptor agonists with anticonvulsant properties. We also address recently established functions of galanin in seizure-associated neuronal degeneration and neuronal plasticity. (C) 2004 Elsevier Ltd. All rights reserved. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Neurol, D Geffen Sch Med, Los Angeles, CA 90095 USA. RP Mazarati, AM (reprint author), W Los Angeles Vet Affairs Med Ctr, Res 151, Los Angeles, CA 90073 USA. EM mazarati@ucla.edu FU NINDS NIH HHS [NS 43409] NR 69 TC 52 Z9 54 U1 0 U2 5 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0143-4179 J9 NEUROPEPTIDES JI Neuropeptides PD DEC PY 2004 VL 38 IS 6 BP 331 EP 343 DI 10.1016/j.npep.2004.07.006 PG 13 WC Endocrinology & Metabolism; Neurosciences SC Endocrinology & Metabolism; Neurosciences & Neurology GA 880HE UT WOS:000225778800001 PM 15567469 ER PT J AU Sweet, RA Hamilton, RL Butters, MA Mulsant, BH Pollock, BG Lewis, DA Lopez, OL DeKosky, ST Reynolds, CF AF Sweet, RA Hamilton, RL Butters, MA Mulsant, BH Pollock, BG Lewis, DA Lopez, OL DeKosky, ST Reynolds, CF TI Neuropathologic correlates of late-onset major depression SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE Alzheimer's disease; geriatric psychiatry; depression; late onset; mood disorders; neurodegenerative diseases; Lewy bodies; cerebrovascular disorders ID LATE-LIFE DEPRESSION; ALZHEIMERS-DISEASE CERAD; LAST 2 DECADES; COGNITIVE IMPAIRMENT; DOUBLE-BLIND; LEWY BODIES; INTERNATIONAL WORKSHOP; CLINICAL-DIAGNOSIS; RATING-SCALE; RISK-FACTORS AB Late life major depression (LLMD) is frequently associated with cognitive impairment, and increases the risk for subsequent dementia. Cerebrovascular disease, Alzheimer's disease ( AD), and dementia with Lewy bodies (DLB) have all been hypothesized to contribute to this increased risk, though prospective studies have yet to examine these hypotheses with autopsy confirmation of the clinical diagnoses. The aim of this study is to examine the rates of cerebrovascular, AD, and DLB pathology among the first 10 participants in an LLMD brain tissue donation program. Subjects' psychiatric diagnoses and cognitive status were prospectively determined during their participation in clinical research protocols of the Intervention Research Center for Late Life Mood Disorders. After death, final clinical diagnoses were made using all clinical information, while blind to neuropathologic diagnoses. Neuropathologic assessments were conducted blind to final clinical diagnoses. Rates of neuropathology were compared with those in a cohort of subjects with dementia, without a history of LLMD, participating in an Alzheimer Disease Research Center. Seven (70%) subjects had evidence of onset of a dementia prior to death. LLMD with dementia was significantly associated with a neuropathologic diagnosis of AD. Cerebrovascular disease and DLB pathology were also frequent in the LLMD subjects with dementia, and were found in an LLMD subject without dementia. Rates of AD, DLB, and cerebrovascular disease were similar to those in the comparison subjects. These preliminary findings suggest that AD is the predominant neuropathologic condition in LLMD subjects with dementia. Further assessment of the role of comorbid cerebrovascular disease and comorbid DLB is needed. C1 Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Neuropathol, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. VA Pittsburgh Hlth Care Syst, GRECC, Pittsburgh, PA USA. RP Sweet, RA (reprint author), Western Psychiat Inst & Clin, TDH, E823,3811 OHara St, Pittsburgh, PA 15213 USA. EM sweetra@upmc.edu RI Lewis, David/G-4053-2014 OI Lewis, David/0000-0002-3225-6778 FU NIA NIH HHS [P50 AG05133]; NIMH NIH HHS [MH65416, MH01684, MH45156, MH52247, MH66231] NR 49 TC 51 Z9 53 U1 1 U2 5 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD DEC PY 2004 VL 29 IS 12 BP 2242 EP 2250 DI 10.1038/sj.npp.1300554 PG 9 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 873ST UT WOS:000225302000015 PM 15354182 ER PT J AU Brody, AL Mandelkern, MA Scheibal, D Hahn, E Hsiao-Wei, L Zamora-Paja, E London, ED McCracken, JT AF Brody, AL Mandelkern, MA Scheibal, D Hahn, E Hsiao-Wei, L Zamora-Paja, E London, ED McCracken, JT TI Genetic variants in the alpha4 subunit of nachr and in COMT predict smoking-induced dopamine release in mesolimbic reward pathways SO NEUROPSYCHOPHARMACOLOGY LA English DT Meeting Abstract CT Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 12-16, 2004 CL San Juan, PR SP Vanderbilt Univ, Sch Med, Dept Psychiaty, Amer Coll Neuropsychopharmacol C1 Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90024 USA. Greater Los Angeles VA Healthcare Syst, Dept Nucl Med, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD DEC PY 2004 VL 29 SU 1 BP S78 EP S79 PG 2 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 877RO UT WOS:000225588000231 ER PT J AU Copland, CM Weickert, CS Kleinman, JE Davis, KL Haroutunian, V AF Copland, CM Weickert, CS Kleinman, JE Davis, KL Haroutunian, V TI Small myelin-associaed glycoprotein (S-Mag) gene expression during normal human development and in elderly schizophrenics SO NEUROPSYCHOPHARMACOLOGY LA English DT Meeting Abstract CT Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 12-16, 2004 CL San Juan, PR SP Vanderbilt Univ, Sch Med, Dept Psychiaty, Amer Coll Neuropsychopharmacol C1 Mt Sinai Sch Med, New York, NY USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD DEC PY 2004 VL 29 SU 1 BP S112 EP S112 PG 1 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 877RO UT WOS:000225588000326 ER PT J AU Gallagher, RM AF Gallagher, RM TI Pain disorders and mood disorder: Mechanisms and management SO NEUROPSYCHOPHARMACOLOGY LA English DT Meeting Abstract CT Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 12-16, 2004 CL San Juan, PR SP Vanderbilt Univ, Sch Med, Dept Psychiaty, Amer Coll Neuropsychopharmacol 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 NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD DEC PY 2004 VL 29 SU 1 BP S58 EP S59 PG 2 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 877RO UT WOS:000225588000175 ER PT J AU Green, MF Wynn, JK AF Green, MF Wynn, JK TI Visual masking in schizophrenia: Applications to neuroirnaging and electrophysiology SO NEUROPSYCHOPHARMACOLOGY LA English DT Meeting Abstract CT Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 12-16, 2004 CL San Juan, PR SP Vanderbilt Univ, Sch Med, Dept Psychiaty, Amer Coll Neuropsychopharmacol C1 Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RI Wynn, Jonathan/H-3749-2014 OI Wynn, Jonathan/0000-0002-1763-8540 NR 0 TC 0 Z9 0 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 DEC PY 2004 VL 29 SU 1 BP S41 EP S42 PG 2 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 877RO UT WOS:000225588000122 ER PT J AU Haroutunian, V Katsel, P Dracheva, S Copland, C Gorman, JM Davis, KL AF Haroutunian, V Katsel, P Dracheva, S Copland, C Gorman, JM Davis, KL TI Myelin-related gene expression abnormalities in 17 cortical and subcortical regions in schizophrenia SO NEUROPSYCHOPHARMACOLOGY LA English DT Meeting Abstract CT Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 12-16, 2004 CL San Juan, PR SP Vanderbilt Univ, Sch Med, Dept Psychiaty, Amer Coll Neuropsychopharmacol C1 Mt Sinai Sch Med, New York, NY USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. NR 0 TC 2 Z9 2 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD DEC PY 2004 VL 29 SU 1 BP S32 EP S32 PG 1 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 877RO UT WOS:000225588000098 ER PT J AU Koenigsberg, HW Siever, LJ Guo, XD New, AS Goodman, M Cheng, H Silverman, J Prohovnik, I AF Koenigsberg, HW Siever, LJ Guo, XD New, AS Goodman, M Cheng, H Silverman, J Prohovnik, I TI Emotion processing in borderline personality disorder: A functional MRI perspective SO NEUROPSYCHOPHARMACOLOGY LA English DT Meeting Abstract CT Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 12-16, 2004 CL San Juan, PR SP Vanderbilt Univ, Sch Med, Dept Psychiaty, Amer Coll Neuropsychopharmacol C1 CUNY Mt Sinai Sch Med, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Bronx, NY USA. NR 0 TC 0 Z9 0 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 DEC PY 2004 VL 29 SU 1 BP S84 EP S84 PG 1 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 877RO UT WOS:000225588000248 ER PT J AU Kozel, FA Johnson, KA Mu, QW Grenesko, EL Laken, SJ George, MS AF Kozel, FA Johnson, KA Mu, QW Grenesko, EL Laken, SJ George, MS TI Developing functional MRI detection of deception SO NEUROPSYCHOPHARMACOLOGY LA English DT Meeting Abstract CT Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 12-16, 2004 CL San Juan, PR SP Vanderbilt Univ, Sch Med, Dept Psychiaty, Amer Coll Neuropsychopharmacol C1 Med Univ S Carolina, Ctr Adv Imaging Res, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RI Kozel, Frank/I-5366-2012 NR 0 TC 1 Z9 1 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD DEC PY 2004 VL 29 SU 1 BP S84 EP S85 PG 2 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 877RO UT WOS:000225588000249 ER PT J AU Yehuda, R Yang, RK Golier, JA Bierer, LM Tischler, L Grossman, RA AF Yehuda, R Yang, RK Golier, JA Bierer, LM Tischler, L Grossman, RA TI Effect of sertraline on a peripheral glucocorticoid-mediated response in PTSD SO NEUROPSYCHOPHARMACOLOGY LA English DT Meeting Abstract CT Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 12-16, 2004 CL San Juan, PR SP Vanderbilt Univ, Sch Med, Dept Psychiaty, Amer Coll Neuropsychopharmacol C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. Bronx Vet Adm Med Ctr, Mental Hlth Patient Care Ctr, Bronx, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD DEC PY 2004 VL 29 SU 1 BP S216 EP S216 PG 1 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 877RO UT WOS:000225588000624 ER PT J AU Gallagher, RM AF Gallagher, RM TI Balancing risks and benefits in pain medicine: Wither Vioxx SO PAIN MEDICINE LA English DT Editorial Material C1 Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Gallagher, RM (reprint author), Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. NR 0 TC 2 Z9 2 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 1526-2375 J9 PAIN MED JI Pain Med. PD DEC PY 2004 VL 5 IS 4 BP 329 EP 330 DI 10.1111/j.1526-4637.2004.04056.x PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 873FK UT WOS:000225265100001 PM 15563316 ER PT J AU Mossey, JM Gallagher, RM AF Mossey, JM Gallagher, RM TI The longitudinal occurrence and impact of comorbid chronic pain and chronic depression over two years in continuing care retirement community residents SO PAIN MEDICINE LA English DT Article DE chronic pain; chronic depression; elderly; longitudinal; subthreshold depression ID SELF-RATED HEALTH; SUBTHRESHOLD DEPRESSION; PHYSICAL-DISABILITY; OLDER-ADULTS; SYMPTOMS; POPULATION; MANAGEMENT; DIAGNOSIS; ARTHRITIS; MEDICINE AB Objective. To describe the longitudinal course of depressive symptoms and pain experienced by continuing care retirement community (CCRC) residents and to investigate the impact of comorbid chronic activity-limiting pain and chronic high depressive symptoms on physical functioning and health service use. Methods. This longitudinal study of 169 CCRC residents involved five assessments (baseline and four in-person interviews at 6-month intervals). The Geriatric Depression Scale (GDS), questions drawn from the McGill Pain Questionnaire, and self-report data on physical functioning and health care use were assessed. Individuals reporting activity-limiting pain and those with GDS scores greater than or equal to11 at three or more assessments were considered to have chronic pain or chronic depression, respectively. The analysis sample included 169 CCRC residents. Multivariate logistic regression was used to test hypotheses. Results. Pain and depressive symptoms were characterized by longitudinal stability. Of the sample, 37% met the criteria for chronic activity-limiting pain, 21% met the criteria for chronic high depressive symptoms, and 13% were comorbid. Adjusting for age and health conditions, those with chronic activity-limiting pain were five times more likely than those in the lowest pain group to persistently be in the worst two quartiles of physical functioning, as were those with even one GDS score >5. The odds of poor physical functioning were 11.2 times greater in those with comorbid chronic pain and depression. Comparable greater odds were seen in this sample for frequency of medical care visits (adjusted odds ratio [AOR]=12.4) and consistently high use of all medical services (AOR=3.5). Conclusions. Pain and depressive symptoms were both common and appeared remarkably stable over time. Depressive symptoms contributed significantly to the prediction of impairment associated with pain, and identification and treatment of such symptoms, even minor symptoms, could reduce pain-related impairment and health care costs in the elderly. C1 Drexel Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Philadelphia, PA 19102 USA. Drexel Univ, Sch Med, Dept Med, Philadelphia, PA 19102 USA. Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Anesthesiol, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Pain Management Serv, Philadelphia, PA USA. RP Mossey, JM (reprint author), Drexel Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Mail Stop 660,1505 Race St,11th Floor, Philadelphia, PA 19102 USA. EM jm55@exchange1.drexel.edu FU NIA NIH HHS [AG 03934] NR 41 TC 49 Z9 51 U1 1 U2 8 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 1526-2375 J9 PAIN MED JI Pain Med. PD DEC PY 2004 VL 5 IS 4 BP 335 EP 348 DI 10.1111/j.1526-4637.2004.04041.x PG 14 WC Medicine, General & Internal SC General & Internal Medicine GA 873FK UT WOS:000225265100003 PM 15563319 ER PT J AU Roman, GC AF Roman, GC TI Vascular dementia - Advances in nosology, diagnosis, treatment and prevention SO PANMINERVA MEDICA LA English DT Review DE vascular dementia; stroke; vascular risk factors; cardiovascular disease; prevention; hypertension; homocysteine; lipids; cholinergic transmission ID ALZHEIMERS-DISEASE; COGNITIVE IMPAIRMENT; BLOOD-PRESSURE; RISK-FACTORS; DOUBLE-BLIND; CEREBROVASCULAR PATHOLOGY; ASSOCIATION CONFERENCE; SYSTOLIC HYPERTENSION; POSTSTROKE DEMENTIA; METABOLIC SYNDROME AB Ischemic or hemorrhagic cerebrovascular disease (CVD) produces injury of brain regions important for executive function, behavior, and memory leading to decline in cognitive functions and vascular dementia (VaD). Cardiovascular disease may cause VaD from hypoperfusion of susceptible brain areas. CVD may worsen degenerative dementias such as Alzheimer disease (AD. Currently, the global diagnostic category for cognitive impairment of vascular origin is vascular cognitive disorder (VCD). VCD ranges from vascular cognitive impairment (VCI) to VaD. The term VCI is limited to cases of cognitive impairment of vascular etiology, without dementia; VCI is equivalent to vascular mild cognitive impairment (MCI). Risk factors for VaD include age, hypertension, diabetes, smoking, cardiovascular disease (coronary heart disease, congestive heart failure, peripheral vascular disease), atrial fibrillation, left ventricular hypertrophy, hyperhomocysteinemia, orthostatic hypotension, cardiac arrhythmias, hyperfibrinogenemia, sleep apnea, infection, and high C-reactive protein. Research on biomarkers revealed increased CSF-NFL levels in VaD, whereas CSF-τ was normal. CSF-TNF-α, VEGF, and TGF-β were increased in, both AD and VaD. VaD shows low CSF acetylcholinesterase levels. This condition responds to acetylcholinesterase inhibitors, confirming the central role of cholinergic deficit in its pathogenesis. Evidence strongly suggests that control of vascular risk factors, in particular hypertension, could prevent VaD. C1 Univ Texas, Hlth Sci Ctr, Dept Med Neurol, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX USA. RP Roman, GC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med Neurol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM rornang@uthscsa.edu NR 92 TC 18 Z9 22 U1 7 U2 13 PU EDIZIONI MINERVA MEDICA PI TURIN PA CORSO BRAMANTE 83-85 INT JOURNALS DEPT., 10126 TURIN, ITALY SN 0031-0808 J9 PANMINERVA MED JI Panminerva Medica PD DEC PY 2004 VL 46 IS 4 BP 207 EP 215 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 924UY UT WOS:000229007300001 PM 15876977 ER PT J AU Elhalel, MD Wald, H Rubinger, D Gal-Moscovici, A Inoue, M Levi, M Popovtzer, MM AF Elhalel, MD Wald, H Rubinger, D Gal-Moscovici, A Inoue, M Levi, M Popovtzer, MM TI Regulation of NaPi-IIa mRNA and transporter protein in chronic renal failure: role of parathyroid hormone (PTH) and dietary phosphate (Pi) SO PFLUGERS ARCHIV-EUROPEAN JOURNAL OF PHYSIOLOGY LA English DT Article DE CRF; FEPi; PTH; NaPi-IIa; PTH/PTHrP-R; low-Pi diet; parathyroidectomy ID NA/P-I-COTRANSPORTER; DOWN-REGULATION; UREMIC RATS; ADAPTATION; HYPERPARATHYROIDISM; EXPRESSION; VESICLES; CELLS AB Chronic renal failure (CRF) is associated with a high fractional phosphate excretion (FEPi), secondary hyperparathyroidism, and resistance to parathyroid hormone (PTH). This study was undertaken to characterize the role of PTH and dietary Pi in the regulation of PTH/PTH-related peptide receptor (PTHrP-R) mRNA and NaPi-IIa mRNA and protein in CRF. The following groups of rats were studied: (1) sham-operated (control); (2) CRF: 6 weeks after 5/6 nephrectomy (NPX); (3) NPX and parathyroidectomy (NPX + PTX); (4) NPX rats fed a low-Pi diet (NPX + LP); (5) sham-operated rats fed a low-Pi diet (control + LP); (6) sham-operated after PTX (control+PTX). Expression of NaPi-IIa mRNA and PTH/PTHrP-R mRNA was determined in the renal cortex by Northern hybridization. NaPi-IIa protein abundance was determined in cortical brush border membranes by immunoblotting. In NPX rats creatinine clearance decreased to 40 +/- 4%, PTH/PTHrP-R mRNA to 52.1 +/- 2% and NaPi-IIa mRNA to 41.2 +/- 5.5% of control. The PTH/PTHrP-R and NaPi-IIa mRNA in the NPX + PTX and NPX + LP group was similar to that in NPX. NaPi-IIa protein abundance was reduced in NPX compared with control, but was increased dramatically in NPX+PTX and NPX + LP compared to NPX, paralleled by a decrease in FEPi. These findings suggest that the elevated FEPi in CRF is maintained by decreased NaPi-IIa mRNA and NaPi-IIa protein abundance. In contrast, the observed decrease in FEPi with PTX or LP diet in CRF is mediated, at least partly, by increased NaPi-IIa protein abundance with no change in NaPi-IIa mRNA, suggesting post-transcriptional regulation of the NaPi-IIa transporter. C1 Univ Arizona, Dept Med, SAVAHCS 1 111B, Tucson, AZ 85723 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Div Renal Dis & Hypertens, Denver, CO 80262 USA. Denver VAMC, Denver, CO 80262 USA. Hadassah Univ Hosp, IL-91120 Jerusalem, Israel. Univ Colorado, Hlth Sci Ctr, Dept Physiol & Biophys, Div Renal Dis & Hypertens, Denver, CO USA. RP Popovtzer, MM (reprint author), Univ Arizona, Dept Med, SAVAHCS 1 111B, 5601 S 6th Ave, Tucson, AZ 85723 USA. EM Mordecai.Popovtzer@med.va.gov OI Levi, Moshe/0000-0002-6225-946X NR 27 TC 8 Z9 10 U1 0 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0031-6768 J9 PFLUG ARCH EUR J PHY JI Pflugers Arch. PD DEC PY 2004 VL 449 IS 3 BP 265 EP 270 DI 10.1007/s00424-004-1298-x PG 6 WC Physiology SC Physiology GA 882YO UT WOS:000225976500006 PM 15452708 ER PT J AU Turner, EH AF Turner, EH TI A taxpayer-funded clinical trials registry and results database - It already exists within the US food and drug administration SO PLOS MEDICINE LA English DT Editorial Material ID PAROXETINE C1 US FDA, Rockville, MD 20857 USA. RP Turner, EH (reprint author), Portland VA Med Ctr, Mood Disorders Program, Portland, OR USA. EM turnere@ohsu.edu RI Turner, Erick/A-4848-2008 OI Turner, Erick/0000-0002-3522-3357 NR 16 TC 39 Z9 41 U1 0 U2 2 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 185 BERRY ST, STE 1300, SAN FRANCISCO, CA 94107 USA SN 1549-1277 J9 PLOS MED JI PLos Med. PD DEC PY 2004 VL 1 IS 3 BP 180 EP 182 AR e60 DI 10.1371/journal.pmed.0010060.g001 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 902TH UT WOS:000227378900009 PM 15562322 ER PT J AU Myrick, H Cluver, J Swavely, S Peters, H AF Myrick, H Cluver, J Swavely, S Peters, H TI Diagnosis and treatment of co-occurring affective disorders and substance use disorders SO PSYCHIATRIC CLINICS OF NORTH AMERICA LA English DT Article ID PLACEBO-CONTROLLED-TRIAL; COGNITIVE-BEHAVIORAL THERAPY; DOUBLE-BLIND; ALCOHOL-WITHDRAWAL; DEPRESSIVE-DISORDERS; FLUOXETINE TREATMENT; RELAPSE PREVENTION; DEPENDENT PATIENTS; BIPOLAR DISORDER; MENTAL-DISORDERS AB There is increasing interest in the comorbidity of affective disorders and substance use disorders. These disorders commonly co-occur, and the relationship is often complex and bidirectional. Two epidemiological surveys have emphasized the prevalence of comorbid mood and substance use disorders in community samples: the National Institute of Mental Health Epidemiologic Catchment Area (ECA) study [1] and the National Comorbidity Study (NCS) [2]. In the ECA study, an estimated 45% of individuals with alcohol use disorders and 72% of individuals with drug use disorders had at least one co-occurring psychiatric disorder. In the NCS, approximately 78% of alcohol-dependent men and 86% of alcohol-dependent women met lifetime criteria for another psychiatric disorder, including drug dependence. Interest in the co-occurrence of psychiatric and substance use disorders is clinically important as comorbidity has been found to have a negative impact on the course, treatment outcome, and prognosis of both syndromes. In this article, the relationship between substance use disorders and specific affective disorders is explored. The article begins with an overview of some of the general principles of diagnosis and treatment of co-occurring disorders; then the relationship between individual affective disorders and substance use disorders will be explored. Specifically, for major depression and bipolar disorder, the prevalence of co-occurrence with substance use, clinical characteristics, and treatment of individuals with co-occurring disorders will be reviewed. C1 Med Univ S Carolina, Ctr Drug & Alcohol Programs, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Ralph H Johnson Vet Adm Med Ctr, Substance Abuse Treatment Ctr, Charleston, SC 29401 USA. RP Myrick, H (reprint author), Med Univ S Carolina, Ctr Drug & Alcohol Programs, Dept Psychiat & Behav Sci, 67 President St, Charleston, SC 29425 USA. EM myrickh@musc.edu FU NIAAA NIH HHS [2 P50 AA10761-03, K23 AA00314-01] NR 46 TC 8 Z9 8 U1 5 U2 7 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0193-953X J9 PSYCHIAT CLIN N AM JI Psychiatr. Clin. North Amer. PD DEC PY 2004 VL 27 IS 4 BP 649 EP + DI 10.1016/j.psc.2004.06.003 PG 13 WC Psychiatry SC Psychiatry GA 879SI UT WOS:000225738800004 PM 15550285 ER PT J AU Grubaugh, AL Elhai, JD Monnier, J Frueh, BC AF Grubaugh, AL Elhai, JD Monnier, J Frueh, BC TI Service utilization among compensation-seeking veterans SO PSYCHIATRIC QUARTERLY LA English DT Article DE PTSD; combat; MMPI; service utilization ID POSTTRAUMATIC-STRESS-DISORDER; VIETNAM COMBAT VETERANS; FLOODING THERAPY; PTSD; AFFAIRS AB To examine the relationship between compensation-seeking status, symptom reporting, and health care utilization among combat veterans presenting for a Posttraumatic Stress disorder (PTSD) evaluation. Archival data for 68 veterans was drawn from electronic medical records for which compensation-seeking status was available. Consistent with previous findings, self-reports of distress and validity scale indices on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were higher among compensation-seeking (CS) veterans than noncompensation-seeking (NCS) veterans despite a lack of difference in actual PTSD diagnoses. However, no significant differences emerged between these two groups on healthcare utilization indices. Although exploratory analyses did not yield significant group differences on various healthcare indices, there was a trend for CS veterans to use PTSD services more, suggesting the need to further explore utilization patterns among these groups. C1 Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Med Univ S Carolina, Charleston, SC 29425 USA. Univ S Dakota, Disaster Mental Hlth Inst, Vermillion, SD 57069 USA. RP Frueh, BC (reprint author), VAMC, Mental Hlth Serv, 109 Bee St, Charleston, SC 29401 USA. EM fruehbe@musc.edu FU NIMH NIH HHS [MH01660, MH61983] NR 22 TC 5 Z9 5 U1 0 U2 0 PU KLUWER ACADEMIC-HUMAN SCIENCES PRESS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013-1578 USA SN 0033-2720 J9 PSYCHIAT QUART JI Psychiatr. Q. PD WIN PY 2004 VL 75 IS 4 BP 333 EP 341 DI 10.1023/B:PSAQ.0000043509.18637.3b PG 9 WC Psychiatry SC Psychiatry GA 866KR UT WOS:000224772900003 PM 15563051 ER PT J AU Friedman, MJ Harris, WW AF Friedman, MJ Harris, WW TI Toward a national PTSD brain bank SO PSYCHIATRY-INTERPERSONAL AND BIOLOGICAL PROCESSES LA English DT Editorial Material ID POSTTRAUMATIC-STRESS-DISORDER; DISASTER VICTIMS SPEAK; EVENTS C1 VA Med Ctr, US Dept Vet Affairs, Natl Ctr PTSD, White River Jct, VT 05009 USA. Dartmouth Coll Sch Med, Dept Psychiat, Hanover, NH USA. Dartmouth Coll Sch Med, Dept Pharmacol, Hanover, NH USA. RP Friedman, MJ (reprint author), VA Med Ctr, US Dept Vet Affairs, Natl Ctr PTSD, 116D,215 N Main St, White River Jct, VT 05009 USA. EM Matthew.J.Friedman@Dartmouth.edu NR 17 TC 3 Z9 3 U1 3 U2 5 PU GUILFORD PUBLICATIONS INC PI NEW YORK PA 72 SPRING STREET, NEW YORK, NY 10012 USA SN 0033-2747 J9 PSYCHIATRY JI Psychiatry-Interpers. Biol. Process. PD WIN PY 2004 VL 67 IS 4 BP 384 EP 390 DI 10.1521/psyc.67.4.384.56564 PG 7 WC Psychiatry SC Psychiatry GA 890GJ UT WOS:000226499400005 PM 15801378 ER PT J AU Raskind, MA AF Raskind, MA TI The challenge of a PTSD brain bank SO PSYCHIATRY-INTERPERSONAL AND BIOLOGICAL PROCESSES LA English DT Editorial Material ID POSTTRAUMATIC-STRESS-DISORDER; HIPPOCAMPAL VOLUME; ALZHEIMERS-DISEASE; NOREPINEPHRINE; EFFICACY; SAFETY; MRI C1 VA Puget Sound Hlth Care Syst, Dept Psychiat & Behav Sci, Seattle, WA 98108 USA. RP Raskind, MA (reprint author), VA Puget Sound Hlth Care Syst, Dept Psychiat & Behav Sci, 116 MIRECC,1660 S Columbian Way, Seattle, WA 98108 USA. EM Murray.Raskind@med.va.gov NR 16 TC 1 Z9 1 U1 0 U2 0 PU GUILFORD PUBLICATIONS INC PI NEW YORK PA 72 SPRING STREET, NEW YORK, NY 10012 USA SN 0033-2747 J9 PSYCHIATRY JI Psychiatry-Interpers. Biol. Process. PD WIN PY 2004 VL 67 IS 4 BP 404 EP 406 DI 10.1521/psyc.67.4.404.56563 PG 3 WC Psychiatry SC Psychiatry GA 890GJ UT WOS:000226499400008 PM 15801381 ER PT J AU Cook, JM Schnurr, PP Foa, EB AF Cook, JM Schnurr, PP Foa, EB TI Bridging the gap between posttraumatic stress disorder research and clinical practice: The example of exposure therapy SO PSYCHOTHERAPY LA English DT Article ID EMPIRICALLY SUPPORTED TREATMENTS; PSYCHOTHERAPY TREATMENT MANUALS; PSYCHOLOGISTS ATTITUDES; CHILDHOOD ABUSE; PTSD; DISSEMINATION; RECOMMENDATIONS; INTERVENTIONS; SCIENCE; TRIAL AB There are notable challenges in translating empirically supported psychosocial treatments (ESTs) into general routine clinical practice. However, there may be additional unique dissemination and implementation obstacles for ESTs for trauma-related disorders. For example, despite considerable evidence from randomized clinical trials that attests to the efficacy of exposure therapy for posttraumatic stress disorder, front-line clinicians in real-world settings rare use this treatment. Perceived and actual barriers that interfere with adoption include clinician misconceptions about what exposure entails and complex cases to which ESTs may not be readily applicable. Specific suggestions for bridging the science-into-service gap in trauma ESTs (in general) and in exposure therapy (in particular) are proposed. C1 Univ Penn, Treatment Res Ctr, Dept Psychiat, Philadelphia, PA 19104 USA. Philadephia VA Med Ctr, Dept Behav Hlth, Philadelphia, PA USA. VA Natl Ctr PTSD, Execut Div, White River Jct, VT USA. Dartmouth Coll Sch Med, Dept Psychiat, Lebanon, NH 03756 USA. RP Cook, JM (reprint author), Univ Penn, Treatment Res Ctr, Dept Psychiat, 3900 Chestnut St, Philadelphia, PA 19104 USA. EM cook_j@mail.trc.upenn.edu NR 75 TC 49 Z9 50 U1 4 U2 6 PU AMER PSYCHOLOGICAL ASSOC, DIV PSYCHOTHERAPY PI CORAL GABLES PA 1390 SOUTH DIXIE HIGHWAY, STE 2222, CORAL GABLES, FL 33146-2946 USA SN 0033-3204 J9 PSYCHOTHERAPY JI Psychotherapy PD WIN PY 2004 VL 41 IS 4 SI SI BP 374 EP 387 DI 10.1037/0033-3204.41.4.374 PG 14 WC Psychology, Clinical SC Psychology GA 906OP UT WOS:000227651800002 ER PT J AU Robbins, LB Pender, NJ Ronis, DL Kazanis, AS Pis, MB AF Robbins, LB Pender, NJ Ronis, DL Kazanis, AS Pis, MB TI Physical activity, self-efficacy, and perceived exertion among adolescents SO RESEARCH IN NURSING & HEALTH LA English DT Article DE physical activity; exercise; self-efficacy; perceived exertion; adolescents ID EXERCISE; CHILDREN; HEALTH; YOUTH; RESPONSES; BEHAVIOR; BURDEN AB The relationship of self-efficacy, a sense of confidence in personal physical activity (PA) skills, to perceived exertion during activity was explored among 168 African American and European American boys and girls between 9 and 17 years of age. Participants walked/ran on a treadmill at a speed equivalent to 60% of their peak VO2 for 20 minutes and provided ratings of exertion every 4 minutes. Pre-activity self-efficacy Predicted Perceived exertion for boys only. Girls were lower than boys in pre-activity self-efficacy and subsequently reported greater perceived exertion. For both genders, lower perceived exertion during PA resulted in higher post-activity self-efficacy. Uncomfortable perceptions of exertion during initial efforts to increase PA are likely to discourage future activity. Interventions that can lower perceptions of exertion may enhance self-efficacy and promote a sense of competence in PA skills. (C) 2004 Wiley Periodicals, Inc. C1 Univ Michigan, Sch Nursing, Ann Arbor, MI 48109 USA. US Dept Vet Affairs, Ann Arbor, MI USA. Univ Michigan, Gerald R Ford Sch Publ Policy, Ann Arbor, MI USA. RP Robbins, LB (reprint author), Univ Michigan, Sch Nursing, 400 N Ingalls, Ann Arbor, MI 48109 USA. FU NINR NIH HHS [5 T32 NR07073-08, 1 F32 NR07509-01A1] NR 49 TC 19 Z9 20 U1 2 U2 12 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0160-6891 J9 RES NURS HEALTH JI Res. Nurs. Health PD DEC PY 2004 VL 27 IS 6 BP 435 EP 446 DI 10.1002/nur.20042 PG 12 WC Nursing SC Nursing GA 873VU UT WOS:000225310300007 PM 15514962 ER PT J AU Brickman, AM Buchsbaum, MS Shihabuddin, L Byne, W Newmark, RE Brand, J Ahmed, S Mitelman, SA Hazlett, EA AF Brickman, AM Buchsbaum, MS Shihabuddin, L Byne, W Newmark, RE Brand, J Ahmed, S Mitelman, SA Hazlett, EA TI Thalamus size and outcome in schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE MRI; schizophrenia; thalamus; functional outcome ID SCHIZOTYPAL PERSONALITY-DISORDER; STRUCTURAL BRAIN ABNORMALITIES; NON-KRAEPELINIAN SCHIZOPHRENIA; SUPERIOR TEMPORAL SULCUS; METABOLIC-RATE; MEDIODORSAL NUCLEUS; PREFRONTAL CORTEX; RHESUS-MONKEYS; STRIATAL SIZE; VOLUMES AB The size of the thalamus was assessed in 106 patients with schizophrenia and 42 normal controls using high-resolution magnetic resonance imaging. The thalamus was traced at five axial levels proportionately spaced from dorsal to ventral directions. Patients with schizophrenia had significantly smaller thalamic areas at more ventral levels. Thalamic size was positively associated with frontal lobe and temporal lobe size. The effects were most marked in the patients with poorer clinical outcome (i.e., "Kraepelinian" patients). These findings are consistent with post-mortem and MRI measurement suggesting reduction in volume of the pulvinar, which occupies a large proportion of the ventral thalamus and which has prominent connections to the temporal lobe. (C) 2004 Elsevier B.V. All rights reserved. C1 CUNY Mt Sinai Sch Med, Dept Psychiat, Neurosci PET Lab, New York, NY 10029 USA. CUNY Queens Coll, Dept Psychol, Flushing, NY 11367 USA. CUNY, Grad Ctr, Flushing, NY 11367 USA. Brown Univ, Sch Med, Dept Psychiat & Human Behav, Providence, RI 02912 USA. Bronx Vet Adm Med Ctr, Dept Vet Affairs, Bronx, NY USA. RP Brickman, AM (reprint author), CUNY Mt Sinai Sch Med, Dept Psychiat, Neurosci PET Lab, Box 1505,1 Gustave L Levy Pl, New York, NY 10029 USA. EM adam.brickman@mssm.edu FU NIMH NIH HHS [MH56489, MH60023, MH60384S] NR 50 TC 34 Z9 35 U1 2 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 DEC 1 PY 2004 VL 71 IS 2-3 BP 473 EP 484 DI 10.1016/j.schres.2004.03.011 PG 12 WC Psychiatry SC Psychiatry GA 864VK UT WOS:000224660900027 PM 15474918 ER PT J AU Rassovsky, Y Green, MF Nuechterlein, KH Breitmeyer, B Mintz, J AF Rassovsky, Y Green, MF Nuechterlein, KH Breitmeyer, B Mintz, J TI Paracontrast and metacontrast in schizophrenia: clarifying the mechanism for visual masking deficits SO SCHIZOPHRENIA RESEARCH LA English DT Article DE visual masking; backward masking; paracontrast; metacontrast; schizophrenia; neurocognition ID BACKWARD-MASKING; COLLEGE-STUDENTS; PATTERN MASKING; CHANNELS; VULNERABILITY; PERFORMANCE; DISORDERS; TRANSIENT; MANIA; LIGHT AB Schizophrenic patients consistently demonstrate performance deficits on visual masking procedures. Visual masking can occur through two distinctly different mechanisms: interruption and integration. One highly effective way to limit the masking mechanism to interruption is to use a mask that surrounds, but does not spatially overlap, the target. These procedures are called paracontrast and metacontrast (for forward and backward masking, respectively). Despite their clear advantages for interpretation, paracontrast and metacontrast have not been used previously in schizophrenia. In the present study, we examined the reliability of the paracontrast and metacontrast procedures by administering these tasks to 103 schizophrenic patients and 49 normal control subjects. In addition, we compared the results to those from a low-energy masking condition, which is an alternative way to limit masking to interruption. Patients showed deficits on both the paracontrast and metacontrast procedures. The deficits in paracontrast and metacontrast were comparable to those seen previously with low-energy masking. These results suggest that the paracontrast/metacontrast procedure and the procedure using a low-energy mask are roughly equally sensitive to deficits in early visual processing among schizophrenic patients. These results bolster previous conclusions that schizophrenic patients show deficits on visual masking tasks even when masking on those tasks occurs entirely through the interruption mechanism. (C) 2004 Elsevier B.V. All rights reserved. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Geffen Sch Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Univ Houston, Dept Psychol, Houston, TX 77004 USA. RP Rassovsky, Y (reprint author), Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Geffen Sch Med, 760 Westwood Plaza C8-747-NPI, Los Angeles, CA 90024 USA. EM yurir@ucla.edu FU NIMH NIH HHS [MH-37705, MH-43292] NR 32 TC 28 Z9 28 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD DEC 1 PY 2004 VL 71 IS 2-3 BP 485 EP 492 DI 10.1016/j.schres.2004.02.018 PG 8 WC Psychiatry SC Psychiatry GA 864VK UT WOS:000224660900028 PM 15474919 ER PT J AU LaVela, SL Smith, B Weaver, FM Miskevics, SA AF LaVela, SL Smith, B Weaver, FM Miskevics, SA TI Geographical proximity and health care utilization in veterans with SCI&D in the USA SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE spinal cord injury; veterans; health care access/utilization; USA ID SPINAL-CORD-INJURY; MYOCARDIAL-INFARCTION; DISABILITIES; HOSPITALS; DISTANCE; CHOICE; READMISSION; POPULATION; MORTALITY; SERVICES AB In the USA, substantial geographic variation in health care utilization exists in the Department of Veterans Affairs (VA) health care system. Utilization of health care services is especially important for veterans with spinal cord injuries and disorders (SCI&D) who are often at high risk for secondary complications related to their SCI&D. Due to impaired mobility, access to health care for veterans with SCI&D may be even more challenging. The goal of this cross-sectional study was to describe health care utilization relative to SCI&D veteran residential geographic proximity to VA health care facilities. A negative binomial regression model was used to examine VA outpatient utilization. Veterans with SCI&D utilized outpatient services less frequently when VA facilities were farther away from their residences (p<0.000). Female (p<0.000), older (p<0.000), and non-white veterans (p<0.000), and veterans with history of respiratory (p<0.000), kidney/urinary tract (p<0.005), circulatory (p<0.000), or digestive system diseases (P<0.003) were more likely to utilize outpatient care during the study period. A Poisson model was used to examine inpatient utilization. Inpatient utilization decreased when travel distance to VA facility increased (p<0.000). Contrary to outpatient, age did not significantly affect veterans' likelihood of using inpatient health care. Marital status, gender, race, and level of injury were not related to inpatient utilization. However, history of prior illnesses including respiratory (p<0.000), kidney/urinary tract (p<0.000), circulatory (p<0.005), digestive system (p<0.015), or skin/subcutaneous tissue/breast-related illnesses (p<0.000) were associated with a greater likelihood of inpatient utilization. Geographic proximity and other factors on health care use must be considered in order to meet the health care demand patterns of veterans with SCI&D. Published by Elsevier Ltd. C1 Dept Vet Affairs, Midw Ctr Hlth Serv & Policy Res, Spinal Cord Injury Qual Enhancement Res Initiat, Edward Hines Jr Vet Affairs Hosp, Hines, IL 60141 USA. US Dept Vet Affairs, Edward Hines Jr Vet Affairs Hosp, SCI QUERI, MCHSPR,DVA, Hines, IL 60141 USA. Edward Hines Jr Vet Adm Hosp, SCI QUERI, DVA, Hines, IL 60141 USA. Northwestern Univ, Inst Hlth Serv Res & Policy Studies, Chicago, IL 60611 USA. RP LaVela, SL (reprint author), Dept Vet Affairs, Midw Ctr Hlth Serv & Policy Res, Spinal Cord Injury Qual Enhancement Res Initiat, Edward Hines Jr Vet Affairs Hosp, 5th Ave & Roosevelt Rd,151-H, Hines, IL 60141 USA. EM lavela@research.hines.med.va.gov NR 43 TC 37 Z9 37 U1 4 U2 13 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD DEC PY 2004 VL 59 IS 11 BP 2387 EP 2399 DI 10.1016/j.socscimed.2004.06.033 PG 13 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA 862WK UT WOS:000224521800016 PM 15450711 ER PT J AU Frueh, BC Monnier, J Elhai, JD Grubaugh, AL Knapp, RG AF Frueh, BC Monnier, J Elhai, JD Grubaugh, AL Knapp, RG TI Telepsychiatry treatment outcome research methodology: Efficacy versus effectiveness SO TELEMEDICINE JOURNAL AND E-HEALTH LA English DT Article ID PSYCHOTHERAPY AB The use of videoconferencing technology to provide mental health services ( telepsychiatry) offers hope for addressing longstanding problems regarding work force shortages and access to care, especially in remote or rural areas. However, data on treatment outcomes ( i. e., based on randomized clinical trials) from telepsychiatry applications are virtually nonexistent, representing an important gap in the literature. An important methodological decision point in developing treatment outcome research is whether to take an efficacy or effectiveness approach. Efficacy approaches offer enhanced internal validity; however, they may have limited generalizability to real- world settings. Effectiveness approaches offer enhanced external validity. But, they are typically less controlled than efficacy studies, thereby limiting the assumptions that can be made about causality. The current state of telepsychiatry research necessitates efficacy studies, the outcomes from which can be used to inform future effectiveness studies. C1 Med Univ S Carolina, Charleston, SC 29425 USA. Univ S Dakota, Disaster Mental Hlth Inst, Vermillion, SD 57069 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Frueh, BC (reprint author), VAMC MHS 116, 109 Bee St, Charleston, SC 29401 USA. EM fruehbc@musc.edu FU AHRQ HHS [HS11642]; NIMH NIH HHS [MH01600] NR 8 TC 15 Z9 16 U1 1 U2 1 PU MARY ANN LIEBERT INC PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1530-5627 J9 TELEMED J E-HEALTH JI Telemed. J. e-Health PD WIN PY 2004 VL 10 IS 4 BP 455 EP 458 DI 10.1089/tmj.2004.10.455 PG 4 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 895GU UT WOS:000226849700007 PM 15689650 ER PT J AU Soroushyari, A AF Soroushyari, A TI Partial withdrawal of levothyroxine to stimulate serum thyroglobulin for thyroid cancer monitoring SO THYROID LA English DT Letter ID HUMAN THYROTROPIN; HYPOTHYROIDISM; THYROXINE C1 Greater Los Angeles VA Med Ctr, Endocrinol & Diabet Div, Los Angeles, CA 90073 USA. RP Soroushyari, A (reprint author), Greater Los Angeles VA Med Ctr, Endocrinol & Diabet Div, Los Angeles, CA 90073 USA. EM jhershmn@ucla.edu NR 9 TC 0 Z9 0 U1 0 U2 0 PU MARY ANN LIEBERT INC PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1050-7256 J9 THYROID JI Thyroid PD DEC PY 2004 VL 14 IS 12 BP 1105 EP 1107 PG 3 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 885AV UT WOS:000226129200018 PM 15666427 ER PT J AU Shekelle, PG AF Shekelle, PG TI Commentary: Socioeconomic inequalities in indicator scores for A diabetes: poor quality or poor measures? SO BRITISH MEDICAL JOURNAL LA English DT Editorial Material ID DISPARITIES; CARE C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Shekelle, PG (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM shekelle@rand.org NR 5 TC 2 Z9 2 U1 0 U2 0 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0959-535X J9 BRIT MED J JI Br. Med. J. PD NOV 27 PY 2004 VL 329 IS 7477 BP 1269 EP 1270 DI 10.1136/bmj.38285.603692.7C PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 876FC UT WOS:000225480900017 PM 15548560 ER PT J AU Yang, H Roberts, LJ Shi, MJ Zhou, LC Ballard, BR Richardson, A Guo, ZM AF Yang, H Roberts, LJ Shi, MJ Zhou, LC Ballard, BR Richardson, A Guo, ZM TI Retardation of atherosclerosis by overexpression of catalase or both Cu/Zn-superoxide dismutase and catalase in mice lacking apolipoprotein E SO CIRCULATION RESEARCH LA English DT Article DE Cu/Zn-superoxide dismutase; catalase; atherosclerosis; F-2-isoprostanes ID LOW-DENSITY-LIPOPROTEIN; APOE-DEFICIENT MICE; SMOOTH-MUSCLE CELLS; FAT-FED MICE; VITAMIN-E; OXIDATIVE STRESS; IN-VIVO; REDUCES ATHEROSCLEROSIS; ANTIOXIDANT ENZYMES; ENDOTHELIAL-CELLS AB Oxidative stress has been suggested to potentiate atherogenesis. However, studies that have investigated the effect of antioxidants on atherosclerosis showed inconsistent results, ie, atherosclerosis was either retarded or not changed by dietary antioxidants. This report directly examined the effect of overexpressing Cu/Zn-superoxide dismutase (Cu/Zn-SOD) and/or catalase on atherosclerosis and lipid peroxidation in mice lacking apolipoprotein E (ApoE(-/-)). Based on lipid staining of the en face of the aorta tree and the serial sections of the proximal aorta, ApoE(-/-) mice overexpressing catalase or both Cu/Zn-SOD and catalase had smaller and relatively early stages of atherosclerotic lesions (eg, foam cells and free lipids) when compared with ApoE(-/-) mice, who developed more advanced lesions (eg, fibrous caps and acellular areas). In addition, the retarded development of atherosclerosis was correlated with a reduced F-2-isoprostanes in the plasma and aortas in ApoE(-/-) mice overexpressing catalase or both Cu/Zn-SOD and catalase. In contrast, the levels of F-2-isoprostanes and atherosclerosis in the ApoE(-/-) mice overexpressing Cu/Zn-SOD alone were comparable to ApoE(-/-) control mice. These observations implied that endogenously produced hydrogen peroxide, but not superoxide anions, contributed to the formation of oxidized lipids and the development of atherosclerosis in ApoE(-/-) mice. C1 Meharry Med Coll, Dept Pathol Anat & Cell Biol, Nashville, TN 37208 USA. Meharry Med Coll, Dept Physiol, Nashville, TN 37208 USA. Vanderbilt Univ, Div Clin Pharmacol, Nashville, TN USA. Univ Texas, Hlth Sci Ctr, Dept Cellular Struct Biol, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Guo, ZM (reprint author), Meharry Med Coll, Dept Pathol Anat & Cell Biol, Nashville, TN 37208 USA. EM ZGUO@mmc.edu FU NHLBI NIH HHS [HL076623, K01 HL076623, HL071525]; NIGMS NIH HHS [S06 GM008037, GM08037] NR 38 TC 120 Z9 126 U1 0 U2 3 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 NOV 26 PY 2004 VL 95 IS 11 BP 1075 EP 1081 DI 10.1161/01.RES.0000149564.49410.0d PG 7 WC Cardiac & Cardiovascular Systems; Hematology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Hematology GA 874MY UT WOS:000225355700005 PM 15528470 ER PT J AU Argraves, KM Wilkerson, BA Argraves, WS Fleming, PA Obeid, LM Drake, CJ AF Argraves, KM Wilkerson, BA Argraves, WS Fleming, PA Obeid, LM Drake, CJ TI Sphingosine-1-phosphate signaling promotes critical migratory events in vasculogenesis SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID PROTEIN-COUPLED RECEPTOR; SPHINGOSINE 1-PHOSPHATE RECEPTOR; VEIN ENDOTHELIAL-CELLS; EMBRYONIC BLOOD-VESSELS; LYSOPHOSPHATIDIC ACID; MURINE ALLANTOIS; EDG-1; LIGAND; MOTILITY; ANGIOGENESIS AB Here we have investigated the role of sphingosine-1-phosphate (S1P) signaling in the process of vasculogenesis in the mouse embryo. At stages preceding the formation of blood vessels (7.5 - 8 dpc) in the embryo proper, yolk sac, and allantois, the S1P receptor S1P(2) is expressed in conjunction with S1P(1) and/or S1P(3). Additionally, sphingosine kinase-2 (SK2), an enzyme that catalyzes the formation of S1P, is expressed in these tissues throughout periods of vasculogenesis. Using the cultured mouse allantois explant model of blood vessel formation, we found that vasculogenesis was dependent on S1P signaling. We showed that S1P could replace the ability of serum to promote vasculogenesis in cultured allantois explants. Instead of small poorly reticulated clusters of rounded endothelial cells that formed under serum-free conditions, S1P promoted the formation of elongated endothelial cells that arranged into expansive branched networks of capillary-like vessels. These effects could not be reproduced by vascular endothelial growth factor or basic fibroblast growth factor administration. The ability of S1P to promote blood vessel formation was not due to effects on cell survival or on changes in numbers of endothelial cells (Flk1(+)/PECAM(+)), angioblasts (Flk1(+)/PECAM(+)), or undifferentiated mesodermal cells (Flk1(+)/PECAM(-)). The S1P effect on blood vessel formation was attributed to it promoting migratory activities of angioblasts and early endothelial cells required for the expansion of vascular networks. Together, our findings suggest that migratory events critical to the de novo formation of blood vessels are under the influence of S1P, possibly synthesized via the action of SK2, with signaling mediated by S1P receptors that include S1P(1), S1P(2), and S1P(3). C1 Med Univ S Carolina, Dept Anat & Cell Biol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Dept Vet Affairs, Charleston, SC 29401 USA. RP Argraves, KM (reprint author), Med Univ S Carolina, Dept Anat & Cell Biol, Charleston, SC 29425 USA. EM argravek@musc.edu OI obeid, lina/0000-0002-0734-0847 FU NCI NIH HHS [CA097132]; NCRR NIH HHS [RR17677]; NHLBI NIH HHS [HL52813, HL57375, HL61873]; NIDCR NIH HHS [DE014347] NR 46 TC 42 Z9 47 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 NOV 26 PY 2004 VL 279 IS 48 BP 50580 EP 50590 DI 10.1074/jbc.M404432200 PG 11 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 872SU UT WOS:000225229500122 PM 15377653 ER PT J AU Wen, PH De Gasperi, R Sosa, MAG Elder, GA AF Wen, PH De Gasperi, R Sosa, MAG Elder, GA TI Neural progenitor cells do not differentiate prematurely in Presenilin-1 null mutant mice SO NEUROSCIENCE LETTERS LA English DT Article DE Presenilin-1; neural progenitor cells; neuronal differentiation; null mutant; telencephalon; mice ID CENTRAL-NERVOUS-SYSTEM; RAT; CORTEX; NEURONS; LOCALIZATION; CALRETININ; EXPRESSION; MIGRATION; IMMUNOREACTIVITY; CALBINDIN-D28K AB Mice with a null mutation of the presenilin-1 (PS1-/-) gene die during late intrauterine life or shortly after birth and exhibit defects in cortical development. A previous report suggested that neurons differentiate prematurely in PS1-/- brain [M. Handler, X. Yang, J. Shen, Presenilin-1 regulates neuronal differentiation during neurogenesis, Development 127 (2000) 2593-2606]. Here we reexamined the issue of whether premature neuronal differentiation occurs in PS1-/- brain using fresh cell suspensions from embryonic E11.5 and E13.5 telencephalon where individual cell phenotypes can be easily determined with cell type specific markers. Immumostaining with seven neuronal specific markers (MAP2, beta-III tubulin, GABA, reelin, GluR2/3, calbindin, and calretinin) failed to reveal any evidence of premature neuronal differentiation in PS1-/- telencephalon. We also determined the fraction of cells expressing the neural progenitor marker nestin and found no evidence for premature depletion of neural progenitor cells in PS1-/- telencephalon. Moreover, based on MAP2 staining of tissue sections from E12.5 embryos the topography of newly generated neurons also appeared to be undisturbed in the telencephalon of PS1-/- embryos. These studies thus argue that premature neuronal differentiation is unlikely to be a core pathophysiological feature underlying the aberrant cortical development that occurs in PS1-/- brain. (C) 2004 Elsevier Ireland Ltd. All rights reserved. C1 CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Adm Med Ctr, Psychiat Serv 3F22, Bronx, NY 10468 USA. RP Elder, GA (reprint author), CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. EM gregory.elder@mssm.edu FU NIA NIH HHS [1R01AG020139] NR 22 TC 4 Z9 4 U1 0 U2 2 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 NOV 23 PY 2004 VL 371 IS 2-3 BP 249 EP 254 DI 10.1016/j.neulet.2004.09.038 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 872JP UT WOS:000225203800034 PM 15519767 ER PT J AU Giordano, TP Kramer, JR Souchek, J Richardson, P El-Serag, HB AF Giordano, TP Kramer, JR Souchek, J Richardson, P El-Serag, HB TI Cirrhosis and hepatocellular carcinoma in HIV-infected veterans with and without the hepatitis C virus - A cohort study, 1992-2001 SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 2nd International-AIDS-Society Conference on HIV Pathogenesis and Treatment CY JUL 13-16, 2003 CL Paris, FRANCE SP Int AIDS Soc ID HUMAN-IMMUNODEFICIENCY-VIRUS; SEVERITY CLASSIFICATION-SYSTEM; MORTALITY; COINFECTION; AIDS; HOSPITALIZATIONS; MORBIDITY; THERAPIES; SURVIVAL; PATTERNS AB Background: Because they develop slowly and infrequently, the incidence and relative risk of cirrhosis at id hepatocellular carcinoma (HCC) in patients with the human immunodeficiency virus (HIV) only and in patients coinfected with the hepatitis C virus (HCV) are not known. Methods: By using national Veterans Health Administration administrative databases, we conducted a retrospective cohort study. Excluding patients with preexisting liver disease, 11678 HIV-only and 4761 coinfected patients hospitalized between October 1, 1991, and September 30, 2000, were included. Incidence rates and adjusted hazard ratios (HRs) for nonalcoholic cirrhos s and HCC after discharge were calculated through September 30, 2001. Results: The incidence rates of cirrhosis in the HIV-only, and coinfected groups were 1.47 and 15.88 per 1000 person-years, respectively. In a Cox multivariate proportion l hazards regression model, coinfected patients had an adjusted HR for cirrhosis of 9.24 compared with HIV-only patients (95% confidence interval, 6.92-12.33; P < .001). The incidence rates of HCC in the HIV-only and coinfected groups were 0.20 and 1.32 per 1000 person-years, respectively. In a Cox multivariate proportional hazards regression model, coinfected patients had an adjusted HR for HCC of 5.35 compared with HIV-only patients (95% confidence interval, 2.34-12.20; P < .00.1). Among patients identified during the highly active antiretroviral therapy era, the HR for cirrhosis was 19.06 (95% confidence interval, 10.14-35.85; P < .001), while the HR for HCC was 5.07 (95% confidence interval, 1.72-14.99; P = .003). Conclusions: To our knowledge, this study is the largest longitudinal study to examine the incidence of nonalcoholic cirrhosis and HCC in HIV-only and HCV-coinfected patients. Hepatitis C virus coinfection dramatically promotes the development of HCC (5-fold) and of cirrhosis (10- to 20-fold), and is especially associated with cirrhosis in the highly active antiretroviral therapy era. Treatment of HCV in HIV-infected patients, while often unsuccessful, should be considered. C1 Dept Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Serv, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Hlth Serv Res, Infect Dis Sect, Houston, TX 77030 USA. RP Giordano, TP (reprint author), Dept Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Serv, 152,2002 Holcombe Blvd, Houston, TX 77030 USA. EM tpg@bcm.tmc.edu FU NIMH NIH HHS [K23MH67505] NR 27 TC 108 Z9 118 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 NOV 22 PY 2004 VL 164 IS 21 BP 2349 EP 2354 DI 10.1001/archinte.164.21.2349 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 874FV UT WOS:000225337200008 PM 15557414 ER PT J AU Schilling, LM Wren, JD Dellavalle, RP AF Schilling, LM Wren, JD Dellavalle, RP TI Untitled SO BIOINFORMATICS LA English DT Letter ID REFERENCES C1 Univ Colorado, Hlth Sci Ctr, Denver, CO 80209 USA. Univ Oklahoma, Adv Ctr Genome Technol, Norman, OK 73019 USA. Denver Vet Affairs Med Ctr, Dermatol Serv, Denver, CO USA. RP Schilling, LM (reprint author), Univ Colorado, Hlth Sci Ctr, 360 S Garfield Ave, Denver, CO 80209 USA. RI Wren, Jonathan/E-5611-2011; Dellavalle, Robert/L-2020-2013 OI Wren, Jonathan/0000-0003-2776-3545; Dellavalle, Robert/0000-0001-8132-088X NR 3 TC 6 Z9 6 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1367-4803 J9 BIOINFORMATICS JI Bioinformatics PD NOV 22 PY 2004 VL 20 IS 17 BP 2903 EP 2903 DI 10.1093/bioinformatics/bth385 PG 1 WC Biochemical Research Methods; Biotechnology & Applied Microbiology; Computer Science, Interdisciplinary Applications; Mathematical & Computational Biology; Statistics & Probability SC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Computer Science; Mathematical & Computational Biology; Mathematics GA 874PD UT WOS:000225361400002 PM 15231533 ER PT J AU Muller, FL Liu, YH Van Remmen, H AF Muller, FL Liu, YH Van Remmen, H TI Complex III releases superoxide to both sides of the inner mitochondrial membrane SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID CYTOCHROME BC(1) COMPLEX; HYDROGEN-PEROXIDE PRODUCTION; ELECTRON-TRANSPORT CHAIN; RESPIRATORY-CHAIN; REACTIVE OXYGEN; Q(O) SITE; HEART-MITOCHONDRIA; MUTANT MICE; UBIHYDROQUINONE OXIDATION; CHLOROPLAST THYLAKOIDS AB Mechanisms of mitochondrial superoxide formation remain poorly understood despite considerable medical interest in oxidative stress. Superoxide is produced from both Complexes I and III of the electron transport chain, and once in its anionic form it is too strongly charged to readily cross the inner mitochondrial membrane. Thus, superoxide production exhibits a distinct membrane sidedness or "topology." In the present work, using measurements of hydrogen peroxide (Amplex red) as well as superoxide ( modified Cypridina luciferin analog and aconitase), we demonstrate that Complex I-dependent superoxide is exclusively released into the matrix and that no detectable levels escape from intact mitochondria. This finding fits well with the proposed site of electron leak at Complex I, namely the iron-sulfur clusters of the (matrix-protruding) hydrophilic arm. Our data on Complex III show direct extramitochondrial release of superoxide, but measurements of hydrogen peroxide production revealed that this could only account for similar to 50% of the total electron leak even in mitochondria lacking CuZn-superoxide dismutase. We posit that the remaining similar to 50% of the electron leak must be due to superoxide released to the matrix. Measurements of ( mitochondrial matrix) aconitase inhibition, performed in the presence of exogenous superoxide dismutase and catalase, confirmed this hypothesis. Our data indicate that Complex III can release superoxide to both sides of the inner mitochondrial membrane. The locus of superoxide production in Complex III, the ubiquinol oxidation site, is situated immediately next to the intermembrane space. This explains extramitochondrial release of superoxide but raises the question of how superoxide could reach the matrix. We discuss two models explaining this result. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Barshop Ctr Longev Studies, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Dept Cellular & Struct Biol, San Antonio, TX 78284 USA. RP Muller, FL (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 7703 Floyd Curl Dr,MSC 7762, San Antonio, TX 78229 USA. EM mullerf@uthscsa.edu FU NIA NIH HHS [5T3-AG021890-02, P01AG14674] NR 80 TC 486 Z9 502 U1 1 U2 22 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 NOV 19 PY 2004 VL 279 IS 47 BP 49064 EP 49073 DI 10.1074/jbc.M407715200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 870ZP UT WOS:000225098100070 PM 15317809 ER PT J AU Inoue, M Digman, MA Cheng, M Breusegem, SY Halaihel, N Sorribas, V Mantulin, WW Gratton, E Barry, NP Levi, M AF Inoue, M Digman, MA Cheng, M Breusegem, SY Halaihel, N Sorribas, V Mantulin, WW Gratton, E Barry, NP Levi, M TI Partitioning of NaPi cotransporter in cholesterol-, sphingomyelin-, and glycosphingolipid-enriched membrane domains modulates NaPi protein diffusion, clustering, and activity SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID FLUORESCENCE CORRELATION SPECTROSCOPY; GPI-ANCHORED PROTEINS; GIANT UNILAMELLAR VESICLES; PHOTON-COUNTING HISTOGRAM; PROXIMAL TUBULAR CELLS; LIPID RAFTS; MODEL MEMBRANES; PHOSPHATE-TRANSPORT; BRUSH-BORDER; FLUCTUATION SPECTROSCOPY AB In dietary potassium deficiency there is a decrease in the transport activity of the type IIa sodium/phosphate cotransporter protein (NaPi) despite an increase in its apical membrane abundance. This novel posttranslational regulation of NaPi activity is mediated by the increased glycosphingolipid content of the potassium-deficient apical membrane. However, the mechanisms by which these lipids modulate NaPi activity have not been determined. We determined if in potassium deficiency NaPi is increasingly partitioned in cholesterol-, sphingomyelin-, and glycosphingolipid-enriched microdomains of the apical membrane and if the increased presence of NaPi in these microdomains modulates its activity. By using a detergent-free density gradient flotation technique, we found that 80% of the apical membrane NaPi partitions into the low density cholesterol-, sphingomyelin-, and GM1-enriched fractions characterized as "lipid raft" fractions. In potassium deficiency, a higher proportion of NaPi was localized in the lipid raft fractions. By combining fluorescence correlation spectroscopy and photon counting histogram methods for control and potassium-deficient apical membranes reconstituted into giant unilamellar vesicles, we showed a 2-fold decrease in lateral diffusion of NaPi protein and a greater than 2-fold increase in size of protein aggregates/clusters in potassium deficiency. Our results indicate that NaPi protein is localized in membrane microdomains, that in potassium deficiency a larger proportion of NaPi protein is present in these microdomains, and that NaPi lateral diffusion is slowed down and NaPi aggregation/clustering is increased in potassium deficiency, both of which could be associated with the decreased Na/P-i cotransport activity in potassium deficiency. C1 Univ Colorado, Hlth Sci Ctr, Dept Med, Div Renal Dis & Hypertens, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Physiol, Div Renal Dis & Hypertens, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Biophys, Div Renal Dis & Hypertens, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO 80262 USA. Univ Illinois, Dept Phys, Fluorescence Dynam Lab, Urbana, IL 61801 USA. Univ Zaragoza, Dept Toxicol, E-50013 Zaragoza, Spain. RP Levi, M (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Med, Div Renal Dis & Hypertens, 4200 E 9th Ave, Denver, CO 80262 USA. EM Moshe.Levi@UCHSC.edu RI Halaihel , Nabil/J-2973-2016 OI Levi, Moshe/0000-0002-6225-946X; Sorribas, Victor/0000-0003-3457-323X FU NCRR NIH HHS [5 P41-RRO3155]; NIDDK NIH HHS [5R01 DK062209-02] NR 70 TC 29 Z9 29 U1 0 U2 6 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD NOV 19 PY 2004 VL 279 IS 47 BP 49160 EP 49171 DI 10.1074/jbc.M408942200 PG 12 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 870ZP UT WOS:000225098100081 PM 15355967 ER PT J AU Peabody, JW Luck, J Glassman, P Jain, S Hansen, J Spell, M Lee, M AF Peabody, JW Luck, J Glassman, P Jain, S Hansen, J Spell, M Lee, M TI Measuring the quality of physician practice by using clinical vignettes: A prospective validation study SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID STANDARDIZED PATIENTS; GENERAL-PRACTITIONERS; FAMILY PHYSICIANS; CHART ABSTRACTION; NURSING RESEARCH; DECISION-MAKING; MEDICAL-RECORD; CARE; DIAGNOSIS; ILL AB Background: worldwide efforts are under way to improve the quality of clinical practice. Most quality measurements, however, are poorly validated, expensive, and difficult to compare among sites. Objective: To validate whether vignettes accurately measure the quality of clinical practice by using a comparison with standardized patients (the gold standard method), and to determine whether vignettes are a more or less accurate method than medical record abstraction. Design: Prospective, multisite study. Setting: Outpatient primary care clinics in 2 Veterans Affairs medical centers and 2 large, private medical centers. Participants: 144 of 163 eligible physicians agreed to participate, and, of these, 116 were randomly selected to see standardized patients, to complete vignettes, or both. Measurements: Scores, expressed as the percentage of explicit quality criteria correctly completed, were obtained by using 3 methods. Results: Among all physicians, the quality of clinical practice as measured by the standardized patients was 73% correct (95% CI, 72.1% to 73.4%). By using exactly the same criteria, physicians scored 68% (CI, 67.9% to 68.9%) when measured by the vignettes but only 63% (CI, 62.7% to 64.0%) when assessed by medical record abstraction. These findings were consistent across all diseases and were independent of case complexity or physician training level. Vignettes also accurately measured unnecessary care. Finally, vignettes seem to capture the range in the quality of clinical practice among physicians within a site. Limitations: Despite finding variation in the quality of clinical practice, we did not determine whether poorer quality translated into worse health status for patients. In addition, the quality scores are based on measurements from 1 patient-provider interaction. As with all other scoring criteria, vignette criteria must be regularly updated. Conclusions: Vignettes are a valid tool for measuring the quality of clinical practice. They can be used for diverse clinical settings, diseases, physician types, and situations in which case-mix variation is a concern. They are inexpensive and easy to use. Vignettes are particularly useful for comparing quality among and within sites and may be useful for longitudinal evaluations of interventions intended to change clinical practice. C1 Univ Calif San Francisco, Inst Global Hlth, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94105 USA. Calif Pacific Med Ctr, San Francisco, CA USA. Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RAND Corp, Santa Monica, CA USA. Vet Affairs Ctr Study Healthcare Provider Behav, Sepulveda, CA USA. So Calif Permanente Med Grp, Los Angeles, CA 90027 USA. RP Peabody, JW (reprint author), Univ Calif San Francisco, Inst Global Hlth, San Francisco Vet Affairs Med Ctr, 74 New Montgomery,Suite 508, San Francisco, CA 94105 USA. EM peabody@psg.ucsf.edu NR 61 TC 309 Z9 309 U1 1 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 NOV 16 PY 2004 VL 141 IS 10 BP 771 EP 780 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 872KU UT WOS:000225206900004 PM 15545677 ER PT J AU Long, JA Chang, VW Ibrahim, SA Asch, DA AF Long, JA Chang, VW Ibrahim, SA Asch, DA TI Update on the health disparities literature SO ANNALS OF INTERNAL MEDICINE LA English DT Review ID OF-VETERANS-AFFAIRS; RENAL-TRANSPLANTATION; RACIAL-DIFFERENCES; PHYSICAL-ACTIVITY; TRENDS; RACE; MORTALITY; PATIENT; CANCER; CARE C1 Univ Penn, Sch Med, Leonard Davis Inst Hlth Econ, Vet Affairs Ctr Hlth Equ Res & Promot,Vet Affairs, Philadelphia, PA 19104 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. Vet Affairs Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. RP Long, JA (reprint author), Univ Penn, Sch Med, Leonard Davis Inst Hlth Econ, Vet Affairs Ctr Hlth Equ Res & Promot,Vet Affairs, Philadelphia, PA 19104 USA. EM jalong@mail.med.upenn.edu FU NICHD NIH HHS [5-K12-HD-0435901] NR 25 TC 39 Z9 39 U1 0 U2 2 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD NOV 16 PY 2004 VL 141 IS 10 BP 805 EP 812 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 872KU UT WOS:000225206900008 PM 15545681 ER PT J AU Means, RT Dallalio, GA Fleury, TW AF Means, RT Dallalio, GA Fleury, TW TI Effects of hepcidin, ferritin, and iron deprivation on erythroid colony formation in vitro. SO BLOOD LA English DT Meeting Abstract CT 46th Annual Meeting of the American-Society-of-Hematology CY DEC 04-07, 2004 CL San Diego, CA SP Amer Soc Hematol C1 Lexington VA Med Ctr, Med & Res Serv, Lexington, KY USA. Univ Kentucky, Lexington, KY USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. Med Univ S Carolina, Charleston, SC 29425 USA. RI Means, Robert/A-4454-2008 NR 0 TC 0 Z9 0 U1 0 U2 0 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 NOV 16 PY 2004 VL 104 IS 11 MA 3704 BP 12B EP 12B PN 2 PG 1 WC Hematology SC Hematology GA 871JO UT WOS:000225127700036 ER PT J AU Behler, CM Shade, SB Gregory, K Abrams, DI Volberding, PA AF Behler, CM Shade, SB Gregory, K Abrams, DI Volberding, PA TI Anemia and HIV in the antiretroviral era: Potential significance of testosterone. SO BLOOD LA English DT Meeting Abstract CT 46th Annual Meeting of the American-Society-of-Hematology CY DEC 04-07, 2004 CL San Diego, CA SP Amer Soc Hematol C1 Univ Calif San Francisco, Posit Hlth Program, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 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 NOV 16 PY 2004 VL 104 IS 11 MA 3722 BP 16B EP 16B PN 2 PG 1 WC Hematology SC Hematology GA 871JO UT WOS:000225127700054 ER PT J AU Means, RT Fleury, TW Dallalio, GA Brunson, CY AF Means, RT Fleury, TW Dallalio, GA Brunson, CY TI Placental growth factor concentrations in bone marrow of sickle cell patients. SO BLOOD LA English DT Meeting Abstract CT 46th Annual Meeting of the American-Society-of-Hematology CY DEC 04-07, 2004 CL San Diego, CA SP Amer Soc Hematol C1 Univ Kentucky, Lexington VA Med Ctr, Med & Res Serv, Lexington, KY USA. Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Div Hematol & Oncol, Charleston, SC USA. RI Means, Robert/A-4454-2008 NR 0 TC 0 Z9 0 U1 0 U2 0 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 NOV 16 PY 2004 VL 104 IS 11 MA 3731 BP 19B EP 19B PN 2 PG 1 WC Hematology SC Hematology GA 871JO UT WOS:000225127700063 ER PT J AU Frost, P Hoang, B Gera, J Sharma, A Shi, YJ Yan, HJ Lichtenstein, A AF Frost, P Hoang, B Gera, J Sharma, A Shi, YJ Yan, HJ Lichtenstein, A TI AKT activity regulates sensitivity of multiple myeloma cells to mTor inhibitors. SO BLOOD LA English DT Meeting Abstract CT 46th Annual Meeting of the American-Society-of-Hematology CY DEC 04-07, 2004 CL San Diego, CA SP Amer Soc Hematol C1 W Los Angeles Vet Affairs Med Ctr, Dept Hematol Oncol, Los Angeles, CA 90073 USA. Washington Univ, Dept Arts & Sci, St Louis, MO USA. NR 0 TC 3 Z9 3 U1 0 U2 0 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 NOV 16 PY 2004 VL 104 IS 11 MA 646 BP 186A EP 186A PN 1 PG 1 WC Hematology SC Hematology GA 871JM UT WOS:000225127500649 ER PT J AU Ebihara, Y Masuya, M Owens, R Yang, S Visconti, RP Fleming, PA Minamiguchi, H Drake, CJ Ogawa, M AF Ebihara, Y Masuya, M Owens, R Yang, S Visconti, RP Fleming, PA Minamiguchi, H Drake, CJ Ogawa, M TI Hematopoietic origin of fibroblasts and their precursors. SO BLOOD LA English DT Meeting Abstract CT 46th Annual Meeting of the American-Society-of-Hematology CY DEC 04-07, 2004 CL San Diego, CA SP Amer Soc Hematol C1 Ralph H Johnson VA Med Ctr, Res Serv, Charleston, SC USA. Med Univ S Carolina, Charleston, SC 29425 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 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 NOV 16 PY 2004 VL 104 IS 11 MA 672 BP 193A EP 193A PN 1 PG 1 WC Hematology SC Hematology GA 871JM UT WOS:000225127500675 ER PT J AU LaRue, AC Masuya, M Fleming, PA Visconti, RP Ogawa, M Drake, CJ AF LaRue, AC Masuya, M Fleming, PA Visconti, RP Ogawa, M Drake, CJ TI The hematopoietic origin of tumor fibroblasts and pericytes. SO BLOOD LA English DT Meeting Abstract CT 46th Annual Meeting of the American-Society-of-Hematology CY DEC 04-07, 2004 CL San Diego, CA SP Amer Soc Hematol C1 Ralph H Johnson VA Med Ctr, Res Serv, Charleston, SC USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Anat & Cell Biol, Charleston, SC 29425 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 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 NOV 16 PY 2004 VL 104 IS 11 MA 673 BP 193A EP 194A PN 1 PG 2 WC Hematology SC Hematology GA 871JM UT WOS:000225127500676 ER PT J AU Toro, JJ Morales, M Loberiza, FR Freytes, CO AF Toro, JJ Morales, M Loberiza, FR Freytes, CO TI Patterns of use of vascular access devices (VAD) in patients undergoing hematopoietic stem cell transplantation (HSCT): Results of an international survey. SO BLOOD LA English DT Meeting Abstract CT 46th Annual Meeting of the American-Society-of-Hematology CY DEC 04-07, 2004 CL San Diego, CA SP Amer Soc Hematol C1 S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Hosp Nuestra Senora de Candelaria, Med Oncol Serv, Santa Cruz de Tenerife, Canary Islands, Spain. Med Coll Wisconsin, Hlth Policy Inst, Milwaukee, WI 53226 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 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 NOV 16 PY 2004 VL 104 IS 11 MA 2195 BP 603A EP 603A PN 1 PG 1 WC Hematology SC Hematology GA 871JM UT WOS:000225127502196 ER PT J AU Scott, BL Maris, M Sandmaier, B Storer, B Chauncey, T Maloney, DG Sorror, M Storb, R Deeg, HJ AF Scott, BL Maris, M Sandmaier, B Storer, B Chauncey, T Maloney, DG Sorror, M Storb, R Deeg, HJ TI Myeloablative versus nonmyeloablative hemopoietic cell transplantation (HCT) for patients with myelodysplasia (MDS) or AML with multilineage dysplasia following MDS (tAML). SO BLOOD LA English DT Meeting Abstract CT 46th Annual Meeting of the American-Society-of-Hematology CY DEC 04-07, 2004 CL San Diego, CA SP Amer Soc Hematol C1 Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA. Univ Washington, Seattle, WA 98195 USA. VA Puget Sound, Seattle, WA USA. NR 0 TC 3 Z9 3 U1 0 U2 0 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 NOV 16 PY 2004 VL 104 IS 11 MA 2320 BP 638A EP 638A PN 1 PG 1 WC Hematology SC Hematology GA 871JM UT WOS:000225127502321 ER PT J AU Schittenhelm, M Shiraga, S Lee, FY Heinrich, MC AF Schittenhelm, M Shiraga, S Lee, FY Heinrich, MC TI BMS-354825 potently inhibits the kinase activity of KIT activation loop mutations associated with systemic mastocytosis and induces apoptosis of mastocytosis cell lines SO BLOOD LA English DT Meeting Abstract CT 46th Annual Meeting of the American-Society-of-Hematology CY DEC 04-07, 2004 CL San Diego, CA SP Amer Soc Hematol C1 Univ Tubingen, Dept Hematol Oncol Rheumatol & Immunol, Tubingen, Germany. Portland VA Med Ctr, Portland, OR USA. OHSU, Div Hematol Med Oncol, Inst Canc, Portland, OR USA. Bristol Myers Squibb Co, Oncol Drug Discovery, Princeton, NJ USA. NR 0 TC 5 Z9 5 U1 0 U2 1 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 NOV 16 PY 2004 VL 104 IS 11 MA 2424 BP 666A EP 666A PN 1 PG 1 WC Hematology SC Hematology GA 871JM UT WOS:000225127502424 ER PT J AU Kampschulte, A Ferguson, MS Kerwin, WS Polissar, NL Chu, B Saam, T Hatsukami, TS Yuan, C AF Kampschulte, A Ferguson, MS Kerwin, WS Polissar, NL Chu, B Saam, T Hatsukami, TS Yuan, C TI Differentiation of intraplaque versus juxtaluminal hemorrhage/thrombus in advanced human carotid atherosclerotic lesions by in vivo magnetic resonance imaging SO CIRCULATION LA English DT Article DE magnetic resonance imaging; atherosclerosis; carotid arteries; plaque; hemorrhage ID HIGH-RESOLUTION MRI; CEREBRAL-ISCHEMIA; PLAQUE HEMORRHAGE; ARTERY STENOSIS; CLASSIFICATION; RUPTURE; ACCURACY; DISEASE; DEATH AB Background - Intraplaque hemorrhage and juxtaluminal hemorrhage/thrombus may differ in cause and clinical implications. This study tested the hypothesis that MRI can distinguish between intraplaque hemorrhage and juxtaluminal hemorrhage/thrombus and investigated the association between hemorrhage and underlying lesion types. Methods and Results - Twenty-six patients scheduled for carotid endarterectomy were imaged with a 1.5-T GE scanner by a multicontrast-weighted MRI technique. Hemorrhages were identified with previously established MRI criteria, and differentiations were made between intraplaque and juxtaluminal hemorrhage/ thrombus. Corresponding histology was used to confirm the magnetic resonance findings. Tissues underlying areas of hemorrhage/ thrombus were histologically categorized according to modified American Heart Association criteria. Of 190 matched sections, 140 contained areas of hemorrhage by histology, of which MRI correctly detected 134. The sensitivity and specificity for MRI to correctly identify cross sections that contained hemorrhage were 96% and 82%, respectively. Furthermore, MRI was able to distinguish juxtaluminal hemorrhage/ thrombus from intraplaque hemorrhage with an accuracy of 96%. The distribution of lesion types underlying hemorrhages differed significantly (P = 0.004). Intraplaque hemorrhage had an underlying lipid-rich type IV/V lesion in 55% of histological sections, whereas juxtaluminal hemorrhage/ thrombus had an underlying calcified lesion type VII in 70% of sections. Conclusions - In vivo high-resolution MRI can detect and differentiate intraplaque hemorrhage from juxtaluminal hemorrhage/ thrombus with good accuracy. The association of hemorrhage and lesion types suggests potential differences in origin. Noninvasive MRI therefore provides a possible tool for prospectively studying differences in origin of plaque hemorrhage and the association of plaque progression and instability. C1 Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Univ Washington, Dept Surg, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Mt Whisper Light Stat Consulting, Seattle, WA USA. Univ Heidelberg, Dept Radiol, Heidelberg, Germany. RP Yuan, C (reprint author), Univ Washington, Dept Radiol, 1959 NE Pacific Ave,Box 357115, Seattle, WA 98195 USA. EM cyuan@u.washington.edu FU NHLBI NIH HHS [HL56874] NR 33 TC 99 Z9 106 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD NOV 16 PY 2004 VL 110 IS 20 BP 3239 EP 3244 DI 10.1161/01.CIR.0000147287.23741.9A PG 6 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 871DQ UT WOS:000225109900014 PM 15533871 ER PT J AU Bent, S Padula, A Neuhaus, J AF Bent, S Padula, A Neuhaus, J TI Safety and efficacy of citrus aurantium for weight loss SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID EPHEDRA; ADULTS AB To examine the safety and efficacy of citrus aurantium, an herb now commonly used as a substitute for ephedra in dietary supplements marketed to promote weight loss, we conducted a systematic review. An extensive search of MEDLINE, EMBASE, BIOSIS, and the Cochrane Collaboration Database identified only 1 eligible randomized placebo controlled trial, which followed 20 patients for 6 weeks, demonstrated no statistically significant benefit for weight loss, and provided limited information about the safety of the herb. (C) 2004 by Excerpta Medica, Inc. C1 San Francisco VA Med Ctr, Dept Med, San Francisco, CA 94121 USA. Univ Calif San Francisco, Osher Ctr Integrat Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. RP Bent, S (reprint author), San Francisco VA Med Ctr, Dept Med, 111-A1,4150 Clement St, San Francisco, CA 94121 USA. EM bent@itsa.ucsf.edu FU NCCIH NIH HHS [1 K08 ATO1338-01] NR 14 TC 55 Z9 60 U1 0 U2 6 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 NOV 15 PY 2004 VL 94 IS 10 BP 1359 EP 1361 DI 10.1016/j.amjcard.2004.07.137 PG 3 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 872LC UT WOS:000225207700036 PM 15541270 ER PT J AU Brown, AM Gordon, D Lee, H Caudy, M Hardy, J Haroutunian, V Blass, JP AF Brown, AM Gordon, D Lee, H Caudy, M Hardy, J Haroutunian, V Blass, JP TI Association of the dihydrolipoamide dehydrogenase gene with Alzheimer's disease in an Ashkenazi Jewish population SO AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS LA English DT Article ID OBSESSIVE-COMPULSIVE DISORDER; HARDY-WEINBERG PROPORTIONS; APOLIPOPROTEIN-E; MITOCHONDRIAL DISEASES; FREQUENCY ESTIMATION; COMPLEX ACTIVITY; ALPHA-SUBUNIT; TYPE-4 ALLELE; ONSET; MUTATIONS AB Abundant biochemical evidence links deficient activity of mitochondrial a-ketoglutarate dehydrogenase with neuropathologically confirmed Alzheimer's disease (AD). Reduced a-ketoglutarate dehydrogenase activity has also been associated with anti-mortem measures of clinical disability. One of the genes encoding this complex, namely, DLD, lies within a chromosome 7 region that is in linkage disequilibrium. with AD. We therefore examined the hypothesis that variation in DLD is associated with AD risk. Denaturing HPLC was used to search for sequence variations in the coding and flanking regions of all exons of DLD, but no abundant variants that alter protein sequence were found. However, four common SNPs were identified and genotyped in a case-control series of 297 Caucasians from New York City, including 229 residents of a Jewish nursing home. Logistic regression analysis was performed for the four-locus DLD genotype, sex, and ApoE4 status to determine the association of these independent variables with AD. Significant associations with AD were observed for ApoE4 (P<10(-6)) and sex combined with DLD genotype (P=0.013). The association with the DLD genotypes appears only in the male population in both the Caucasian series (P=0.0009, n=83) and the Ashkenazi Jewish subseries (P=0.017, n=49). The DLD genotype appears to operate independently of APOE in conferring AD risk. (C) 2004 Wiley-Liss, Inc. C1 Dementia Res Serv, Burke Med Res Inst, White Plains, NY 10605 USA. Cornell Univ, Weill Med Coll, Dept Biochem, New York, NY USA. Cornell Univ, Weill Med Coll, Dept Neurol & Neurosci, New York, NY USA. Cornell Univ, Weill Med Coll, Dept Med, New York, NY USA. Rockefeller Univ, Lab Stat Genet, New York, NY 10021 USA. NINDS, Neurogenet Lab, Bethesda, MD 20892 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. RP Brown, AM (reprint author), Dementia Res Serv, Burke Med Res Inst, 785 Mamaroneck Ave, White Plains, NY 10605 USA. EM ambrown@med.cornell.edu RI Hardy, John/C-2451-2009 FU NHGRI NIH HHS [K01-HG00055]; NIA NIH HHS [P01-AG02219, P01-AG14930]; NIMH NIH HHS [MH44292] NR 48 TC 11 Z9 11 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0148-7299 J9 AM J MED GENET B JI Am. J. Med. Genet. B PD NOV 15 PY 2004 VL 131B IS 1 BP 60 EP 66 DI 10.1002/ajmg.b.30008 PG 7 WC Genetics & Heredity; Psychiatry SC Genetics & Heredity; Psychiatry GA 866RP UT WOS:000224790900011 PM 15389771 ER PT J AU Mortensen, EM Restrepo, M Anzueto, A Pugh, J AF Mortensen, EM Restrepo, M Anzueto, A Pugh, J TI Effects of guideline-concordant antimicrobial therapy on mortality among patients with community-acquired pneumonia SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID ELDERLY-PATIENTS; MANAGEMENT; DIAGNOSIS; SEVERITY; OUTCOMES; QUALITY; ADULTS; CARE AB PURPOSE: National practice guidelines have recommended specific initial empiric antimicrobial regimens for patients with community-acquired pneumonia. Our aim was to determine the association between the use of guideline-concordant antimicrobial therapy and 30-day mortality in patients with pneumonia. METHODS: We conducted a retrospective cohort study at two tertiary teaching hospitals. Eligible patients were admitted with a diagnosis of community-acquired pneumonia, had a chest radiograph consistent with pneumonia, and had a discharge diagnosis of pneumonia. All eligible patients were identified and a random sample was abstracted. We determined whether the use of guideline-concordant antibiotics was associated with 30-day mortality in an analysis that adjusted for potential confounders using propensity scores. RESULTS: Information was obtained on 420 patients with pneumonia. The mean (+/- SD) age was 63 +/- 16 years, 355 were men, and 82 patients were initially admitted to the intensive care unit. At 30 days after presentation, 41 patients (9.8%) had died: 21 of 97 (21.7%) in the non-guideline-concordant group and 20 of 323 (6.2%) in the guideline-concordant group. Antibiotics were concordant with national guidelines in 323 patients. In the regression analysis, after adjustment for the propensity score, failure to comply with antimicrobial therapy guidelines was associated with increased 30-day mortality (odds ratio = 5.7; 95% confidence interval: 2.0 to 16.0). CONCLUSION: Receipt of antimicrobial regimens concordant with national published guidelines may reduce 30-day mortality among patients hospitalized with pneumonia. (C) 2004 by Elsevier Inc. C1 UTHSCSA, ALMD, Vet Evidence Based Res Disseminat & Implementat C, Div Gen Internal Med, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Div Pulm Crit Care Med, San Antonio, TX USA. RP Mortensen, EM (reprint author), UTHSCSA, ALMD, Vet Evidence Based Res Disseminat & Implementat C, Div Gen Internal Med, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. EM mortensen@verdict.uthscsa.edu OI Pugh, Jacqueline/0000-0003-4933-141X; Mortensen, Eric/0000-0002-3880-5563 NR 17 TC 87 Z9 90 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 NOV 15 PY 2004 VL 117 IS 10 BP 726 EP 731 DI 10.1016/j.amjmed.2004.06.028 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 872UA UT WOS:000225232900002 PM 15541321 ER PT J AU Arterburn, DE McDonell, MB Hedrick, SC Diehr, P Fihn, SD AF Arterburn, DE McDonell, MB Hedrick, SC Diehr, P Fihn, SD TI Association of body weight with condition-specific quality of life in male veterans SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID PRIMARY-CARE PATIENTS; HEALTH-STATUS; OBESITY; QUESTIONNAIRE; OVERWEIGHT; DISEASE; POPULATION; DEPRESSION; GUIDELINES; ADULTS AB PURPOSE: We hypothesized that obese adults with coronary heart disease, obstructive lung disease, or depression would report greater impairments in health-related quality of life owing to their angina, dyspnea, or depressive symptoms as compared with persons with normal body weight. METHODS: We analyzed cross-sectional data from the Ambulatory Care Quality Improvement Project, a multicenter Study of veterans enrolled in general internal medicine clinics. Health-related quality of life was assessed using the Medical Outcomes Study Short Form-36, the Seattle Angina Questionnaire, the Seattle Obstructive Lung Disease Questionnaire, and the Hopkins Symptom Checklist for Depression. RESULTS: Compared with patients of normal weight (body mass index: 18.5 to 24.9 kg/m(2)), underweight patients (body mass index <18.5 kg/m(2)) reported health-related quality-of-life scores that were at least 5% lower (worse) in all 15 quality-of-life domains examined. Patients with class III obesity (body 2 mass index greater than or equal to40 kg/m(2)) reported quality-of-life scores that were at least 5% lower than those of normal weight patients in eight domains. Scores of overweight patients (body mass index: 25 to 29.9 kg/m(2)) were higher (better) than those of normal weight patients in I I domains. CONCLUSION: Body mass index was strongly associated with generic- and condition-specific health-related quality of life. Our results suggest that, when considering health-related quality-of-life outcomes among veterans, the optimal body mass index may be above the "normal" range. Further research should test the validity of the 1998 National Institutes of Health body mass index categories as predictors of health outcomes among veterans. (C) 2004 by Elsevier Inc. C1 Cincinnati Vet Affairs Med Ctr, Hlth Serv Res & Dev, Cincinnati, OH 45220 USA. Univ Cincinnati, Ctr Med, Dept Internal Med, Div Gen Internal Med,Sect Outcomes Res, Cincinnati, OH USA. Univ Cincinnati, Inst Hlth Policy & Hlth Serv Res, Cincinnati, OH USA. Vet Affairs Puget Sound Hlth Care Syst, NW Hlth Serv Res, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Dev Ctr Excellence, Seattle, WA USA. Univ Washington, Dept Hlth Serv, Seattle, WA USA. Univ Washington, Dept Biostat, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. RP Arterburn, DE (reprint author), Cincinnati Vet Affairs Med Ctr, Hlth Serv Res & Dev, 3200 Vine St 151, Cincinnati, OH 45220 USA. EM David.Arterburn@uc.edu NR 30 TC 24 Z9 25 U1 1 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 NOV 15 PY 2004 VL 117 IS 10 BP 738 EP 746 DI 10.1016/j.amjmed.2004.06.031 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 872UA UT WOS:000225232900004 PM 15541323 ER PT J AU Steinman, MA Fischer, MA Shlipak, MG Bosworth, HB Oddone, EZ Hoffman, BB Goldstein, MK AF Steinman, MA Fischer, MA Shlipak, MG Bosworth, HB Oddone, EZ Hoffman, BB Goldstein, MK TI Clinician awareness of adherence to hypertension guidelines SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID PRIMARY-CARE PHYSICIANS; BLOOD-PRESSURE; SELF-ASSESSMENTS; PERFORMANCE; MEDICINE; MANAGEMENT; INFORMATION; ATTITUDES; ACCURACY; FEEDBACK AB PURPOSE: Little is known about how well clinicians are aware of their own adherence to clinical guidelines, an important indicator of quality. We compared clinicians' beliefs about their adherence to hypertension guidelines with data on their actual performance. METHODS: We surveyed 139 primary care clinicians at three Veterans Affairs medical centers, asking them to assess their own adherence to hypertension guidelines. We then extracted data from the centers' clinical databases on guideline-concordant medication use and blood pressure control for patients cared for by these providers during a 6-month period. Data were collected for patients with hypertension and diabetes, hypertension and coronary disease, or hypertension with neither of these comorbid conditions. RESULTS: Eighty-six clinicians (62%) completed the survey. Each clinician saw a median of 94 patients with hypertension (mean age, 65 years). Patients were treated with an average of 1.6 antihypertensive medications. Overall, clinicians overestimated the proportion of their patients who were prescribed guideline-concordant medications (75% perceived vs. 67% actual, P <0.001) and who had blood pressure levels <140/90 mm Hg on their last visit (68% perceived vs. 43% actual, P <0.001). Among individual clinicians, there were no significant correlations between perceived and actual guideline adherence (r = 0.18 for medications, r = 0.14 for blood pressure control; P greater than or equal to0.10 for both). Clinicians with relatively low actual guideline performance were most likely to overestimate their adherence to medication recommendations and blood pressure targets. CONCLUSION: Clinicians appear to overestimate their adherence to hypertension guidelines, particularly with regards to the proportion of their patients with controlled blood pressure. This limited awareness may represent a barrier to successful implementation of guidelines, and could be addressed through the use of provider profiles and point-of-service feedback to clinicians. (C) 2004 by Elsevier Inc. C1 San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, Div Gen Internal Med, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Univ Massachusetts, Ctr Med, Dept Med, Worcester, MA USA. Durham VA Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC USA. Duke Univ, Div Gen Internal Med, Dept Med, Durham, NC 27706 USA. Harvard Univ, Sch Med, Boston, MA USA. VA Boston, Dept Med, Boston, MA USA. Stanford Univ, Dept Med, Ctr Primary Care & Outcomes Res, Palo Alto, CA 94304 USA. VA Palo Alto Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Palo Alto, CA USA. RP Steinman, MA (reprint author), San Francisco VA Med Ctr, Div Geriatr, 4150 Clement St,Box 181-G, San Francisco, CA 94121 USA. EM mstein@itsa.ucsf.edu NR 30 TC 58 Z9 58 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 NOV 15 PY 2004 VL 117 IS 10 BP 747 EP 754 DI 10.1016/j.amjmed.2004.03.035 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 872UA UT WOS:000225232900005 PM 15541324 ER PT J AU Hu, KK Veenstra, DL Lipsky, BA Saint, S AF Hu, KK Veenstra, DL Lipsky, BA Saint, S TI Use of maximal sterile barriers during central venous catheter insertion: Clinical and economic outcomes SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID BLOOD-STREAM INFECTION; CRITICALLY-ILL PATIENTS; POVIDONE-IODINE; SITE CARE; PREVENTION; MORTALITY; RISK; SEPSIS; CONSEQUENCES; METAANALYSIS AB Background. We performed a cost-effectiveness analysis to determine the effect of maximal sterile barriers (MSBs) on reducing central venous catheter (CVC)-related infections. Use of MSBs when placing CVCs may reduce the risk of infections but is more cumbersome, time-consuming, and expensive than other techniques. Methods. We developed a decision analytic model in which a patient could have a CVC placed with either an MSB or a less stringent technique. We calculated total direct medical costs and the incidences of catheterrelated bloodstream infections, catheter colonization, and death. Results. Use of MSBs lowered costs (from $621 to $369 per catheter insertion) and decreased the incidences of catheter-related bloodstream infections (from 5.3% to 2.8%), catheter colonization with local infection (from 5.5% to 2.9%) and death (from 0.8% to 0.4%). MSBs improved patient safety throughout all sensitivity analyses. Conclusions. Use of MSBs during CVC insertion likely lowers medical costs and decreases the incidences of catheter colonization, catheter-related bloodstream infections, and death. Cost savings were found over a wide range of clinical and economic assumptions, suggesting that MSBs should be routinely used when CVCs are inserted. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, NW Hlth Serv Res & Dev Program, Seattle, WA 98108 USA. Univ Washington, Pharmaceut Outcomes Res & Policy Program, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98108 USA. Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA. Univ Michigan, Patient Safety Enhancement Program, Ann Arbor, MI 48109 USA. Ann Arbor Vet Affairs Med Ctr, Hlth Serv Res & Dev Ctr Excellence, Ann Arbor, MI USA. RP Hu, KK (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,HSR&D 152, Seattle, WA 98108 USA. EM kenthu@u.washington.edu OI Lipsky, Benjamin A./0000-0001-9886-5114 FU AHRQ HHS [P20-HS11540] NR 29 TC 33 Z9 36 U1 0 U2 0 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD NOV 15 PY 2004 VL 39 IS 10 BP 1441 EP 1445 DI 10.1086/425309 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 904JH UT WOS:000227492000007 PM 15546079 ER PT J AU Bray, NJ Jehu, L Moskvina, V Buxbaum, JD Dracheva, S Haroutunian, V Williams, J Buckland, PR Owen, MJ O'Donovan, MC AF Bray, NJ Jehu, L Moskvina, V Buxbaum, JD Dracheva, S Haroutunian, V Williams, J Buckland, PR Owen, MJ O'Donovan, MC TI Allelic expression of APOE in human brain: effects of epsilon status and promoter haplotypes SO HUMAN MOLECULAR GENETICS LA English DT Article ID SPORADIC ALZHEIMERS-DISEASE; APOLIPOPROTEIN-E; CEREBROSPINAL-FLUID; REGULATORY REGION; MESSENGER-RNA; TYPE-4 ALLELE; GENE; POLYMORPHISM; RISK; PLASMA AB The epsilon4 haplotype of APOE is the only undisputed genetic risk factor for late-onset Alzheimer's disease (LOAD). It has been proposed that at least two other polymorphisms in the promoter of the APOE gene (-219G>T and -491A>T) might also contribute to disease susceptibility, and modulate the impact of structural changes in the ApoE protein, by altering its expression. In order to assess the extent of cis-acting influences on APOE expression in human brain, highly quantitative measures of allele discrimination were applied to cortical RNA from individuals heterozygous for the epsilon alleles. A small, but significant, increase in the expression of epsilon4 allele was observed relative to that of the epsilon3 and epsilon2 alleles (P<0.0001). Similar differences were observed in brain tissue from confirmed LOAD subjects, and between cortical regions BA10 (frontopolar) and BA20 (inferior temporal). Stratification of epsilon4/epsilon3 allelic expression ratios according to heterozygosity for the -219G>T promoter polymorphism revealed significantly lower relative expression of haplotypes containing the -219T allele (P=0.02). Our data indicate that, in human brain, most of the cis-acting variance in APOE expression is accounted for by the epsilon4 haplotype, but there are additional, small, cis-acting influences associated with promoter genotype. C1 Univ Wales Coll Cardiff, Dept Psychol Med, Sch Med, Cardiff CF14 4XN, S Glam, Wales. Univ Wales Coll Cardiff, Biostat Bioinformat Unit, Sch Med, Cardiff CF14 4XN, S Glam, Wales. CUNY, Mt Sinai Med Ctr, Dept Psychiat, New York, NY 10021 USA. Bronx Vet Affairs Med Ctr, MIRECC, Bronx, NY 10468 USA. RP O'Donovan, MC (reprint author), Univ Wales Coll Cardiff, Dept Psychol Med, Sch Med, Heath Pk, Cardiff CF14 4XN, S Glam, Wales. EM odonovanmc@cardiff.ac.uk RI turton, miranda/F-4682-2011 OI Buxbaum, Joseph/0000-0001-8898-8313; Escott-Price, Valentina/0000-0003-1784-5483; O'Donovan, Michael/0000-0001-7073-2379 NR 27 TC 31 Z9 32 U1 0 U2 2 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0964-6906 J9 HUM MOL GENET JI Hum. Mol. Genet. PD NOV 15 PY 2004 VL 13 IS 22 BP 2885 EP 2892 DI 10.1093/hmg/ddh299 PG 8 WC Biochemistry & Molecular Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Genetics & Heredity GA 873BG UT WOS:000225253100015 PM 15385439 ER PT J AU Zhang, XK Gallant, S Molano, I Moussa, OM Ruiz, P Spyropoulos, DD Watson, DK Gilkeson, G AF Zhang, XK Gallant, S Molano, I Moussa, OM Ruiz, P Spyropoulos, DD Watson, DK Gilkeson, G TI Decreased expression of the Ets family transcription factor Fli-1 markedly prolongs survival and significantly reduces renal disease in MRL/lpr mice SO JOURNAL OF IMMUNOLOGY LA English DT Article ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; AUTOIMMUNE-DISEASE; MRL-FAS(LPR) MICE; MURINE LUPUS; GENE; GAMMA; ACTIVATION; MEMBER; ELF-1; CHAIN AB Increased Fli-1 mRNA is present in PBLs from systemic lupus erythematosus patients, and transgenic overexpression of Fli-1 in normal mice leads to a lupus-like disease. We report in this study that MRL/lpr mice, an animal model of systemic lupus erythematosus, have increased splenic expression of Fli-1 protein compared with BALB/c mice. Using mice with targeted gene disruption, we examined the effect of reduced Fli-1 expression on disease development in MRL/lpr mice. Complete knockout of Fli-1 is lethal in utero. Fli-1 protein expression in heterozygous MRL/lpr (Fli-l(+/-)) mice was reduced by 50% compared with wild-type MRL/lpr (Fli-1(+/+)) mice. Fli-1(+/-) MRL/lpr mice had significantly decreased serum levels of total IgG and anti-dsDNA Abs as disease progressed. Fli-1(+/-) MRL/lpr mice had significantly increased splenic CD8(+) and naive T cells compared with Fli-1(+/+) MRL/lpr mice. Both in vivo and in vitro production of MCP-1 were significantly decreased in Fli-1+/- MRL/lpr mice. The Fli-1(+/-) mice had markedly decreased proteinuria and significantly lower pathologic renal scores. At 48 wk of age, survival was significantly increased in the Fli-1(+/-) MRL/lpr mice, as 100% of Fli-1+/- MRL/lpr mice were alive, in contrast to only 27% of Fli-1(+/+) mice. These findings indicate that Fli-1 expression is important in lupus-like disease development, and that modulation of Fli-1 expression profoundly decreases renal disease and improves survival in MRL/lpr mice. C1 Med Univ S Carolina, Dept Med, Div Rheumatol & Immunol, Med Res Serv,Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pathol & Lab Med, Charleston, SC 29425 USA. Univ Miami, Sch Med, Miami, FL 33136 USA. RP Zhang, XK (reprint author), Med Univ S Carolina, Dept Med, Div Rheumatol & Immunol, Med Res Serv,Ralph H Johnson Vet Affairs Med Ctr, 96 Jonathon Lucas St,POB 250623, Charleston, SC 29425 USA. EM zhangjo@musc.edu FU NCI NIH HHS [P01 CA 78582]; NIAMS NIH HHS [AR 47451, K01 AR051385] NR 36 TC 40 Z9 42 U1 0 U2 0 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD NOV 15 PY 2004 VL 173 IS 10 BP 6481 EP 6489 PG 9 WC Immunology SC Immunology GA 869QL UT WOS:000224999000070 PM 15528390 ER PT J AU Erkinjuntti, T Roman, G Gauthier, S AF Erkinjuntti, T Roman, G Gauthier, S TI Treatment of vascular dementia - evidence from clinical trials with cholinesterase inhibitors SO JOURNAL OF THE NEUROLOGICAL SCIENCES LA English DT Article; Proceedings Paper CT 1st Congress of the International-Society-for-Vascular-Behavioural-and-Cognitive-Disorders (VAS-COG 2003) CY AUG 28-31, 2003 CL Goteborg, SWEDEN SP Int Soc Vasc Behav Cognit Disorders DE vascular dementia; Alzheimer's disease; cholinesterase inhibitors ID ALZHEIMERS-DISEASE; CEREBROVASCULAR-DISEASE; COGNITIVE DECLINE; EFFICACY; RIVASTIGMINE; GALANTAMINE; DONEPEZIL; TOLERABILITY AB Cerebrovascular disease (CVD), as well as secondary ischemic brain injury from cardiovascular disease, are common causes of dementia and cognitive decline in the elderly. In addition, CVD frequently contributes to cognitive loss in patients with Alzheimer's disease (AD). Progress in understanding the pathogenetic mechanism involved in vascular cognitive impairment (VCI) and vascular dementia (VaD) has resulted in promising treatments of these conditions. Cholinergic deficits in VaD are due to ischemia of basal forebrain nuclei and of cholinergic pathways and can be treated with the use of the cholinesterase inhibitor agents used in AD. Controlled clinical trials with donepezil, galantamine and rivastigmine in VaD, as well as in patients with AD plus CVD, have demonstrated improvements in cognition, behavior and activities of daily living. (C) 2004 Elsevier B.V. All rights reserved. C1 Univ Helsinki, Cent Hosp, Helsinki, Finland. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. A Murphy Vet Adm Hosp, San Antonio, TX 78229 USA. McGill Ctr Studies Aging, MCSA, Alzheimers Dis Res Unit, Montreal, PQ, Canada. RP Erkinjuntti, T (reprint author), Univ Helsinki, Cent Hosp, Helsinki, Finland. EM Timo.Erkinjuntti@HUS.fi NR 21 TC 38 Z9 48 U1 1 U2 2 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 NOV 15 PY 2004 VL 226 IS 1-2 BP 63 EP 66 DI 10.1016/j.jns.2004.09.018 PG 4 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 873XI UT WOS:000225314400014 PM 15537522 ER PT J AU Roman, GC Sachdev, P Royall, DR Bullock, RA Orgogozo, JM Lopez-Pousa, S Arizaga, R Wallin, A AF Roman, GC Sachdev, P Royall, DR Bullock, RA Orgogozo, JM Lopez-Pousa, S Arizaga, R Wallin, A TI Vascular cognitive disorder: a new diagnostic category updating vascular cognitive impairment and vascular dementia SO JOURNAL OF THE NEUROLOGICAL SCIENCES LA English DT Article; Proceedings Paper CT 1st Congress of the International-Society-for-Vascular-Behavioural-and-Cognitive-Disorders (VAS-COG 2003) CY AUG 28-31, 2003 CL Goteborg, SWEDEN SP Int Soc Vasc Behav Cognit Disorders DE aging; cerebrovascular disease; cognition; dementia; vascular cognitive disorder; vascular cognitive impairment; vascular dementia ID EXECUTIVE CONTROL FUNCTION; ALZHEIMERS-DISEASE; SILENT EPIDEMIC; DONEPEZIL; TOLERABILITY; DYSFUNCTION; EFFICACY; RETIREES; CRITERIA AB Vascular cognitive impairment (VCI) was proposed as an umbrella term to include subjects affected with any degree of cognitive impairment resulting from cerebrovascular disease (CVD), ranging from mild cognitive impairment (MCI) to vascular dementia. VCI may or may not exclude the host of "focal" circumscribed impairments of specialized functions such as language (aphasia), intentional gesture (apraxia), or categorical recognition (agnosia), among others, that may result from a stroke. Therefore, there are no universally accepted diagnostic criteria for VCI. We conclude that this concept could be more useful if it were to be limited to cases of vascular MCI without dementia, by analogy with the concept of amnestic MCI, currently considered the earliest clinically diagnosable stage of Alzheimer disease (AD). In agreement with our view, the Canadian Study on Health and Aging successfully implemented a restricted definition of VCI, excluding cases of dementia (i.e., vascular cognitive impairment no dementia, VCI-ND). The Canadian definition and diagnostic criteria could be utilized for future studies of VCI. This definition excludes isolated impairments of specialized cognitive functions. Vascular dementia (VaD): The main problem of this diagnostic category stems from the currently accepted definition of dementia that requires memory loss as the sine qua non for the diagnosis. This may result in over-sampling of patients with AD worsened by stroke (AD+CVD). This problem was minimized in controlled clinical trials of VaD by excluding patients with a prior diagnosis of AD, those with pre-existing memory loss before the index stroke, and those with amnestic MCI. We propose a definition of dementia in VaD based on presence of abnormal executive control function, severe enough to interfere with social or occupational functioning. Vascular cognitive disorder (VCD): This term, proposed by Sachdev [P. Sachdev, Vascular cognitive disorder. Int J Geriat Psychiatry 14 (1999) 402-403.] would become the global diagnostic category for cognitive impairment of vascular origin, ranging from VCI to VaD. It would include specific disease entities such as post-stroke VCI, post-stroke VaD, CADASIL, Binswanger disease, and AD plus CVD. This category explicitly excludes isolated cognitive dysfunctions such as those mentioned above. (C) 2004 Elsevier B.V. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Med Neurol, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78229 USA. Univ New S Wales, Sch Psychiat, Sydney, NSW, Australia. Prince Wales Hosp, Inst Neuropsychiat, Sydney, NSW, Australia. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78229 USA. Victoria Hosp, Kingshill Res Ctr, Swindon, Wilts, England. CHU Pellegrin, Bordeaux, France. Hosp Santa Catarina, Memory & Dementia Unit, Girona, Spain. Natl Inst Social Serv Retirees, Memory Disorders Res Ctr, Buenos Aires, DF, Argentina. Natl Inst Social Serv Retirees, Neuroepidemiol Branch, Buenos Aires, DF, Argentina. Sahlgrens Univ Hosp, Inst Clin Neurosci, Molndal, Sweden. RP Roman, GC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med Neurol, 7703 Floyd Curl Dr,Mail Code 7883, San Antonio, TX 78229 USA. EM romang@uthscsa.edu; p.sachdev@unsw.edu.au; uvamid@ias.scs.es; anders.wallin@neuro.gu.se OI Sachdev, Perminder/0000-0002-9595-3220 NR 48 TC 133 Z9 146 U1 2 U2 15 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 NOV 15 PY 2004 VL 226 IS 1-2 BP 81 EP 87 DI 10.1016/j.jns.2004.09.016 PG 7 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 873XI UT WOS:000225314400018 PM 15537526 ER PT J AU Jiang, HY Zhou, XH AF Jiang, HY Zhou, XH TI Bootstrap confidence intervals for medical costs with censored observations SO STATISTICS IN MEDICINE LA English DT Article DE skewed distribution; censored data; cost data; bootstrap method AB Medical costs data with administratively censored observations often arise in cost-effectiveness studies of treatments for life-threatening diseases. Mean of medical costs incurred from the start of a treatment until death or a certain time point after the implementation of treatment is frequently of interest. In many situations, due to the skewed nature of the cost distribution and non-uniform rate of cost accumulation over time, the currently available normal approximation confidence interval has poor coverage accuracy. In this paper, we propose a bootstrap confidence interval for the mean of medical costs with censored observations. In simulation studies, we show that the proposed bootstrap confidence interval had much better coverage accuracy than the normal approximation one when medical costs had a skewed distribution. When there is light censoring on medical costs (less than or equal to,25 per cent), we found that the bootstrap confidence interval based on the simple weighted estimator is preferred due to its simplicity and good coverage accuracy. For heavily censored cost data (censoring rate greater than or equal to30 per cent) with larger sample sizes (n greater than or equal to 200), the bootstrap confidence intervals based on the partitioned estimator has superior performance in terms of both efficiency and coverage accuracy. We also illustrate the use of our methods in a real example. Copyright (C) 2004 John Wiley Sons, Ltd. C1 Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. VA Puget Sound Hlth Care Syst, NW HSR&D Ctr Excellence, Biostat Unit, Seattle, WA USA. RP Zhou, XH (reprint author), Univ Washington, Dept Biostat, Seattle, WA 98195 USA. EM azhou@u.washington.edu FU AHRQ HHS [R01HS013105]; NIAID NIH HHS [R01AI24643] NR 12 TC 15 Z9 16 U1 0 U2 3 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0277-6715 J9 STAT MED JI Stat. Med. PD NOV 15 PY 2004 VL 23 IS 21 BP 3365 EP 3376 DI 10.1002/sim.1556 PG 12 WC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Medicine, Research & Experimental; Statistics & Probability SC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Research & Experimental Medicine; Mathematics GA 867UO UT WOS:000224868200009 PM 15490430 ER PT J AU Calsyn, DA Saxon, AJ Bush, KR Howell, DN Baer, JS Sloan, KL Malte, CA Kivlahan, DR AF Calsyn, DA Saxon, AJ Bush, KR Howell, DN Baer, JS Sloan, KL Malte, CA Kivlahan, DR TI The addiction severity index medical and psychiatric composite scores measure similar domains as the SF-36 in substance-dependent veterans: concurrent and discriminant validity SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE functional status; quality of life; substance dependence; assessment; medical illness; co-morbidity ID QUALITY-OF-LIFE; FUNCTIONAL IMPAIRMENT; MENTAL-DISORDERS; ABUSE TREATMENT; HEALTH-STATUS; ALCOHOL; COMORBIDITY; SERVICES; DRUG; PREDICTORS AB Background: Recently attention has focused on the assessment of functional health status in substance-dependent individuals. The addiction severity index (ASI) is a widely used assessment instrument that includes scales to reflect current medical and psychiatric status. This study examines the concurrent validity of these ASI composite scores in relation to the short form 36-item health survey (SF-36), a well-established measure of health-related quality of life/functional health status. Methods: Veterans (n = 674) were assessed at admission to substance dependence treatment. Correlations were performed between ASI composite scores and SF-36 scales and the physical and mental summary components (PSC and MSC, respectively). Areas under receiver operating characteristic (ROC) curves determined the descriminative ability of the ASI composites to ascertain impairment. Results: The ASI medical composite score demonstrated robust correlations with the four SF-36 scales that relate to physical health and with the PCS. The ASI psychiatric composite score had robust correlations with the four SF-36 scales related to mental health and with the mental component summary (MCS). ROC curves indicated that the ASI medical (AUC = 0.83) and psychiatric composites (AUC = 0.90) accurately detected subjects with impairment. Conclusions: ASI medical and psychiatric composite scores provide effective initial screening for patients with impaired functional status as measured by the corresponding SF-36 component summary scores. (C) 2004 Elsevier Ireland Ltd. All rights reserved. C1 Ctr Excellence Substance Abuse Treatment & Educ, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Pacific Grad Sch Psychol, Palo Alto, CA 94303 USA. Univ Washington, Dept Psychol, Seattle, WA 98195 USA. RP Calsyn, DA (reprint author), Ctr Excellence Substance Abuse Treatment & Educ, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM donald.calsyn@med.va.gov NR 25 TC 35 Z9 36 U1 2 U2 5 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 NOV 11 PY 2004 VL 76 IS 2 BP 165 EP 171 DI 10.1016/j.drugalcdep.2004.04.018 PG 7 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 870KV UT WOS:000225056900006 PM 15488340 ER PT J AU Li, G Higdon, R Kukull, WA Peskind, E Moore, KV Tsuang, D van Belle, G McCormick, W Bowen, JD Teri, L Schellenberg, GD Larson, EB AF Li, G Higdon, R Kukull, WA Peskind, E Moore, KV Tsuang, D van Belle, G McCormick, W Bowen, JD Teri, L Schellenberg, GD Larson, EB TI Statin therapy and risk of dementia in the elderly - A community-based prospective cohort study SO NEUROLOGY LA English DT Article ID COA REDUCTASE INHIBITORS; CORONARY-HEART-DISEASE; ALZHEIMERS-DISEASE; CONTROLLED TRIAL; APOLIPOPROTEIN-E; CHOLESTEROL; SIMVASTATIN; STROKE; INDIVIDUALS; MONOTHERAPY AB Objective: To assess the association between statin therapy and risk of Alzheimer disease ( AD) in a prospective cohort study with documented statin exposure and incident dementia. Methods: This is a prospective, cohort study of statin use and incident dementia and probable AD. A cohort of 2,356 cognitively intact persons, aged 65 and older, were randomly selected from a health maintenance organization (HMO), and were assessed biennially for dementia. Statin use was identified using the HMO pharmacy database. A proportional hazards model with statin use as a time-dependent covariate was used to assess the statin-dementia/AD association. Results: Among 312 participants with incident dementia, 168 had probable AD. The unadjusted hazard ratios (HRs) with statin use were 1.33 (95% CI 0.95 to 1.85) for all-cause dementia and 0.90 (CI 0.54 to 1.51) for probable AD. Adjusted corresponding HRs were 1.19 (CI 0.82 to 1.75) and 0.82 (CI 0.46 to 1.46). A subgroup analysis of participants with at least one APOE-epsilon4 allele who entered the study before age 80 produced an adjusted HR of 0.33 (CI 0.10 to 1.04). Conclusion: Employing time-dependent proportional hazards modeling, the authors found no significant association between statin use and incident dementia or probable AD. In contrast, when the data were analyzed, inappropriately, as a case-control study, the authors found an OR of 0.55 for probable AD, falsely indicating a protective effect of statins. Study design and analytic methods may explain the discrepancy between the current null findings and earlier findings. C1 VA Puget Sound Hlth Care Syst, Mental Illness Res & Educ Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Environm Hlth & Biostat, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Psychosocial & Commun Hlth, Seattle, WA 98195 USA. Univ Washington, Dept Geriatr & Gerontol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. RP Li, G (reprint author), VA Puget Sound Hlth Care Syst, Mental Illness Res & Educ Clin Ctr, 1660 S Columbian Way,Mailstop S-116 MIRECC, Seattle, WA 98108 USA. EM gli@u.washington.edu RI Tsuang, Debby/L-7234-2016 OI Tsuang, Debby/0000-0002-4716-1894; Kukull, Walter/0000-0001-8761-9014 FU NIA NIH HHS [AG05136, AG06781, AG16976, AG20020] NR 30 TC 167 Z9 181 U1 1 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD NOV 9 PY 2004 VL 63 IS 9 BP 1624 EP 1628 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 869MJ UT WOS:000224987700016 PM 15534246 ER PT J AU Yaffe, K Clemons, TE McBee, WL Lindblad, AS AF Yaffe, K Clemons, TE McBee, WL Lindblad, AS CA Age-Related Eye Dis Study Res Grp TI Impact of antioxidants, zinc, and copper on cognition in the elderly - A randomized, controlled trial SO NEUROLOGY LA English DT Article ID ALZHEIMER-DISEASE; DIETARY-INTAKE; VITAMIN-E; RISK; SUPPLEMENTS; ASSOCIATION AB Participants in the Age-Related Eye Disease Study were randomly assigned to receive daily antioxidants (vitamin C, 500 mg; vitamin E, 400 IU; beta carotene, 15 mg), zinc and copper ( zinc, 80 mg; cupric oxide, 2 mg), antioxidants plus zinc and copper, or placebo. A cognitive battery was administered to 2,166 elderly persons after a median of 6.9 years of treatment. Treatment groups did not differ on any of the six cognitive tests (p > 0.05 for all). These results do not support a beneficial or harmful effect of antioxidants or zinc and copper on cognition in older adults. C1 EMMES Corp, AREDS Coordinating Ctr, Rockville, MD 20850 USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Yaffe, K (reprint author), EMMES Corp, AREDS Coordinating Ctr, 401 N Washington St,Suite 700, Rockville, MD 20850 USA. EM aredspub@emmes.com FU NEI NIH HHS [Z01 EY000394-03] NR 10 TC 77 Z9 79 U1 1 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD NOV 9 PY 2004 VL 63 IS 9 BP 1705 EP 1707 PG 3 WC Clinical Neurology SC Neurosciences & Neurology GA 869MJ UT WOS:000224987700031 PM 15534261 ER PT J AU Prochazka, AV Kick, S Steinbrunn, C Miyoshi, T Fryer, GE AF Prochazka, AV Kick, S Steinbrunn, C Miyoshi, T Fryer, GE TI A randomized trial of nortriptyline combined with transdermal nicotine for smoking cessation SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID SUSTAINED-RELEASE BUPROPION; DOUBLE-BLIND; WITHDRAWAL; PLACEBO; CLONIDINE; SMOKERS; HEAVY AB Background: Smoking cessation rates with current therapy are suboptimal. Tricyclic antidepressants improve cessation rates. We hypothesized that addition of nortriptyline hydrochloride to transdermal nicotine would enhance cessation rates. Methods: We conducted a randomized, double-blind, placebo-controlled trial at a Department of Veterans Affairs medical center. Subjects were aged 18 to 65 years, smoked 10 or more cigarettes per day, and did not have current major depression. Nortriptyline hydrochloride or matched placebo was started at 25 mg 14 days before quit day. titrated to 75 mg/d as tolerated, and continued for 12 weeks after quit day. Transdermal nicotine (21 mg/d) was started on quit day and continued for 8 weeks. The behavioral intervention consisted of 12 brief, individual visits. Withdrawal symptoms were measured by means of a daily diary, and smoking cessation was defined as self-reported abstinence, expired carbon monoxide level of 9 ppm or less, and a 6-month urine cotinine level less than 50 ng/mL (284 nmol/L). Results: A total of 158 patients were randomized (79 to nortriptyline and 79 to placebo). There was no significant reduction in withdrawal symptoms. The cessation rates at 6 months were 23% (18/79) and 10% (8/79), respectively (absolute difference, 13%; 95% confidence interval, 1.3%-24.5%; P=.052). Nortriptyline caused frequent side effects, including dry mouth (38%) and sedation (20%). Conclusions: Nortriptyline combined with transdermal nicotine resulted in an increased cessation rate with little effect on withdrawal symptoms. This combination may represent an option for smokers in whom standard therapy has failed. C1 Univ Colorado, Hlth Sci Ctr, Div Gen Internal Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Family Med, Denver, CO USA. Denver Vet Affairs Med Ctr, Ambulat Care, Denver, CO USA. Amer Acad Family Phys, Robert Graham Ctr Policy Studies Family Practice, Washington, DC USA. RP Prochazka, AV (reprint author), Ambulat Care 11B, 1055 Clermont, Denver, CO 80220 USA. EM Allan.Prochazka@med.va.gov NR 26 TC 35 Z9 39 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 NOV 8 PY 2004 VL 164 IS 20 BP 2229 EP 2233 DI 10.1001/archinte.164.20.2229 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 869EG UT WOS:000224965600007 PM 15534159 ER PT J AU Buckland, PR Hoogendoom, B Guy, CA Coleman, SL Smith, SK Buxbaum, JD Haroutunian, V O'Donovan, MC AF Buckland, PR Hoogendoom, B Guy, CA Coleman, SL Smith, SK Buxbaum, JD Haroutunian, V O'Donovan, MC TI A high proportion of polymorphisms in the promoters of brain expressed genes influences transcriptional activity SO BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR BASIS OF DISEASE LA English DT Article DE Tf; NPY; PCSK1; NEFL; LM04; HSPA1B ID FUNCTIONAL-ANALYSIS; NEUROPEPTIDE-Y; SCHIZOPHRENIA; SUSCEPTIBILITY; ASSOCIATION; IDENTIFICATION; NEUREGULIN-1; DATABASE; ELEMENT; DISEASE AB There is increasing interest in the possibility that polymorphisms affecting gene expression are responsible for a significant proportion of heritable human phenotypic variation, including human disease. We have sought to determine if polymorphisms in the promoters of brain expressed genes are commonly functional. We screened for polymorphism 56 genes previously reported to be differentially expressed in the brains of schizophrenics [Y Hakak, JR. Walker, C. Li, W.H. Wong, K.L. Davis, J.D. Buxbaum, V Haroutunian, A.A. Fienberg, Genome-wide expression analysis reveals dysregulation of myelination-related genes in chronic schizophrenia. Proc. Natl. Acad. Sci. 98 (2001) 4746-4751.]. We found 60 variants distributed across 31 of the genes. A total of 77 haplotypes representing 28 different putative promoters were analyzed in a reporter gene assay in two. cell lines. Of a total of 54 sequence variants represented in the haplotypes, 12 (or around 22%) were functional according to a highly conservative definition. These were found in the promoters of eight genes: NPY, PCSK1, NEFL, KIAA0513, LMO4, HSPA1B, TF and MDH1. We therefore estimate that around 20-25% of promoter polymorphisms in brain expressed genes are functional, and this is likely to be an underestimate. Our data therefore provide for the first time empirical evidence that promoter element polymorphisms, at least in brain expressed genes, should be afforded a high priority for molecular genetic studies. (C) 2004 Elsevier B.V. All rights reserved. C1 Univ Wales Coll Med, Dept Med Psychol, Cardiff CF14 4XN, S Glam, Wales. Mt Sinai Sch Med, Dept Psychiat, New York, NY 10021 USA. Bronx Vet Affairs Med Ctr, MIRECC, Bronx, NY 10468 USA. RP Buckland, PR (reprint author), Univ Wales Coll Med, Dept Med Psychol, Heath Pk, Cardiff CF14 4XN, S Glam, Wales. EM buckland@cardiff.ac.uk OI Hoogendoorn, Bastiaan/0000-0001-9753-169X; Buxbaum, Joseph/0000-0001-8898-8313; O'Donovan, Michael/0000-0001-7073-2379 FU Medical Research Council [G9810900]; NIMH NIH HHS [P50 MH66932] NR 35 TC 50 Z9 53 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0925-4439 J9 BBA-MOL BASIS DIS JI Biochim. Biophys. Acta-Mol. Basis Dis. PD NOV 5 PY 2004 VL 1690 IS 3 BP 238 EP 249 DI 10.1016/j.bbadis.2004.06.023 PG 12 WC Biochemistry & Molecular Biology; Biophysics; Cell Biology SC Biochemistry & Molecular Biology; Biophysics; Cell Biology GA 870LG UT WOS:000225058000007 PM 15511631 ER PT J AU Linseman, DA Butts, BD Precht, TA Phelps, RA Le, SS Laessig, TA Bouchard, RJ Florez-McClure, ML Heidenreich, KA AF Linseman, DA Butts, BD Precht, TA Phelps, RA Le, SS Laessig, TA Bouchard, RJ Florez-McClure, ML Heidenreich, KA TI Glycogen synthase kinase-3 beta phosphorylates bax and promotes its mitochondrial localization during neuronal apoptosis SO JOURNAL OF NEUROSCIENCE LA English DT Article DE glycogen synthase kinase; cerebellar granule neuron; apoptosis; mitochondria; Bax; phosphorylation ID CEREBELLAR GRANULE NEURONS; PROGRAMMED CELL-DEATH; GROWTH-FACTOR-I; BCL-2 FAMILY; KINASE; SURVIVAL; PATHWAY; GSK3-BETA; DISEASE; TRANSLOCATION AB Glycogen synthase kinase-3beta(GSK-3beta)is a critical activator of neuronal apoptosis induced by a diverse array of neurotoxic insults. However, the downstream substrates of GSK-3beta that ultimately induce neuronal death are unknown. Here, we show that GSK-3beta phosphorylates and regulates the activity of Bax, a pro-apoptotic Bcl-2 family member that stimulates the intrinsic ( mitochondrial) death pathway by eliciting cytochrome c release from mitochondria. In cerebellar granule neurons undergoing apoptosis, inhibition of GSK-3beta suppressed both the mitochondrial translocation of an expressed green fluorescent protein (GFP)-Bax(alpha) fusion protein and the conformational activation of endogenous Bax. GSK-3beta directly phosphorylated Bax(alpha) on Ser163, a residue found within a species-conserved, putative GSK-3beta phosphorylation motif. Coexpression of GFP-Bax(alpha) with a constitutively active mutant of GSK-3beta, GSK-3beta(Ser9Ala), enhanced the in vivo phosphorylation of wild-type Bax(alpha), but not a Ser163Ala mutant of Bax(alpha), in transfected human embryonic kidney 293 (HEK293) cells. Moreover, cotransfection with constitutively active GSK-3beta promoted the localization of Bax(alpha) to mitochondria and induced apoptosis in both transfected HEK293 cells and cerebellar granule neurons. In contrast, neither a Ser163Ala point mutant of Bax(alpha) nor a naturally occurring splice variant that lacks 13 amino acids encompassing Ser163 (Bax(sigma)) were driven to mitochondria in HEK293 cells coexpressing constitutively active GSK-3beta. In a similar manner, either mutation or deletion of the identified GSK-3beta phosphorylation motif prevented the localization of Bax to mitochondria in cerebellar granule neurons undergoing apoptosis. Our results indicate that GSK-3beta exerts some of its pro-apoptotic effects in neurons by regulating the mitochondrial localization of Bax, a key component of the intrinsic apoptotic cascade. C1 Univ Colorado, Hlth Sci Ctr Fitzsimons, Dept Pharmacol, Aurora, CO 80045 USA. Denver Vet Affairs Med Ctr, Denver, CO 80262 USA. RP Heidenreich, KA (reprint author), Univ Colorado, Hlth Sci Ctr Fitzsimons, Dept Pharmacol, POB 6511,Mail Stop 8303, Aurora, CO 80045 USA. EM Kim.Heidenreich@UCHSC.edu FU NIDDK NIH HHS [P30-DK57516]; NINDS NIH HHS [NS38619] NR 39 TC 239 Z9 252 U1 0 U2 4 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD NOV 3 PY 2004 VL 24 IS 44 BP 9993 EP 10002 DI 10.1523/JNEUROSCI.2057-04.2004 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 867VC UT WOS:000224869600030 PM 15525785 ER PT J AU Samaha, FF Stern, L AF Samaha, FF Stern, L TI Low-carbohydrate diets - In response SO ANNALS OF INTERNAL MEDICINE LA English DT Letter ID CORONARY-HEART-DISEASE C1 Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Samaha, FF (reprint author), Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. NR 4 TC 0 Z9 0 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 NOV 2 PY 2004 VL 141 IS 9 BP 738 EP 739 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 867JT UT WOS:000224839600017 ER PT J AU Sonnenberg, A AF Sonnenberg, A TI Personal view: cost and benefit of medical rituals in gastroenterology SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID MANAGEMENT; SCIENCE AB Background: Unable to resolve a medical problem, gastroenterologists occasionally choose an ineffectual intervention instead. The elusive path to effectual management becomes substituted with an ineffectual but readily available medical ritual. The term 'ritual' refers to the utilization of an ineffectual intervention with little chances of achieving a medically relevant goal. Aim: The aim of the article is to analyse the cost-benefit relationship of rituals in gastroenterology and the reasons why gastroenterologists utilize them. Methods: Ritualistic disease management is described in terms of medical decision and threshold analysis. Results: If the perceived benefit of a ritual exceeds its cost, the ineffectual path becomes more attractive than expectant management or doing nothing. To engage in an ineffectual intervention, the threshold probability for success needs to exceed its cost-benefit difference divided by the benefit associated with success. In choosing an ineffectual intervention, doctors tend to underestimate the true costs of a ritual and overestimate its probability of success. The availability of an effectual path leads to more stringent conditions for the benefit associated with an ineffectual path. Conclusions: A better understanding of their economical underpinnings should lead to more restricted utilization of rituals in gastroenterology, especially, in situations where they drain scarce resources disproportionately to their perceived benefit. C1 Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Portland, OR USA. RP Sonnenberg, A (reprint author), Portland VA Med Ctr, P3-GI,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM sonnenbe@ohsu.edu NR 18 TC 2 Z9 2 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD NOV 1 PY 2004 VL 20 IS 9 BP 939 EP 942 DI 10.1111/j.1365-2036.2004.02252.x PG 4 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 867QE UT WOS:000224856300003 PM 15521840 ER PT J AU Au, DH Udris, EM Curtis, JR McDonnell, MB Fihn, SD AF Au, DH Udris, EM Curtis, JR McDonnell, MB Fihn, SD CA ACQUIP Investigators TI Association between chronic heart failure and inhaled beta-2-adrenoceptor agonists SO AMERICAN HEART JOURNAL LA English DT Article ID IDIOPATHIC DILATED CARDIOMYOPATHY; LEFT-VENTRICULAR FUNCTION; PHARMACY RECORDS; MERIT-HF; DISEASE; POLYMORPHISMS; TERBUTALINE; MANAGEMENT; METOPROLOL; DENSITY AB Background Recent reports suggest an association between beta-agonists and the risk of incident chronic heart failure (CHF). We sought to examine the association between inhaled beta-agonists and risk,of incident and nonincident heart failure. Methods We performed a nested case-control study within the Ambulatory Care Quality Improvement Project (ACQUIP). Case subjects were defined as having had a hospitalization with a primary discharge diagnosis of CHF. Controls were randomly selected from the ACQUIP cohort. The exposure was the number of beta-agonist canisters filled in the 90 days before an index date. Results After adjusting for potentially confounding factors, there appeared to be no association between the use of inhaled beta-agonists and the risk of heart failure (1-2 canisters per month, OR 1.3 [95% Cl 0.9, 1.8], greater than or equal to3 canisters per month, 1.1 [95% Cl 0.8, 1.6]). However, among the cohort that had a history of CHF, there appeared to be a close-response association between the number of inhaled beta-agonists and the risk of hospitalization for chronic heart failure (1-2 canisters per month, adjusted OR 1.8 [95% Cl 1.1, 3.0], greater than or equal to3 canisters per month, adjusted OR 2.1 [95% Cl 1.2, 3.8]). Conclusion beta-Agonists did not appear to be associated with incident heart failure but were associated with risk of CHIF hospitalization among those subjects with a previous CHIF diagnosis. Although a causal relationship cannot be inferred from these findings, further research is warranted to determine the safety and effectiveness of inhaled beta-agonists for patients with CHF. C1 VA Puget Sound Hlth Care Syst, Div Pulm & Crit Care Med, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA USA. RP Au, DH (reprint author), VA Puget Sound Hlth Care Syst, Div Pulm & Crit Care Med, 1660 S Columbian Way, Seattle, WA 98108 USA. EM dau@u.washington.edu NR 28 TC 31 Z9 33 U1 1 U2 1 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 NOV PY 2004 VL 148 IS 5 BP 915 EP 920 DI 10.1016/j.ahj.2004.03.048 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 870GH UT WOS:000225045100027 PM 15523327 ER PT J AU Pierpont, GL Moritz, TE Goldman, S Krupski, WC Littooy, F Ward, HB McFalls, E AF Pierpont, GL Moritz, TE Goldman, S Krupski, WC Littooy, F Ward, HB McFalls, E CA Revascularization Study Grp TI Disparate opinions regarding indications for coronary artery revascularization before elective vascular surgery SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID CARDIAC RISK; NONCARDIAC SURGERY; CLINICAL-TRIALS; DISEASE; BYPASS; MANAGEMENT; MORTALITY; INDEX AB Despite consensus guidelines, the optimal strategy for preoperative cardiac risk management among patients scheduled for major noncardiac surgery remains controversial. This study assesses current opinion about the role of preoperative coronary revascularization for patients with coronary artery disease scheduled for elective vascular surgery. Thirty-one practicing cardiologists recruited from 4 different regions reviewed case records, imaging tests, and coronary angiograms of 12 patients with coronary artery disease participating in the Coronary Artery Revascularization Prophylaxis (CARP) trial. The need for preoperative coronary revascularization was determined and results summarized using 3 categories: favoring conservative management, neutral, or recommending revascularization (either by percutaneous intervention or bypass surgery). We found recommendations were frequently disparate and often deviated from published guidelines (40% of the time). The likelihood of discordance between 2 cardiologists was 54%, with a 26% chance that recommendations for revascularization would be directly contradictory. Opinions were more often conservative (43%) or aggressive (40%) than neutral (17%). Similar inconsistency was found as to the preferred method of revascularization, with only 1 patient having complete agreement. Thus, this study reveals substantial differences of opinion among cardiologists across the country about the role of preoperative coronary artery. revascularization for patients scheduled for elective vascular operations. Deviations from published guidelines are common, suggesting that current consensus statements need additional data to support their recommendations. (C)2004 by Excerptal Medica, Inc. C1 Minneapolis VA Med Ctr, Minneapolis, MN 55417 USA. Univ Minnesota, Minneapolis, MN USA. Hines VA Hosp, Cooperat Studies Program Coorinating Ctr, Hines, IL USA. So Arizona VA Hlth Care Ctr, Tucson, AZ USA. Denver VA Med Ctr, Denver, CO USA. RP Pierpont, GL (reprint author), Minneapolis VA Med Ctr, 1 Vet Dr,Med Ctr 111-C, Minneapolis, MN 55417 USA. EM pierp002@umn.edu NR 17 TC 20 Z9 21 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 NOV 1 PY 2004 VL 94 IS 9 BP 1124 EP 1128 DI 10.1016/j.amjcard.2004.07.077 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 867IY UT WOS:000224837500004 PM 15518605 ER PT J AU Mozaffarian, D Rimm, EB Herrington, DM AF Mozaffarian, D Rimm, EB Herrington, DM TI Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Article DE diet; saturated fat; carbohydrate; coronary atherosclerosis; women ID AMERICAN-HEART-ASSOCIATION; ARTERY DISEASE; MYOCARDIAL-INFARCTION; ESTROGEN REPLACEMENT; CARDIOVASCULAR RISK; INTERVENTION TRIAL; UNSATURATED FAT; FOLLOW-UP; A-I; CHOLESTEROL AB Background: The influence of diet on atherosclerotic progression is not well established, particularly in postmenopausal women, in whom risk factors for progression may differ from those for men. Objective: The objective was to investigate associations between dietary macronutrients and progression of coronary atherosclerosis among postmenopausal women. Design: Quantitative coronary angiography was performed at baseline and after a mean follow-up of 3.1 y in 2243 coronary segments in 235 postmenopausal women with established coronary heart disease. Usual dietary intake was assessed at baseline. Results: The mean (+/-SD) total fat intake was 25+/-6% of energy. In multivariate analyses. a higher saturated fat intake was associated with a smaller decline in mean minimal coronary diameter (P = 0.001) and less progression of coronary stenosis (P = 0.002) during follow-up. Compared with a 0.22-mm decline in the lowest quartile of intake. there was a 0.10-mm decline in the second quartile (P = 0.002), a 0.07-mm decline in the third quartile (P = 0.002), and no decline in the fourth quartile (P < 0.001); P for trend = 0.001. This inverse association was more pronounced among women with lower monounsaturated fat (P for interaction = 0.04) and higher carbohydrate (P for interaction 0.004) intakes and possibly lower total fat intake (P for interaction 0.09). Carbohydrate intake was positively associated with atherosclerotic progression (P = 0.001), particularly when the glycemic index was high. Polyunsaturated fat intake was positively associated with progression when replacing other fats (P = 0.04) but not when replacing carbohydrate or protein. Monounsaturated and total fat intakes were not associated with progression. Conclusions: In postmenopausal women with relatively low total fat intake, a greater saturated fat intake is associated with less progression of coronary atherosclerosis. whereas carbohydrate intake is associated with a greater progression. C1 Brigham & Womens Hosp, Channing Lab, Dept Med, Boston, MA 02115 USA. Harvard Univ, Sch Med, Boston, MA 02115 USA. Harvard Univ, Sch Publ Hlth, Dept Epodemiol & Nutr, Boston, MA 02115 USA. Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Program, Seattle, WA USA. Tufts Univ, Cardiovasc Nutr Lab, Jean Mayer US Dept Agr, Human Nutr Res Ctr Aging, Boston, MA 02111 USA. Wake Forest Univ, Cardiol Sect, Dept Internal Med, Winston Salem, NC 27109 USA. Wake Forest Univ, Dept Publ Hlth Sci, Winston Salem, NC 27109 USA. RP Mozaffarian, D (reprint author), 665 Huntington Ave,Bldg 2,Room 315, Boston, MA 02115 USA. RI Mozaffarian, Dariush/B-2276-2008 FU NCRR NIH HHS [M01 RR07122, M01 RR007122]; NHLBI NIH HHS [K08 HL075628, U01 HL-45488]; NIDDK NIH HHS [DK07703, T32 DK007703] NR 53 TC 80 Z9 83 U1 0 U2 8 PU AMER SOC CLINICAL NUTRITION PI BETHESDA PA 9650 ROCKVILLE PIKE, SUBSCRIPTIONS, RM L-3300, BETHESDA, MD 20814-3998 USA SN 0002-9165 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD NOV PY 2004 VL 80 IS 5 BP 1175 EP 1184 PG 10 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 870EE UT WOS:000225036000011 PM 15531663 ER PT J AU Shaib, Y El-Serag, HB AF Shaib, Y El-Serag, HB TI The prevalence and risk factors of functional dyspepsia in a. multiethnic population in the United States SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID GASTROESOPHAGEAL-REFLUX; NONULCER DYSPEPSIA; HELICOBACTER-PYLORI; PEPTIC-ULCER; SYMPTOMS; ASSOCIATION; SUBGROUPS; IMPACT AB BACKGROUND AND AIMS: The prevalence of functional dyspepsia (FD) in the general population is not known. The aim of this study is to measure the prevalence of FD and its risk factors in a multiethnic volunteer sample of the U.S. population. METHODS: One thousand employees at the Houston VA Medical Center were targeted with a symptom questionnaire asking about upper abdominal symptoms, followed by a request to undergo endsocopy. Dyspepsia was defined by the presence of epigastric pain, fullness, nausea, or vomiting, and FD was defined as dyspepsia in the absence of esophageal erosions, gastric ulcers, or duodenal ulcers or erosions. The presence of dyspepsia and FD was examined in multiple logistic regression analyses. RESULTS: A total of 465 employees completed the relevant questions and of those 203 had endoscopic examination. The age-adjusted prevalence rate of dyspepsia was 31.9 per 100 (95% CI: 26.7-37.1), and 15.8 per 100 (95% CI: 9.6-22.0) if participants with concomitant heartburn or acid regurgitation were excluded. Subjects with dyspepsia were more likely to report smoking, using antacids, aspirin or nonsteroidal antiinflammatory drugs (NSAIDs), and consulting a physician for their symptoms (p < 0.05) than participants without dyspepsia. Most (64.5%) participants with dyspepsia who underwent endoscopy had FD. The age-adjusted prevalence rate of FD was 29.2 per 100 (95% CI: 21.9-36.5), and 15.0 per 100 (6.7-23.3) if subjects with GERD were excluded. Apart from a trend towards association with older age in the multiple regression analysis, there were no significant predictors of FD among participants with dyspepsia. CONCLUSIONS: Most subjects with dyspepsia have FD. The prevalence of FD is high but predictors of FD remain poorly defined. C1 Michael E Debakey Vet Affairs Med Ctr, Sect Hlth Serv Res & Gastroenterol, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. RP El-Serag, HB (reprint author), Michael E Debakey Vet Affairs Med Ctr, Sect Hlth Serv Res & Gastroenterol, 2002 Holcombe Blvd,152, Houston, TX 77030 USA. NR 20 TC 85 Z9 96 U1 1 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD NOV PY 2004 VL 99 IS 11 BP 2210 EP 2216 DI 10.1111/j.1572-0241.2004.40052.x PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 866IT UT WOS:000224767900023 PM 15555004 ER PT J AU Chan, KS Morton, SC Shekelle, PG AF Chan, KS Morton, SC Shekelle, PG TI Systematic reviews for evidence-based management: How to find them and what to do with them SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID MEDICAL LITERATURE; USERS GUIDES; QUALITY; CARE; INTERVENTIONS; METAANALYSIS; PRINCIPLES; GUIDELINES; MEDLINE AB Objective: To identify strategies for retrieval and evaluation of systematic reviews from a management perspective. Study Design: Review of available literature and resources on systematic reviews. Methods: From published literature on evidence-based medicine and systematic review, we identified resources and adapted retrieval and evaluation strategies for healthcare managers. A published systematic review then was assessed for quality and relevance to management decisions. Results: Systematic reviews relevant to the organization and delivery of care are available. Criteria for evaluating the relevance and quality of systematic reviews on clinical topics may be adapted for systematic reviews on organizational topics. However, even a systematic review that focuses on an organizational topic can lack important information on costs and study setting. Conclusions: Greater familiarity with the retrieval and evaluation of systematic reviews can help managers use these sources effectively and encourage the development of evidence-based management. C1 Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA. RAND Corp, Hlth Program, Santa Monica, CA USA. So Calif Evidence Based Practice Ctr, Santa Monica, CA USA. Greater Los Angeles Vet Adm Hlth Care Syst, Los Angeles, CA USA. RP Chan, KS (reprint author), 624 N Broadway,Rm 644, Baltimore, MD 21205 USA. EM kchan@jhsph.edu NR 25 TC 13 Z9 13 U1 0 U2 4 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD NOV PY 2004 VL 10 IS 11 BP 806 EP 812 PN 1 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 871DX UT WOS:000225110600009 PM 15623270 ER PT J AU Corson, K Gerrity, MS Dobscha, SK AF Corson, K Gerrity, MS Dobscha, SK TI Screening for depression and suicidality in a VA primary care setting: 2 items are better than 1 item SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID CASE-FINDING INSTRUMENTS; DISORDERS; VALIDITY; PHQ-9; VALIDATION; UTILITY; LIFE AB Objective: To evaluate the psychometric properties of a single-item depression screen against validated scoring algorithms for the Patient Health Questionnaire (PHQ) and the utility of these algorithms in screening for depression and suicidality in a Department of Veterans Affairs (VA) primary care setting. Study Design: Recruitment phase of a randomized trial. Methods: A total of 1211 Portland VA patients with upcoming primary care clinic appointments were administered by telephone a single item assessing depressed mood over the past year and the PHQ. The PHQ-9 (9 items) encompasses DSM-IV criteria for major depression, the PHQ-8 (8 items) excludes the thoughts of death or suicide item, and the PHQ-2 (2 items) assesses depressed mood and anhedonia. Patients whose responses suggested potential suicidality were administered 2 additional items assessing suicidal ideation. Patients receiving mental health specialty care were excluded. Results: Using the PHQ-9 algorithm for major depression as the reference standard, the VA single-item screen was specific (88%) but less sensitive (78%). A PHQ-2 score of greater than or equal to3 demonstrated similar specificity (91%) with high sensitivity (97%). For case finding, the PHQ-8 was similar to the PHQ-9. Approximately 20% of patients screened positive for moderate depression, 7% reported thoughts of death or suicide, 2% reported thoughts of harming themselves, and 1% had specific plans. Conclusions: The PHQ-2 offers brevity and better psychometric properties for depression screening than the single-item screen. The PHQ-9 item assessing thoughts of death or suicide does not improve depression case finding; however, one third of patients endorsing this item reported recent active suicidal ideation. C1 Portland VA Med Ctr, Res Serv, Behav Hlth & Clin Neurosci Div, Portland, OR 97207 USA. Portland VA Med Ctr, Div Hosp & Specialty Med, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Dept Psychiat, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Med, Portland, OR 97201 USA. RP Corson, K (reprint author), Portland VA Med Ctr, Res Serv, Behav Hlth & Clin Neurosci Div, POB 1034,P3 DEP-PC, Portland, OR 97207 USA. EM kathryn.corson@med.va.gov NR 28 TC 103 Z9 104 U1 3 U2 5 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 NOV PY 2004 VL 10 IS 11 BP 839 EP 845 PN 2 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 874BE UT WOS:000225325100003 PM 15609737 ER PT J AU Weiner, J Aguirre, A Ravenell, K Kovath, K McDevit, L Murphy, J Asch, DA Shea, JA AF Weiner, J Aguirre, A Ravenell, K Kovath, K McDevit, L Murphy, J Asch, DA Shea, JA TI Designing an illustrated patient satisfaction instrument for low-literacy populations SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID IMPROVE COMPREHENSION; INJURY PREVENTION; READABILITY; INFORMATION; QUALITY; CARE; INSTRUCTIONS; CHILDREN; VERSION AB Up to 25% of adults in the United States have difficulty with everyday reading tasks. As patients, adults with low literacy may not be able to complete many self-administered written questionnaires, which often are used to obtain information from patients and to gauge their satisfaction with care. We developed an illustrated version of a patient satisfaction instrument used by the Veterans Health Administration. This paper describes the extensive design process used to develop, pilot-test, and revise this 63-item illustrated instrument. A total of 438 patients were interviewed over a 1-year period to obtain feedback on illustrations, with at least 15 people viewing and commenting on each picture and revision. All pictures were revised, with the majority revised at least 4 times. We report on this iterative design process as well as on lessons we learned in illustrating questions for low-literacy populations. C1 Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Div Gen Internal Med, Philadelphia, PA 19104 USA. RP Weiner, J (reprint author), Univ Penn, Leonard Davis Inst Hlth Econ, 3641 Locust Walk, Philadelphia, PA 19104 USA. EM weinerja@mail.med.upenn.edu OI Weiner, Janet/0000-0001-5810-5807 NR 35 TC 9 Z9 9 U1 2 U2 4 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD NOV PY 2004 VL 10 IS 11 BP 853 EP 860 PN 2 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 874BE UT WOS:000225325100005 PM 15609739 ER PT J AU Fung, CH Woods, JN Asch, SM Glassman, P Doebbeling, BN AF Fung, CH Woods, JN Asch, SM Glassman, P Doebbeling, BN TI Variation in implementation and use of computerized clinical reminders in an integrated healthcare system SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID INFORMATION TECHNOLOGY; AMBULATORY-CARE; ISSUES AB Objectives: To identify patterns of use of computerized clinical reminders (CCRs) across an integrated healthcare system and describe institutional factors associated with their implementation. Study Design: Cross-sectional study. Methods: At a national electronic health record (EHR) meeting, we surveyed 261 participants from 104 Veterans Health Administration (VHA) healthcare facilities regarding the number and types of CCRs available at each facility. Potential explanatory measures included perceived utility and ease of use of CCRs, training and personnel support for computer use, EHR functionalities, and performance data feedback to providers at each facility. Results: The number of conditions with CCRs in use at a facility ranged from I to 15; most reported implementation of reminders for 10 of the 15 conditions surveyed. The most commonly implemented CCRs, used in more than 85% of facilities, were for conditions with VHA national performance measures (eg, tobacco cessation, immunizations, diabetes mellitus). The least commonly implemented CCRs were for post-deployment health evaluation and management, medically unexplained symptoms, and erectile dysfunction. Facilities that had implemented greater numbers of clinical reminders had providers who reported greater ease of use and utility of the reminders (P=.01). Conclusions: VHA facilities Vary markedly in their implementation of CCRs. This effect may be partly explained by greater incorporation of clinical reminders for conditions with performance measures. Further study is needed to determine how to best implement clinical reminders and the institutional factors important in their use. C1 VA Greater Los Angeles Healthcare Syst, Div Gen Internal Med, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Univ Iowa, Coll Publ Hlth, Dept Epidemiol, Iowa City, IA USA. VA Ctr Study Healthcare Provider Behav, Los Angeles, CA USA. Richard L Roudebush Vet Affairs Med Ctr, HSR&D Ctr Excellence Implementing Evidence Based, Indianapolis, IN USA. Indiana Univ, Sch Med, Dept Internal Med, Indianapolis, IN 46204 USA. Regenstrief Inst Hlth Care, Indianapolis, IN 46202 USA. RP Fung, CH (reprint author), 11301 Wilshire Blvd,111G, Los Angeles, CA 90073 USA. EM cfung@mednet.ucla.edu NR 19 TC 53 Z9 53 U1 0 U2 7 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 NOV PY 2004 VL 10 IS 11 BP 878 EP 885 PN 2 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 874BE UT WOS:000225325100008 PM 15609742 ER PT J AU Davila, JA Brooks, JM Pendergast, JF Chrischilles, EA AF Davila, JA Brooks, JM Pendergast, JF Chrischilles, EA TI The effect of physician characteristics and their practice environment on surgical referral patterns for early-stage breast cancer in Iowa SO AMERICAN JOURNAL OF MEDICAL QUALITY LA English DT Article DE breast cancer; physician behavior; physician practice patterns; surveillance; epidemiology and end results program ID CLINICAL-PRACTICE GUIDELINES; UNITED-STATES; FEEDBACK; WOMEN; SURGERY; TRIAL; AUDIT AB The objective of this article was to examine whether characteristics of referring physicians and their practice environment were associated with surgical referral behavior for early-stage breast cancer patients. A total of 2801 women diagnosed with early-stage breast cancer and their referring physicians were identified from the Iowa Surveillance, Epidemiology, and End Results (SEER) database during 1989-1996. The Iowa Physician Inventory was used to collect information on characteristics of referring physicians. Multiple logistic regression analyses were conducted to evaluate characteristics of the referring physicians and their practice environment to explain surgical referral behavior. Affiliation with physicians' networks and professional diversity among area specialists were associated with increased referrals to surgeons more likely to perform breast-conserving surgery. Promoting interaction among physicians, particularly among those with different specialties, may increase the diffusion of new behaviors into clinical practice. C1 Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. Houston Vet Adm Med Ctr, Houston, TX USA. Univ Iowa, Coll Pharm, Iowa City, IA 52242 USA. Univ Iowa, Coll Publ Hlth, Iowa City, IA USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. RP Davila, JA (reprint author), Houston Vet Affairs Med Ctr, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM jdavila@bcm.tmc.edu NR 24 TC 1 Z9 1 U1 0 U2 3 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 NOV-DEC PY 2004 VL 19 IS 6 BP 266 EP 273 DI 10.1177/106286060401900606 PG 8 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 872UN UT WOS:000225234300005 PM 15620078 ER PT J AU Gooch, JL Toro, JJ Guler, RL Barnes, JL AF Gooch, JL Toro, JJ Guler, RL Barnes, JL TI Calcineurin A-alpha but not A-beta is required for normal kidney development and function SO AMERICAN JOURNAL OF PATHOLOGY LA English DT Article ID DEFICIENT MICE; HYPERTROPHY; PHOSPHORYLATION; EXPRESSION; P27(KIP1); PROTEIN; CYCLOSPORINE; HYPERPLASIA; ACTIVATION; REDUCTION AB Calcineurin is an important signaling molecule in the kidney and may be involved in a variety of processes. The phosphatase subunit of calcineurin (CnA) has three isoforms, alpha, beta, and gamma. In this study, we investigated the effect of loss of calcineurin A-alpha (CnA-alpha) or calcineurin A-beta (CnA-beta) on the development and function of the kidney. Total calcineurin expression and activity was significantly reduced in whole kidney homogenates from both CnA-alpha -/- and CnA-beta -/- mice. Kidneys of CnA-beta -/- mice appear normal and the mice develop with no phenotypic abnormalities. in contrast, kidneys of CnA-alpha -/- animals fail to fully develop. in particular, postnatal maturation of the nephrogenic zone (NZ) is defective. Within the NZ, glomeruli also fail to mature and lack mesangial cells. In addition to alterations in development, there is an absence of proliferation and an increase of cell death in the NZ with loss of CnA-alpha. Finally, increased collagen deposition is observed and serum creatinine levels are significantly increased in CnA-alpha -/- animals compared to wild-type littermates, indicating that kidney function is impaired. In summary, absence of CnA-alpha but not CnA-beta leads to a defect in normal maturation of the NZ and glomeruli, alterations in the cell cycle, and impaired kidney function. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie Murphy Div, San Antonio, TX USA. RP Gooch, JL (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM Gooch@uthscsa.edu NR 35 TC 50 Z9 51 U1 0 U2 0 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3993 USA SN 0002-9440 J9 AM J PATHOL JI Am. J. Pathol. PD NOV PY 2004 VL 165 IS 5 BP 1755 EP 1765 DI 10.1016/S0002-9440(10)63430-X PG 11 WC Pathology SC Pathology GA 865XF UT WOS:000224736800028 PM 15509543 ER PT J AU Roose, SP Sackeim, HA Krishnan, KRR Pollock, BG Alexopoulos, G Lavretsky, H Katz, IR Hakkarainen, H AF Roose, SP Sackeim, HA Krishnan, KRR Pollock, BG Alexopoulos, G Lavretsky, H Katz, IR Hakkarainen, H CA Old Old Depression Study Grp TI Antidepressant pharmacotherapy in the treatment of depression in the very old: A randomized, placebo-controlled trial SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID RECURRENT MAJOR DEPRESSION; NURSING-HOME RESIDENTS; DOUBLE-BLIND; SUBCORTICAL HYPERINTENSITIES; ELECTROCONVULSIVE-THERAPY; HEART-DISEASE; NORTRIPTYLINE; SERTRALINE; PAROXETINE; DISORDER AB Objective: This study determined the efficacy of antidepressant medication for the treatment of depression in the "old-old." Method: This randomized 8-week medication trial compared citalopram, 10-40 mg/day, to placebo in the treatment of patients 75 and older with unipolar depression. Results: A total of 174 patients who were 58% women with a mean age of 79.6 years (SD=4.4) and a mean baseline Hamilton Depression Rating Scale score of 24.3 (SD=4.1) were randomly assigned to treatment at 15 sites. There was a main effect for site but not for treatment condition. The remission rate, defined as a final Hamilton depression scale score <10, was 35% for the citalopram and 33% for the placebo groups. However, patients with severe depression (baseline Hamilton depression scale score >24) tended to have a higher remission rate with medication than with placebo (35% versus 19%). Conclusions: In the oldest group of community-dwelling patients to be studied to date, medication was not more effective than placebo for the treatment of depression. However, given the considerable psychosocial support received by all patients, the placebo condition represents more than the ingestion of an inactive pill. Across sites, there was considerable range in response to medication, 18% to 82%, and to placebo, 16% to 80%. C1 Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, Dept Psychiat, New York, NY 10032 USA. Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, Dept Radiol, New York, NY 10032 USA. Duke Univ, Dept Psychiat & Behav Sci, Durham, NC 27706 USA. Univ Pittsburgh, Acad Div Geriatr Psychiat, Pittsburgh, PA 15260 USA. Cornell Univ, Weill Med Coll, Cornell Inst Geriatr Psychiat, White Plains, NY USA. Univ Calif Los Angeles, David Geffen Sch Med, Neuropsychiat Inst & Hosp, Los Angeles, CA USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Forest Res Inst, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. RP Roose, SP (reprint author), Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, Dept Psychiat, 1051 Riverside Dr, New York, NY 10032 USA. EM spr2@columbia.edu RI Lavretsky, Helen/M-5711-2015 OI Lavretsky, Helen/0000-0001-9990-5085 FU NIMH NIH HHS [K23 MH001948-01A1, K23 MH001948] NR 40 TC 114 Z9 120 U1 1 U2 5 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD NOV PY 2004 VL 161 IS 11 BP 2050 EP 2059 DI 10.1176/appi.ajp.161.11.2050 PG 10 WC Psychiatry SC Psychiatry GA 866IY UT WOS:000224768400017 PM 15514406 ER PT J AU Nguyen, L Fagan, SP Lee, TC Aoki, N Itani, KMF Berger, DH Awad, SS AF Nguyen, L Fagan, SP Lee, TC Aoki, N Itani, KMF Berger, DH Awad, SS TI Use of a predictive equation for diagnosis of acute gangrenous cholecystitis SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 28th Annual Surgical Symposium of the Association-of-VA-Surgeons CY APR 25-27, 2004 CL Richmond, VA SP Assoc VA Surg DE gangrenous cholecystitis; cholecystectomy; predictive equation ID LAPAROSCOPIC CHOLECYSTECTOMY AB Background: Factors previously identified by multivariate logistic regression that were predictive for gangrenous cholecystitis (GC) were used to develop a predictive equation. Our objective was to evaluate the sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values of this equation for detecting GC in patients with acute cholecystitis (AC). Methods: Medical records of patients who presented to a tertiary care hospital with AC were reviewed. Twenty-one patient and clinical variables were recorded. We prospectively tested the results of the following equation against pathologic diagnosis: P = e ((0.7116+0.9944.DM+1.7157-WBC-1.0319-ALT-2.0518.ALP+2.7078-PCF))/(1 +e([-0.7116+0.9944-DM+1.7157-WBC-1.0319-ALT-2.0518-ALP+2.7078-PCF])), where P = predicted value: DM = diabetes mellitus; WBC = white blood cell count; ALT = alanine aminotransferase; AST = aspartate aminotransferase; and PCF = pericholecystic fluid. Results: Ninety-eight patients presented with AC and 18% had GC (18 of 98). Using a cutoff of P = 0.724, our equation had a specificity of 93%, sensitivity of 83%. PPV of 71%, and NPV of 96%, P <0.001 for the detection of GC. Conclusions: Our study demonstrates the equation may be useful in detecting the subset of AC patients who have GC. (C) 2004 Excerpta Medica, Inc. All rights reserved. C1 Baylor Coll Med, Houston Vet Affairs Med Ctr, Michael E DeBakey Dept Surg, Michael E DeBakey VAMC, Houston, TX 77030 USA. Univ Texas, Hlth Sci Ctr, Sch Hlth Informat Sci, Houston, TX USA. RP Awad, SS (reprint author), Baylor Coll Med, Houston Vet Affairs Med Ctr, Michael E DeBakey Dept Surg, Michael E DeBakey VAMC, OCL 112,2002 Holcombe Blvd, Houston, TX 77030 USA. EM sawad@bcm.tmc.edu NR 14 TC 15 Z9 18 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD NOV PY 2004 VL 188 IS 5 BP 463 EP 466 DI 10.1016/j.amjsurg.2004.07.013 PG 4 WC Surgery SC Surgery GA 872LL UT WOS:000225208600003 PM 15546551 ER PT J AU Awad, SS Hayley, B Fagan, SP Berger, DH Brunicardi, FC AF Awad, SS Hayley, B Fagan, SP Berger, DH Brunicardi, FC TI The impact of a novel resident leadership training curriculum SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 28th Annual Surgical Symposium of the Association-of-VA-Surgeons CY APR 25-27, 2004 CL Richmond, VA SP Assoc VA Surg DE alignment; communication; curriculum; integrity; leadership AB Background: Today's complex health care environment Coupled with the 80-hour workweek mandate has required that surgical resident team interactions evolve from a military command-and-control style to a collaborative leadership style. Methods: A novel educational Curriculum was implemented with objectives of training the residents to have the capacity/ability to create and manage powerful teams through alignment, communication, and integrity integral tools to practicing a collaborative leadership style while working 80 hours per week. Specific strategies were as follows: (1) to focus on quality of patient care and service while receiving a high education-to-service ratio, and (2) to maximize efficiency through time management. Results: This article shows that leadership training as part of a resident Curriculum can significantly increase a resident's view of leadership in the areas of alignment. communication, and integrity; tools previously shown in business models to be vital for effective and efficient teams. Conclusion: This curriculum, over the course of the surgical residency, can provide residents with the necessary tools to deliver efficient quality of care while working within the 80-hour workweek mandate in a more collaborative style environment. (C) 2004 Excerpta Medica, Inc. All rights reserved. C1 Baylor Coll Med, Houston Vet Affairs Med Ctr, Michael E DeBakey Dept Surg, Surg Serv 112, Houston, TX 77030 USA. RP Awad, SS (reprint author), Baylor Coll Med, Houston Vet Affairs Med Ctr, Michael E DeBakey Dept Surg, Surg Serv 112, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM sawad@bcm.tmc.edu NR 11 TC 13 Z9 14 U1 0 U2 2 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD NOV PY 2004 VL 188 IS 5 BP 481 EP 484 DI 10.1016/j.amjsurg.2004.07.024 PG 4 WC Surgery SC Surgery GA 872LL UT WOS:000225208600006 PM 15546554 ER PT J AU Kaafarani, HMA Itani, KMF Thornby, J Berger, DH AF Kaafarani, HMA Itani, KMF Thornby, J Berger, DH TI Thirty-day and one-year predictors of death in noncardiac major surgical procedures SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 28th Annual Surgical Symposium of the Association-of-VA-Surgeons CY APR 25-27, 2004 CL Richmond, VA SP Assoc VA Surg DE operative surgical procedure; risk factors; death; mortality; mortality determinant; cardiac risk classifications; obesity; smoking; hyperlipidemia; renal insufficiency ID PERIOPERATIVE CARDIOVASCULAR EVALUATION; PRACTICE GUIDELINES COMMITTEE; ASSOCIATION TASK-FORCE; CARDIAC-ASSESSMENT; AMERICAN-COLLEGE; SURGERY; RISK; HEART; MORTALITY; INDEX AB Background: We evaluated the predictive value of the American College of Cardiology/Ainerican Heart Association (ACC/AHA) cardiac risk classification, as well as other potential risk factors (procedure risk, smoking, obesity, hyperlipidemia, and renal insufficiency), on all-cause mortality at 30 days and at 1 year postoperatively. Methods: In the year 2000, 1238 consecutive patients undergoing general anesthesia for various noncardiac surgical procedures at the Houston veterans Affairs Medical Center were screened preoperatively and classified according to the ACC/AHA guidelines. Patients' charts were reviewed for the above-mentioned risk factors. Results: A logistic regression analysis demonstrated that older age and higher procedure risk were associated with higher 30-day mortalities (P = 0.0012 and 0.0441, respectively). The ACC/AHA classification was positively correlated with mortality at 1 year (P = 0.0071). Conclusions: The ACC/AHA classification predicts mortality at 1 year but not at 30 days for major noncardiac surgeries; procedure-related risk is a better predictor of 30-day postoperative mortality in our patient population. Published by Excerpta Medica, Inc. C1 Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Dept Surg, Houston, TX 77030 USA. VA Boston Hlth Care Syst 112, Dept Surg, Boston, MA 02132 USA. RP Itani, KMF (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. EM kitani@med.va.gov NR 14 TC 7 Z9 7 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD NOV PY 2004 VL 188 IS 5 BP 495 EP 499 DI 10.1016/j.amjsurg.2004.07.018 PG 5 WC Surgery SC Surgery GA 872LL UT WOS:000225208600009 PM 15546557 ER PT J AU Farnsworth, N Fagan, SP Berger, DH Awad, SS AF Farnsworth, N Fagan, SP Berger, DH Awad, SS TI Child-Turcotte-Pugh versus MELD score as a predictor of outcome after elective and emergent surgery in cirrhotic patients SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 28th Annual Surgical Symposium of the Association-of-VA-Surgeons CY APR 25-27, 2004 CL Richmond, VA SP Assoc VA Surg DE Child-Turcotte-Pugh; cirrhosis; MELD; surgery ID STAGE LIVER-DISEASE; SURVIVAL; MODEL; PROGNOSIS AB Background: Cirrhotic patients who present for elective and emergent surgery pose a formidable challenge for the surgeon because of the high reported morbidity and mortality. The Child-Turcotte-Pugh (CTP) score previously has been used to evaluate preoperative severity of liver dysfunction and to predict postoperative outcome. Recently, a more objective scoring classification, the model for end-stage liver disease (MELD), has been shown to predict accurately the 3-month mortality for cirrhotic patients awaiting transplantation. We sought to compare the CTP and MELD scores in predicting outcomes in Cirrhotic patients undergoing surgical procedures requiring general anesthesia. Methods: During the study period, 40 patients with a history of cirrhosis who required elective (E) or emergent (EM) surgical procedures under general anesthesia were reviewed (E = 24, EM = 16). The preoperative CTP and MELD scores were calculated and patient short(30-day) and long-term (3-month) outcomes were recorded. Results: There was a significant difference in the 1-month and 3-month mortality rates between the emergent and elective groups (EM group: 1 mo = 19%, 3 mo = 44%; E group: 1 mo = 17%, 3 mo = 21 %, P < 0.05). There was good correlation between the CP and MELD scores, which was greater in the emergent groups as compared with the elective group (EM: r = 0.81; E: r = 0.65). Conclusions: Our study shows that cirrhotic patients who undergo surgery under general anesthesia have an extremely high 1 - and 3-month mortality rate that progressively increases with severity of preoperative liver dysfunction. Additionally, the MELD score correlates well with the CTP score, providing a more objective predictor of postoperative mortality in cirrhotic patients undergoing surgery. (C) 2004 Excerpta Medica, Inc. All rights reserved. C1 Baylor Coll Med, Surg Serv 112, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Awad, SS (reprint author), Baylor Coll Med, Surg Serv 112, Michael E DeBakey Vet Affairs Med Ctr, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM sawad@bcm.tmc.edu NR 17 TC 120 Z9 125 U1 0 U2 8 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD NOV PY 2004 VL 188 IS 5 BP 580 EP 583 DI 10.1016/j.amjsurg.2004.07.034 PG 4 WC Surgery SC Surgery GA 872LL UT WOS:000225208600026 PM 15546574 ER PT J AU Magid, DJ Rurnsfeld, JS Masoudi, FA AF Magid, DJ Rurnsfeld, JS Masoudi, FA TI Chest pain in the emergency department in search of the holy grail SO ANNALS OF EMERGENCY MEDICINE LA English DT Editorial Material ID ACUTE CARDIAC ISCHEMIA; MYOCARDIAL-INFARCTION; DIAGNOSIS; PROTOCOL; CARE; NEED C1 Kaiser Permanente Clin Res Unit, Denver, CO 80237 USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Div Emergency Med, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Div Cardiol, Denver, CO 80202 USA. Denver VA Med Ctr, Denver, CO USA. Denver Hlth Med Ctr, Denver, CO USA. RP Magid, DJ (reprint author), Kaiser Permanente Clin Res Unit, POB 378066, Denver, CO 80237 USA. EM David.J.Magid@kp.org NR 8 TC 1 Z9 1 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD NOV PY 2004 VL 44 IS 6 BP 575 EP 576 DI 10.1016/j.annemergmed.2004.06.001 PG 2 WC Emergency Medicine SC Emergency Medicine GA 876NN UT WOS:000225503900002 PM 15573031 ER PT J AU Noel, PH Williams, JW Unutzer, J Worchel, J Lee, S Cornell, J Katon, W Harpole, LH AF Noel, PH Williams, JW Unutzer, J Worchel, J Lee, S Cornell, J Katon, W Harpole, LH TI Depression and comorbid illness in elderly primary care patients: Impact on multiple domains of health status and well-being SO ANNALS OF FAMILY MEDICINE LA English DT Article DE depression; primary health care; quality of life; health status ID RANDOMIZED CONTROLLED-TRIAL; QUALITY-OF-LIFE; OLDER-ADULTS; COLLABORATIVE CARE; MAJOR DEPRESSION; SYMPTOMS; DISORDERS; OUTCOMES; RELIABILITY; DISABILITY AB PURPOSE Our objective was to examine the relative association of depression severity and chronicity, other comorbid psychiatric conditions, and coexisting medical illnesses with multiple domains of health status among primary care patients with clinical depression. METHODS We collected cross-sectional data as part of a treatment effectiveness trial that was conducted in 8 diverse health care organizations. Patients aged 60 years and older (N = 1,801) who met diagnostic criteria for major depression or dysthymia participated in a baseline survey. A survey instrument included questions on sociodemographic characteristics, depression severity and chronicity, neuroticism, and the presence of 11 common chronic medical illnesses, as well as questions screening for panic disorder and posttraumatic stress disorder. Measures of 4 general health indicators (physical and mental component scales of the SF-12, Sheehan Disability Index, and global quality of life) were included. We conducted separate mixed-effect regression linear models predicting each of the 4 general health indicators. RESULTS Depression severity was significantly associated with all 4 indicators of general health after controlling for sociodemographic differences, other psychological dysfunction, and the presence of 11 chronic medical conditions. Although study participants had an average of 3.8 chronic medical illnesses, depression severity made larger independent contributions to 3 of the 4 general health indicators (mental functional status, disability, and quality of life) than the medical comorbidities. CONCLUSIONS Recognition and treatment of depression has the potential to improve functioning and quality of life in spite of the presence of other medical comorbidities. C1 S Texas Vet Hlth Care Syst, VERDICT, HSR&D Ctr Excellence, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Duke Univ, Med Ctr, Durham, NC USA. Durham Vet Affairs Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC USA. Univ Calif Los Angeles, Los Angeles, CA USA. Cent Texas Vet Hlth Care Syst, Austin, TX USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. Grp Hlth Cooperat Puget Sound, Seattle, WA 98121 USA. Kaiser Permanente, Oakland, CA USA. RP Noel, PH (reprint author), S Texas Vet Hlth Care Syst, VERDICT, HSR&D Ctr Excellence, 7400 Merton Minter Blvd 11C6, San Antonio, TX 78229 USA. EM pollyh@verdict.uthscsa.edu RI Williams, Jr., John/A-3696-2008 OI Williams, Jr., John/0000-0002-5267-5558 NR 40 TC 86 Z9 90 U1 5 U2 10 PU ANNALS FAMILY MEDICINE PI LEAWOOD PA 11400 TOMAHAWK CREEK PARKWAY, LEAWOOD, KS 66211-2672, UNITED STATES SN 1544-1709 J9 ANN FAM MED JI Ann. Fam. Med. PD NOV-DEC PY 2004 VL 2 IS 6 BP 555 EP 562 DI 10.1370/afm.143 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 892TE UT WOS:000226672100007 PM 15576541 ER PT J AU O'Connell, JB Maggard, MA Ko, CY AF O'Connell, JB Maggard, MA Ko, CY TI Cancer-directed surgery for localized disease: Decreased use in the elderly SO ANNALS OF SURGICAL ONCOLOGY LA English DT Article DE elderly; cancer; surgery; cancer registry; SEER; quality ID TREATMENT TRIALS; RECTAL-CANCER; COLON-CANCER; AGE; CHEMOTHERAPY; OLDER; POPULATION AB Background: Previous studies report underuse of radiation and chemotherapy in the elderly, yet few have examined the rates of use (or underuse) of surgery. Using national data, we examined rates of surgical resection for patients with local-stage cancers. Methods: By using the Surveillance, Epidemiology, and End Results database (1988-1997), patients (greater than or equal to40 years) were identified with localized adenocarcinoma of the breast, esophagus, stomach, pancreas, colon, or rectum; non-small-cell lung carcinoma; and sarcoma (n = 200,360). Rates of cancer-directed surgery (CDS) were compared across age groups (at 5-year intervals). Multivariate regression was used to identify predictors of receipt of CDS in each tumor group. Results: Rates of CDS declined steadily with increasing age for all nine localized tumors. Most striking were the low rates of CDs for patients >70 years with esophagus, stomach, pancreas, and lung cancers (range, 0%-83%). However, CDS rates were >90% for breast and colon and >84% for rectal cancer in all age groups. Multivariate regression found lower odds of CDS for elderly patients for all cancers except colon. For example, age significantly decreased the odds of receiving CDS beginning at 60 years for lung cancer (odds ratio [OR], .550; P = .03), at 70 years for liver cancer (OR, .109; P = .003), and at 80 years for pancreatic cancer (OR, .120; P < .05). Conclusions: Although CDS for localized disease is being performed regularly in the elderly for some cancers (e.g. breast, colon, and rectum), this analysis shows that elderly patients are not receiving surgery for many potentially curable cancers. Whether these rates are appropriate or too low requires further evaluation. This is particularly essential because our population is aging. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. W Los Angeles Vet Affairs Hosp, Dept Surg, Los Angeles, CA USA. RP O'Connell, JB (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, 10833 Le Conte Ave,Room 72-215, Los Angeles, CA 90095 USA. EM jbocjboc@hotmail.com NR 11 TC 52 Z9 54 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1068-9265 J9 ANN SURG ONCOL JI Ann. Surg. Oncol. PD NOV PY 2004 VL 11 IS 11 BP 962 EP 969 DI 10.1245/ASO.2004.03.052 PG 8 WC Oncology; Surgery SC Oncology; Surgery GA 866NX UT WOS:000224781300005 PM 15525824 ER PT J AU Wambaugh, J Cameron, R Kalinyak-Fliszar, M Nessler, C Wright, S AF Wambaugh, J Cameron, R Kalinyak-Fliszar, M Nessler, C Wright, S TI Retrieval of action names in aphasia: Effects of two cueing treatments SO APHASIOLOGY LA English DT Article ID BRAIN-DAMAGED SUBJECTS; VERB RETRIEVAL; LEXICAL RETRIEVAL; DEFICITS; AGRAMMATISM; ANOMIA; NOUNS AB Background: The treatment of word-retrieval deficits in aphasia has most frequently focused oil the retrieval of object names. The retrieval of action names has received relatively little attention in terms of rehabilitation despite the important role played by verbs in communication. Treatments that have been successful in promoting improved object name retrieval cannot be assumed to also facilitate improved action name retrieval. Aims: The Purpose Of this investigation was to examine the effects Of two cueing treatments oil the retrieval of action names with speakers with chronic aphasia. Methods & Procedures: The effects Of two Cueing treatments, Phonological Cueing Treatment (PCT) and Semantic Cueing Treatment (SCT), were examined with five speakers with aphasia. Treatment effects oil action naming were measured using single subject, multiple baseline, and alternating treatments designs. Outcomes & Results: Results varied across participants. For two speakers, both treatments produced strong positive increases in naming, with effects being similar across treatments. For two other speakers, modest increases in correct naming were observed and for the remaining speaker, no increases were found. Conclusions: These findings indicate that PCT and SCT may have utility in facilitating action naming for some speakers with aphasia, but that the effects may vary across speakers. C1 VA Salt Lake City Healthcare Syst, Res Serv 151A, Salt Lake City, UT 84148 USA. Univ Utah, Salt Lake City, UT 84112 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. VA Philadelphia Healthcare Syst, Philadelphia, PA USA. RP Wambaugh, J (reprint author), VA Salt Lake City Healthcare Syst, Res Serv 151A, 500 Foothill Blvd, Salt Lake City, UT 84148 USA. EM julie.wambaugh@health.utah.edu NR 36 TC 32 Z9 32 U1 1 U2 6 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 0268-7038 J9 APHASIOLOGY JI Aphasiology PD NOV PY 2004 VL 18 IS 11 BP 979 EP 1004 DI 10.1080/02687030444000471 PG 26 WC Clinical Neurology SC Neurosciences & Neurology GA 877LN UT WOS:000225572200001 ER PT J AU Choi, S Schwartz, DL Farwell, DG Austin-Seymour, M Futran, N AF Choi, S Schwartz, DL Farwell, DG Austin-Seymour, M Futran, N TI Radiation therapy does not impact local complication rates after free flap reconstruction for head and neck cancer SO ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY LA English DT Article; Proceedings Paper CT 45th Annual Meeting of the American-Society-for-Therapeutic-Radiology-and-Oncology CY OCT 19-23, 2003 CL SALT LAKE CITY, UT SP Amer Soc Therapeut Radiol & Oncol ID FREE-TISSUE TRANSFER; MANDIBULAR RECONSTRUCTION; RADIOTHERAPY; TRANSFERS; VESSELS; REGION AB Objective(m: To determine whether external beam radiation therapy (XRT), administered either before or after surgery, increases the rate and/or severity of local postoperative complications in patients with head and neck cancer who undergo microvascular free flap reconstruction. Design: Retrospective cohort study. Setting: University of Washington Medical Center, Seattle, a tertiary care hospital. Patients: A total of 100 consecutive patients underwent fibular free flap reconstruction of the mandible. The study cohort was divided according to radiation treatment status: (1) no XRT (28 patients), (2) preoperative XRT (37 patients), and (3) postoperative XRT (35 patients). The median follow-up after surgery was 11 months (range, 1-89 months). Main Outcome Measures. Rate and severity of local postoperative complications. Results: Fifty-four patients (54%) had at least I postoperative complication. There were no differences among the 3 XRT subgroups in the overall proportion of patients with complications of any severity (15 [54%] of 28 patients in the no XRT group, 24 [65%] of 37 patients in the preoperative XRT group, and 16 [46%] of 35 patients in the postoperative XRT group; P=.26, X2 analysis). There were also no differences seen when mild and severe complication rates were specifically examined (P=.58 and P=.10, respectively). No case of complete flap loss was observed. We noted no significant correlations between the rate of postoperative complications and the following covariates: total radiation dose, size of radiation field, disease stage, exposure to chemotherapy, presence of serious medical comorbidities, patient age, or history of tobacco use. Conclusions: Our experience suggests that XRT can be safety administered before or after surgery to patients undergoing head and neck free flap reconstruction at an experienced surgical referral center. Postoperative complication rates were not significantly affected by administration, timing, dose, or extent of XRT. C1 Univ Texas, MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USA. Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Radiat Oncol, Seattle, WA USA. RP Schwartz, DL (reprint author), Univ Texas, MD Anderson Canc Ctr, Dept Radiat Oncol, 1515 Holcombe Blvd,Unit 97, Houston, TX 77030 USA. EM docdls@mdanderson.org NR 12 TC 53 Z9 54 U1 0 U2 3 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 NOV PY 2004 VL 130 IS 11 BP 1308 EP 1312 DI 10.1001/archotol.130.11.1308 PG 5 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 868TK UT WOS:000224935700011 PM 15545587 ER PT J AU Chaves, ES Boninger, ML Cooper, R Fitzgerald, SG Gray, DB Cooper, RA AF Chaves, ES Boninger, ML Cooper, R Fitzgerald, SG Gray, DB Cooper, RA TI Assessing the influence of wheelchair technology on perception of participation in spinal cord injury SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE activities of daily living; outcomes research; rehabilitation; spinal cord injuries; wheelchairs ID QUALITY-OF-LIFE; ASSISTIVE TECHNOLOGY; SATISFACTION; USERS AB Objective: To investigate factors related to the wheelchair, impairment, and environment that affect perception of participation of persons with spinal cord injury (SCI) in activities performed in 3 settings: in the home, in the community, and during transportation. Design: Cross-sectional study. Setting: Research centers and a specialized assistive technology (AT) clinic in Pittsburgh (Pitt). Research centers and communitybased rehabilitation technology suppliers in Saint Louis (SL). Participants: Seventy wheelchair users with SCI. Interventions: Subjects from Pitt and SL completed a written survey of AT usage in daily activities. Main Outcome Measures: Subjects were asked 5 questions within each setting (home, community, transportation) related to their perceived reason for functional limitations. Results: The wheelchair was the most commonly cited factor limiting participation, followed by physical impairment and physical environment. Twenty-one percent of subjects with paraplegia reported pain as a limiting factor for their transportation use, significantly more (P=.047) than subjects with tetraplegia (3%). A trend (P=.099) was seen toward a higher percentage of subjects with tetraplegia (tetraplegia, 7%; paraplegia, 3%) reporting lack of equipment as a limiting factor for use of transportation. Differences were also seen across sites. Conclusions: The wheelchair was the most commonly cited limiting factor, followed by physical impairment and physical environmental The wheelchair is the most important mobility device used by persons with SCI and the one that users most associate with barriers. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA 15206 USA. VA Pittsburgh Healthcare Syst, VA Rehabil Res & Dev Ctr, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci, Pittsburgh, PA USA. Univ Pittsburgh, Dept Technol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. Washington Univ, Sch Med, Program Occupat Therapy, St Louis, MO USA. VA Pittsburgh Healthcare Syst, VA Rehabil Res & Dev Ctr, Human Engn Res Labs, Pittsburgh, PA USA. RP Boninger, ML (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM Boninger@pitt.edu OI Boninger, Michael/0000-0001-6966-919X NR 26 TC 46 Z9 47 U1 1 U2 3 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD NOV PY 2004 VL 85 IS 11 BP 1854 EP 1858 DI 10.1016/j.apmr.2004.03.033 PG 5 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 870WO UT WOS:000225089700015 PM 15520981 ER PT J AU Algood, SD Cooper, RA Fitzgerald, SG Cooper, R Boninger, ML AF Algood, SD Cooper, RA Fitzgerald, SG Cooper, R Boninger, ML TI Impact of a pushrim-activated power-assisted wheelchair on the metabolic demands, stroke frequency, and range of motion among subjects with tetraplegia SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article; Proceedings Paper CT RESNA 2003 Conference CY JUN 21-23, 2003 CL ATLANTA, GA SP RESNA DE kinematics; metabolism; rehabilitation; tetraplegia; wheelchairs ID SHOULDER JOINT KINETICS; BEARING UPPER EXTREMITY; COORDINATE SYSTEM; PHYSICAL STRAIN; 2 SPEEDS; PROPULSION; BIOMECHANICS; EFFICIENCY; PARAPLEGIA; KINEMATICS AB Objectives: To determine differences in metabolic demands, stroke frequency, and upper-extremity joint range of motion (ROM) during pushrim-activated power-assisted wheelchair (PAPAW) propulsion and traditional manual wheelchair propulsion among subjects with tetraplegia. Design: Repeated measures. Setting: A biomechanics laboratory within a Veterans Affairs medical center. Participants: Fifteen full-time manual wheelchair users who had sustained cervical-level spinal cord injuries. Interventions: Participants propelled both their own manual wheelchairs and a PAPAW through 3 different resistances (slight, 10W; moderate, 12W; high, 14W) on a wheelchair dynamometer. Each propulsion trial was 3 minutes long. Main Outcome Measures: Primary variables that were compared between the 2 wheelchairs were participants' mean steady-state oxygen consumption, ventilation, heart rate, mean stroke frequency, and maximum upper-extremity joint ROM. Results: When using the PAPAW, participants showed a significant (P<.05) decrease in mean oxygen consumption and ventilation throughout all trials. Mean heart rate was significantly lower when using the PAPAW for the high resistance trial. Stroke frequency was significantly lower when using the PAPAW for the slight and moderate resistances. Overall joint ROM was significantly lower when using the PAPAW. Conclusions: For subjects with tetraplegia, PAPAWs reduce the energy demands, stroke frequency, and overall joint ROM when compared with traditional manual wheelchair propulsion. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Lab, VA Rehabil Res & Dev Ctr, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15260 USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Lab, VA Rehabil Res & Dev Ctr, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM rcooper@pitt.edu OI Boninger, Michael/0000-0001-6966-919X NR 31 TC 26 Z9 27 U1 3 U2 7 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 NOV PY 2004 VL 85 IS 11 BP 1865 EP 1871 DI 10.1016/j.apmr.2004.04.043 PG 7 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 870WO UT WOS:000225089700017 PM 15520983 ER PT J AU Samaha, FF Hibbard, C Sacks, J Chen, H Varello, MA George, T Kahn, ML AF Samaha, FF Hibbard, C Sacks, J Chen, H Varello, MA George, T Kahn, ML TI Measurement of platelet collagen receptor density in human subjects SO ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY LA English DT Letter ID 2 SILENT POLYMORPHISMS; GLYCOPROTEIN-VI; MYOCARDIAL-INFARCTION; GENE POLYMORPHISM; RISK FACTOR; ADHESION; ASSOCIATION; DEFICIENT; RESPONSES C1 Univ Penn Hlth Syst, Philadelphia Vet Affairs Med Ctr, Div Cardiovasc Dis, Philadelphia, PA 19104 USA. Univ Penn Hlth Syst, Dept Med, Div Cardiovasc Dis, Philadelphia, PA USA. RP Samaha, FF (reprint author), Univ Penn Hlth Syst, Philadelphia Vet Affairs Med Ctr, Div Cardiovasc Dis, Philadelphia, PA 19104 USA. NR 18 TC 9 Z9 9 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 NOV PY 2004 VL 24 IS 11 BP E181 EP E182 DI 10.1161/01.ATV.0000144809.49724.71 PG 2 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 868FU UT WOS:000224900300038 PM 15528484 ER PT J AU Griswold, IJ Shen, LJ La Rosee, P Demehri, S Heinrich, MC Braziel, RM McGreevey, L Haley, AD Giese, N Druker, BJ Deininger, MWN AF Griswold, IJ Shen, LJ La Rosee, P Demehri, S Heinrich, MC Braziel, RM McGreevey, L Haley, AD Giese, N Druker, BJ Deininger, MWN TI Effects of MLN518, a dual FLT3 and KIT inhibitor, on normal and malignant hematopoiesis SO BLOOD LA English DT Article ID ACUTE MYELOID-LEUKEMIA; INTERNAL TANDEM DUPLICATION; ACUTE MYELOGENOUS LEUKEMIA; RECEPTOR TYROSINE KINASE; PROGNOSTIC-SIGNIFICANCE; MYELOBLASTIC-LEUKEMIA; PROGENITOR CELLS; MUTATIONS; GROWTH; LIGAND AB Internal tandem duplications (ITDs) of the FMS-like tyrosine kinase 3 (FLT3) receptor tyrosine kinase are found in approximately 30% of patients with acute myelogenous leukemia (AML) and are associated with a poor prognosis. FLT3 ITD mutations result in constitutive kinase activation and are thought to be pathogenetically relevant, implicating FLT3 as a plausible therapeutic target. MLN518 (formerly CT53518) is a small molecule inhibitor of the FLT3, KIT, and platelet-derived growth-factor receptor (PDGFR) tyrosine kinases with significant activity in murine models of FLT3 ITD-positive leukemia. Given the importance of FLT3 and KIT for normal hematopoietic progenitor cells, we analyzed the effect of MLN518 on murine hematopoiesis under steady-state conditions, after chemotherapy-induced myelosuppression, and during bone marrow transplantation. In these assays, we show that MLN518 has mild toxicity toward normal hematopoiesis at concentrations that are effective in treating FLT3 ITD-positive leukemia in mice. We also demonstrate that MLN518 preferentially inhibits the growth of blast colonies from FLT3 ITD-positive compared with ITD-negative patients with AML, at concentrations that do not significantly affect colony formation by normal human progenitor cells. In analogy to imatinib mesylate in BCR-ABL-positive acute leukemia, MLN518-induced remissions may not be durable. Our studies provide the basis for integrating this compound into chemotherapy and transplantation protocols. (C) 2004 by The American Society of Hematology. C1 Oregon Hlth Sci Univ, Howard Hughes Med Inst, BMT Leukemia Ctr, Inst Canc, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Pathol, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. Millenium Pharmaceut, San Francisco, CA USA. Univ Heidelberg, Fak Klin Med Mannheim, Med Klin 3, Heidelberg, Germany. RP Deininger, MWN (reprint author), Oregon Hlth Sci Univ, Howard Hughes Med Inst, BMT Leukemia Ctr, Inst Canc, 3181 SW Sam Jackson Pk Rd,L592, Portland, OR 97239 USA. EM deininge@ohsu.edu NR 32 TC 27 Z9 29 U1 0 U2 2 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 NOV 1 PY 2004 VL 104 IS 9 BP 2912 EP 2918 DI 10.1182/blood-2003-05-1669 PG 7 WC Hematology SC Hematology GA 866TI UT WOS:000224795700050 PM 15242881 ER PT J AU Tien, PC Kovacs, A Bacchetti, P French, AL Augenbraun, M Cole, SR Hessol, N Justman, J AF Tien, PC Kovacs, A Bacchetti, P French, AL Augenbraun, M Cole, SR Hessol, N Justman, J TI Association between syphilis, antibodies to herpes simplex virus type 2, and recreational drug use and hepatitis B virus infection in the women's interagency HIV study SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID CORE ANTIGEN; HETEROSEXUAL TRANSMISSION; LIVER-DISEASE; UNITED-STATES; PREVALENCE; INDIVIDUALS; MORTALITY; IMPACT; RISK AB Background. Liver disease is a leading cause of death in human immunodeficiency virus (HIV)-infected women; however, risk factors for hepatitis B virus (HBV) infection in this population have not been well studied. Methods. We describe the seroprevalence and predictors of HBV infection in a cross-sectional analysis of 2132 women with and at risk for HIV infection enrolled in the Women's Interagency HIV Study during the periods 1994-95 and 2001-02. Any test result positive for antibody to hepatitis B core antigen defined infection; those women with serological evidence of vaccine immunity were excluded from analysis. Women were stratified into those with a history of injection drug use (IDU), those with a history of noninjection drug use (non- IDU), and those with no history of illicit drug use. Results. Of 1606 HIV-infected and 526 HIV-uninfected women, 7% and 12%, respectively, appeared to be vaccine immune. After exclusion of these women, 43% of 1500 HIV-infected and 22% of 461 HIV-uninfected women had HBV infection. HBV infection prevalence differed among the IDU, non- IDU, and no illicit drug use groups (76%, 30%, and 17%, respectively;). HBV infection was strongly associated with herpes simplex virus 2 (HSV-2) seropositivity in the IDU group (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.6-5.4) and with a history of syphilis in the non-IDU group (OR, 2.7; 95% CI, 1.4-5.0). Discussion. We found a high prevalence of HBV infection in our cohort of women with and at risk for HIV infection. HSV-2 seropositivity and a history of syphilis appeared to be important correlates of HBV infection. Sexual transmission of HBV, particularly in those with a history of genital ulcer disease, should be a major focus of education in all high-risk groups. C1 Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Univ So Calif, San Francisco Vet Affairs Med Ctr, Los Angeles, CA USA. Univ So Calif, Dept Med, Los Angeles, CA USA. Cook Cty Hosp, Rush Med Coll, CORE Ctr, Chicago, IL 60612 USA. Suny Downstate Med Ctr, Dept Med, Brooklyn, NY 11203 USA. Albert Einstein Coll Med, Dept Med, Bronx, NY 10467 USA. Bronx Lebanon Hosp Ctr, Bronx, NY 10456 USA. Johns Hopkins Univ, Dept Epidemiol, Baltimore, MD 21218 USA. RP Tien, PC (reprint author), VAMC, Metab Sect, 111F,4150 Clement St, San Francisco, CA 94121 USA. EM ptien@medicine.ucsf.edu FU NIAID NIH HHS [U01 AI034993, AI-34989, R01 AI052065, R01 AI052065-01, U01 AI031834, U01 AI034989, U01 AI034994, U01 AI035004, U01 AI042590, U01-AI-31834, U01-AI-34993, U01-AI-34994, U01-AI-35004, U01-AI-42590]; NICHD NIH HHS [U01 HD032632, U01-HD-32632] NR 24 TC 9 Z9 11 U1 1 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 NOV 1 PY 2004 VL 39 IS 9 BP 1363 EP 1370 DI 10.1086/424879 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 904JG UT WOS:000227491800013 PM 15494914 ER PT J AU Temple, RO Horner, MD Taylor, RM AF Temple, RO Horner, MD Taylor, RM TI Relationship of MMPI-2 anxiety and defensiveness to neuropsychological test performance and psychotropic medication use SO COGNITION & EMOTION LA English DT Article ID ATTENTIONAL BIAS; TRAIT ANXIETY; RESPONSE SET; THREAT; MEMORY; INFORMATION; STRESS AB Research has suggested an adverse effect of anxiety on cognitive functioning, and high defensive individuals may have poorer control of their anxiety than low defensive individuals. Thus, these individuals may be more likely to have a prescription for psychotropic medication. The purpose of this study was to further delineate the effects of anxiety and defensiveness on neuropsychological test performance and psychotropic medication use. Participants were 143 US veterans referred for neuropsychological evaluation. Four groups were established based on median splits on MMPI-2 approximations of anxiety and defensiveness. Anxiety and defensiveness were unrelated to neuropsychological test performance. Defensive high anxious individuals were more likely than truly high anxious individuals to have anxiolytic and narcotic prescriptions. There was also a trend toward truly low anxious participants being more likely to be prescribed anxiolytics than repressor participants. Thus, defensiveness appears to attenuate the experience of anxiety in individuals who are low, but not high, in self-reported anxiety. C1 Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC USA. Med Univ S Carolina, Charleston, SC 29425 USA. RP Temple, RO (reprint author), Brown Med Sch, Phys Off Bldg,Suite 430,593 Eddy St, Providence, RI 02903 USA. EM rtemple@lifespan.org NR 27 TC 2 Z9 2 U1 2 U2 4 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 0269-9931 J9 COGNITION EMOTION JI Cogn. Emot. PD NOV PY 2004 VL 18 IS 7 BP 989 EP 998 DI 10.1080/02699930341000012 PG 10 WC Psychology, Experimental SC Psychology GA 861SA UT WOS:000224437700007 ER PT J AU Martin, TR AF Martin, TR TI Direct lung injury by bacteria: Clarifying the tools of the trade SO CRITICAL CARE MEDICINE LA English DT Editorial Material ID ACUTE RESPIRATORY-DISTRESS; EPITHELIAL INJURY; VASCULAR LEAKAGE; TIDAL VOLUMES; RABBIT LUNGS; ENDOTOXIN; VENTILATION; EXPRESSION; PNEUMONIA; RESPONSES C1 Univ Washington, Dept Med, Div Pulm & Crit Care Med, VA Puget Sound Hlth Care Syst,Med Res Serv, Seattle, WA USA. RP Martin, TR (reprint author), Univ Washington, Dept Med, Div Pulm & Crit Care Med, VA Puget Sound Hlth Care Syst,Med Res Serv, Seattle, WA USA. NR 20 TC 2 Z9 2 U1 0 U2 0 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 NOV PY 2004 VL 32 IS 11 BP 2360 EP 2361 DI 10.1097/01.CCM.0000146135.19642.72 PG 2 WC Critical Care Medicine SC General & Internal Medicine GA 872MN UT WOS:000225211400037 PM 15640664 ER PT J AU Cavendish, JJ Fugit, RV Safani, M AF Cavendish, JJ Fugit, RV Safani, M TI Role of antiplatelet therapy in cardiovascular disease I: acute coronary syndromes SO CURRENT MEDICAL RESEARCH AND OPINION LA English DT Article DE acute coronary syndromes; antiplatelet; atherothrombosis; myocardial infarction; unstable angina ID PRACTICE GUIDELINES COMMITTEE; ASSOCIATION TASK-FORCE; ST-SEGMENT ELEVATION; MYOCARDIAL-INFARCTION; AMERICAN-COLLEGE; INTERVENTION; CLOPIDOGREL; MANAGEMENT; ASPIRIN; UPDATE AB The acute coronary syndromes (ACS), consisting of ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), and unstable angina, remain a leading cause of death in the United States. Through the process of atherothrombosis, underlying atherosclerosis can progress to an acute ischemic coronary event. This disease mechanism is also common to ischemic stroke and peripheral arterial disease. As ACS is a heterogeneous disease, accurate patient diagnosis and risk categorization is essential. Treatment approaches for both STEMI and NSTEMI ACS consist of a combination of surgical intervention and pharmacotherapy, with antiplatelet agents such as clopidogrel, aspirin and glycoprotein IIb/IIIa receptor antagonists playing an essential role. C1 USN, Ctr Med, Dept Cardiol, San Diego, CA 92134 USA. Denver Vet Affairs Med Ctr, Dept Pharm, Denver, CO USA. Univ Calif San Francisco, Long Beach Mem Med Ctr, CA & Volunteer Fac, Redondo Beach, CA USA. RP Cavendish, JJ (reprint author), USN, Ctr Med, Dept Cardiol, Bldg 3,3rd Floor,34800 Bob Wilson Dr, San Diego, CA 92134 USA. EM JJCavendish@nmcsd.med.navy.mil NR 12 TC 6 Z9 7 U1 0 U2 1 PU LIBRAPHARM PI NEWBURY PA C/O DR. PETER L CLARKE, 26-32 VENTURE WEST, NEW GREENHAM PARK, NEWBURY RG19 6HX, BERKSHIRE, ENGLAND SN 0300-7995 J9 CURR MED RES OPIN JI Curr. Med. Res. Opin. PD NOV PY 2004 VL 20 IS 11 BP 1839 EP 1843 DI 10.1185/030079904X10665 PG 5 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 876HX UT WOS:000225488600018 PM 15537484 ER PT J AU Kaunitz, JD Akiba, Y AF Kaunitz, JD Akiba, Y TI Gastroduodenal mucosal defense: role of endogenous mediators SO CURRENT OPINION IN GASTROENTEROLOGY LA English DT Article DE stomach; duodenum; injury; Helicobacter pylori; nonsteroidal anti-inflammatory drugs; proteinase-activated receptors; prostaglandin; nitric oxide ID PROTEASE-ACTIVATED RECEPTOR-1; SENSITIVE SENSORY NEURONS; GASTRIC EPITHELIAL-CELLS; NO-RELEASING ASPIRIN; GENE-RELATED PEPTIDE; HELICOBACTER-PYLORI; DUODENAL-ULCER; GROWTH-FACTOR; VANILLOID RECEPTORS; RAT STOMACH AB Purpose of review The remarkable resistance of the mucosal lining of the upper gastrointestinal tract to concentrated gastric acid remains one of the biggest unsolved mysteries of upper gastrointestinal physiology. In the past year, there have been prominent findings regarding prostaglandin subtypes, growth factors, proteinase-activated receptors, peroxisome proliferator-activated receptors, and nitric oxide releasing nonsteroidal antiinflammatory agents. Recent findings The prostaglandin I receptor subtype is involved with the mucosal acid-sensing neural circuit termed the capsaicin pathway. Proteinase-activated receptors and peroxisome proliferator activated receptor-gamma are important components of host defense against acid injury. Nitric oxide releasing nonsteroidal antiinflammatory agents have potential usefulness in subjects with mucosal injury related to the use of nonsteroidal antiinflammatory agents and may be an important alternative to selective cyclooxygenase-2 inhibitors for patients who need aspirin cotherapy for the prevention of arterial thrombus formation. Summary Peptic ulcer disease, although declining in prevalence, appears to be increasing in virulence, perhaps because of the overall aging of the population and improved care in the intensive care unit. Although Helicobacter pylori and nonsteroidal antiinflammatory agents have been identified as key pro-ulcerogenic factors, many ulcers may also result from a deficiency of other, unknown host protective factors. A more detailed understanding of the host factors involved in mucosal protection will thus help identify novel therapeutic targets aimed at the prevention and treatment of upper gastrointestinal tract mucosal injury. C1 WLAVA Med Ctr, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Div Digest Dis, CURE,David Geffen Sch Med, Ctr Digest Dis,Dept Med, Los Angeles, CA USA. Brentwood Biomed Res Inst, Los Angeles, CA USA. RP Kaunitz, JD (reprint author), Bldg 114,Suite 217 W Los Angeles VAMC, Los Angeles, CA 90073 USA. EM jake@ucla.edu NR 53 TC 10 Z9 11 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0267-1379 J9 CURR OPIN GASTROEN JI Curr. Opin. Gastroenterol. PD NOV PY 2004 VL 20 IS 6 BP 526 EP 532 DI 10.1097/00001574-200411000-00004 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 866OY UT WOS:000224784000003 PM 15703677 ER PT J AU Kilbourne, AM Pincus, HA AF Kilbourne, AM Pincus, HA TI Improving quality of care for bipolar disorder SO CURRENT OPINION IN PSYCHIATRY LA English DT Article DE quality of care; mood disorders; bipolar; guidelines ID STAFF-MODEL HMO; BIOLOGICAL TREATMENT; BRITISH-ASSOCIATION; WFSBP GUIDELINES; ACUTE MANIA; I DISORDER; PART II; COSTS; LIFE; OLANZAPINE AB Purpose of review Bipolar disorder is a chronic illness associated with significant functional impairment and health care costs. Despite the existence of clinical guidelines, outcomes for this disease remain sub-optimal. We reviewed the relevant literature concerning current efforts to improve the quality of care for bipolar disorder, highlighting advances in quality measures, practice guidelines, care improvement strategies, and other emerging trends in this field. We evaluated the recent developments in the diagnosis and treatment of bipolar disorder. Recent findings Several emerging areas of research were evident from this recent literature review, encompassing issues including detection and diagnosis (e.g. bipolar II, use of secondary data), estimating costs and burden of bipolar disorder (including lost work productivity), treatment guideline updates, the need to develop strategies for implementing guidelines, and measuring quality. Summary Additional evidence is needed to clarify the criteria for diagnosing bipolar II disorder. More research is needed to clarify guidelines regarding the treatment of specific episodes, notably bipolar depression, and to compare the different guidelines. Given the adverse impact of bipolar disorder on lost work productivity, guidelines should also cover important followup care as well as recommend best practices in social services (e.g. vocational training). Finally, system-level interventions that promote continuity of care, provider decision support, and quality measurement are needed to implement practice guidelines and subsequently improve care. C1 Univ Pittsburgh, VA Pittsburgh Ctr Hlth Equ Res & Promot, Dept Med, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. Univ Pittsburgh, VA Pittsburgh Ctr Hlth Equ Res & Promot, Dept Psychiat, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. Univ Pittsburgh, RAND, Hlth Inst, Pittsburgh, PA USA. RP Kilbourne, AM (reprint author), Univ Pittsburgh, VA Pittsburgh Ctr Hlth Equ Res & Promot, Dept Med, VA Pittsburgh Healthcare Syst, Univ Dr C, Pittsburgh, PA 15240 USA. EM Amy.Kilbourne@med.va.gov NR 34 TC 1 Z9 1 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 NOV PY 2004 VL 17 IS 6 BP 513 EP 517 DI 10.1097/00001504-200411000-00016 PG 5 WC Psychiatry SC Psychiatry GA 870TS UT WOS:000225081800015 ER PT J AU Utzschneider, KM Carr, DB Hull, RL Kodama, K Shofer, JB Retzlaff, BM Knopp, RH Kahn, SE AF Utzschneider, KM Carr, DB Hull, RL Kodama, K Shofer, JB Retzlaff, BM Knopp, RH Kahn, SE TI Impact of intra-abdominal fat and age on insulin sensitivity and beta-cell function SO DIABETES LA English DT Article ID PANCREATIC B-CELL; GLUCOSE-TOLERANCE; BODY-FAT; JAPANESE-AMERICANS; VISCERAL ADIPOSITY; MINIMAL MODEL; RESISTANCE; INTOLERANCE; SECRETION; MEN AB The prevalence of glucose intolerance and type 2 diabetes increases with age. To determine whether the hyperbolic relationship between insulin sensitivity and the insulin response is affected by age and whether the decline in beta-cell function with age is related to increases in intra-abdominal fat or age per se, we studied 220 healthy subjects with fasting glucose <6.1 mmol/l (89 men and 131 women, aged 26-75 years, BMI 18.7-40.4 kg/m(2)). The insulin sensitivity index (S-i) and the acute insulin response to glucose (AIRg) were determined, and from these beta-cell function was estimated as the disposition index (S-i x AIRg). Intra-abdominal fat and subcutaneous fat areas were quantified by computed tomography. S-i (5.40 +/- 0.5 vs. 7.86 +/- 0.7 x 10(-5) min(-1)/[pmol/l]), P < 0.01) was decreased and intra-abdominal fat (117 +/-10 vs. 81 +/- 9 cm(2), P < 0.05) was increased in the oldest (age 60-75 years) versus the youngest (age 26-44 years) quartile. The hyperbolic relationship between S-i and AIRg was present independent of age; thus, beta-cell function measured as the disposition index (1,412 +/- 120 vs. 2,125 +/- 150 x 10(-5) min(-1) P < 0.01) was lower in the oldest versus the youngest quartile. In multiple regression, intra-abdominal fat (r = -0.470, P < 0.001) but not age was associated with S-i, but both intra-abdominal fat (r = -0.198, P = 0.003) and age (r = -0.131, P = 0.05) were correlated with the disposition index. These data suggest that although intra-abdominal fat is a strong determinant of insulin sensitivity and beta-cell function, age has an independent effect on beta-cell function that may contribute to the increased prevalence of type 2 diabetes in older populations. C1 VA Puget Sound Hlth Care Syst, Harborview Med Ctr, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. Univ Washington, Div Maternal Fetal Med, Dept Obstet & Gynecol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Dept Rehabil & Res & Dev, Seattle, WA 98108 USA. RP Utzschneider, KM (reprint author), VA Puget Sound Hlth Care Syst, Harborview Med Ctr, Dept Med, Div Metab Endocrinol & Nutr, 151,1660 S Columbian Way, Seattle, WA 98108 USA. EM kutzschn@u.washington.edu FU NCRR NIH HHS [RR-37]; NHLBI NIH HHS [HL-07028, HL-30086]; NIDDK NIH HHS [DK-02456, DK-02654, DK-17047, DK-35747, DK-35816, DK-59417] NR 35 TC 42 Z9 45 U1 1 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD NOV PY 2004 VL 53 IS 11 BP 2867 EP 2872 DI 10.2337/diabetes.53.11.2867 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 867EV UT WOS:000224826000016 PM 15504967 ER PT J AU Wen, LK Shepherd, MD Parchman, ML AF Wen, LK Shepherd, MD Parchman, ML TI Family support, diet, and exercise among older Mexican Americans with type 2 diabetes SO DIABETES EDUCATOR LA English DT Article ID SELF-CARE BEHAVIORS; SOCIAL SUPPORT; MANAGEMENT; ADULTS; ADHERENCE; RECOMMENDATIONS; POPULATION; MELLITUS; EFFICACY; ENVIRONMENT AB PURPOSE The purpose of this study was to examine the relationship between diabetes-specific family support and other psychosocial factors with regard to diet and exercise self-care behavior among older Mexican Americans with type 2 diabetes. METHODS Adults aged 55 years and older who presented for care in a primary care clinic for type 2 diabetes (N= 138) completed a survey to assess family support specific to diabetes barriers to, self-management, self-efficacy, and diabetes self-care activities. Multivariate regression analyses were conducted to evaluate the relationship between family support and self-care activities for diet and exercise. RESULTS Higher levels of perceived family support and greater self-efficacy were associated with higher reported levels of diet and exercise self-care. As the barriers to exercise increased, the levels of exercise self-care decreased. Living with family members (more than just a spouse or significant other) was associated with higher levels of diet self-care, as was older age. CONCLUSIONS Family behavior is associated with diet and exercise self-care. Diabetes educators and healthcare providers should consider involving the entire family in the management of older patients with type 2 diabetes. Interventions designed to improve diabetes self-management should address family support specific to diabetes, self-efficacy, and barriers to self-care. C1 Pfizer Inc, San Antonio, TX 78258 USA. S Texas Vet Hlth Care Syst, Vet Evidence Based Res Dissemination & Implementa, VERDICT, San Antonio, TX USA. Univ Texas, Coll Pharm, Austin, TX 78712 USA. Univ Texas, Hlth Sci Ctr, Dept Family & Community Med, San Antonio, TX USA. RP Wen, LK (reprint author), Pfizer Inc, 17827 Salado Draw, San Antonio, TX 78258 USA. EM lonnie.k.wen@pfizer.com OI Parchman, Michael/0000-0001-7129-2889 NR 48 TC 88 Z9 92 U1 2 U2 12 PU AMER ASSOC DIABETES EDUCATORS PI CHICAGO PA STE 1240, 444 NORTH MICHIGAN AVE, CHICAGO, IL 60611-3901 USA SN 0145-7217 J9 DIABETES EDUCATOR JI Diabetes Educ. PD NOV-DEC PY 2004 VL 30 IS 6 BP 980 EP 993 DI 10.1177/014572170403000619 PG 14 WC Endocrinology & Metabolism; Public, Environmental & Occupational Health SC Endocrinology & Metabolism; Public, Environmental & Occupational Health GA 886LQ UT WOS:000226229200009 PM 15641619 ER PT J AU Davila, JA Morgan, RO Shaib, Y McGlynn, KA El-Serag, HB AF Davila, JA Morgan, RO Shaib, Y McGlynn, KA El-Serag, HB TI Hepatitis C infection and the increasing incidence of hepatocellular carcinoma: A population-based study SO GASTROENTEROLOGY LA English DT Article ID CHRONIC LIVER-DISEASE; UNITED-STATES; INTERFERON THERAPY; DIABETES-MELLITUS; VIRAL-HEPATITIS; VIRUS-INFECTION; RISK-FACTORS; CIRRHOSIS; CANCER AB Background & Aims: A significant increase in the incidence of hepatocellular carcinoma (HCC) has been reported in the United States. The risk factors underlying this increase remain unclear. Methods: By using Surveillance, Epidemiology, and End-Results program (SEER)-Medicare-linked data, we conducted a population-based study to examine temporal changes in risk factors for patients 65 years and older diagnosed with HCC between 1993 and 1999. Only patients with continuous Medicare enrollment for 2 years before and up to 2 years after HCC diagnosis were examined. Univariate and multiple logistic regression analyses were used to evaluate changes in risk factors over time (January 1993-June 1996 and July 1996-December 1999). Results: The age-adjusted incidence of HCC among persons 65 years of age and older significantly increased from 14.2 per 100,000 in 1993 to 18.1 per 100,000 in 1999. We identified 2584 patients with continuous Medicare enrollment 2 years before and up to 2 years after HCC diagnosis. The proportion of hepatitis C virus (HCV)-related HCC increased from 11% during January of 1993 to June of 1996 to 21% during July of 1996 to December of 1999, whereas hepatitis B virus (HBV)-related HCC increased from 6% to 11% (P < .0001). In multiple logistic regression analyses that adjusted for age, sex, race, and geographic region, the risk for HCV-related HCC and HBV-related HCC increased by 226% and 67%, respectively. Idiopathic HCC decreased from 43% to 39%. This decrease did not fully account for the significant increases observed for HCV and HBV. No significant changes over time were observed for alcohol-induced liver disease, nonspecific cirrhosis, or nonspecific hepatitis. Conclusions: There has been a significant recent increase in HCV- and HBV-related HCC. Increasing rates of HCV-related HCC can explain a substantial proportion of the reported increase in HCC incidence during recent years. C1 Houston Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. NCI, Div Canc Epidemiol & Genet, Dept Hlth & Human Serv, Bethesda, MD 20892 USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr, Sect Hlth Serv Res, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu RI Morgan, Robert/A-8577-2009 NR 23 TC 286 Z9 298 U1 1 U2 6 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 NOV PY 2004 VL 127 IS 5 BP 1372 EP 1380 DI 10.1053/j.gastro.2004.07.020 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 870IC UT WOS:000225049800012 PM 15521006 ER PT J AU El-Serag, HB AF El-Serag, HB TI Hepatocellular carcinoma: Recent trends in the United States SO GASTROENTEROLOGY LA English DT Article; Proceedings Paper CT Workshop on Hepatocellular Carcinoma CY APR 01-03, 2004 CL Bethesda, MD ID PRIMARY LIVER-CANCER; HEPATITIS-C VIRUS; DIABETES-MELLITUS; RISK-FACTORS; NONALCOHOLIC STEATOHEPATITIS; VIRAL-HEPATITIS; DISEASE; POPULATION; PREVALENCE; INFECTION AB Hepatocellular carcinoma (HCC) is increasing in frequency in the United States. The age-adjusted incidence rates have doubled over the past 2 decades. Similar increases have affected the mortality and hospitalization rates. Although there has been a small recent improvement in survival, it remains generally dismal (median, 8 months). It is estimated that 8500 to 11,500 new cases of HCC occur annually in the United States. There are striking differences in the incidence of HCC related to age, gender, race, and geographic region. Although it remains an affliction of the elderly (mean age, 65 years) population, there has been a shift toward relatively younger age cases. Men are affected 3 times more frequently than women, Asians are affected 2 times more than blacks, and Hispanics are affected 2 times more often than whites. However, the recent increase has disproportionately affected white (and Hispanic) men between ages 45 and 65 years. The temporal changes of risk factors among HCC cases in the United States remain unclear. However, available studies indicate that hepatitis C virus (HCV) infection acquired 2-4 decades ago explains at least half of the observed increase in HCC; HCV-related HCC is likely to continue to increase for the next decade. A variable but significant proportion of cases (15% to 50%) do not have evidence of the risk factors of viral hepatitis or heavy alcohol consumption, The insulin resistance syndrome, manifesting as obesity and diabetes, is emerging as a risk factor for HCC in the United States; however, its impact on the current trend in HCC remains unclear. C1 Michael E DeBakey Vet Adm Med Ctr, Houston, TX USA. Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu RI Jepsen, Peter/A-2593-2010 OI Jepsen, Peter/0000-0002-6641-1430 NR 37 TC 601 Z9 614 U1 3 U2 11 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 NOV PY 2004 VL 127 IS 5 SU 1 BP S27 EP S34 DI 10.1053/j.gastro.2004.09.013 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 871TJ UT WOS:000225156200004 PM 15508094 ER PT J AU Carey, K Dor, A AF Carey, K Dor, A TI Trends in contract management: The hidden evolution in hospital organization SO HEALTH AFFAIRS LA English DT Article ID MARKET-STRUCTURE; COMPETITION; EMPLOYMENT; IMPACT AB Contract management is an arrangement whereby the day-to-day operation of the hospital is contracted to an outside organization. In the past two decades there has been dramatic growth in the number of hospitals opting for contract management, yet surprisingly little attention has been paid to this phenomenon. Using national data, we report trends and demonstrate that adoption of contracts results in decreases in service offerings more often than increases. Since contract-managed hospitals tend to be located in rural areas, this raises concerns regarding access to care. On the other hand, contract management may allow distressed hospitals to survive. C1 Boston Univ, Sch Publ Hlth, Boston, MA 02215 USA. US Dept Vet Affairs, Management Sci Grp, Bedford, MA USA. Case Western Reserve Univ, Weatherhead Sch Management, Cleveland, OH 44106 USA. Natl Bur Econ Res, Cambridge, MA 02138 USA. RP Carey, K (reprint author), Boston Univ, Sch Publ Hlth, Boston, MA 02215 USA. EM Kathleen.Carey@med.va.gov OI Carey, Kathleen/0000-0002-7924-431X NR 22 TC 4 Z9 4 U1 1 U2 1 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD NOV-DEC PY 2004 VL 23 IS 6 BP 192 EP 199 DI 10.1377/hlthaff.23.6.192 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 909CF UT WOS:000227835800026 PM 15537598 ER PT J AU Davis-Michaud, M Yurk, R Lansky, D Asch, S Wu, AW AF Davis-Michaud, M Yurk, R Lansky, D Asch, S Wu, AW TI Quality care for people with HIV/AIDS: Patients perspectives SO HIV CLINICAL TRIALS LA English DT Article DE evaluation studies; focus groups; human immunodeficiency virus; outcomes assessment (health care); patient satisfaction; quality of care ID HUMAN-IMMUNODEFICIENCY-VIRUS; HIV-INFECTED ADULTS; UNITED-STATES; DRUG-THERAPY; OF-LIFE; HEALTH; SERVICES; DISEASE; RELIABILITY; STRATEGIES AB Purpose: To explore patient preferences to aid in the development of quality measures to assess quality of health care for people living with human immunodeficiency virus/acquired immunodeficiency disease (HIV/AIDS). Method: This study involved three 2-hour focus groups with 29 people living with HIV/AIDS in Portland, Oregon, and San Francisco, California. Eighteen quality of care indicators for HlV/AlDS health care were presented to each group and quantitative rankings were obtained. Aggregated weightings were used to rank and prioritize the quality measures for further exploration. Results: Participants identified 38 themes relevant to high-quality care for HIV/AIDS. Patients ranked the following candidate measures most important: effective relationship with provider, prevention of opportunistic infections, involvement in care and treatment decisions, being offered antiretroviral treatment, and access to health care services. We observed attitudinal differences among focus group participants that corresponded to gender and race/ethnicity. Conclusion: Participants favored quality information that rated the experience of care and outcome measures including indicators of access to services, standard treatments, and competence of the providers. Patient perspectives can inform the development of quality measures that are meaningful to consumers and can assist in the design of services that meet patients' demographic and socioeconomic needs. C1 Johns Hopkins Univ, Hlth Serv Res, Bloomberg Sch Publ Hlth, Baltimore, MD 21205 USA. Portland VA Med Ctr, Med Serv, Portland, OR USA. Fdn Accountabil, Portland, OR USA. RAND Corp, Los Angeles, CA USA. Vet Adm Healthcare Syst, Los Angeles, CA USA. RP Wu, AW (reprint author), Johns Hopkins Univ, Hlth Serv Res, Bloomberg Sch Publ Hlth, 624 N Broadway, Baltimore, MD 21205 USA. EM awu@jhsph.edu NR 40 TC 8 Z9 9 U1 0 U2 0 PU THOMAS LAND PUBLISHERS, INC PI ST LOUIS PA 255 JEFFERSON RD, ST LOUIS, MO 63119 USA SN 1528-4336 J9 HIV CLIN TRIALS JI HIV Clin. Trials PD NOV-DEC PY 2004 VL 5 IS 6 BP 406 EP 415 PG 10 WC Infectious Diseases; Pharmacology & Pharmacy SC Infectious Diseases; Pharmacology & Pharmacy GA 894NY UT WOS:000226800000006 PM 15682354 ER PT J AU Franco, V Chen, YF Oparil, S Feng, JA Wang, DJ Hage, F Perry, G AF Franco, V Chen, YF Oparil, S Feng, JA Wang, DJ Hage, F Perry, G TI Atrial natriuretic peptide dose-dependently inhibits pressure overload-induced cardiac remodeling SO HYPERTENSION LA English DT Article DE atrial natriuretic factor; natriuretic peptides; receptors, atrial natriuretic factor; hypertrophy, cardiac; remodeling; extracellular matrix; collagen ID CLEARANCE-RECEPTOR GENE; GUANYLYL CYCLASE-A; MATRIX METALLOPROTEINASES; ESSENTIAL-HYPERTENSION; INDEPENDENT ENHANCEMENT; TRANSGENIC MICE; DEFICIENT MICE; NITRIC-OXIDE; HYPERTROPHY; EXPRESSION AB We hypothesized that a single copy of the proatrial natriuretic peptide gene (Nppa(+/-)) would not be adequate to protect heterozygous mice against exaggerated cardiac hypertrophy and remodeling after pressure-overload stress. Nppa(+/+), Nppa(+/-), and Nppa(-/-) mice were subjected to sham surgery or transverse aortic constriction and fed a basal salt diet. Heart weight varied inversely with Nppa gene load by 1 week after either surgery. Fractional shortening did not differ among genotypes at baseline and fell in Nppa(-/-) mice only after transverse aortic constriction. There was a graded response in collagen deposition related to atrial natriuretic peptide (ANP) expression after either surgery. A robust interstitial and perivascular fibrosis was noted in Nppa(-/-) and Nppa(+/-) but not in Nppa(+/+) mice after transverse aortic constriction. Our findings are consistent with a growing body of evidence that ANP is an important modulator of cardiac hypertrophy and remodeling in response to hemodynamic stress. The observation that partial ANP deficiency results in exaggerated hypertrophy and remodeling after pressure overload suggests that genetic or environmental variation in ANP levels may play a role in the development of cardiac hypertrophy, remodeling, and failure in humans. C1 Univ Alabama, Div Cardiovasc Dis, Vasc Biol & Hypertens Program, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Cardiol Sect, Birmingham, AL USA. RP Franco, V (reprint author), Univ Alabama, Div Cardiovasc Dis, Vasc Biol & Hypertens Program, ZRB 1024,703 19th St S, Birmingham, AL 35294 USA. EM vfranco@uab.edu RI Franco, Veronica/E-3080-2011 OI Hage, Fadi/0000-0002-1397-4942 FU NHLBI NIH HHS [HL07457, HL44195] NR 34 TC 50 Z9 51 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0194-911X J9 HYPERTENSION JI Hypertension PD NOV PY 2004 VL 44 IS 5 BP 746 EP 750 DI 10.1161/01.HYP.0000144801.09557.4c PG 5 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 866GI UT WOS:000224761500029 PM 15452027 ER PT J AU Ding, D Cooper, RA Guo, SF Corfman, TA AF Ding, D Cooper, RA Guo, SF Corfman, TA TI Analysis of driving backward in an electric-powered wheelchair SO IEEE TRANSACTIONS ON CONTROL SYSTEMS TECHNOLOGY LA English DT Article DE directional stability control; electric-powered wheelchair; reverse driving; simulation; wheelchair dynamics model ID STABILITY; MODEL AB The purpose of this study was to examine the influences of caster orientations and driving speeds on the reverse directional stability of electric-powered wheelchairs. An experiment was set up to record wheelchair trajectories and ground reaction forces/moments for the front caster wheels and rear wheels when a wheelchair initiates reverse motions at six initial caster orientations and three desired driving speeds. A kinematic model as well as a dynamic model were developed to simulate the wheelchair motion and conduct a parametric study of different factors on wheelchair reverse directional stability. The experimental and simulation results show agreement, both of which indicate that different caster orientations at the start of reverse driving introduce disturbances and the faster the intended speed, the less deviation of the wheelchair from its desired heading. The center of gravity (CG) was also found to be a dominant influence on the reverse directional stability of power wheelchairs. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA 15026 USA. Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Rehabil Sci & Technol, Human Engn Res Labs, Pittsburgh, PA 15026 USA. Univ Pittsburgh, Sch Engn, Dept Bioengn, Pittsburgh, PA 15260 USA. RP VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA 15026 USA. EM dad5@pitt.edu; rcooper@pitt.edu; sguo@pitt.edu; corfmant@herlpitt.org NR 21 TC 18 Z9 18 U1 0 U2 2 PU IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC PI PISCATAWAY PA 445 HOES LANE, PISCATAWAY, NJ 08855-4141 USA SN 1063-6536 EI 1558-0865 J9 IEEE T CONTR SYST T JI IEEE Trans. Control Syst. Technol. PD NOV PY 2004 VL 12 IS 6 BP 934 EP 943 DI 10.1109/TCST.2004.833638 PG 10 WC Automation & Control Systems; Engineering, Electrical & Electronic SC Automation & Control Systems; Engineering GA 865GI UT WOS:000224690200011 ER PT J AU LaVela, SL Smith, B Weaver, FM Legro, MW Goldstein, B Nichol, K AF LaVela, SL Smith, B Weaver, FM Legro, MW Goldstein, B Nichol, K TI Attitudes and practices regarding influenza vaccination among healthcare workers providing services to individuals with spinal cord injuries and disorders SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID LONG-TERM-CARE; RANDOMIZED CONTROLLED-TRIAL; PLACEBO-CONTROLLED TRIAL; NOSOCOMIAL INFLUENZA; NURSING-HOMES; PNEUMOCOCCAL VACCINATION; ADVERSE REACTIONS; ELDERLY PATIENTS; WORKING ADULTS; MORTALITY AB OBJECTIVE: To examine influenza vaccination status and predictors for vaccine receipt among healthcare workers (HCWs) caring for patients with spinal cord injuries and disorders. DESIGN: Cross-sectional, nationwide anonymous survey. SETTING: Twenty-three Veterans Affairs spinal cord injury centers. PARTICIPANTS: One thousand five hundred fifty-six HCWs. METHODS: the primary outcome was staff vaccination status. Independent variables included staff demographic and employment characteristics, health status, attitudes and beliefs about the vaccine, and implications for its use. RESULTS: The staff vaccination rate was 51%. Leading motivators of vaccine receipt were self-protection (77%) and patient protection (49%). The most common reasons for nonreceipt were concerns about side effects (49%), preventive quality (20%), and inconvenience (14%). Logistic regression results suggested that age of 50 years or older (OR, 1.47; P =.021), male gender (OR, 2.50; P <.001), strong belief in vaccine effectiveness (OR, 19.03; P =.008), and importance of HCW vaccination (OR, 20.50; P =.005) significantly increased the probability of vaccination. Recommending the vaccine to coworkers, patients, or patients' families was also associated with HCW vaccination (OR, 3.20; P <.001). Providers who did not believe the vaccine was protective (P <.001) or effective (P <.001) were less likely to recommend it to patients. CONCLUSIONS: Strategies to increase vaccination rates among HCWs should address concerns about side effects, effectiveness, and protective value of the vaccine and access to it. The impact of provider recommendations should be stressed. Vaccination and subsequent prevention of illness may limit morbidity and mortality, thus benefiting HCWs, healthcare facilities, and patients (Infect Control Hosp Epidemiol 2004;25:933-940). C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Spinal Cord Injury Quality Enhancement Res Initia, Midwest Ctr Hlth Serv & Policy Res, Hines, IL 60141 USA. Northwestern Univ, Inst Hlth Serv Res & Policy Studies, Chicago, IL 60611 USA. Puget Sound Hlth Care Syst, Spinal Cord Injury Qual Enhancement Res Initiat, Hlth Serv Res & Dev, Seattle, WA USA. US Dept Vet Affairs, Spinal Cord Injury & Disorders Strateg Healthcare, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. US Dept Vet Affairs, Dept Rehabil Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. US Dept Vet Affairs, Minneapolis Vet Affairs Med Ctr, Med Serv, Minneapolis, MN USA. RP LaVela, SL (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Spinal Cord Injury Quality Enhancement Res Initia, Midwest Ctr Hlth Serv & Policy Res, 151-H, Hines, IL 60141 USA. NR 68 TC 57 Z9 60 U1 0 U2 1 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD NOV PY 2004 VL 25 IS 11 BP 933 EP 940 DI 10.1086/502323 PG 8 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 870TA UT WOS:000225079800015 PM 15566027 ER PT J AU Jubran, A AF Jubran, A TI Pulse oximetry SO INTENSIVE CARE MEDICINE LA English DT Article C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Hines, IL 60141 USA. RP Jubran, A (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Route 111 N, Hines, IL 60141 USA. EM ajubran@lumc.edu NR 11 TC 59 Z9 60 U1 0 U2 6 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0342-4642 J9 INTENS CARE MED JI Intensive Care Med. PD NOV PY 2004 VL 30 IS 11 BP 2017 EP 2020 DI 10.1007/s00134-004-2399-x PG 4 WC Critical Care Medicine SC General & Internal Medicine GA 869AZ UT WOS:000224956000005 PM 15278272 ER PT J AU Coviello, AD Bremner, WJ Matsumoto, AM Herbst, KL Amory, JK Anawalt, BD Yan, XH Brown, TR Wright, WW Zirkin, BR Jarow, JP AF Coviello, AD Bremner, WJ Matsumoto, AM Herbst, KL Amory, JK Anawalt, BD Yan, XH Brown, TR Wright, WW Zirkin, BR Jarow, JP TI Intratesticular testosterone concentrations comparable with serum levels are not sufficient to maintain normal sperm production in men receiving a hormonal contraceptive regimen SO JOURNAL OF ANDROLOGY LA English DT Article DE intratesticular androgens; spermatogenesis; gonadotropins; progestogens ID FOLLICLE-STIMULATING-HORMONE; EXOGENOUSLY ADMINISTERED TESTOSTERONE; GONADOTROPIN-RELEASING-HORMONE; HUMAN CHORIONIC-GONADOTROPIN; CYPROTERONE-ACETATE; LUTEINIZING-HORMONE; INDUCED AZOOSPERMIA; ADULT-RATS; SPERMATOGENESIS; SUPPRESSION AB Intratesticular testosterone (ITT) is thought to play a key role in the control of spermatogenesis in man but is rarely measured. The purposes of this study were 1) to examine the relationship between intratesticular fluid and serum testosterone (T) at baseline and during treatment with a contraceptive regimen known to suppress spermatogenesis and 2) to measure intratesticular fluid androgenic bioactivity. Seven men received 6 months of T enanthate (TE) 100 mg weekly intramuscularly plus levonorgestrel (LNG) 62.5 or 31.25 mug orally daily. Testicular fluid was obtained by percutaneous aspiration at baseline and during month 6. Mean luteinizing hormone (LH) was suppressed 98% from 3.79 +/- 0.80 IU/L at baseline to 0.08 +/- 0.03 IU/L. Mean follicle stimulating hormone (FSH) was suppressed 97%, from 3.29 +/- 0.67 IU/ L to 0.10 +/- 0.03 IU/L. Mean serum T levels were similar before (22.8 +/- 1.9 nmol/L) and during treatment (28.7 +/- 2.0 nmol/L) (P = .12). ITT (822 +/- 136 nmol/L) was similar to40X higher than serum T (P < .001) at baseline. ITT was suppressed 98% during treatment to 13.1 +/- 4.5 nmol/L, a level similar to baseline serum T (P = .08) but significantly lower than on-treatment serum T (P = .01). At baseline, intratesticular fluid androgenic bioactivity (583 +/- 145 nmol/L) was 70% of the ITT concentration measured by radioimmunoassay. Intratesticular androgenic bioactivity was suppressed 93% to 40 +/- 22 nmol/L (P < .01) during treatment, but was 3X higher than ITT (13.1 +/- 4.5 nmol/L). Sperm counts declined from 65 +/- 15 million/mL to 1.3 +/- 1.3 million/mL. In summary, TE plus LNG dramatically suppressed ITT (98%) and intratesticular androgenic bioactivity (93%) to levels approximating those in serum. ITT levels comparable with serum T were insufficient to support normal spermatogenesis. Intratesticular androgenic bioactivity was higher than ITT during treatment, suggesting that other androgens may be prevalent in the low-ITT environment. C1 Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Univ Washington, Sch Med, Geriatr Res Educ & Clin Ctr, Seattle, WA USA. Johns Hopkins Sch Publ Hlth, Dept Biochem, Baltimore, MD USA. Johns Hopkins Sch Publ Hlth, Dept Biol Mol, Baltimore, MD USA. Johns Hopkins Univ, Sch Med, Dept Urol, Baltimore, MD USA. RP Coviello, AD (reprint author), Northwestern Univ, Feinberg Sch Med, Tarry 15-751,303 Chicago Ave, Chicago, IL 60611 USA. EM a-coviello@northwestern.edu FU NICHD NIH HHS [T32HD07453, U54HD12629, U54 HD36209, HD44258, U54HD42454] NR 32 TC 43 Z9 43 U1 0 U2 1 PU AMER SOC ANDROLOGY, INC PI LAWRENCE PA C/O ALLEN PRESS, INC PO BOX 368, LAWRENCE, KS 66044 USA SN 0196-3635 J9 J ANDROL JI J. Androl. PD NOV-DEC PY 2004 VL 25 IS 6 BP 931 EP 938 PG 8 WC Andrology SC Endocrinology & Metabolism GA 865NE UT WOS:000224709000015 PM 15477366 ER PT J AU Lee, SD Kearney, DJ AF Lee, SD Kearney, DJ TI A randomized controlled trial of gastric lavage prior to endoscopy for acute upper gastrointestinal bleeding SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Society-for-Gastrointestinal-Endoscopy CY MAY 20-23, 2001 CL ATLANTA, GA SP Amer Soc Gastrointestinal Endoscopy DE upper gastrointestinal bleeding; gastric lavage; endoscopy; esophagogastroduodenoscopy ID HEMORRHAGE AB Goals: We hypothesized that large volume gastric lavage prior to endoscopy for acute upper gastrointestinal bleeding would improve the quality of endoscopic examination. Background: Blood retained in the stomach can impair visualization during esophagogastroduodenoscopy. Patients with acute upper gastrointestinal bleeding and a retained gastric fundic pool during endoscopy may have worse outcomes than patients without a retained fundic pool. No trials to date have evaluated if large volume gastric lavage prior to endoscopy improves visualization during acute upper gastrointestinal bleeding. Study Methods: Patients with acute upper gastrointestinal bleeding were randomized to esophagogastroduodenoscopy alone or large volume tap water gastric lavage prior to esophagogastroduodenoscopy. The quality of endoscopic visualization was assessed using a 5-point scale. Clinical outcomes were compared for lavaged and nonlavaged patients. Results: A total of 39 patients were randomized. In 1 patient, lavage was unsuccessful. The quality of visualization was not significantly different between groups for the esophagus, gastric antrum, or duodenum but was significantly better for the gastric fundus for patients randomized to lavage (P = 0.02). There was no significant difference between groups for ability to define a bleeding source, achieve hemostasis, recurrent bleeding, need for repeat endoscopy, and length of stay or death. There were no complications. Conclusions: Large volume gastric lavage prior to esophagogastroduodenoscopy for acute upper gastrointestinal bleeding is safe and provides better visualization of the gastric fundus. C1 Univ Washington, Sch Med, Med Ctr, Div Gastroenterol,Gastroenterol Sect, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Lee, SD (reprint author), Univ Washington, Sch Med, Med Ctr, Div Gastroenterol,Gastroenterol Sect, 1959 NE Pacific Ave,Box 356424, Seattle, WA 98195 USA. EM leesd@u.washington.edu NR 9 TC 27 Z9 28 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 NOV-DEC PY 2004 VL 38 IS 10 BP 861 EP 865 DI 10.1097/00004836-200411000-00005 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 865QR UT WOS:000224718100005 PM 15492601 ER PT J AU Hussein, MR Al-Badaiwy, ZH Guirguis, MN AF Hussein, MR Al-Badaiwy, ZH Guirguis, MN TI Analysis of p53 and bcl-2 protein expression in the non-tumorigenic, pretumorigenic, and tumorigenic keratinocytic hyperproliferative lesions SO JOURNAL OF CUTANEOUS PATHOLOGY LA English DT Article ID SQUAMOUS-CELL CARCINOMA; ORAL LICHEN-PLANUS; NONMELANOMA SKIN CANCERS; EPIDERMODYSPLASIA-VERRUCIFORMIS; ACTINIC KERATOSIS; SOLAR KERATOSIS; APOPTOSIS; PROLIFERATION; GENE; DNA AB Background: The hyperproliferative keratinocytic lesions encompass a wide range of non-tumorigenic, pretumorigenic, and tumorigenic conditions. The aim of this work was to examine the expression patterns of apoptosis-linked molecules (bcl-2 and p53) in these lesions. Methods: Immunoperoxidase staining methods were applied to analyze p53 and bcl-2 protein expression in a total of 66 cases, including 12 squamous cell carcinomas (both in situ and invasive SCC), 11 actinic keratoses (AK), 13 psoriasis vulgaris (PV), eight verruca vulgaris (VV), six chronic dermatitis (CD), five seborrheic keratosis (SK), four lichen planus (LP), three epidermodysplasia verruciformis (EDV), two condyloma acuminata (CA), two lichen simplex chronicus (LSC), and 10 specimens from normal skin. Results: As compared to normal skin (0.70 +/- 0.26), the bcl-2 average weighted scores in the non-tumorigenic (0.76 +/- 0.16), pretumorigenic (1.45 +/- 0.28), and tumorigenic lesions (2.83 +/- 0.50 and 2.92 +/- 0.50 for in situ and invasive SCC, respectively) showed significant up-regulation (p = 0.001). In the non-tumorigenic lesions, the bcl-2 expression values decreased in the following order: SK > EDV > CD > LP > CA > PV > VV (1.40 +/- 0.24 > 1.33 +/- 0.67 > 0.83 +/- 0.40 > 0.67 +/- 0.21 > 0.50 +/- 0.20 > 0.46 +/- 0.22 > 0.13 +/- 0.01, respectively). As compared to normal skin (1.10 +/- 0.23), the p53 average weighted scores in the non-tumorigenic (1.86 +/- 0.18), pretumorigenic (3.64 +/- 0.53), and tumorigenic lesions (5.00 +/- 1.00 and 5.08 +/- 0.86 for in situ and invasive SCC, respectively) showed significant up-regulation (p = 0.021). In the non-tumorigenic lesions, p53 average weighted scores decreased in the following order: SK > PV > CA > LP > CD > VV > EDV (3.20 +/- 0.49 > 2.38 +/- 0.27 > 2.0 +/- 0.0 > 1.83 +/- 0.48 > 1.0 +/- 0.37 > 1.0 +/- 0.33 > 1.0 0.0, respectively). There was a positive correlation between bcl-2 and p53 protein expression in normal skin (r = 0.966, p = 0.0001), non-tumorigenic (r = 0.775, p = 0.0001), pretumorigenic (r = 0.830, p = 0.001), and tumorigenic lesions (r = 0.757, p = 0.003). Conclusions: Bcl-2 and p53 proteins are altered in the keratinocytic hyperproliferative lesions. Determination of whether these alterations reflect underlying gene mutations will require further investigations. C1 Assiut Univ, Fac Med, Dept Pathol, Assiut, Egypt. S Valley Univ, Fac Med, Assiut, Egypt. Univ Wisconsin, Sch Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Hussein, MR (reprint author), Assiut Univ, Fac Med, Dept Pathol, Assiut, Egypt. EM mrh17@swissinfo.org NR 63 TC 44 Z9 45 U1 0 U2 1 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 NOV PY 2004 VL 31 IS 10 BP 643 EP 651 DI 10.1111/j.0303-6987.2004.00244.x PG 9 WC Dermatology; Pathology SC Dermatology; Pathology GA 867SM UT WOS:000224862500002 PM 15491323 ER PT J AU Peck, BM Ubel, PA Roter, DL Goold, SD Asch, DA Jeffreys, AS Grambow, SC Tulsky, JA AF Peck, BM Ubel, PA Roter, DL Goold, SD Asch, DA Jeffreys, AS Grambow, SC Tulsky, JA TI Do unmet expectations for specific tests, referrals, and new medications reduce patients' satisfaction? SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE patient expectations; patient satisfaction; veterans ID PATIENTS DESIRES; PHYSICIAN RELATIONSHIP; REQUEST FULFILLMENT; DECISION-MAKING; OFFICE PRACTICE; CARE; PERCEPTIONS; OUTCOMES; INTERVIEW; ENCOUNTER AB BACKGROUND: Patient-centered care requires clinicians to recognize and act on patients' expectations. However, relatively little is known about the specific expectations patients bring to the primary care visit. OBJECTIVE: To describe the nature and prevalence of patients' specific expectations for tests, referrals, and new medications, and to examine the relationship between fulfillment of these expectations and patient satisfaction. DESIGN: Prospective cohort study. SETTING: VA general medicine clinic. PATIENTS/PARTICIPANTS: Two hundred fifty-three adult male outpatients seeing their primary care provider for a scheduled visit. MEASUREMENTS AND MAIN RESULTS: Fifty-six percent of patients reported at least 1 expectation for a test, referral, or new medication. Thirty-one percent had 1 expectation, while 25% had 2 or more expectations. Expectations were evenly distributed among tests, referrals, and new medications (37%, 30%, and 33%, respectively). Half of the patients who expressed an expectation did not receive one or more of the desired tests, referrals, or new medications. Nevertheless, satisfaction was very high (median of 1.5 for visit-specific satisfaction on a 1 to 5 scale, with 1 representing "excellent"). Satisfaction was not related to whether expectations were met or unmet, except that patients who did not receive desired medications reported lower satisfaction. CONCLUSIONS: Patients' expectations are varied and often vague. Clinicians trying to implement the values of patient-centered care must be prepared to elicit, identify, and address many expectations. C1 Univ Oklahoma, Hlth Sci Ctr, Dept Hlth Adm & Policy, Coll Publ Hlth, Oklahoma City, OK 73104 USA. Vet Adm Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC 27705 USA. Duke Univ, Med Ctr, Dept Biostat & Bioinformat, Durham, NC USA. Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. Philadelphia VA Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Ann Arbor VA Med Ctr, Ann Arbor, MI USA. Univ Michigan, Med Ctr, Ann Arbor, MI USA. Johns Hopkins Sch Publ Hlth, Baltimore, MD USA. RP Peck, BM (reprint author), Univ Oklahoma, Hlth Sci Ctr, Dept Hlth Adm & Policy, Coll Publ Hlth, 801 NE 13th St, Oklahoma City, OK 73104 USA. EM bmitchellpeck@tamu.edu RI Roter, Debra/N-8830-2014; Grambow, Steven/E-1422-2015 OI Grambow, Steven/0000-0001-6037-3253; Goold, Susan Dorr/0000-0002-0258-9774 NR 50 TC 41 Z9 41 U1 0 U2 4 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 NOV PY 2004 VL 19 IS 11 BP 1080 EP 1087 DI 10.1111/j.1525-1497.2004.30436.x PG 8 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 867TJ UT WOS:000224864900002 PM 15566436 ER PT J AU Budoff, JE AF Budoff, JE TI The prevalence of rotator cuff weakness in patients with injured hands SO JOURNAL OF HAND SURGERY-AMERICAN VOLUME LA English DT Article DE hand injury; rotator cuff; weakness; shoulder-hand ID HELD DYNAMOMETRY; REHABILITATION PROGRAM; ISOKINETIC DYNAMOMETRY; SHOULDER STRENGTH; MUSCLE STRENGTH; BREAK TESTS; RELIABILITY; INHIBITION; REFLEX; TORQUE AB Purpose: The purpose of this study was to document bilateral rotator cuff strength in patients with unilateral hand or wrist disorders. Methods: Fifty-seven patients who had suffered a unilateral injury or disorder isolated to their hand or wrist, distal to the distal radius, had their bilateral rotator cuff strength measured. Results: A statistically significant decrease in strength was found in the ipsilateral shoulder for both elevation in the plane of the scapula (supraspinatus) and for elevated external rotation (infraspinatus). Younger patients and the nondominant extremity were affected more adversely. Conclusions: An increased prevalence of rotator cuff weakness is shown proximal to ipsilateral hand injuries or disorders. Copyright (C) 2004 by the American Society for Surgery of the Hand. C1 Baylor Coll Med, Dept Orthopaed Surg, Hand & Upper Extrem Inst, Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Budoff, JE (reprint author), Baylor Coll Med, Dept Orthopaed Surg, Hand & Upper Extrem Inst, Houston Vet Affairs Med Ctr, 6550 Fannin,2525, Houston, TX 77030 USA. RI Lempereur, Mathieu/G-5470-2012 NR 37 TC 4 Z9 4 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 0363-5023 J9 J HAND SURG-AM JI J. Hand Surg.-Am. Vol. PD NOV PY 2004 VL 29A IS 6 BP 1154 EP 1159 DI 10.1016/j.jhsa.2004.06.006 PG 6 WC Orthopedics; Surgery SC Orthopedics; Surgery GA 876SQ UT WOS:000225518200027 PM 15576231 ER PT J AU Rosen, HR Hinrichs, DJ Leistikow, RL Callender, GC Wertheimer, AM Nishimura, MI Lewinsohn, DM AF Rosen, HR Hinrichs, DJ Leistikow, RL Callender, GC Wertheimer, AM Nishimura, MI Lewinsohn, DM TI Cutting edge: Identification of hepatitis C virus-specific CD8(+) T cells restricted by donor HLA alleles following liver transplantation SO JOURNAL OF IMMUNOLOGY LA English DT Article ID CLASS-I MOLECULES; INFECTION; LYMPHOCYTES; MECHANISMS; ANTIGEN AB By necessity, human liver transplantation is performed across HLA barriers. As a result, intracellular infection of the allograft presents a unique immunologic challenge for the recipient's immune system. In this study, we describe the presence of HLA-A2-restricted, hepatitis C virus (HCV)-specific CD8(+) T cells in liver transplant recipients in whom the allograft is HLA-A2 positive and the recipient is HLA-A2 negative. These memory-effector T cells are recipient derived and recognize HCV peptide uniquely in the context of HLA-A2. Furthermore, these cells were absent before the transplant, suggesting that the allograft is capable of selectively expanding naive CD8(+) T cells. The in vitro specificity to donor HLA allele-restricted CD8(+) T cells suggests that these cells may function to control HCV spread in the allograft. C1 Oregon Hlth Sci Univ, Hepatol & Liver Transplantat Program, Portland Vet Affairs Med Ctr, Portland, OR 97207 USA. Portland Vet Affairs Med Ctr, Res Serv, Portland, OR 97207 USA. Portland Vet Affairs Med Ctr, Div Pulm & Crit Care, Portland, OR 97207 USA. Univ Chicago, Dept Surg, Chicago, IL 60637 USA. RP Rosen, HR (reprint author), Oregon Hlth Sci Univ, Hepatol & Liver Transplantat Program, Portland Vet Affairs Med Ctr, 3710 SW US Vet Hosp Rd,P3-GI, Portland, OR 97207 USA. EM rosenhu@ohsu.edu RI Lewinsohn, David/I-4936-2013 OI Lewinsohn, David/0000-0001-9906-9494 FU NCI NIH HHS [CA102280, CA90873]; NIDDK NIH HHS [R01 DK060590] NR 20 TC 32 Z9 32 U1 0 U2 0 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD NOV 1 PY 2004 VL 173 IS 9 BP 5355 EP 5359 PG 5 WC Immunology SC Immunology GA 864XH UT WOS:000224665900005 PM 15494481 ER PT J AU Klyushnenkova, E Link, J Oberle, W Kodak, J Rich, C Vandenbark, A Alexander, R AF Klyushnenkova, E Link, J Oberle, W Kodak, J Rich, C Vandenbark, A Alexander, R TI Identification of HLA-DRB1*1501-restricted T cell epitopes from prostate-specific antigen (PSA) using DR2b transgenic mice SO JOURNAL OF IMMUNOTHERAPY LA English DT Meeting Abstract CT 19th Annual Scientific Meeting of the International-Society-for-Biological-Therapy-of-Cancer CY NOV 04-07, 2004 CL San Francisco, CA SP Int Soc Biol Therapy Canc C1 VA Maryland Hlth Care Syst, Urol Sect, Baltimore, MD USA. Univ Maryland, Sch Med, Div Urol, Baltimore, MD 21201 USA. Portland VA Med Ctr, Dept Neuroimmunol, Portland, OR 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 1524-9557 J9 J IMMUNOTHER JI J. Immunother. PD NOV-DEC PY 2004 VL 27 IS 6 BP S25 EP S25 DI 10.1097/00002371-200411000-00091 PG 1 WC Oncology; Immunology; Medicine, Research & Experimental SC Oncology; Immunology; Research & Experimental Medicine GA 868GT UT WOS:000224902800092 ER PT J AU Corless, CL McGreevey, L Town, A Schroeder, A Bainbridge, T Harrell, P Fletcher, JA Heinrich, MC AF Corless, CL McGreevey, L Town, A Schroeder, A Bainbridge, T Harrell, P Fletcher, JA Heinrich, MC TI KIT gene deletions at the intron 10 exon 11 boundary in GI stromal tumors SO JOURNAL OF MOLECULAR DIAGNOSTICS LA English DT Article ID OF-FUNCTION MUTATIONS; GERMLINE MUTATION; C-KIT; TYROSINE KINASE; JUXTAMEMBRANE REGION; PHASE-I; IMATINIB; DOMAIN; ASSOCIATION; ACTIVATION AB Most gastrointestinal stromal tumors (GISTs) harbor oncogenic mutations in the KIT gene, and the majority of these mutations affect the juxtamembrane domain of the kinase encoded by exon 11. Screening GIST' for KIT gene mutations is important for translational research studies and for providing prognostic information on the likelihood of tumor response to treatment with the kinase inhibitor imatinib mesylate (Gleevec). In a series of GIST' analyzed in our laboratory by a combination of denaturing HPLC and direct DNA sequencing, we identified 19 cases with KIT exon 11 deletions that included from 1 to 14 by of intron 10 sequence and resulted in loss of the normal splice acceptor site at the beginning of exon 11. Predicted use of the next potential splice-acceptor site was confirmed by cDNA sequencing in 4 cases. Thus, the resulting mutant isoform, deletion KPMYEVQWK 550-558, was the same in all 19 cases. Only two other examples of deletions across the intron 10-exon 11 boundary have been reported, yet among 722 GIST' analyzed in our laboratories these deletions were not uncommon, accounting for 3.9% of exon 11 mutations and 2.6% of all tumors. Loss of KIT intron 10 sequences may be under-recognized if the forward primer is too close to exon 11, or if cases are examined exclusively at the cDNA level. Laboratories that offer clinical screening for KIT mutations in GI stromal tumors should be aware of this class of mutations. C1 Oregon Hlth Sci Univ, Inst Canc, Dept Pathol, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Div Hematol & Oncol, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR USA. Brigham & Womens Hosp, Dept Pathol, Boston, MA 02115 USA. RP Corless, CL (reprint author), Oregon Hlth Sci Univ, Inst Canc, Dept Pathol, L471,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM corlessc@ohsu.edu NR 31 TC 29 Z9 31 U1 0 U2 1 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3993 USA SN 1525-1578 J9 J MOL DIAGN JI J. Mol. Diagn. PD NOV PY 2004 VL 6 IS 4 BP 366 EP 370 DI 10.1016/S1525-1578(10)60533-8 PG 5 WC Pathology SC Pathology GA 885XG UT WOS:000226190000012 PM 15507676 ER PT J AU Ozen, M Ittmann, M DeBakey, ME AF Ozen, M Ittmann, M DeBakey, ME TI Increased CDC25C phosphatase activity in prostate cancer: Correlation to biochemical recurrence SO JOURNAL OF MOLECULAR DIAGNOSTICS LA English DT Meeting Abstract CT Annual Meeting of the Association-for-Molecular-Pathology CY NOV 10-13, 2004 CL Los Angeles, CA SP Assoc Mole Pathol C1 Baylor Coll Med, Houston, TX 77030 USA. Dept Vet Affairs Med Ctr, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3993 USA SN 1525-1578 J9 J MOL DIAGN JI J. Mol. Diagn. PD NOV PY 2004 VL 6 IS 4 MA ST22 BP 431 EP 431 PG 1 WC Pathology SC Pathology GA 885XG UT WOS:000226190000165 ER PT J AU McMillan, PJ Wilkinson, CW Greenup, L Raskind, MA Peskind, ER Leverenz, JB AF McMillan, PJ Wilkinson, CW Greenup, L Raskind, MA Peskind, ER Leverenz, JB TI Chronic cortisol exposure promotes the development of a GABAergic phenotype in the primate hippocampus SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE brain-derived neurotrophic factor; calbindin; dentate gyrus; GABAergic; glucocorticoid; glutamic acid decarboxylase ID MESSENGER-RNA EXPRESSION; ACTIVITY-DEPENDENT EXPRESSION; GRANULE CELL DEGENERATION; CALCIUM-BINDING PROTEINS; AMINOBUTYRIC-ACID LEVELS; MOSSY FIBER PATHWAY; NEUROTROPHIC FACTOR; RAT HIPPOCAMPUS; GENE-EXPRESSION; PYRAMIDAL NEURONS AB Glucocorticoids regulate plasticity and survival of hippocampal neurons. Aberrant exposure to this steroid hormone can result in neurodegeneration, perhaps secondary to disruption of calcium homeostasis. Calbindin, a calcium-binding protein that buffers excess calcium, may protect against neurodegeneration resulting from overabundance of intracellular calcium. In this study, we examined whether chronic treatment (1 year) with cortisol enhances hippocampal calbindin expression in primates. Calbindin is a marker for inhibitory neurons and the dentate gyrus is known to adopt an inhibitory phenotype in response to extreme conditions such as seizures. Thus, we hypothesized that chronic cortisol exposure may also promote a GABAergic phenotype. Therefore, we examined the expression of the GABA-synthesizing enzyme glutamic acid decarboxylase. The expression of brain-derived neurotrophic factor, which is responsive to glucocorticoids, was also examined. Our results demonstrate significant increases in calbindin, glutamic acid decarboxylase and brain-derived neurotrophic factor in several regions of the primate hippocampus, including the dentate gyrus and CA3, in response to chronic cortisol exposure. These results suggest that chronic cortisol exposure may shift the balance towards a GABAergic phenotype, perhaps as part of a compensatory feedback mechanism to dampen the initial excitatory effects of glucocorticoids in the hippocampus. C1 VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Parkinsons Dis Res Educ & Clin Ctr, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Psychiat, Seattle, WA USA. Univ Washington, Sch Med, Dept Behav Sci, Seattle, WA USA. RP McMillan, PJ (reprint author), VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, GRECC S-182,Box 358280,1660 S Columbian Way, Seattle, WA 98108 USA. EM pammcm@u.washington.edu FU NIA NIH HHS [AG06136] NR 78 TC 11 Z9 11 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 NOV PY 2004 VL 91 IS 4 BP 843 EP 851 DI 10.1111/j.1471-4159.2004.02760.x PG 9 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 867TI UT WOS:000224864800009 PM 15525338 ER PT J AU Paintlia, MK Paintlia, AS Barbosa, E Singh, I Singh, AK AF Paintlia, MK Paintlia, AS Barbosa, E Singh, I Singh, AK TI N-acetylcysteine prevents endotoxin-induced degeneration of oligodendrocyte progenitors and hypomyelination in developing rat brain SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE periventricular leukomalacia; cerebral palsy; N-acetylcysteine; oligodendrocyte progenitors; hypomyelination ID NECROSIS-FACTOR-ALPHA; PRETERM PREMATURE RUPTURE; FOCAL CEREBRAL-ISCHEMIA; PERIVENTRICULAR LEUKOMALACIA; IMMUNE-SYSTEM; WHITE-MATTER; TNF-ALPHA; KAPPA-B; INJURY; INFLAMMATION AB Periventricular leukomalacia (PVL), the dominant form of brain injury in premature infants, is characterized by diffuse white matter injury and is associated with cerebral palsy (GP). Maternal and placental infections are major causes of prematurity and identifiable etiology of PVL and CP. Here we have evaluated the therapeutic efficacy of N-acetylcysteine (NAC), a potent antioxidant and precursor of glutathione, to attenuate lipopolysaccharide (LPS)-induced white matter injury and hypomyelination in the developing rat brain, an animal model of PVL. Intraperitoneal pretreatment of pregnant female rats with NAC (50 mg/kg), 2 hr prior to administration of LIPS at embryonic day 18 (E18), attenuated the LIPS-induced expression of inflammatory cytokines such as tumor necrosis factor-alpha, interleukin-1beta, and inducible nitric oxide synthase in fetal rat brains. There were significantly reduced numbers of TUNEL+ nuclei coimmunostained for platelet-derived growth factor-alphaR(+) [a surface marker for oligodendrocyte progenitor cells (OPCs)] at E20 in the subventricular zone of fetal rat brain in the NAC + LPS group compared with the untreated LIPS group. Interestingly, immunostaining for O4 and O1 as markers for late OPCs and immature oligodendrocytes demonstrated fewer O4(+) and O1(+) cells in the LIPS group compared with the NAC + LIPS and control groups. Consistent with O4(+)/O1(+) cell counts, the expression of myelin proteins such as myelin basic protein, proteolipid protein, and 2'3'-cyclic nucleotide phosphodiesterase, including transcription factors such as MyT1 and Gtx, was less in the LIPS group at late postnatal days, indicating severe hypomyelination in the developing rat brain when compared with NAC + LIPS and control groups. Collectively, these data support the hypothesis that NAC may provide neuroprotection and attenuate the degeneration of OPCs against LIPS evoked inflammatory response and white matter injury in developing rat brain. Moreover, these data suggest the possible use of NAC as a treatment for pregnant women with maternal or placental infection as a means of minimizing the risk of PVL and CP. (C) 2004 Wiley-Liss, Inc. C1 Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pathol & Lab Med, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Singh, I (reprint author), Med Univ S Carolina, Dept Pediat, 96 Jonathan Lucas St,CSB-316, Charleston, SC 29425 USA. EM singhi@musc.edu OI Paintlia, Ajaib/0000-0003-4525-5333 FU NINDS NIH HHS [NS-34741, NS-22576, NS-37766, NS-40144, NS-40810] NR 44 TC 103 Z9 104 U1 1 U2 8 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0360-4012 J9 J NEUROSCI RES JI J. Neurosci. Res. PD NOV 1 PY 2004 VL 78 IS 3 BP 347 EP 361 DI 10.1002/jnr.20261 PG 15 WC Neurosciences SC Neurosciences & Neurology GA 869GP UT WOS:000224971700005 PM 15389835 ER PT J AU Marracci, GH McKeon, GP Marquardt, WE Winter, RW Riscoe, MK Bourdette, DN AF Marracci, GH McKeon, GP Marquardt, WE Winter, RW Riscoe, MK Bourdette, DN TI alpha lipoic acid inhibits human T-cell migration: Implications for multiple sclerosis SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE antioxidant; matrix metalloproteinase-9; transmigration ID EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; CENTRAL-NERVOUS-SYSTEM; KAPPA-B ACTIVATION; ADHESION MOLECULE EXPRESSION; MATRIX-METALLOPROTEINASE; INTERFERON BETA-1B; IN-VITRO; TRANSENDOTHELIAL MIGRATION; CONTROLLED-TRIAL; FLOW CONDITIONS AB We have demonstrated previously the ability of the antioxidant a lipoic acid (ALA) to suppress and treat a model of multiple sclerosis (MS), relapsing experimental autoimmune encephalomyelitis (EAE). We describe the effects of ALA and its reduced form, dihydrolipoic acid (DHLA), on the transmigration of human Jurkat T cells across a fibronectin barrier in a transwell system. ALA and DHLA inhibited migration of Jurkat cells in a dose-dependent fashion by 16-75%. ALA and DHLA reduced matrix metalloproteinase-9 (MMP-9) activity by 18-90% in Jurkat cell supernatants. GM6001, a synthetic inhibitor of MMP, reduced Jurkat cell migration, but not as effectively as ALA and DHLA did. Both ALA and DHLA down-modulated the surface expression of the alpha4beta1 integrin (very late activation-4 antigen; VLA-4), which binds fibronectin and its endothelial cell ligand vascular cell adhesion molecule-1 (VCAM-1). Moreover, ALA, but not DHLA, reduced MMP-9-specific mRNA and extracellular MMP-9 from Jurkat cells and their culture supernatants as detected by relative reverse transcriptase-polymerise chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. ALA and DHLA inhibited Jurkat cell migration and have different mechanisms for inhibiting MMP-9 activity. These data, coupled with its ability to treat relapsing EAE, suggest that ALA warrants investigation as a therapy for MS. (C) 2004 Wiley-Liss, Inc. C1 Portland Vet Affairs Med Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Biochem, Portland, OR USA. Portland State Univ, Portland, OR 97207 USA. RP Bourdette, DN (reprint author), Oregon Hlth & Sci Univ, Dept Neurol, 3181 SW Sam Jackson Pk Rd,L226, Portland, OR 97239 USA. EM bourdett@ohsu.edu FU NCCIH NIH HHS [P50AT00066-01] NR 47 TC 34 Z9 38 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0360-4012 J9 J NEUROSCI RES JI J. Neurosci. Res. PD NOV 1 PY 2004 VL 78 IS 3 BP 362 EP 370 DI 10.1002/jnr.20255 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 869GP UT WOS:000224971700006 PM 15389837 ER PT J AU Schouten, JW Fulp, CT Royo, NC Saatman, KE Watson, DJ Snyder, EY Trojanowski, JQ Prockop, DJ Maas, AIR McIntosh, TK AF Schouten, JW Fulp, CT Royo, NC Saatman, KE Watson, DJ Snyder, EY Trojanowski, JQ Prockop, DJ Maas, AIR McIntosh, TK TI A review and rationale for the use of cellular transplantation as a therapeutic strategy for traumatic brain injury SO JOURNAL OF NEUROTRAUMA LA English DT Review DE cell death; cell replacement; head injury; progenitor cells; stem cells ID NEURAL STEM-CELLS; MARROW STROMAL CELLS; CENTRAL-NERVOUS-SYSTEM; CONTROLLED CORTICAL IMPACT; RAT SPINAL-CORD; ADULT BONE-MARROW; FACTOR GENE-TRANSFER; LONG-TERM SURVIVAL; DIFFERENTIATION FOLLOWING TRANSPLANTATION; AMYOTROPHIC-LATERAL-SCLEROSIS AB Experimental research during the past decade has greatly increased our understanding of the pathophysiology of traumatic brain injury (TBI) and allowed us to develop neuroprotective pharmacological therapies. Encouraging results of experimental pharmacological interventions, however, have not been translated into successful clinical trials, to date. Traumatic brain injury is now believed to be a progressive degenerative disease characterized by cell loss. The limited capacity for self-repair of the brain suggests that functional recovery following TBI is likely to require cellular transplantation of exogenous cells to replace those lost to trauma. Recent advances in central nervous system transplantation techniques involve technical and experimental refinements and the analysis of the feasibility and efficacy of transplantation of a range of stem cells, progenitor cells and postmitotic cells. Cellular transplantation has begun to be evaluated in several models of experimental TBI, with promising results. The following is a compendium of these new and exciting studies, including a critical discussion of the rationale and caveats associated with cellular transplantation techniques in experimental TBI research. Further refinements in future research are likely to improve results from transplantation-based treatments for TBI. C1 Univ Penn, Sch Med, Ctr Neurodegenerat Dis Res, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Erasmus Med Ctr, Dept Neurosurg, Rotterdam, Netherlands. Burnham Inst, Program Dev & Regenerat Cell Biol, La Jolla, CA 92037 USA. Tulane Univ, Hlth Sci Ctr, Ctr Gene Therapy, New Orleans, LA USA. Univ Penn, Sch Med, Dept Neurosurg, Traumat Brain Injury Lab, Philadelphia, PA 19104 USA. RP McIntosh, TK (reprint author), Univ Penn, Sch Med, Dept Neurosurg, Traumat Brain Injury Lab, 105C Hayden Hall,3320 Smith Walk, Philadelphia, PA 19104 USA. EM mcintosh@seas.upenn.edu RI Maas, Andrew/C-5584-2013 OI Maas, Andrew/0000-0003-1612-1264 FU NINDS NIH HHS [P50-NS08803, R01-NS40978] NR 312 TC 41 Z9 47 U1 1 U2 11 PU MARY ANN LIEBERT INC PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 0897-7151 J9 J NEUROTRAUM JI J. Neurotrauma PD NOV PY 2004 VL 21 IS 11 BP 1501 EP 1538 DI 10.1089/0897715042441774 PG 38 WC Critical Care Medicine; Clinical Neurology; Neurosciences SC General & Internal Medicine; Neurosciences & Neurology GA 872IL UT WOS:000225200800001 PM 15684646 ER PT J AU Chang, JS Van Remmen, H Ward, WF Regnier, FE Richardson, A Cornell, J AF Chang, JS Van Remmen, H Ward, WF Regnier, FE Richardson, A Cornell, J TI Processing of data generated by 2-dimensional gel electrophoresis for statistical analysis: Missing data, normalization, and statistics SO JOURNAL OF PROTEOME RESEARCH LA English DT Article DE 2-D PAGE; missing data; normalization; mitochondria; permutation test; false discovery rates ID MANGANESE SUPEROXIDE-DISMUTASE; COMPARATIVE PROTEOMICS; MESSENGER-RNA; PROTEIN; IDENTIFICATION; COMPLEX; DAMAGE; GENES; MOUSE; MICE AB Several high-throughput statistical methods were evaluated for processing data generated by two-dimensional polyacrylamide gel electrophoresis, including how to handle missing data, normalization, and statistical analysis of data obtained from 2-D gels. Quantile normalization combined with a nonparametric permutation test based on minimizing false discover rates gave the highest yield of proteins that changed with genotype and detected the anticipated 50% decrease in Mn-superoxide dismutase (MnSOD) protein levels in mitochondrial extracts obtained from MnSOD-deficient mice. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, 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, San Antonio, TX 78284 USA. Purdue Univ, Dept Chem, W Lafayette, IN 47907 USA. RP Cornell, J (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78284 USA. EM cornell@uthscsa.edu FU NCI NIH HHS [CA P30 54174]; NEI NIH HHS [R01 EY 11733]; NIA NIH HHS [P01 AG 20591, 1P30 AG 13319, R01 AG 23843] NR 30 TC 41 Z9 42 U1 0 U2 1 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 1535-3893 J9 J PROTEOME RES JI J. Proteome Res. PD NOV-DEC PY 2004 VL 3 IS 6 BP 1210 EP 1218 DI 10.1021/pr049886m PG 9 WC Biochemical Research Methods SC Biochemistry & Molecular Biology GA 881EX UT WOS:000225847300013 PM 15595730 ER PT J AU Lefler, DM Pafford, RG Black, NA Raymond, JR Arthur, JM AF Lefler, DM Pafford, RG Black, NA Raymond, JR Arthur, JM TI Identification of proteins in slow continuous ultrafiltrate by reversed-phase chromatography and proteomics SO JOURNAL OF PROTEOME RESEARCH LA English DT Article DE proteomics; dialysate; 2D gel; continuous renal replacement therapy ID CONTINUOUS VENOVENOUS HEMOFILTRATION; LIPID-MOBILIZING FACTOR; D-BINDING PROTEIN; PANCREATITIS; CLEARANCE; MEDIATORS; TOXICITY; THERAPY; PLASMA AB Continuous modes of renal replacement therapy (CRRT) are increasingly being utilized in the intensive care unit. The removal of cytokines and other inflammatory proteins during ultrafiltration may be responsible for some of the beneficial effects of CRRT. We used proteomic tools to identify proteins found in the ultrafiltrate from a patient with acute renal failure. Identification of these proteins could help elucidate the mechanism(s) of improved outcome with continuous renal replacement therapy. Protein was loaded on a reversed-phase C4 column and eluted with stepwise isocratic flows starting with 0%, 5%, 10%, 25%, and 50% of acetonitrile. Effluent was collected, pooled, desalted, and separated by two-dimensional gel electrophoresis (2DE). Reversed-phase separation improved the resolution and the number of spots seen on the gels. Protein spots were digested with trypsin and spotted onto MALDI plates. Proteins were identified by either peptide mass fingerprinting using a MALDI-TOF mass spectrometer or by peptide sequencing using a MALDI-TOF/TOF tandem mass spectrometer. From 196 spots cut, 47 were identified, representing multiple charge forms of 10 different proteins. Proteins identified were albumin, apolipoprotein A-IV, beta-2-microglobulin, lithostathine, mannose-binding lectin associated serine protease 2 associated protein, plasma retinol-binding protein, transferrin, transthyretin, vitamin D-binding protein and Zn alpha-2 glycoprotein. Continuous renal replacement therapy is frequently used in acutely ill patients with renal failure. Removal of proteins occurs during this process. The physiological significance of this protein removal is unclear. Identification of these proteins will lead to better understanding of the role of protein removal in continuous renal replacement therapy. C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. RP Arthur, JM (reprint author), Med Univ S Carolina, Charleston, SC 29425 USA. EM arthurj@musc.edu FU NHLBI NIH HHS [N01 HV 28181] NR 21 TC 22 Z9 23 U1 0 U2 2 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 1535-3893 J9 J PROTEOME RES JI J. Proteome Res. PD NOV-DEC PY 2004 VL 3 IS 6 BP 1254 EP 1260 DI 10.1021/pr0498640 PG 7 WC Biochemical Research Methods SC Biochemistry & Molecular Biology GA 881EX UT WOS:000225847300018 PM 15595735 ER PT J AU Hester, EJ Johnson, KR Crane, LA Schilling, LM Dellavalle, RP AF Hester, EJ Johnson, KR Crane, LA Schilling, LM Dellavalle, RP TI Indoor UV tanning operator opinion regarding youth access: An electronic survey SO JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY LA English DT Article ID MALIGNANT-MELANOMA; FACILITIES; RISK; ADOLESCENTS; SUNSCREEN; SUNLAMPS; SUNBEDS; DEVICES; STATE AB Background: Adolescents frequently use indoor tanning facilities, but little is known about tanning facility operator opinions regarding this use. Objective: To assess indoor tanning operator attitudes and stated practices regarding youth access. Methods: We electronically surveyed 89 indoor tanning facilities and 130 spas with active e-mail addresses. Results. The survey response rate was 21% for both indoor tanning facilities (19/89) and spas (27/130). Most tanning operators (92%) felt that a client can be too young to receive indoor tanning, and most felt that written parental permission should be required (80%). Most facilities required adult accompaniment (92%), and most operators had discouraged a customer from receiving indoor tanning based on age (77%). The reported age of the youngest patron receiving indoor tanning ranged from 5 to 21 years. Conclusion. Our sample of indoor tanning facility operators believed that minimum age and parental consent regulations for indoor tanning should be required. C1 Univ Colorado, Hlth Sci Ctr, Dept Dermatol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Denver VA Med Ctr, Denver, CO USA. RP Dellavalle, RP (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Dermatol, 4200 E 9th Ave,Box B-153, Denver, CO 80262 USA. EM robert.dellavaIle@uchsc.edu RI Dellavalle, Robert/L-2020-2013 OI Dellavalle, Robert/0000-0001-8132-088X FU NCI NIH HHS [CA92550]; NIAMS NIH HHS [T32 AR07411] NR 26 TC 6 Z9 6 U1 0 U2 1 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0190-9622 J9 J AM ACAD DERMATOL JI J. Am. Acad. Dermatol. PD NOV PY 2004 VL 51 IS 5 BP 814 EP 816 DI 10.1016/j.jaad.2004.05.023 PG 3 WC Dermatology SC Dermatology GA 867BB UT WOS:000224816000027 PM 15523366 ER PT J AU Shrank, WH Ettner, SL Glassman, P Asch, SM AF Shrank, WH Ettner, SL Glassman, P Asch, SM TI A bitter pill: Formulary variability and the challenge to prescribing physicians SO JOURNAL OF THE AMERICAN BOARD OF FAMILY PRACTICE LA English DT Article ID PRESCRIPTION DRUGS AB Background: Multitiered, incentive-based formularies have been increasingly used as a mechanism to control prescription drug expenditures. Prescribing physicians who manage patients from multiple insurers must be familiar with the variability in their patients' formulary incentives to help patients choose therapy wisely. However, the degree of formulary variability among and within health plans over time is unclear. Methods: In 6 major health plans in California, we evaluated formulary incentive variability in 4 of the 5 drug classes with the highest expenditures in California: proton pump inhibitors, hydroxymethylglutaryl coenzyme A reductase inhibitors ("statins"), calcium channel blockers, and angiotensin-converting enzyme inhibitors. We categorized 20 branded members of these classes into either "preferred" or nonpreferred/uncovered categories. We calculated the consistency that brands were preferred across health plans and the frequency of changes in formulary status for each drug within plans between 2000 and 2002. Results: None of the branded drugs evaluated were preferred on all formularies in 2002, and 10% were not available on any of the formularies. Formulary status varied greatly across plans, and more than 60% of drugs were preferred on 2 to 4 of the 6 formularies studied. Formulary status within health plans varied between 2000 and 2002 in more than half of the plans in the drug classes evaluated. Conclusions: In the drug classes evaluated, over a 2-year period, considerable variability was seen among and within formularies over time. This variability poses a challenge to physicians who wish to reduce patients' expenditures by prescribing the least expensive among similarly effective drugs within a drug class. This variability is especially relevant because recent legislation increases the likelihood that more Medicare beneficiaries will receive their medications from private health plans. C1 VA Greater Los Angeles Hlth Care Syst, Div Gen Internal Med 111G, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA USA. RP Shrank, WH (reprint author), VA Greater Los Angeles Hlth Care Syst, Div Gen Internal Med 111G, 11301 Wilshire Blkvd, Los Angeles, CA 90073 USA. EM william.shrank@med.va.gov NR 21 TC 18 Z9 18 U1 0 U2 0 PU AMER BOARD FAMILY PRACTICE PI LEXINGTON PA 2228 YOUNG DR, LEXINGTON, KY 40505 USA SN 0893-8652 J9 J AM BOARD FAM PRACT JI J. Am. Board Fam. Pract. PD NOV-DEC PY 2004 VL 17 IS 6 BP 401 EP 407 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 875YE UT WOS:000225458200001 PM 15575031 ER PT J AU Lawrence, VA Hazuda, HP Cornell, JE Pederson, T Bradshaw, PT Mulrow, CD Page, CP AF Lawrence, VA Hazuda, HP Cornell, JE Pederson, T Bradshaw, PT Mulrow, CD Page, CP TI Functional independence after abdominal surgery in the elderly SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Article; Proceedings Paper CT Symposium on Surgery in the Elderly Patient CY 2004 CL Galveston, TX SP Univ Texas Med Branch, Sealy Ctr Aging, Dept Surg ID QUALITY-OF-LIFE; HIP FRACTURE REPAIR; HAND GRIP STRENGTH; PULMONARY COMPLICATIONS; INSTRUMENTAL ACTIVITIES; ELECTIVE SURGERY; CONTROLLED TRIAL; AORTIC-ANEURYSM; MUSCLE STRENGTH; OLDER PERSONS AB BACKGROUND: Elders undergo approximately 40% of more than 1 million major abdominal operations annually. Yet evidence about recovery to preoperative levels of functional independence is limited. This study details course and predictors of functional recovery after elective major abdominal operations in the elderly. STUDY DESIGN: This was a prospective cohort of 372 consecutive patients, 60 years old or more, enrolled from surgeons in private practice and two university-affiliated hospitals, assessed preoperatively and postoperatively at 1, 3, and 6 weeks, 3 and 6 months, using self-report and performance-based measures (Activities of Daily Living [ADL], Instrumental Activities of Daily Living [IADL], Medical Outcomes Study Short Form-36 Physical Component and Mental Component Scales [PCS, MCS], Geriatric Depression Scale [GDS], Folstein Mini-Mental State Exam [MMSE], timed walk, functional reach, hand grip strength). RESULTS: Mean age was 69 +/- 6 years with 56% men, 47% nonHispanic Caucasian, and 42% Mexican American; hospital distribution was 49% private, 51% university-affiliated. Maximum functional declines (95% Cl) occurred 1 week postoperatively: ADL, 2.8 points (2.4 to 3.2); IADL, 7.6 points (7 to 8.3); SF-36 PCS, 6.5 points (5.4 to 7.6); Mini-Mental State Exam, 0.5 points (0.2 to 0.7); timed walk, 6.8 seconds (5.2 to 8.4); functional reach, 1.7 inches (1.2 to 2.2); grip strength, 2 kilograms (1.3 to 2.7) (p < 0.001 for all). SF-36 mental component scale and Geriatric Depression Scale scores did not worsen. Mean recovery times were: Mini-Mental State Exam, 3 weeks; timed walk, 6 weeks; ADL, SF-36 PCS, and functional reach, 3 months; and IADL, 6 months. Mean grip strength did not return to preoperative status by 6 months. The incidence of persistent disability at 6 months, compared with preoperative status, was: ADL, 9%; IADL, 19%; PCS, 16%; mental component scale, 17%; timed walk, 39%; functional reach, 58%; and grip strength, 52%. Potentially modifiable independent predictors of ADL and IADL recovery were preoperative physical conditioning and depression plus serious postoperative complications. CONCULSIONS: The clinical course of functional recovery varied across different measures. Protracted disability at 6 months after operation was substantial. Several potentially modifiable factors consistently predicted recovery. ((C) 2004 by the American College of Surgeons). C1 S Texas Vet Hlth Care Syst, Audie L Murphy Div, VERDICT, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Div Gen Med, San Antonio, TX 78285 USA. Univ Texas, Hlth Sci Ctr, Div Clin Epidemiol, San Antonio, TX 78285 USA. Univ Texas, Hlth Sci Ctr, Ctr Biostat & Epidemiol, San Antonio, TX 78285 USA. Univ Texas, Hlth Sci Ctr, Dept Surg, San Antonio, TX 78285 USA. RP Lawrence, VA (reprint author), S Texas Vet Hlth Care Syst, Audie L Murphy Div, VERDICT, Ambulatory Care 11C-67400 Merton Minter Blvd, San Antonio, TX USA. FU NIA NIH HHS [R01 AG14304, P20 AG12044, R01 AG10444, R01 AG16518] NR 49 TC 100 Z9 101 U1 3 U2 9 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1072-7515 J9 J AM COLL SURGEONS JI J. Am. Coll. Surg. PD NOV PY 2004 VL 199 IS 5 BP 762 EP 772 DI 10.1016/j.jamcollsurg.2004.05.280 PG 11 WC Surgery SC Surgery GA 868TW UT WOS:000224936900017 PM 15501119 ER PT J AU Naik, AD Concato, J Gill, TM AF Naik, AD Concato, J Gill, TM TI Bathing disability in community-living older persons: Common, consequential, and complex SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MD SP Amer Geriatr Soc DE bathing; disability; activities of daily living; geriatric epidemiology ID MEDICAL CONDITIONS; PEOPLE; RISK; PATTERNS; OUTCOMES; HEALTH; ADULTS; HOME; ADL; AGE AB Objectives: To identify the specific bathing subtasks that are affected in community-living-older persons with bathing disability and to determine the self-reported reasons for bathing disability. Design: Cross-sectional study. Setting: General community of greater New Haven, Connecticut. Participants: A total of 626 community-living persons, aged 73 and older, who completed a comprehensive assessment, including a detailed evaluation of bathing disability. Measurements: Trained research nurses assessed bathing disability (defined as requiring personal assistance or having difficulty washing and drying the whole body), the specific bathing subtasks that were affected, and the main reasons (up to three) for bathing disability. Results: Disability in bathing was present in 195 (31%) participants; of these, 97 required personal assistance (i.e., dependence), and 98 had difficulty bathing. Participants with bathing disability reported a mean+/-standard deviation of 4.0+/-2.4 affected subtasks. The prevalence rate of disability for the eight prespecified bathing subtasks ranged from 25% for taking off clothes to 75% for leaving the bathing position. The majority of participants (59%) provided more than one reason for bathing disability. The most common reasons cited by participants for their bathing disability were balance problems (28%), arthritic complaints (26%), and fall or fear of falling (23%). Conclusion: For community-living older persons, disability in bathing is common, involves multiple subtasks, and is attributable to an array of physical and psychological problems. Preventive and restorative interventions for bathing disability will need to account for the inherent complexity of this essential activity of daily living. C1 Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies, VA Med Ctr 152, Houston, TX 77030 USA. Yale Univ, Sch Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT USA. Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06510 USA. W Haven Vet Adm, Clin Epidemiol Res Ctr, West Haven, CT USA. RP Naik, AD (reprint author), Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies, VA Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM anaik@bmc.tmc.edu FU NIA NIH HHS [K23 AG 00759, R01 AG 17560, K23 AG000759, K24 AG 021507] NR 30 TC 38 Z9 39 U1 0 U2 1 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 NOV PY 2004 VL 52 IS 11 BP 1805 EP 1810 DI 10.1111/j.1532-5415.2004.52513.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 863WM UT WOS:000224594100002 PM 15507055 ER PT J AU Boockvar, KS Litke, A Penrod, JD Halm, EA Morrison, RS Silberzweig, SB Magaziner, J Koval, K Siu, AL AF Boockvar, KS Litke, A Penrod, JD Halm, EA Morrison, RS Silberzweig, SB Magaziner, J Koval, K Siu, AL TI Patient relocation in the 6 months after hip fracture: Risk factors for fragmented care SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE patient transfer; hospitalization; hip fracture; risk factors ID POST-HOSPITAL CARE; TRANSITIONAL CARE; ADVERSE EVENTS; OUTCOMES; DISCHARGE; SETTINGS; SYSTEM; CRACKS; ELDERS; COSTS AB Objectives: To describe the incidence and patterns of patient relocation after hip fracture, identify factors associated with relocation, and examine effect of relocation on outcomes. Design: Prospective cohort study. Setting: Four hospitals in the New York metropolitan area. Participants: A total of 562 patients hospitalized for hip fracture discharged alive in 1997 to 1998. Measurements: Patient characteristics and hospital course were ascertained using patient or surrogate interview, research nurse assessment, and medical record review. Patient location was ascertained at five time points using patient or surrogate interview, and hospital readmissions were identified using New York state and hospital admission databases. Mobility was measured using patient or surrogate report using the Functional Independence Measure. Results: During 6 months of follow-up, the mean number of relocations per patient+/-standard deviation was 3.5+/-1.5 (range 2-10). Forty-one percent of relocations were between home and hospital, 36% between rehabilitation or nursing facility and hospital, 17% between rehabilitation or nursing facility and home, and 4% between two rehabilitation/nursing facilities. In a Poisson regression model that controlled for patient characteristics, hospital course, and length of follow-up, factors associated with relocation (P<.05) were absence of dementia, in-hospital delirium, one or more new impairments at hospital discharge, hospital discharge other than to home, and not living at home alone prefracture. Relocation was not significantly associated with immobility or mortality at 6 months (odds ratio=1.14, 95% confidence interval=0.97-1.35). Conclusion: Subgroups of patients with elevated risk of relocation after hip fracture may be target groups for intensive care coordination and care planning interventions. C1 Bronx Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY 10468 USA. CUNY Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Dept Hlth Policy, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Dept Med, New York, NY 10029 USA. Univ Maryland, Sch Med, Dept Epidemiol & Prevent Med, Baltimore, MD 21201 USA. NYU, Sch Med, Dept Orthoped Surg, New York, NY USA. RP Boockvar, KS (reprint author), Bronx Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, 130 W Kingsbridge Rd,Rm 4 A-17, Bronx, NY 10468 USA. EM kenneth.boockvar@mssm.edu OI Boockvar, Kenneth/0000-0003-1165-5558 FU AHRQ HHS [HS 09973, R01 HS009973, U18 HS 09459, U18 HS009459]; NIA NIH HHS [K24 AG000918, R01 AG021992] NR 29 TC 18 Z9 19 U1 4 U2 7 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 NOV PY 2004 VL 52 IS 11 BP 1826 EP 1831 DI 10.1111/j.1532-5415.2004.52512.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 863WM UT WOS:000224594100005 PM 15507058 ER PT J AU Kurella, M Chertow, GM Luan, J Yaffe, K AF Kurella, M Chertow, GM Luan, J Yaffe, K TI Cognitive impairment in chronic kidney disease SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE cognitive impairment; chronic kidney disease; end-stage renal disease; dementia ID CHRONIC-HEMODIALYSIS PATIENTS; QUALITY-OF-LIFE; NEUROPSYCHOLOGICAL FUNCTION; ALZHEIMERS-DISEASE; DIALYSIS PATIENTS; ELDERLY PERSONS; NORMATIVE DATA; RISK-FACTORS; DEMENTIA; PREVALENCE AB Objectives: To assess the prevalence of cognitive impairment in persons with chronic kidney disease (CKD) and its relation to the severity of CKD. Design: Cross-sectional study. Setting: University-affiliated ambulatory nephrology and dialysis practices. Participants: Eighty subjects with CKD Stages III and IV not requiring dialysis (CKD) and 80 subjects with CKD Stage V on hemodialysis (end-stage renal disease (ESRD)) with a mean age+/-standard deviation of 62.5+/-14.3. Measurements: Three standardized cognitive tests, the Modified Mini-Mental State Examination (3MS), Trailmaking Test B (Trails B), and California Verbal Learning Trial (CVLT). Glomerular filtration rate was estimated in subjects with CKD using the six-variable Modification of Diet in Renal Disease equation. Results: There was a graded relation between cognitive function and severity of CKD. Mean scores on the 3MS, Trails B, and CVLT immediate and delayed recall were significantly worse for subjects with ESRD than for subjects with CKD or published norms (P<.001 for all comparisons). Scores on the Trails B (P<.001) and CVLT immediate (P=.01) and delayed (P<.001) recall were significantly worse for subjects with CKD not requiring dialysis than for published norms. In addition, the fraction of subjects with impairment on the 3MS and Trails B increased with decreasing kidney function. Conclusion: Cognitive impairment is associated with the severity of kidney disease. Further studies are needed to determine the reasons for cognitive impairment in subjects with CKD and ESRD. C1 Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. Univ Calif San Francisco, Moffitt Long Hosp, Mt Zion Med Ctr, Dept Med,Div Nephrol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Moffitt Long Hosp, Mt Zion Med Ctr, Dept Med,Div Psychiat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Moffitt Long Hosp, Mt Zion Med Ctr, Dept Med,Div Neurol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Moffitt Long Hosp, Mt Zion Med Ctr, Dept Med,Div Epidemiol, San Francisco, CA 94143 USA. RP Yaffe, K (reprint author), Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Box 181, San Francisco, CA 94143 USA. EM kyaffe@itsa.ucsf.edu RI Kurella Tamura, Manjula/C-8284-2014 OI Kurella Tamura, Manjula/0000-0001-5227-2479 FU NIA NIH HHS [AG 00888, R01 AG 021918]; NIDDK NIH HHS [R01 DK 58411, R01 DK 01005] NR 36 TC 185 Z9 191 U1 0 U2 5 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 NOV PY 2004 VL 52 IS 11 BP 1863 EP 1869 DI 10.1111/j.1532-5415.2004.52508.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 863WM UT WOS:000224594100010 PM 15507063 ER PT J AU Casarett, DJ Crowley, RL Hirschman, KB AF Casarett, DJ Crowley, RL Hirschman, KB TI How should clinicians describe hospice to patients and families? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE hospice; end-of-life; decision-making ID ADVANCE DIRECTIVES; TERMINAL CARE; LAST YEAR; LIFE; CANCER; DECISIONS; DEATH; PAIN; END AB Objectives: To describe hospice enrollment from the perspective of bereaved family members and to identify information about hospice that would encourage patients and families to enroll sooner. Design: Cross-sectional interviews. Setting: Three Medicare-certified hospice organizations. Participants: One hundred family members of 100 patients who died in hospice. Measurements: Semistructured interviews assessed prior knowledge of hospice, patients' and physicians' involvement in the enrollment process, features of hospice that motivated enrollment, and features that patients and families wished they had learned about sooner. Results: Almost all family members (n=92) and patients (n=71) knew about hospice before the patient's illness. Almost half the patients (n=44) were not involved at all in the hospice enrollment decision. The patient's physician (n=51) or the patient or family (n=34) initiated most hospice discussions, but patients and families usually obtained information about hospice from a hospice representative (n=75) rather than from the patient's physician (n=22). Family members identified several kinds of information about hospice that were particularly helpful in deciding whether to enroll and described several aspects of hospice that they wished they had known about sooner. Conclusion: Many patients and families learn about hospice from someone other than the patient's physician, and most learn about valuable hospice features and services only after enrollment. By providing more information about hospice earlier in the illness course, clinicians may be able to facilitate more-informed and more-timely decisions about hospice enrollment. C1 Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. Univ Penn, Ctr Bioeth, Philadelphia, PA 19104 USA. Univ Penn, Div Geriatr, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Sch Social Work, Philadelphia, PA 19104 USA. RP Casarett, DJ (reprint author), Inst Aging, 3615 Chestnut St, Philadelphia, PA 19104 USA. EM casarett@mail.med.upenn.edu FU NIA NIH HHS [T32 AG 00255] NR 29 TC 52 Z9 53 U1 1 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 NOV PY 2004 VL 52 IS 11 BP 1923 EP 1928 DI 10.1111/j.1532-5415.2004.52520.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 863WM UT WOS:000224594100020 PM 15507073 ER PT J AU Sohn, L Harada, ND AF Sohn, L Harada, ND TI Time since immigration and health services utilization of Korean-American older adults living in Los Angeles County SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE older persons; healthcare utilization; Korean American; minority; health services ID INSURANCE COVERAGE; AMBULATORY-CARE; UNITED-STATES; ACCESS; ACCULTURATION; POPULATION; NEEDS AB The aim of this study was to characterize ambulatory healthcare utilization of older Korean Americans and its association with length of time since immigration. It was hypothesized that older Korean Americans who were recent immigrants would use outpatient physician visits less often than early immigrants. The data are from the 2000 Korean-American Health Survey, which assessed the health status and medical needs of Korean Americans living in Los Angeles County. The dependent variable was the number of visits to a physician for check-up or consultation. Multivariate regression modeling was used to assess the influence of length of time since immigration on the dependent variable controlling for predisposing, enabling, and need variables for a sample of 208 Koreans Americans aged 65 and older. Results indicated that high school education in Korea and health insurance status were significant predictors of number of visits to a physician during the previous year (P<.05). The main variable of interest, the number of years living in the United States, approached significance at P=.09. It was concluded that enabling variables such as education and health insurance significantly influenced use of healthcare services in the older Korean-American population. The lack of studies regarding older minority populations and their access to healthcare further highlight theneed not only to characterize the access of these often-vulnerable populations, but also to generate interest for further studies. C1 VA Greater Los Angeles Healthcare Syst, Special Fellowship Program Adv Geriatr, Los Angeles, CA 90073 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med & Publ Hlth, Los Angeles, CA USA. RP Sohn, L (reprint author), VA Greater Los Angeles Healthcare Syst, Special Fellowship Program Adv Geriatr, 11G,11301 Wilshire Blvd,Bldg 220,Room 334, Los Angeles, CA 90073 USA. EM Linda.sohn@med.va.gov NR 26 TC 14 Z9 14 U1 0 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 NOV PY 2004 VL 52 IS 11 BP 1946 EP 1950 DI 10.1111/j.1532-5415.2004.52524.x PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 863WM UT WOS:000224594100024 PM 15507077 ER PT J AU Abrass, CK AF Abrass, CK TI Overview: Obesity: What does it have to do with kidney disease? SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Editorial Material ID GLOMERULAR MESANGIAL CELLS; RENAL-DISEASE; INSULIN-RESISTANCE; ESSENTIAL-HYPERTENSION; MICROALBUMINURIA; HYPERINSULINEMIA; LIPIDS; GLOMERULOSCLEROSIS; CONSEQUENCES; PROGRESSION C1 Univ Washington, Sch Med, Dept Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Abrass, CK (reprint author), Univ Washington, Sch Med, Dept Med, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM cabrass@u.washington.edu NR 52 TC 47 Z9 50 U1 0 U2 0 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 NOV PY 2004 VL 15 IS 11 BP 2768 EP 2772 DI 10.1097/01.ASN.0000141963.04540.3E PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 865EB UT WOS:000224684200001 PM 15504929 ER PT J AU Odden, MC Whooley, MA Shlipak, MG AF Odden, MC Whooley, MA Shlipak, MG TI Association of chronic kidney disease and anemia with physical capacity: The heart and soul study SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID QUALITY-OF-LIFE; CHRONIC RENAL-INSUFFICIENCY; SEATTLE ANGINA QUESTIONNAIRE; EXERCISE CAPACITY; HEMODIALYSIS-PATIENTS; FUNCTIONAL STATUS; ELDERLY PERSONS; ERYTHROPOIETIN; PERFORMANCE; HEMOGLOBIN AB Chronic kidney disease (CKD) and anemia are common conditions in the outpatient setting, but their independent and additive effects on physical capacity have not been well characterized. The association of CKD and anemia with self-reported physical function was evaluated and exercise capacity was measured in patients with coronary disease. A cross-sectional study of 954 outpatients enrolled in the Heart and Soul study was performed. CKD was defined as a measured creatinine clearance <60 ml/min, and anemia was defined as a hemoglobin level of <12g/dl. Physical function was self-assessed using the physical limitation subscale of the Seattle Angina Questionnaire (0 to 100), and exercise capacity was defined as metabolic equivalent tasks achieved at peak exercise. In unadjusted analyses, CKD was associated with lower self-reported physical function (67.6 versus 74.9; P < 0.001) and lower exercise capacity (5.5 versus 7.9; P < 0.001). Similarly, anemia was associated with lower self-reported physical function (62.6 versus 74.3; P < 0.001) and exercise capacity (5.7 versus 7.5; P < 0.001). After multivariate adjustment, CKD (69.4 versus 74.2; P = 0.003) and anemia (67.5 versus 73.6; P = 0.009) each remained associated with lower mean self-reported physical function. In addition, patients with CKD (6.3 versus 7.7; P < 0.001) or anemia (6.5 versus 7.4; P = 0.004) had lower adjusted mean exercise capacities. Participants with both CKD and anemia had lower self-reported physical function and exercise capacity than those with either alone. CKD and anemia are independently associated with physical limitation and reduced exercise capacity in outpatients with coronary disease, and these effects are additive. The broad impact of these disease conditions merits further study. C1 San Francisco VA Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. RP Shlipak, MG (reprint author), San Francisco VA Med Ctr, Gen Internal Med Sect, 4150 Clement St,111A-1, San Francisco, CA 94121 USA. EM shlip@itsa.ucsf.edu FU NHLBI NIH HHS [R01 HL079235, R01 HL079235-01A1] NR 30 TC 41 Z9 44 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 NOV PY 2004 VL 15 IS 11 BP 2908 EP 2915 DI 10.1097/01.ASN.0000143743.78092.E3 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 865EB UT WOS:000224684200016 PM 15504944 ER PT J AU Block, M Lefkowitz, T Ravenel, J Leon, S Hannegan, C AF Block, M Lefkowitz, T Ravenel, J Leon, S Hannegan, C TI Endovascular coil embolization for acute management of traumatic pulmonary artery pseudoaneurysm SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Editorial Material C1 Med Univ S Carolina, Div Cardiothorac Surg, Dept Surg, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Dept Surg, Charleston, SC USA. RP Block, M (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, Dept Surg, 96 Jonathan Lucas St,409 CSB, Charleston, SC 29425 USA. EM blockm@musc.edu NR 5 TC 9 Z9 11 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0022-5223 J9 J THORAC CARDIOV SUR JI J. Thorac. Cardiovasc. Surg. PD NOV PY 2004 VL 128 IS 5 BP 784 EP 785 DI 10.1016/j.jtcvs.2004.03.028 PG 2 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 867JO UT WOS:000224839100029 PM 15514619 ER PT J AU Bush, RL Lin, PH Bates, JT Mureebe, L Zhou, W Lumsden, AB AF Bush, RL Lin, PH Bates, JT Mureebe, L Zhou, W Lumsden, AB TI Pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis: Safety and feasibility study SO JOURNAL OF VASCULAR SURGERY LA English DT Article; Proceedings Paper CT 16th Annual Meeting of the American-Venous-Forum CY FEB 26-29, 2004 CL Orlando, FL SP Amer Venous Forum ID VEIN THROMBOSIS AB Purpose: The current standard of care for deep venous thromboembolism (DVT) is anticoagulation; however, this treatment method does not rapidly relieve clot burden or clinical symptoms. We describe a rapid and effective method of thrombus removal, with simultaneous percutaneous mechanical thrombectomy (PMT) and thrombolysis. Methods. Over 26 months 20 patients (22 men, 2 women; mean age, 52 +/- 6 years [range, 38-79 years]) with extensive lower extremity DVT were treated with PMT with the AngioJet thrombectomy device in combination with lytic agent (urokinase, tissue plasminogen activator, or reteplase) added to the infusion. Three patients underwent treatment twice, because of recurrent DVT. The primary end point was angiographic evidence. of restoration of venous patency at completion of the procedure. Complications, recurrent ipsilateral DVT, and improvement in clinical symptoms were evaluated. Results. Complete thrombus removal was obtained in 15 procedures (65%), and partial resolution in the remaining 8 procedures (35%). Inciting occlusive lesions responsible for acute DVT were revealed in 14 patients (61%), and angioplasty with or without stenting was performed when necessary. In the 8 procedures with partial resolution additional catheter-directed thrombolysis was carried out on average for 5.7 hours, with further thrombus reduction. Overall, immediate (<24 hours) improvement in clinical symptoms was noted in 17 patients (74%). There were no complications related to either PMT or the short duration of lytic agent infusion. At average follow-up of 10.2 +/- 0.3 months (range, 3-26 months), 3 patients had recurrent ipsilateral DVT, and underwent repeat treatment. Conclusions. Addition of lytic agent to PMT facilitates thrombus extraction, decreases overall interventional treatment time, and improves patient outcomes. In addition, definitive management of underlying anatomic lesions can be performed in the same setting. Further outcome measures are necessary to study the long-term efficacy of this treatment method on preservation of valve function, reduction of chronic venous insufficiency, and improved quality of life. C1 Baylor Coll Med, Michael E De Bakey Dept Surg, Houston VAMC, Div Vasc Surg & Envovasc Therapy, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. New York Presbyterian Hosp, Columbia Weill Cornell Div Vasc Surg, New York, NY USA. RP Bush, RL (reprint author), Baylor Coll Med, Michael E De Bakey Dept Surg, Houston VAMC, Div Vasc Surg & Envovasc Therapy, 2002 Holcomb Blvd 112, Houston, TX 77030 USA. EM rbush@bcm.tmc.edu RI Mureebe, Leila/C-2132-2009 OI Mureebe, Leila/0000-0001-5272-2871 NR 10 TC 64 Z9 69 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 NOV PY 2004 VL 40 IS 5 BP 965 EP 970 DI 10.1016/j.jvs.2004.08.025 PG 6 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 902XD UT WOS:000227389100027 PM 15557912 ER PT J AU Hazzard, WR AF Hazzard, WR TI Geriatrics: Specialty, subspecialty, or supraspecialty? SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Editorial Material C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. RP Hazzard, WR (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,S-182-GEC, Seattle, WA 98108 USA. EM william.hazzard@med.va.gov NR 1 TC 3 Z9 3 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 NOV PY 2004 VL 59 IS 11 BP 1161 EP 1162 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 882EH UT WOS:000225921200015 PM 15602065 ER PT J AU Ness, J Ahmed, A Aronow, WS AF Ness, J Ahmed, A Aronow, WS TI Demographics and payment characteristics of nursing home residents in the United States: A 23-year trend SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID LONG-TERM-CARE AB Background. With the aging of our population, an increased number of older Americans are expected to reside in nursing homes. Our objective is to determine the national trend in nursing home residence for older Americans. Methods. Using the Beyond 20/20 software, we analyzed publicly available data from National Nursing Home Surveys 1977-1999 to determine the trend in the demographics, marital status, and source of payments for older Americans residing in nursing homes. Results. The absolute number of persons aged 65 years and older residing in nursing homes increased from 1, 126,000 to 1,469,500 during the 23-year study period, with those aged 85 years and older, women, and African Americans being at a higher risk for nursing home placement. The rate of residence per 1000 civilian population actually declined from 58 to 43. Decline was most notable for persons aged 85 years and older, female, and white residents. The proportion of widowed persons among residents declined during the study period as well. Overall, Medicaid and private sources were the most common sources of payment. In 1999, Medicaid use was particularly prevalent among residents who were aged 65-74 years old, women, and/or African Americans. Conclusions. Older Americans at high risk for placement in nursing home facilities are aged 85 years and older, women, and African Americans, who are also more likely to rely on Medicaid as their primary source of payment. Preventive programs to keep older adults in the community should focus on this group of high-risk older adults. C1 New York Med Coll, Cardiol Div, Valhalla, NY 10595 USA. Univ Iowa Hlth Care, Dept Internal Med, Div Gen Internal Med, Iowa City, IA USA. Univ Alabama, Geriatr Heart Failure Clin, Birmingham, AL USA. Univ Alabama, Ctr Outcomes & Effectiveness Res & Educ, Ctr Aging, Sch Publ Hlth,Dept Epidemiol, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Med, Div Gerontol & Geriatr Med, Birmingham, AL USA. Birmingham VA Med Ctr, Sect Geriatr, Birmingham, AL USA. Birmingham VA Med Ctr, Geriatr Heart Failure Clin, Birmingham, AL USA. Alabama Qual Assurance Fdn, Heart Failure Project, Birmingham, W Midlands, England. New York Med Coll, Dept Med, Sect Cardiol, Valhalla, NY USA. New York Med Coll, Dept Med, Sect Geriatr, Valhalla, NY USA. Mt Sinai Sch Med, New York, NY USA. RP Aronow, WS (reprint author), New York Med Coll, Cardiol Div, Macy Pavil,Room 138, Valhalla, NY 10595 USA. EM wsaronow@aol.com NR 16 TC 24 Z9 24 U1 0 U2 2 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 NOV PY 2004 VL 59 IS 11 BP 1213 EP 1217 PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 882EH UT WOS:000225921200031 PM 15602078 ER PT J AU Kestenbaum, B Andress, DL Schwartz, SM Gillen, DL Seliger, SL Jadav, PR Sherrard, DJ Stehman-Breen, C AF Kestenbaum, B Andress, DL Schwartz, SM Gillen, DL Seliger, SL Jadav, PR Sherrard, DJ Stehman-Breen, C TI Survival following parathyroidectomy among United States dialysis patients SO KIDNEY INTERNATIONAL LA English DT Article DE parathyroidectomy; parathyroid hormone; hyperparathyroidism; mortality; dialysis ID STAGE RENAL-DISEASE; SECONDARY HYPERPARATHYROIDISM; HEMODIALYSIS-PATIENTS; SUBTOTAL PARATHYROIDECTOMY; CARDIOVASCULAR-DISEASE; CALCIUM HOMEOSTASIS; MORTALITY RISK; BLOOD-PRESSURE; BONE-DISEASE; SHORT-TERM AB Background. Secondary hyperparathyroidism (SHPTH) is highly prevalent among persons with end-stage renal disease (ESRD). SHPTH has been linked to uremic bone disease, vascular calcification, and a higher risk of death. Parathyroidectomy (PTX) can dramatically reduce parathyroid hormone (PTH) and phosphate levels; however, the relationship between PTX and survival is not known. Methods. We conducted an observational matched cohort study utilizing data from the United States Renal Database System (USRDS) in which 4558 patients undergoing a first PTX while on hemodialysis or peritoneal dialysis were individually matched by age, race, gender, cause of ESRD, dialysis duration, prior transplantation status, and dialysis modality to 4558 control patients who did not undergo PTX. Patients were followed from the date of PTX until they died or were lost to follow-up. Results. The 30-day postoperative mortality rate following PTX was 3.1%. Long-term relative risks of death among patients undergoing PTX were estimated to be 10% to 15% lower than those of matched control patients not undergoing surgery. Survival curves between the 2 groups crossed 587 days following PTX. Median survival was 53.4 months (95% CI: 51.2-56.4) in the PTX group, and 46.8 months (95% CI: 44.7-48.9) in the control group. Conclusion. PTX was associated with higher short-term, and lower long-term, mortality rates among U. S. patients receiving chronic dialysis. Measures to attenuate SHPTH may play an important role in reducing mortality among patients with end-stage renal disease. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Div Nephrol, Seattle, WA 98108 USA. Univ Washington, Dept Epidemiol, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA. Fred Hutchinson Canc Res Ctr, Program Epidemiol, Seattle, WA 98104 USA. Univ Chicago, Dept Hlth Studies, Chicago, IL USA. Univ Washington, Div Nephrol, Seattle, WA USA. Amgen Inc, Thousand Oaks, CA 91320 USA. RP Kestenbaum, B (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Div Nephrol, Mail Stop 111A,1660 S Columbian Way, Seattle, WA 98108 USA. EM brk@u.washington.edu NR 28 TC 109 Z9 112 U1 0 U2 5 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD NOV PY 2004 VL 66 IS 5 BP 2010 EP 2016 DI 10.1111/j.1523-1755.2004.00972.x PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 862CS UT WOS:000224467900030 PM 15496173 ER PT J AU Peabody, JW Luck, J Jain, S Bertenthal, D Glassman, P AF Peabody, JW Luck, J Jain, S Bertenthal, D Glassman, P TI Assessing the accuracy of administrative data in health information systems SO MEDICAL CARE LA English DT Article DE administrative data; medical informatics; quality of care; standardized patients; diagnostic errors; medical records/standards ID MEDICAL-RECORDS; VETERANS-AFFAIRS; PATIENT RECORDS; CARE; QUALITY; DATABASES; OUTCOMES; STROKE; PHYSICIAN; PATTERNS AB Background: Administrative data play a central role in health care. Inaccuracies in such data are costly to health systems, they obscure health research, and they affect the quality of patient care. Objectives: We sought to prospectively determine the accuracy of the primary and secondary diagnoses recorded in administrative data sets. Research Design: Between March and July 2002, standardized patients (SPs) completed unannounced visits at 3 sites. We abstracted the 348 medical records from these visits to obtain the written diagnoses made by physicians. We also examined the patient files to identify the diagnoses recorded on the administrative encounter forms and extracted data from the computerized administrative databases. Because the correct diagnosis was defined by the SP visit, we could determine whether the final diagnosis in the administrative data set was correct and, if not, whether it was caused by physician diagnostic error, missing encounter forms, or incorrectly filled out forms. Subjects: General internal medicine outpatient clinics at 2 Veterans Administration facilities and a large, private medical center participated in this study. Measures: A total of 45 trained SPs presented to physicians with 4 common outpatient conditions. Results: The correct primary diagnosis was recorded for 57% of visits. Thirteen percent of errors were caused by physician diagnostic error, 8% to missing encounter forms, and 22% to incorrectly entered data. Findings varied by condition and site but not by level of training. Accuracy of secondary diagnosis data (27%) was even poorer. Conclusions: Although more research is needed to evaluate the cause of inaccuracies and the relative contributions of patient, provider, and system level effects, it appears that significant inaccuracies in administrative data are common. Interventions aimed at correcting these errors appear feasible. C1 Univ Calif San Francisco, Inst Global Hlth, San Francisco, CA 94105 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. RAND, Santa Monica, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. VA Ctr Study Healthcare Provider Behav, Sepulveda, CA USA. RP Peabody, JW (reprint author), Univ Calif San Francisco, Inst Global Hlth, 74 New Montgomery,Suite 508, San Francisco, CA 94105 USA. EM peabody@psg.ucsf.edu NR 49 TC 130 Z9 131 U1 1 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 NOV PY 2004 VL 42 IS 11 BP 1066 EP 1072 DI 10.1097/00005650-200411000-00005 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 864RU UT WOS:000224651400005 PM 15586833 ER EF