FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Kwiatkowski, BA Richard, RE AF Kwiatkowski, Boguslaw A. Richard, Robert E. TI Angiotensin II Receptor-Associated Protein (AGTRAP) Synergizes with Mpl Signaling to Promote Survival and to Increase Proliferation Rate of Hematopoietic Cells. SO BLOOD LA English DT Meeting Abstract CT 51st Annual Meeting of the American-Society-of-Hematology CY DEC 05-08, 2009 CL New Orleans, LA SP Amer Soc Hematol C1 [Kwiatkowski, Boguslaw A.] VA Puget Sound Hlth Care Syst, Seattle Inst Biomed & Clin Res, Seattle, WA USA. [Richard, Robert E.] Univ Washington, Seattle, WA 98195 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 20 PY 2009 VL 114 IS 22 BP 1395 EP 1395 PG 1 WC Hematology SC Hematology GA 532DS UT WOS:000272725804270 ER PT J AU Shi, YJ Gera, J Lichtenstein, A AF Shi, Yijiang Gera, Joseph Lichtenstein, Alan TI Interleukin-6 (IL-6) Enhances C-MYC Translation IN MULTIPLE MYELOMA (MM) CELLS: ROLE of IL-6-INDUCED EFFECTS On the C-MYC RNA-Binding PROTEIN, HNRNPA1 SO BLOOD LA English DT Meeting Abstract CT 51st Annual Meeting of the American-Society-of-Hematology CY DEC 05-08, 2009 CL New Orleans, LA SP Amer Soc Hematol C1 [Shi, Yijiang; Gera, Joseph] Univ Calif Los Angeles, Dept Med, Div Hematol Oncol, Greater Los Angeles VA Healthcare Ctr, Los Angeles, CA 90024 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 20 PY 2009 VL 114 IS 22 BP 1477 EP 1477 PG 1 WC Hematology SC Hematology GA 532DS UT WOS:000272725804503 ER PT J AU Wharton, W Dowling, M Khosropour, CM Carlsson, C Asthana, S Gleason, CE AF Wharton, Whitney Dowling, Maritza Khosropour, Christine M. Carlsson, Cynthia Asthana, Sanjay Gleason, Carey E. TI Cognitive benefits of hormone therapy: Cardiovascular factors and healthy-user bias SO MATURITAS LA English DT Article DE Hormone therapy; Estrogen; Healthy-user bias; Cardiovascular risk; Cognition; Alzheimer's disease ID CORONARY-HEART-DISEASE; ESTROGEN REPLACEMENT THERAPY; POSTMENOPAUSAL WOMEN; BLOOD-PRESSURE; ALZHEIMERS-DISEASE; CLINICAL-TRIALS; PLUS PROGESTIN; SELF-REPORT; PREVENTION; HYPERTENSION AB Objective: The Women's Health Initiative (WHI) study and its ancillary Memory Study (WHIMS) revealed increased rates of cardiovascular risk, cognitive decline and dementia with opposed conjugated equine estrogens (CEE). As a result, previously accepted observational data suggesting cardiovascular and cognitive benefits and reduced risk for dementia with hormone therapy (HT) were largely attributed to 'healthy-user' bias. The present observational, community-based, case-controlled study examined the 'healthy-user' bias theory by comparing cognitive task performance in two groups of postmenopausal women, who were either HT users or non-users. Design: Participants were 213 non-demented, postmenopausal women residing in the community and in assisted-living facilities who completed a self-report health questionnaire and underwent a 1-h cognitive test battery. To study the independent contribution of variables in the prediction of cognitive performance, we employed a series of hierarchical regression models adding terms in three stages. The first stage included only HT, the second stage added demographics, and the last stage added alcohol, depression and a cardiovascular risk factor (CVRF) composite derived from a confirmatory factor analysis. The CVRF composite consisted of: stroke, diabetes, hypertension, and hypercholesterolemia. Results: Although independent samples t-tests revealed no statistically significant differences in the CVRF composite and its individual components between the two groups, HT users tended to possess fewer CVRF than non-users. Conversely, HT users were younger and more educated than non-users. HT users outperformed non-users on 7/9 cognitive variables. The full regression model controlling for CVRF, demographic variables, and mood showed HT users outperformed non-users on measures of verbal memory and abstract reasoning. Conclusions: While there is some evidence HT users possess fewer preexisting CVRF than non-users, the observed positive association between HT and cognition is not completely explained by this trend. (C) 2009 Elsevier Ireland Ltd. All rights reserved. C1 [Wharton, Whitney; Dowling, Maritza; Carlsson, Cynthia; Asthana, Sanjay; Gleason, Carey E.] Univ Wisconsin, Sch Med & Publ Hlth, Madison, WI 53705 USA. [Khosropour, Christine M.] Emory Univ, Sch Publ Hlth, Atlanta, GA 30322 USA. [Wharton, Whitney; Dowling, Maritza; Carlsson, Cynthia; Asthana, Sanjay; Gleason, Carey E.] William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI USA. RP Wharton, W (reprint author), Univ Wisconsin, Sch Med & Publ Hlth, William S Middleton VA Hosp, 2500 Overlook Terrace,GRECC 11G, Madison, WI 53705 USA. EM wlwharto@medicine.wisc.edu FU NIH [AG029624, K07AG021582, K23AG024302, K23AG026752]; National Center for Research Resources, National Institutes of Health [1UL1RR025011] FX This research was conducted with the help of the Section of Geriatrics and Gerontology, Department of Medicine at the University of Wisconsin, Madison, and the Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital. This research was supported by NIH grants AG029624, K07AG021582, K23AG024302 and K23AG026752, and by grant 1UL1RR025011 from the Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources, National Institutes of Health. NR 37 TC 7 Z9 8 U1 0 U2 4 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0378-5122 J9 MATURITAS JI Maturitas PD NOV 20 PY 2009 VL 64 IS 3 BP 182 EP 187 DI 10.1016/j.maturitas.2009.09.014 PG 6 WC Geriatrics & Gerontology; Obstetrics & Gynecology SC Geriatrics & Gerontology; Obstetrics & Gynecology GA 526QQ UT WOS:000272308000007 PM 19879073 ER PT J AU Kerlikowske, K AF Kerlikowske, Karla TI Evidence-Based Breast Cancer Prevention: The Importance of Individual Risk SO ANNALS OF INTERNAL MEDICINE LA English DT Editorial Material ID COST-EFFECTIVENESS ANALYSIS; SCREENING MAMMOGRAPHY; WOMEN 40; TAMOXIFEN; MODEL; TRIAL; AGE; CHEMOPREVENTION; VALIDATION; PHYSICIANS C1 San Francisco VA Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. RP Kerlikowske, K (reprint author), San Francisco VA Med Ctr, Gen Internal Med Sect, 111A1,4150 Clement St, San Francisco, CA 94121 USA. EM karla.kerlikowske@ucsf.edu FU NCI NIH HHS [U01CA63740, P50 CA58207] NR 30 TC 29 Z9 30 U1 1 U2 1 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD NOV 17 PY 2009 VL 151 IS 10 BP 750 EP 752 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 524LP UT WOS:000272145100009 PM 19920276 ER PT J AU Simon, JA AF Simon, Joel A. TI Review: Evidence for the effectiveness of vitamin D and calcium for reducing CV outcomes, cancer, and death is limited SO ANNALS OF INTERNAL MEDICINE LA English DT Editorial Material ID D SUPPLEMENTATION C1 [Simon, Joel A.] San Francisco VA Med Ctr, San Francisco, CA USA. [Simon, Joel A.] Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Simon, JA (reprint author), San Francisco VA Med Ctr, San Francisco, CA USA. NR 4 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD NOV 17 PY 2009 VL 151 IS 10 AR JC5-5 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 524LP UT WOS:000272145100016 PM 19920263 ER PT J AU Ganz, DA Yano, EM Saliba, D Shekelle, PG AF Ganz, David A. Yano, Elizabeth M. Saliba, Debra Shekelle, Paul G. TI Design of a continuous quality improvement program to prevent falls among community-dwelling older adults in an integrated healthcare system SO BMC HEALTH SERVICES RESEARCH LA English DT Article ID VULNERABLE ELDERS; MOBILITY PROBLEMS; CONTROLLED-TRIAL; METAANALYSIS; MANAGEMENT; PEOPLE; RISK; IMPLEMENTATION; ORGANIZATIONS; INTERVENTIONS AB Background: Implementing quality improvement programs that require behavior change on the part of health care professionals and patients has proven difficult in routine care. Significant randomized trial evidence supports creating fall prevention programs for community-dwelling older adults, but adoption in routine care has been limited. Nationally-collected data indicated that our local facility could improve its performance on fall prevention in community-dwelling older people. We sought to develop a sustainable local fall prevention program, using theory to guide program development. Methods: We planned program development to include important stakeholders within our organization. The theory-derived plan consisted of 1) an initial leadership meeting to agree on whether creating a fall prevention program was a priority for the organization, 2) focus groups with patients and health care professionals to develop ideas for the program, 3) monthly workgroup meetings with representatives from key departments to develop a blueprint for the program, 4) a second leadership meeting to confirm that the blueprint developed by the workgroup was satisfactory, and also to solicit feedback on ideas for program refinement. Results: The leadership and workgroup meetings occurred as planned and led to the development of a functional program. The focus groups did not occur as planned, mainly due to the complexity of obtaining research approval for focus groups. The fall prevention program uses an existing telephonic nurse advice line to 1) place outgoing calls to patients at high fall risk, 2) assess these patients' risk factors for falls, and 3) triage these patients to the appropriate services. The workgroup continues to meet monthly to monitor the progress of the program and improve it. Conclusion: A theory-driven program development process has resulted in the successful initial implementation of a fall prevention program. C1 [Ganz, David A.; Yano, Elizabeth M.; Saliba, Debra; Shekelle, Paul G.] VA Greater Los Angeles HSR&D Ctr Excellence, Sepulveda, CA 91343 USA. [Ganz, David A.; Saliba, Debra] Vet Affairs Greater Los Angeles Healthcare Syst, Geriatr Res Educ & Clin Ctr, Los Angeles, CA 90073 USA. [Ganz, David A.; Saliba, Debra; Shekelle, Paul G.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Yano, Elizabeth M.] Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90095 USA. [Saliba, Debra] Univ Calif Los Angeles, Borun Ctr Gerontol Res, Los Angeles, CA 90095 USA. RP Ganz, DA (reprint author), VA Greater Los Angeles HSR&D Ctr Excellence, 16111 Plummer St, Sepulveda, CA 91343 USA. EM David.Ganz@va.gov; Elizabeth.Yano@va.gov; Debra.Saliba@va.gov; Paul.Shekelle@va.gov FU U. S. Department of Veterans Affairs; U. S. Department of Veterans Affairs, Veterans Health Administration; VA Health Services Research & Development (HSR&D) Service through the VA Greater Los Angeles HSR&D Center of Excellence [VA CD2 08-012-1]; UCLA Older Americans Independence Center; NIH/NIA [P30-AG028748]; Greater Los Angeles VA Health Services Research & Development Center of Excellence [LIP 65-150] FX The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the U. S. Department of Veterans NR 30 TC 11 Z9 12 U1 3 U2 13 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1472-6963 J9 BMC HEALTH SERV RES JI BMC Health Serv. Res. PD NOV 16 PY 2009 VL 9 AR 206 DI 10.1186/1472-6963-9-206 PG 11 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 521LA UT WOS:000271921700001 PM 19917122 ER PT J AU Jayachandran, J Banez, LL Aronson, WJ Terris, MK Presti, JC Amling, CL Kane, CJ Freedland, SJ AF Jayachandran, Jayakrishnan Banez, Lionel L. Aronson, William J. Terris, Martha K. Presti, Joseph C., Jr. Amling, Christopher L. Kane, Christopher J. Freedland, Stephen J. CA SEARCH Database Study Grp TI Obesity as a Predictor of Adverse Outcome Across Black and White Race Results From the Shared Equal Access Regional Cancer Hospital (SEARCH) Database SO CANCER LA English DT Article DE prostatic neoplasms; prostatectomy; recurrence; obesity; continental population groups ID PROSTATE-CANCER; RADICAL PROSTATECTOMY; STEROID-HORMONES; UNITED-STATES; WEIGHT CHANGE; RISK; RECURRENCE; MORTALITY; MEN; IMPACT AB BACKGROUND: Across multiple studies, obesity has been associated with an increased risk of higher grade disease and prostate-specific antigen (PSA) recurrence after radical prostatectomy (RP). Whether these associations vary by race is unknown. In the current study, the authors examined the association between obesity and outcome after RID stratified by race. METHODS: A retrospective analysis was performed on 1415 men in the Shared Equal Access Regional Cancer Hospital (SEARCH) database who underwent RID between 1989 and 2008. The association between increased body mass index (BMI) and adverse pathology and biochemical recurrence was examined using multivariate logistic regression and Cox models, respectively. Data were examined stratified by race. RESULTS: After adjusting for preoperative clinical characteristics, higher BMI was associated with higher tumor grade (P = .008) and positive surgical margins (P < .001) in white men, and similar but statistically nonsignificant trends were observed in black men. No significant interaction was noted between race and BMI for associations with adverse pathology (P(interaction)>=.12). After adjusting for preoperative clinical characteristics, higher BMI was associated with an increased risk of recurrence in both white men (P = .001) and black men (P = .03). After further adjusting for pathologic variables, higher BMI was associated with significantly increased risk of recurrence in white men (P = .002) and black men (P = .01). No significant interactions were observed between race and BMI for predicting biochemical progression adjusting either for preoperative factors (P(interaction) = .35) or for preoperative and pathologic features (P(interaction) = .47). CONCLUSIONS: Obesity was associated with a greater risk of recurrence among both black men and white men. Obesity did not appear to be more or less influential in 1 race than another but, rather, was identified as a risk factor for aggressive cancer regardless of race. Cancer 2009;115:5263-71. (C) 2009 American Cancer Society. C1 [Jayachandran, Jayakrishnan; Banez, Lionel L.; Freedland, Stephen J.] Duke Univ, Sch Med, Dept Surg, Div Urol Surg, Durham, NC 27710 USA. [Jayachandran, Jayakrishnan; Banez, Lionel L.; Freedland, Stephen J.] Duke Univ, Sch Med, Dept Pathol, Div Urol Surg, Durham, NC 27710 USA. [Jayachandran, Jayakrishnan; Banez, Lionel L.; Freedland, Stephen J.] Duke Univ, Sch Med, Duke Prostate Ctr, Durham, NC 27710 USA. [Jayachandran, Jayakrishnan; Banez, Lionel L.; Freedland, Stephen J.] Vet Affairs Med Ctr, Urol Sect, Durham, NC USA. [Aronson, William J.] Vet Affairs Greater Los Angeles Healthcare Syst, Urol Sect, Los Angeles, CA USA. [Aronson, William J.] Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA USA. [Terris, Martha K.] Med Coll Georgia, Urol Sect, Augusta, GA 30912 USA. [Presti, Joseph C., Jr.] Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA. [Presti, Joseph C., Jr.] Vet Affairs Med Ctr, Urol Sect, Palo Alto, CA 94304 USA. [Amling, Christopher L.] Univ Alabama, Div Urol, Birmingham, AL USA. [Amling, Christopher L.] Birmingham Vet Affairs Med Ctr, Urol Sect, Birmingham, AL USA. [Kane, Christopher J.] Univ Calif San Diego, Sch Med, Div Urol, San Diego, CA 92103 USA. RP Freedland, SJ (reprint author), Duke Univ, Sch Med, Med Ctr, Div Urol, Box 2626, Durham, NC 27710 USA. EM steve.freedland@duke.edu OI Terris, Martha/0000-0002-3843-7270 FU Department of Veterans Affairs, National Institutes of Health (NIH) [RO1CA100938]; NIH Specialized Programs of Research Excellence [P50 CA92131-01A1]; Georgia Cancer Coalition; Department of Defense, Prostate Cancer Research Program; American Urological Association Foundation/Astellas Rising Star in Urology Award FX Supported by the Department of Veterans Affairs, National Institutes of Health (NIH) Grant RO1CA100938 (to W.J.A.); NIH Specialized Programs of Research Excellence Grant P50 CA92131-01A1 (to W.J.A.); the Georgia Cancer Coalition (to M.K.T.); the Department of Defense, Prostate Cancer Research Program, (to S.J.F. and J.J.); and the American Urological Association Foundation/Astellas Rising Star in Urology Award (to S.J.F.). NR 22 TC 38 Z9 38 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER JI Cancer PD NOV 15 PY 2009 VL 115 IS 22 BP 5263 EP 5271 DI 10.1002/cncr.24571 PG 9 WC Oncology SC Oncology GA 516SW UT WOS:000271564100020 PM 19670453 ER PT J AU Yanagawa, J Walser, TC Zhu, LX Hong, LS Fishbein, MC Mah, V Chia, D Goodglick, L Elashoff, DA Luo, J Magyar, CE Dohadwala, M Lee, JM St John, MA Strieter, RM Sharma, S Dubinett, SM AF Yanagawa, Jane Walser, Tonya C. Zhu, Li X. Hong, Longsheng Fishbein, Michael C. Mah, Vei Chia, David Goodglick, Lee Elashoff, David A. Luo, Jie Magyar, Clara E. Dohadwala, Mariam Lee, Jay M. St John, Maie A. Strieter, Robert M. Sharma, Sherven Dubinett, Steven M. TI Snail Promotes CXCR2 Ligand-Dependent Tumor Progression in Non-Small Cell Lung Carcinoma SO CLINICAL CANCER RESEARCH LA English DT Article ID EPITHELIAL-MESENCHYMAL TRANSITION; E-CADHERIN EXPRESSION; TRANSCRIPTION FACTOR; CANCER-CELLS; COLON-CANCER; KAPPA-B; SURVIVAL; ANGIOGENESIS; METASTASIS; INVASION AB Purpose: As a transcriptional repressor of E-cadherin, Snail has predominantly been associated with epithelial-mesenchymal transition, invasion, and metastasis. However, other important Snail-dependent malignant phenotypes have not been fully explored. Here, we investigate the contributions of Snail to the progression of non-small cell lung cancer (NSCLC). Experimental Design: Immunohistochemistry was done to quantify and localize Snail in human lung cancer tissues, and tissue microarray analysis was used to correlate these findings with survival. NSCLC cell lines gene-modified to stably overexpress Snail were evaluated in vivo in two severe combined immunodeficiency murine tumor models. Differential gene expression between Snail-overexpressing and control cell lines was evaluated using gene expression microarray analysis. Results: Snail is upregulated in human NSCLC tissue, and high levels of Snail expression correlate with decreased survival (P < 0.026). In a heterotopic model, mice bearing Snail-overexpressing tumors developed increased primary tumor burden (P = 0.008). In an orthotopic model, mice bearing Snail-overexpressing tumors also showed a trend toward increased metastases. In addition, Snail overexpression led to increased angiogenesis in primary tumors as measured by MECA-32 (P < 0.05) positivity and CXCL8 (P = 0.002) and CXCL5 (P = 0.0003) concentrations in tumor homogenates. Demonstrating the importance of these proangiogenic chemokines, the Snail-mediated increase in tumor burden was abrogated with CXCR2 blockade. Gene expression analysis also revealed Snail-associated differential gene expression with the potential to affect angiogenesis and diverse aspects of lung cancer progression. Conclusion: Snail upregulation plays a role in human NSCLC by promoting tumor progression mediated by CXCR2 ligands. (Clin Cancer Res 2009;15(22):6820-9) C1 [Dubinett, Steven M.] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Lung Canc Res Program, Div Pulm & Crit Care Med, Los Angeles, CA 90095 USA. [Yanagawa, Jane; Walser, Tonya C.; Elashoff, David A.; Luo, Jie; Dohadwala, Mariam; Dubinett, Steven M.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. [Hong, Longsheng; Fishbein, Michael C.; Mah, Vei; Chia, David; Goodglick, Lee; Magyar, Clara E.; Dubinett, Steven M.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. [Elashoff, David A.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Biostat, Los Angeles, CA 90095 USA. [Yanagawa, Jane; Lee, Jay M.; St John, Maie A.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. [Zhu, Li X.; Dohadwala, Mariam; Sharma, Sherven; Dubinett, Steven M.] VA Greater Los Angeles Hlth Care Ctr, Los Angeles, CA USA. [Strieter, Robert M.] Univ Virginia, Dept Med, Charlottesville, VA USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Lung Canc Res Program, Div Pulm & Crit Care Med, 10833 Le Conte Ave,37-131 CHS, Los Angeles, CA 90095 USA. EM sdubinett@mednet.ucla.edu FU National Cancer Institute [CA90388]; University of California [NIH/NHLBI T32 HL72752]; Reiss Family and Piansky Family Trust; Early Detection Research Network [NCI CA-86366] FX Specialized Programs of Research Excellence in Lung Cancer grant P50-CA90388, National Cancer Institute, LUNGevity/Thoracic Surgery Foundation for Research and Education Research Fellowship, University of California at Los Angeles Pulmonary & Critical Care Training Grant, NIH/NHLBI T32 HL72752, Department of Veteran Affairs Medical Research Funds, Tobacco Related Disease Program Award Program of the University of California, Reiss Family and Piansky Family Trust, and the Early Detection Research Network, NCI CA-86366. NR 50 TC 60 Z9 62 U1 0 U2 6 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 NOV 15 PY 2009 VL 15 IS 22 BP 6820 EP 6829 DI 10.1158/1078-0432.CCR-09-1558 PG 10 WC Oncology SC Oncology GA 520EJ UT WOS:000271822600011 PM 19887480 ER PT J AU Lipsky, BA Hoey, C AF Lipsky, Benjamin A. Hoey, Christopher TI Topical Antimicrobial Therapy for Treating Chronic Wounds SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID ANTIBIOTIC-RESISTANT BACTERIA; DIABETIC FOOT ULCERS; VENOUS LEG ULCERS; SKIN INFECTIONS; IN-VITRO; COLONIZATION; RETAPAMULIN; HONEY; MICROBIOLOGY; MANAGEMENT AB Various agents have been applied topically to treat infected wounds for millennia, but their proper role remains unclear. Topical therapy affords many potential advantages but also has disadvantages. Opinions differ on which clinical signs define wound infection and on whether quantitative microbiological studies are useful. Clinically infected wounds usually require systemic antibiotic therapy, whereas clinically uninfected wounds that are healing as expected do not require antimicrobials. There is controversy over how to treat poorly healing wounds with "secondary" signs suggesting infection; these may benefit from topical antimicrobial agents. Some evidence supports using topical agents for malodorous or burn wounds. Meta-analyses and systematic reviews suggest there are few proven indications for topical antimicrobials. Use of a newer, relatively nontoxic antiseptic (eg, cadexomer iodine or silver dressings) is preferable to use of topical antibiotics, especially agents that are available for systemic use. We provide clinically relevant information on currently available topical antimicrobial agents. C1 [Lipsky, Benjamin A.; Hoey, Christopher] VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. [Lipsky, Benjamin A.] Univ Washington, Sch Med, Seattle, WA USA. RP Lipsky, BA (reprint author), VA Puget Sound Hlth Care Syst, S-111-PCC 1660 S Columbian Way, Seattle, WA 98108 USA. EM balipsky@u.washington.edu OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 53 TC 114 Z9 120 U1 7 U2 54 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1058-4838 EI 1537-6591 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD NOV 15 PY 2009 VL 49 IS 10 BP 1541 EP 1549 DI 10.1086/644732 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 511EH UT WOS:000271146200015 PM 19842981 ER PT J AU Aujesky, D McCausland, JB Whittle, J Obrosky, DS Yealy, DM Fine, MJ AF Aujesky, Drahomir McCausland, Julie B. Whittle, Jeff Obrosky, D. Scott Yealy, Donald M. Fine, Michael J. TI Reasons Why Emergency Department Providers Do Not Rely on the Pneumonia Severity Index to Determine the Initial Site of Treatment for Patients with Pneumonia SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID COMMUNITY-ACQUIRED PNEUMONIA; LOW-RISK PATIENTS; RESEARCH TEAM COHORT; PREDICTION RULE; ADMISSION DECISION; CLINICAL JUDGMENT; RANDOMIZED-TRIAL; HOSPITALIZATION; OUTCOMES; CARE AB Background. Many emergency department (ED) providers do not follow guideline recommendations for the use of the pneumonia severity index (PSI) to determine the initial site of treatment for patients with community-acquired pneumonia (CAP). We identified the reasons why ED providers hospitalize low-risk patients or manage higher-risk patients as outpatients. Methods. As a part of a trial to implement a PSI-based guideline for the initial site of treatment of patients with CAP, we analyzed data for patients managed at 12 EDs allocated to a high-intensity guideline implementation strategy study arm. The guideline recommended outpatient care for low-risk patients (nonhypoxemic patients with a PSI risk classification of I, II, or III) and hospitalization for higher-risk patients (hypoxemic patients or patients with a PSI risk classification of IV or V). We asked providers who made guideline-discordant decisions on site of treatment to detail the reasons for nonadherence to guideline recommendations. Results. There were 1,306 patients with CAP (689 low-risk patients and 617 higher-risk patients). Among these patients, physicians admitted 258 (37.4%) of 689 low-risk patients and treated 20 (3.2%) of 617 higher-risk patients as outpatients. The most commonly reported reasons for admitting low-risk patients were the presence of a comorbid illness (178 [71.5%] of 249 patients); a laboratory value, vital sign, or symptom that precluded ED discharge (73 patients [29.3%]); or a recommendation from a primary care or a consulting physician (48 patients [19.3%]). Higher-risk patients were most often treated as outpatients because of a recommendation by a primary care or consulting physician (6 [40.0%] of 15 patients). Conclusion. ED providers hospitalize many low-risk patients with CAP, most frequently for a comorbid illness. Although higher-risk patients are infrequently treated as outpatients, this decision is often based on the request of an involved physician. C1 [Aujesky, Drahomir] Univ Lausanne, Dept Med, Div Gen Internal Med, Lausanne, Switzerland. [McCausland, Julie B.; Yealy, Donald M.] Univ Pittsburgh, Dept Emergency Med, Pittsburgh, PA USA. [Obrosky, D. Scott; Fine, Michael J.] Univ Pittsburgh, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. [Obrosky, D. Scott; Fine, Michael J.] Vet Affairs Pittsburgh Healthcare Syst, Vet Affairs Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Whittle, Jeff] Med Coll Wisconsin, Clement J Zablocki Vet Affairs Med Ctr, Primary Care Div, Milwaukee, WI 53226 USA. [Whittle, Jeff] Med Coll Wisconsin, Dept Med, Div Gen Internal Med, Milwaukee, WI 53226 USA. RP Aujesky, D (reprint author), CHU Vaudois, Serv Med Interne, BH 10-622, CH-1011 Lausanne, Switzerland. EM drahomir.aujesky@chuv.ch FU Agency for Healthcare Research and Quality [R01 HS10049]; National Institute of Allergy and Infectious Diseases [K24 AI001769] FX Financial support. This research was conducted as part of the project entitled "Guideline to Improve Quality of Initial Pneumonia Care," funded by the Agency for Healthcare Research and Quality (grant R01 HS10049). M.J.F. received support in part from a career development award from the National Institute of Allergy and Infectious Diseases (grant K24 AI001769). NR 25 TC 38 Z9 39 U1 1 U2 3 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 15 PY 2009 VL 49 IS 10 BP E100 EP E108 DI 10.1086/644741 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 511EH UT WOS:000271146200032 PM 19842971 ER PT J AU Rossen, RD Rubio, JA Porter, WJ Trial, J Orson, FM Rodriguez-Barradas, MC Birdsall, HH AF Rossen, Roger D. Rubio, Jose A. Porter, Wendy J. Trial, JoAnn Orson, Frank M. Rodriguez-Barradas, Maria C. Birdsall, Holly H. TI Monocyte CD49e and 110-120 kDa fibronectin fragments: HIV prognostic indicators independent of viral load and CD4 T-cell counts SO AIDS LA English DT Article DE cell-binding 110-120 kDa fibronectin fragments; inflammation; monocytes; patient survival; protease-antiprotease balance ID HUMAN-IMMUNODEFICIENCY-VIRUS; TRANSENDOTHELIAL MIGRATION; PROTEASE INHIBITORS; SECRETION; ALPHA(1)-ANTITRYPSIN; INFECTIVITY; ACTIVATION; EXPRESSION; LEUKOCYTES; TYPE-1 AB Objective: To investigate the prognostic impact of chronic inflammation associated with HIV infections. Previously, we had observed that proteases, released in the course of HIV infections, cause 110-120 kDa fibronectin fragments (FNf) to appear in the blood of many patients. In vitro, at concentrations within the range found in patients' plasma, FNf stimulate monocytes to release proteolytic enzymes that remove CD49e from the cell surface and produce cytokines that suppress proliferation of activated T cells when stimulated by agents that crosslink their antigen receptors. Design: A long-term observational study of patients whose plasma FNf and monocyte CD49e had been measured at 90-day intervals for 1.4 +/- 0.5 years. Methods: Plasma FNf was measured by a quantitative western blot assay and monocyte CD49e expression by flow cytometry. Patients were monitored clinically for up to 5 years after enrollment. Results: All-cause mortality was significantly higher in patients who had at least 5 mu g/ml FNf in more than 50% of plasma samples and/or persistent depletion of monocyte CD49e. Persistence of FNf and depletion of monocyte CD49e were not associated with changes in viral load or CD4 T-cell counts. Conclusion: Persistently reduced expression of blood monocyte CD49e and/or the persistent presence of FNf in plasma are adverse prognostic markers in HIV-infected patients. (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins C1 [Rossen, Roger D.; Rubio, Jose A.; Porter, Wendy J.; Trial, JoAnn; Orson, Frank M.; Rodriguez-Barradas, Maria C.; Birdsall, Holly H.] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Rossen, Roger D.; Rubio, Jose A.; Porter, Wendy J.; Trial, JoAnn; Orson, Frank M.; Rodriguez-Barradas, Maria C.; Birdsall, Holly H.] Baylor Coll Med, Houston, TX 77030 USA. RP Rossen, RD (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Bldg 109,Room 228,2002 Holcombe Blvd, Houston, TX 77030 USA. EM rrossen@bcm.tmc.edu FU Department of Veterans Affairs Merit Review Program; National Institutes of Health [RO1-AI46285, RO1-MH63035] FX The support for this study was provided by the Department of Veterans Affairs Merit Review Program and National Institutes of Health grants: RO1-AI46285 and RO1-MH63035. NR 30 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 J9 AIDS JI Aids PD NOV 13 PY 2009 VL 23 IS 17 BP 2247 EP 2253 DI 10.1097/QAD.0b013e3283318ff4 PG 7 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 517CF UT WOS:000271589700002 PM 19710592 ER PT J AU Xiu, MH Hui, L Dang, YF De Hou, T Zhang, CX Zheng, YL Chen, DC Kosten, TR Zhang, XY AF Xiu, Mei Hong Hui, Li Dang, Yu Feng De Hou, Tian Zhang, Chong Xi Zheng, You Lan Chen, Da Chun Kosten, Thomas R. Zhang, Xiang Yang TI Decreased serum BDNF levels in chronic institutionalized schizophrenia on long-term treatment with typical and atypical antipsychotics SO PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY LA English DT Review DE Antipsychotic drug; Brain-derived neurotrophic factor; Neurotrophin; Psychopathology; Schizophrenia ID NEUROTROPHIC FACTOR; RAT HIPPOCAMPUS; MESSENGER-RNA; GROWTH-FACTOR; PREFRONTAL CORTEX; BIPOLAR DISORDER; WEIGHT-GAIN; BRAIN; EXPRESSION; PLASMA AB Accumulating evidence showed that brain-derived neurotrophic factor (BDNF) may be involved in the pathophysiology of schizophrenia. Decreased BDNFlevels have been found in the serum of schizophrenic patients with mixed results. In the present study, we assessed serum BDNF levels in a large group of 364 schizophrenic patients (157 on clozapine, 89 on risperidone and 118 on typical antipsychotics), compared to 323 healthy control subjects matched for age and gender. The schizophrenia symptomatology was assessed by the Positive and Negative Syndrome Scale (PANSS), and serum BDNF levels were measured by sandwich ELISA. The results showed that BDNF levels were significantly lower in chronic patients with schizophrenia than in healthy control subjects (9.9 +/- 2.0 ng/ml vs. 11.9 +/- 23 ng/ml, p < 0.0001). Lower BDNF levels were observed in patients treated with risperidone (9.3 +/- 2.3 ng/ml) compared to those with clozapine (10.2 +/- 2.0 ng/ml, p < 0.001) and typical antipsychotics(10.0 +/- 2.1 ng/ml,p <0.01). Furthermore, a stepwise multiple regression analysis identified types of antipsychotic drugs (beta=-0.37, t=-3.15, p=0.001) and BDNF levels (beta=-0.26, t=-2.51, p = 0.014) as the influencing factor for the positive symptom subscore of PANSS. In addition, there was a sex difference in BDNF levels inpatients with schizophrenia (9.7 +/- 1.9 ng/ml for males vs. 10.4 +/- 2.1 ng/ml for female, p<0.005). but not in normal controls. Our findings indicated decreased BDNF serum levels in chronic patients with schizophrenia, which may be related to clinical phenotypes, including gender, antipsychotic treatment and the severity of psychotic symptoms. (C) 2009 Elsevier Inc. All rights reserved. C1 [Kosten, Thomas R.; Zhang, Xiang Yang] Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. [Xiu, Mei Hong; Chen, Da Chun] Beijing HuiLongGuan Hosp, Ctr Biol Psychiat, Beijing, Peoples R China. [Hui, Li; De Hou, Tian] NW Normal Univ Lanzhou, Coll Life Sci, Lanzhou, Gansu, Peoples R China. [Dang, Yu Feng; Zheng, You Lan] Jilin Agr Univ, Coll Chinese Med Mat, Changchun, Peoples R China. [Zhang, Chong Xi] Shandong Univ Weihai Shandong, Weihai 264209, Peoples R China. RP Kosten, TR (reprint author), VA Med Ctr, Res Bldg 110,Room 229,2002 Holcombe Blvd, Houston, TX 77030 USA. EM kosten@bcm.edu; xyzhang@bcm.edu NR 34 TC 72 Z9 74 U1 0 U2 4 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0278-5846 J9 PROG NEURO-PSYCHOPH JI Prog. Neuro-Psychopharmacol. Biol. Psychiatry PD NOV 13 PY 2009 VL 33 IS 8 BP 1508 EP 1512 DI 10.1016/j.pnpbp.2009.08.011 PG 5 WC Clinical Neurology; Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 532RL UT WOS:000272767100030 PM 19720106 ER PT J AU Nemoto, T Yamazawa, R Kobayashi, H Fujita, N Chino, B Fujii, C Kashima, H Rassovsky, Y Green, MF Mizuno, M AF Nemoto, Takahiro Yamazawa, Ryoko Kobayashi, Hiroyuki Fujita, Nobuharu Chino, Bun Fujii, Chiyo Kashima, Haruo Rassovsky, Yuri Green, Michael F. Mizuno, Masafumi TI Cognitive training for divergent thinking in schizophrenia: A pilot study SO PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY LA English DT Review DE Cognitive training; Divergent thinking; Negative symptoms; Schizophrenia; Social functioning ID NEUROCOGNITIVE DEFICITS; REMEDIATION; SCALE AB Individuals with schizophrenia demonstrate deficits in divergent thinking. This ability is indispensable for generating creative solutions and navigating the complexities of social interactions. In a pilot study, seventeen stable schizophrenia outpatients were randomly assigned to a training program for divergent thinking or a control program on convergent thinking. After eight weeks of training, participants in the divergent thinking program had significantly greater improvements on measures of idea fluency, negative symptoms, and interpersonal relations than did participants receiving the control program. These preliminary results suggest that interventions for divergent thinking in schizophrenia may lead to improvements in patients' social functioning. (C) 2009 Elsevier Inc. All rights reserved. C1 [Nemoto, Takahiro] Keio Univ, Sch Med, Dept Neuropsychiat, Shinjuku Ku, Tokyo 1608582, Japan. [Nemoto, Takahiro] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. [Nemoto, Takahiro; Green, Michael F.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Fujii, Chiyo] Saitama Prefectural Univ, Dept Social Work, Saitama, Japan. [Rassovsky, Yuri; Green, Michael F.] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Semel Inst Neurosci & Human Behav, Los Angeles, CA 90024 USA. [Mizuno, Masafumi] Toho Univ, Sch Med, Dept Neuropsychiat, Tokyo, Japan. RP Nemoto, T (reprint author), Keio Univ, Sch Med, Dept Neuropsychiat, Shinjuku Ku, 35 Shinanomachi, Tokyo 1608582, Japan. EM nemotaka@aol.com FU Research Group for Schizophrenia, Japan FX We thank Mr. Ryosuke Ito, who kindly consulted on the development of the tasks in the study, and Dr. Jin Hwan Choi for help in interpretation of the data. Funding for this study was provided by a grant to Takahiro Nemoto from the Research Group for Schizophrenia, Japan. NR 26 TC 7 Z9 7 U1 2 U2 18 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0278-5846 J9 PROG NEURO-PSYCHOPH JI Prog. Neuro-Psychopharmacol. Biol. Psychiatry PD NOV 13 PY 2009 VL 33 IS 8 BP 1533 EP 1536 DI 10.1016/j.pnpbp.2009.08.015 PG 4 WC Clinical Neurology; Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 532RL UT WOS:000272767100035 PM 19733608 ER PT J AU Goebel, M Stengel, A Wang, LX Tache, Y AF Goebel, Miriam Stengel, Andreas Wang, Lixin Tache, Yvette TI Restraint stress activates nesfatin-1-immunoreactive brain nuclei in rats SO BRAIN RESEARCH LA English DT Article DE Fos; Nesfatin-1; NUCB2; Restraint; Hypothalamus; Medulla ID CORTICOTROPIN-RELEASING-FACTOR; DORSAL VAGAL COMPLEX; FOS EXPRESSION; C-FOS; PARAVENTRICULAR NUCLEUS; NEUROENDOCRINE RESPONSES; EMOTIONAL STRESSOR; SUPRAOPTIC NUCLEI; FACTOR RECEPTORS; CELL RESPONSES AB Nesfatin-1 is a newly discovered peptide that was reported to reduce food intake when injected centrally. We recently described its wide distribution in rat brain autonomic nuclei which implies potential recruitment of nesfatin-1 by stress. We investigated whether restraint, a mixed psychological and physical stressor, activates nesfatin-1-immunoreactive (ir) neurons in the rat brain. Male Sprague-Dawley rats were either subjected to 30 min restraint or left undisturbed and 90 min later brains were processed for double immunohistochemical labeling of Fos and nesfatin-1. Restraint induced significant Fos expression in neurons of the supraoptic nucleus (SON), paraventricular nucleus (PVN), locus coeruleus (LC), rostral raphe pallidus (rRPa), nucleus of the solitary tract (NTS), and ventrolateral medulla (VLM). Double Fos/nesfatin-1 labeling revealed that Fos-ir neurons comprised 95% of nesfatin-1-ir cells in the SON, 90% in the VLM, 80% in the LC, 48% in the caudal NTS, 57% in the rRPa, 48% in the anterior parvicellular PVN, 27% in the medial magnocellular PVN, 18% in the lateral magnocellular PVN and 10% in the medial parvicellular PVN. These data demonstrate that nesfatin-1 neurons are part of the hypothalamic and hindbrain neuronal cell groups activated by restraint suggesting a possible role of nesfatin-1 in the response to stress. Published by Elsevier B.V. C1 [Tache, Yvette] VA Greater Los Angeles Healthcare Syst, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, CURE Digest Dis Res Ctr,Ctr Neurobiol Stress, Digest Dis Div,Dept Med, Los Angeles, CA 90095 USA. RP Tache, Y (reprint author), VA Greater Los Angeles Healthcare Syst, Ctr Neurovisceral Sci & Womens Hlth, CURE Bldg 115,Room 117, Los Angeles, CA 90073 USA. EM ytache@mednet.ucla.edu FU German Research Foundation fellowship [Go 1718/1-1, STE 1765/1-1]; VA Research Career Scientist Award; Department of Veterans Affairs; NIHDK [33061]; Center [DK41301] FX This work was supported by German Research Foundation fellowship grants Go 1718/1-1 (M.G.) and STE 1765/1-1 (A.S.), the VA Research Career Scientist Award, Department of Veterans Affairs, NIHDK 33061 (Y.T.) and Center grant DK41301 (Animal Core, Y.T.). We are grateful to Mrs. Honghui Liang for her excellent technical support and Ms. Eugenia Hu for reviewing the manuscript. NR 53 TC 64 Z9 64 U1 1 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD NOV 10 PY 2009 VL 1300 BP 114 EP 124 DI 10.1016/j.brainres.2009.08.082 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 520DC UT WOS:000271819200012 PM 19733157 ER PT J AU Bilimoria, KY Raval, MV Bentrem, DJ Wayne, JD Balch, CM Ko, CY AF Bilimoria, Karl Y. Raval, Mehul V. Bentrem, David J. Wayne, Jeffrey D. Balch, Charles M. Ko, Clifford Y. TI National Assessment of Melanoma Care Using Formally Developed Quality Indicators SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID CANCER DATA-BASE; COLORECTAL-CANCER; UNITED-STATES; APPROPRIATENESS METHOD; PERFORMANCE-MEASURES; MALIGNANT-MELANOMA; ASSESSMENT TOOLS; CARDIAC-SURGERY; SURGICAL CARE; HEALTH-CARE AB Purpose There is considerable variation in the quality of cancer care delivered in the United States. Assessing care by using quality indicators could help decrease this variability. The objectives of this study were to formally develop valid quality indicators for melanoma and to assess hospital-level adherence with these measures in the United States. Methods Quality indicators were identified from available literature, consensus guidelines, and melanoma experts. Thirteen experts ranked potential measures for validity on the basis of the RAND/University of California, Los Angeles Appropriateness Methodology. Adherence with individual valid indicators and a composite measure of all indicators were assessed at 1,249 Commission on Cancer hospitals by using the National Cancer Data Base (NCDB; 2004 through 2005). Results Of 55 proposed quality indicators, 26 measures (47%) were rated as valid. These indicators assessed structure (n = 1), process (n = 24), and outcome (n = 1). Of the 26 measures, 10 are readily assessable by using cancer registry data. Adherence with valid indicators ranged from 11.8% to 96.5% at the patient level and 3.7% to 83.0% at the hospital level. (Adherence required that > 90% of patients at a hospital receive concordant care.) Most hospitals were adherent with 50% or fewer of the individual indicators (median composite score, five; interquartile range, four to seven). Adherence was higher for diagnosis and staging measures and was lower for treatment indicators. Conclusion There is considerable variation in the quality of melanoma care in the United States. By using these formally developed quality indicators, hospitals can assess their adherence with current melanoma care guidelines through feedback mechanisms from the NCDB and can better direct quality improvement efforts. C1 [Bilimoria, Karl Y.] Amer Coll Surg, Canc Programs, Chicago, IL 60611 USA. Northwestern Univ, Dept Surg, Feinberg Sch Med, Chicago, IL 60611 USA. Johns Hopkins Sch Med, Dept Surg, Baltimore, MD USA. Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. RP Bilimoria, KY (reprint author), Amer Coll Surg, Canc Programs, 633 N St Clair St,22nd Floor, Chicago, IL 60611 USA. EM kbilimoria@facs.org OI Raval, Mehul/0000-0002-1527-2661 FU American College of Surgeons Clinical Scholars in Residence program; American College of Surgeons; Commission on Cancer; American Cancer Society (National Cancer Data Base) FX Supported by the American College of Surgeons Clinical Scholars in Residence program (K.Y.B. and M.V.R.); and by the American College of Surgeons, the Commission on Cancer, and the American Cancer Society (National Cancer Data Base). NR 51 TC 36 Z9 36 U1 0 U2 1 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD NOV 10 PY 2009 VL 27 IS 32 BP 5445 EP 5451 DI 10.1200/JCO.2008.20.9965 PG 7 WC Oncology SC Oncology GA 516GT UT WOS:000271530900025 PM 19826131 ER PT J AU Liang, HY Yoo, SE Na, R Walter, CA Richardson, A Ran, QT AF Liang, Hanyu Yoo, Si-Eun Na, Ren Walter, Christi A. Richardson, Arlan Ran, Qitao TI Short Form Glutathione Peroxidase 4 Is the Essential Isoform Required for Survival and Somatic Mitochondrial Functions SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID OXIDATIVE DAMAGE; LIPID-PEROXIDATION; CELLS; EXPRESSION; PHGPX; GPX4; GLUTATHIONE-PEROXIDASE-4; APOPTOSIS; PROTECTS; SEQUENCE AB Glutathione peroxidase 4 (Gpx4) is an essential antioxidant enzyme having multiple functions. A long form Gpx4 protein and a short form Gpx4 protein, which are distinguishable by the presence or lack of a mitochondrial signal peptide at the N terminus, are generated from the Gpx4 gene. In this study, we generated transgenic mice using mutated GPX4 genes encoding either the long form Gpx4 (lPX4 gene) or the short form Gpx4 (sGPX4 gene). Our results showed that transgenic mice with the sGPX4 gene had increased Gpx4 protein in all tissues and were protected against diquat-induced apoptosis in liver. Moreover, the sGPX4 gene was able to rescue the lethal phenotype of the mouse Gpx4-null mutation. In contrast, transgenic mice with the lGPX4 gene had increased Gpx4 protein only in the testes, and the lGPX4 gene failed to rescue the lethal phenotype of the mouse Gpx4-null mutation. In Gpx4-null mice rescued by the sGPX4 gene, the Gpx4 protein was present in mitochondria isolated from somatic tissues, and the submitochondrial distribution pattern of the Gpx4 protein in these mice was identical to that in wild-type mice. Interestingly, the male Gpx4-null mice rescued by the sGPX4 gene were infertile and exhibited sperm malformation. Together, our results demonstrated for the first time that the short form Gpx4 protein is present in somatic tissue mitochondria and is essential for survival and protection against apoptosis in mice, whereas the long form Gpx4 protein is important for male fertility. C1 Univ Texas Hlth Sci Ctr San Antonio, Sam & Ann Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. [Yoo, Si-Eun] Univ Texas Hlth Sci Ctr San Antonio, Dept Physiol, San Antonio, TX 78229 USA. [Walter, Christi A.; Richardson, Arlan; Ran, Qitao] Univ Texas Hlth Sci Ctr San Antonio, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. [Walter, Christi A.; Richardson, Arlan; Ran, Qitao] S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Ran, QT (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Sam & Ann Barshop Inst Longev & Aging Studies, 15355 Lambda Dr, San Antonio, TX 78245 USA. EM ran@uthscsa.edu RI Liang, Hanyu/A-1066-2010 FU National Institutes of Health [P01AG19316, R37 AG026557, AG021163]; San Antonio Nathan Shock Aging Center [1P30-AG13319]; Veterans Affairs Merit FX This work was supported, in whole or in part, by National Institutes of Health Grants P01AG19316, R37 AG026557, and AG021163, San Antonio Nathan Shock Aging Center Grant 1P30-AG13319, and Veterans Affairs Merit grants (to A. R. and Q. R.). NR 26 TC 34 Z9 35 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 6 PY 2009 VL 284 IS 45 BP 30836 EP 30844 DI 10.1074/jbc.M109.032839 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 514EZ UT WOS:000271378400011 PM 19744930 ER PT J AU Sharma, S Lichtenstein, A AF Sharma, Sanjai Lichtenstein, Alan TI Aberrant splicing of the E-cadherin transcript is a novel mechanism of gene silencing in chronic lymphocytic leukemia cells SO BLOOD LA English DT Article ID MESSENGER-RNA DECAY; CANCER; EXPRESSION; MUTATIONS; TRANSACTIVATION; SURVEILLANCE; INHIBITION; FAMILY; BRCA1; FORM AB Premature termination codon (PTC) mutations are due to insertion or deletion of nucleotides causing a frameshift and premature termination codon in RNA. These transcripts are degraded by the nonsense-mediated decay pathway and have a very short half-life. We used a microarray technique to screen for genes that up-regulate their RNA signal upon nonsense-mediated decay pathway blockade in chronic lymphocytic leukemia (CLL) specimens and identified an Ecadherin transcript with PTC. Sequencing revealed an aberrant E-cadherin transcript lacking exon 11, resulting in a frameshift and PTC. The aberrant E-cadherin transcript was also identified in normal B cells, but occurred at a much lower level compared with CLL cells. In CLL specimens, E-cadherin expression was depressed more than 50% in 62% cases (relative to normal B cells). By real-time polymerase chain reaction analysis, the relative amounts of wild-type transcript inversely correlated with amounts of aberrant transcript (P = .018). Ectopic expression of E-cadherin in CLL specimens containing high amounts of aberrant transcript resulted in down-regulation of the wnt-beta-catenin pathway reporter, a pathway known to be up-regulated in CLL. Our data point to a novel mechanism of E-cadherin gene inactivation, with CLL cells displaying a higher proportion of aberrant nonfunctional transcripts and resulting up-regulation of the wnt-beta-catenin pathway. (Blood. 2009; 114: 4179-4185) C1 [Sharma, Sanjai; Lichtenstein, Alan] Univ Calif Los Angeles, W Los Angeles Vet Affairs Med Ctr, Div Hematol Oncol, Los Angeles, CA 90073 USA. RP Sharma, S (reprint author), Univ Calif Los Angeles, W Los Angeles Vet Affairs Med Ctr, Div Hematol Oncol, Bldg 304,Rm E1-115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM sasharma@mednet.ucla.edu FU American Society of Clinical Oncology (ASCO) Foundation [CA96920, CA111448]; Veterans Administration FX S.S. is a recipient of a grant from Flight Attendants Medical Research Institute and an American Society of Clinical Oncology (ASCO) Foundation Young Investigator Award. A. L. was supported by Grants CA96920 and CA111448, and research funds from the Veterans Administration. NR 33 TC 24 Z9 25 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 5 PY 2009 VL 114 IS 19 BP 4179 EP 4185 DI 10.1182/blood-2009-03-206482 PG 7 WC Hematology SC Hematology GA 515TJ UT WOS:000271495500031 PM 19745069 ER PT J AU Khan, M Im, YB Shunmugavel, A Gilg, AG Dhindsa, RK Singh, AK Singh, I AF Khan, Mushfiquddin Im, Yeong-Bin Shunmugavel, Anandakumar Gilg, Anne G. Dhindsa, Ramanpreet K. Singh, Avtar K. Singh, Inderjit TI Administration of S-nitrosoglutathione after traumatic brain injury protects the neurovascular unit and reduces secondary injury in a rat model of controlled cortical impact SO JOURNAL OF NEUROINFLAMMATION LA English DT Article ID NITRIC-OXIDE SYNTHASE; FOCAL CEREBRAL-ISCHEMIA; RECEPTOR AGONIST 8-OH-DPAT; ISCHEMIA/REPERFUSION INJURY; MATRIX METALLOPROTEINASES; ENDOTHELIAL DYSFUNCTION; EXPERIMENTAL STROKE; COGNITIVE DEFICITS; FLAP SURVIVAL; HEAD-INJURY AB Background: Traumatic brain injury (TBI) is a major cause of preventable death and serious morbidity in young adults. This complex pathological condition is characterized by significant blood brain barrier (BBB) leakage that stems from cerebral ischemia, inflammation, and redox imbalances in the traumatic penumbra of the injured brain. Once trauma has occurred, combating these exacerbations is the keystone of an effective TBI therapy. Following other brain injuries, nitric oxide modulators such as S-nitrosoglutathione (GSNO) maintain not only redox balance but also inhibit the mechanisms of secondary injury. Therefore, we tested whether GSNO shows efficacy in a rat model of experimental TBI. Methods: TBI was induced by controlled cortical impact (CCI) in adult male rats. GSNO (50 mu g/kg body weight) was administered at two hours after CCI. GSNO-treated injured animals (CCI+GSNO group) were compared with vehicle-treated injured animals (CCI+VEH group) in terms of tissue morphology, BBB leakage, edema, inflammation, cell death, and neurological deficit. Results: Treatment of the TBI animals with GSNO reduced BBB disruption as evidenced by decreased Evan's blue extravasation across brain, infiltration/activation of macrophages (ED1 positive cells), and reduced expression of ICAM-1 and MMP-9. The GSNO treatment also restored CCI-mediated reduced expression of BBB integrity proteins ZO-1 and occludin. GSNO-mediated improvements in tissue histology shown by reduction of lesion size and decreased loss of both myelin (measured by LFB staining) and neurons (assayed by TUNEL) further support the efficacy of GSNO therapy. GSNO-mediated reduced expression of iNOS in macrophages as well as decreased neuronal cell death may be responsible for the histological improvement and reduced exacerbations. In addition to these biochemical and histological improvements, GSNO-treated injured animals recovered neurobehavioral functions as evaluated by the rotarod task and neurological score measurements. Conclusion: GSNO is a promising candidate to be evaluated in humans after brain trauma because it not only protects the traumatic penumbra from secondary injury and improves overall tissue structure but also maintains the integrity of BBB and reduces neurologic deficits following CCI in a rat model of experimental TBI. C1 [Khan, Mushfiquddin; Im, Yeong-Bin; Shunmugavel, Anandakumar; Gilg, Anne G.; Dhindsa, Ramanpreet K.; Singh, Inderjit] Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. [Singh, Avtar K.] Med Univ S Carolina, Dept Pathol & Lab Med, Charleston, SC 29425 USA. [Singh, Avtar K.] Ralph H Johnson VA Med Ctr, Charleston, SC 29401 USA. RP Singh, I (reprint author), Med Univ S Carolina, Dept Pediat, 171 Ashley Ave, Charleston, SC 29425 USA. EM khanm@musc.edu; imyb@musc.edu; anandak@musc.edu; gilg@musc.edu; mushfiquddinkhan@gmail.com; singha@musc.edu; singhi@musc.edu FU Betty and Guy Beatty Foundation; National Institutes of Health [NS-22576, NS-34741, NS-37766]; Veteran Administration Merit; National Center for Research Resources [C06 RR018823, C06 RR015455] FX These studies were supported by grants from Betty and Guy Beatty Foundation, National Institutes of Health (NS-22576, NS-34741 and NS-37766) and Veteran Administration Merit Award. This work was also supported by the NIH, Grants C06 RR018823 and No C06 RR015455 from the Extramural Research Facilities Program of the National Center for Research Resources. We thank Dr Md Nasrul Hoda and Dr Bilgen Mehmet for their valuable technical assistance. We are grateful to Dr Tom Smith from the MUSC Writing Center for his valuable editing and correction of the manuscript. We would like to thank Ms. Joyce Bryan for procurement of animals and chemicals and Chara Williams for secretarial assistance. NR 77 TC 70 Z9 73 U1 0 U2 3 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. PD NOV 4 PY 2009 VL 6 AR 32 DI 10.1186/1742-2094-6-32 PG 12 WC Immunology; Neurosciences SC Immunology; Neurosciences & Neurology GA 525XX UT WOS:000272252200001 PM 19889224 ER PT J AU Qaseem, A Snow, V Denberg, TD Casey, DE Forciea, MA Owens, DK Shekelle, P AF Qaseem, Amir Snow, Vincenza Denberg, Thomas D. Casey, Donald E., Jr. Forciea, Mary Ann Owens, Douglas K. Shekelle, Paul CA Amer Coll Phys TI Hormonal Testing and Pharmacologic Treatment of Erectile Dysfunction: A Clinical Practice Guideline From the American College of Physicians SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID PLACEBO-CONTROLLED TRIAL; SILDENAFIL CITRATE VIAGRA((R)); SPARING RADICAL PROSTATECTOMY; RANDOMIZED CONTROLLED-TRIAL; URINARY-TRACT SYMPTOMS; ON-DEMAND TADALAFIL; PHOSPHODIESTERASE TYPE-5 INHIBITOR; BENIGN PROSTATIC HYPERPLASIA; EXTERNAL-BEAM RADIOTHERAPY; INCREASES PENILE RIGIDITY AB Description: The American College of Physicians developed this guideline to present the available evidence on hormonal testing in and pharmacologic management of erectile dysfunction. Current pharmacologic therapies include phosphodiesterase-5 (PDE-5) inhibitors, such as sildenafil, vardenafil, tadalafil, mirodenafil, and udenafil, and hormonal treatment. Methods: Published literature on this topic was identified by using MEDLINE (1966 to May 2007), EMBASE (1980 to week 22 of 2007), Cochrane Central Register of Controlled Trials (second quarter of 2007), PsycINFO (1985 to June 2007), AMED (1985 to June 2007), and SCOPUS (2006). The literature search was updated by searching for articles in MEDLINE and EMBASE published between May 2007 and April 2009. Searches were limited to English-language publications. This guideline grades the evidence and recommendations by using the American College of Physicians' clinical practice guidelines grading system. Recommendation 1: The American College of Physicians recommends that clinicians initiate therapy with a PDE-5 inhibitor in men who seek treatment for erectile dysfunction and who do not have a contraindication to PDE-5 inhibitor use (Grade: strong recommendation; high-quality evidence). Recommendation 2: The American College of Physicians recommends that clinicians base the choice of a specific PDE-5 inhibitor on the individual preferences of men with erectile dysfunction, including ease of use, cost of medication, and adverse effects profile (Grade: weak recommendation; low-quality evidence). Recommendation 3: The American College of Physicians does not recommend for or against routine use of hormonal blood tests or hormonal treatment in the management of patients with erectile dysfunction (Grade: insufficient evidence to determine net benefits and harms). C1 [Qaseem, Amir] Amer Coll Physicians, Philadelphia, PA 19104 USA. Univ Penn, Philadelphia, PA 19104 USA. Univ Colorado, Aurora, CO USA. Atlantic Hlth, Morristown, NJ USA. Vet Affairs Palo Alto Hlth Care Syst, Stanford, CA USA. Stanford Univ, Stanford, CA 94305 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Qaseem, A (reprint author), Amer Coll Physicians, 190 N Independence Mall W, Philadelphia, PA 19104 USA. EM aqaseem@acponline.org FU American College of Physicians' operating budget FX Financial support for the development of this guideline comes exclusively from the American College of Physicians' operating budget. NR 211 TC 42 Z9 43 U1 2 U2 3 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 3 PY 2009 VL 151 IS 9 BP 639 EP W208 PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA 514IM UT WOS:000271387700006 PM 19884625 ER PT J AU Bautista, LE Vera, L Herrera, V Casas, J Orostegui, M Miranda, J Perel, P Pichardo, R Gonzalez, A Sanchez, J Ferreccio, C Aguilera, X Silva, E Gomez, L Chirinos, J Medina-Lezama, J Perez, C Suarez, E Ortiz, A Rosero, L Schapochnik, N Ortiz, Z Ferrante, D AF Bautista, Leonelo E. Vera, Lina Herrera, Victor Casas, Juan Orostegui, Myriam Miranda, Jaime Perel, Pablo Pichardo, Rafael Gonzalez, Angel Sanchez, Jose Ferreccio, Catterina Aguilera, Ximena Silva, Egle Gomez, Luis Chirinos, Julio Medina-Lezama, Josefina Perez, Cynthia Suarez, Erick Ortiz, Ana Rosero, Luis Schapochnik, Norberto Ortiz, Zulma Ferrante, Daniel TI Hypertension Awareness, Treatment and Control in Latin America SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Bautista, Leonelo E.; Vera, Lina; Herrera, Victor] Univ Wisconsin, Madison, WI USA. [Casas, Juan; Miranda, Jaime; Perel, Pablo] London Sch Hyg & Trop Med, London WC1, England. [Orostegui, Myriam] Univ Ind Santander, Bucaramanga, Colombia. [Pichardo, Rafael; Gonzalez, Angel] Inst Dominicano Cardiol, Santo Domingo, Dominican Rep. [Sanchez, Jose] Inst Nacl Salud, Ctr Nacl Alimentac & Nutr, Lima, Peru. [Ferreccio, Catterina] Pontificia Univ Catolica Chile, Santiago, Chile. [Aguilera, Ximena] Minist Salud Chile, Santiago, Chile. [Silva, Egle] Univ Zulia, Maracaibo 4011, Venezuela. [Gomez, Luis] Fdn FES Social, Bogota, Colombia. [Chirinos, Julio] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. [Chirinos, Julio] Philadelphia VA Med Ctr, Philadelphia, PA USA. [Medina-Lezama, Josefina] Santa Maria Catholic Univ, Arequipa, Peru. [Medina-Lezama, Josefina] Santa Maria Res Inst, Arequipa, Peru. [Perez, Cynthia; Suarez, Erick; Ortiz, Ana] Univ Puerto Rico, San Juan, PR 00936 USA. [Rosero, Luis] Univ Costa Rica, San Jose, Costa Rica. [Schapochnik, Norberto] Minist Salud Prov Tierra del Fuego, Ushuaia, Argentina. [Ortiz, Zulma] Acad Nacl med, Inst Invest Epidemiol, Buenos Aires, DF, Argentina. [Ferrante, Daniel] Minist Salud & Ambiente, Buenos Aires, DF, Argentina. RI Herrera, Victor/C-5602-2008; Miranda, J. Jaime/A-8482-2008 OI Miranda, J. Jaime/0000-0002-4738-5468 NR 0 TC 0 Z9 0 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 NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S439 EP S440 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831500555 ER PT J AU Carson, P Komajda, M Zile, M Johnson, RH Hetzel, S Mckelvie, R McMurray, J Staiger, C Ptaszynska, A Massie, B AF Carson, Peter Komajda, Michel Zile, Michael Johnson, Ralph H. Hetzel, Scott Mckelvie, Robert McMurray, John Staiger, Christoph Ptaszynska, Agata Massie, Barry TI The Relation of Quality of Life Score to Outcome in Heart Failure With Preserved Ejection Fraction: Findings From the Irbesartan in Heart Failure With Preserved Ejection Fraction Trial (I-PRESERVE) SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Carson, Peter] Washington VA Med Ctr, Washington, DC USA. [Komajda, Michel] Univ Paris 06, Paris, France. [Komajda, Michel] Hosp Pitie Salpetriere, Paris, France. [Zile, Michael; Johnson, Ralph H.] Vet Affairs Med Ctr, Charleston, SC 29403 USA. [Zile, Michael; Johnson, Ralph H.] Med Univ S Carolina, Charleston, SC 29425 USA. [Hetzel, Scott] Univ Wisconsin, Madison, WI USA. [Mckelvie, Robert] McMaster Univ, Hamilton, ON, Canada. [McMurray, John] Univ Glasgow, British Heart Fdn, Glasgow Cardiovasc Rsch Ctr, Glasgow, Lanark, Scotland. [Staiger, Christoph] Sanofi Aventis, Bridgewater, NJ USA. [Ptaszynska, Agata] Bristol Myers Squibb Co, Princeton, NJ USA. [Massie, Barry] San Francisco VA Med Ctr, San Francisco, CA USA. [Massie, Barry] Univ Calif San Francisco, San Francisco, CA 94143 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 0009-7322 J9 CIRCULATION JI Circulation PD NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S749 EP S749 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831502208 ER PT J AU Greyson, C Ahmad, H Schwartz, GG Lu, L Ye, SY Xu, Y AF Greyson, Clifford Ahmad, Hasan Schwartz, Gregory G. Lu, Li Ye, Shuyu Xu, Ya TI Calpain Inhibition Attenuates Right Heart Failure and Prevents Talin Degradation During Acute Pressure Overload SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Greyson, Clifford; Ahmad, Hasan; Schwartz, Gregory G.; Lu, Li; Ye, Shuyu; Xu, Ya] Denver VAMC, Denver, CO USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S805 EP S805 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831502436 ER PT J AU Kitzman, DW Haas, MM Carson, PE Hetzel, S Komajda, M Zile, M Mckelvie, R Mcmurray, JJ Demets, D Staiger, C Ptaszynska, A Massie, B AF Kitzman, Dalane W. Haas, Marcus M. Carson, Peter E. Hetzel, Scott Komajda, Michael Zile, Michael Mckelvie, Robert Mcmurray, John J. Demets, D. Staiger, C. Ptaszynska, Agata Massie, Barry TI Obesity and Its Relationship to Adverse Cardiovascular Outcomes in Older Patients With Heart Failure and Preserved Ejection Fraction in the I-PRESERVE Trial SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Kitzman, Dalane W.] Wake Forest Univ Hlth Sci, F-75634 Winston Salem, NC USA. [Haas, Marcus M.] Theresienkrankenhaus, Mannheim, Germany. [Carson, Peter E.] Washington VAMC, Washington, DC 29425 USA. [Carson, Peter E.] Georgetown Univ, Washington, DC USA. [Hetzel, Scott; Demets, D.] Univ Wisconsin, Madison, WI USA. [Komajda, Michael] Univ Paris 06, Paris, France. [Komajda, Michael] Grp Hosp Pitie Salpetriere, Paris, France. [Zile, Michael] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. [Zile, Michael] Med Univ S Carolina, Charleston, SC 94143 USA. [Mckelvie, Robert] McMaster Univ, Hamilton, ON, Canada. [Mcmurray, John J.] British Heart Fdn, Glasgow Cardiovasc Rsch Cntr, Glasgow, Lanark, Scotland. [Ptaszynska, Agata] Bristol Myers Squibb Co, Princeton, NJ USA. [Staiger, C.] Sanofi Aventis, Bridgeport, CT USA. [Massie, Barry] San Francisco VA Med Ctr, San Francisco, CA USA. [Massie, Barry] Univ Calif San Francisco, San Francisco, CA 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 0009-7322 J9 CIRCULATION JI Circulation PD NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S757 EP S758 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831502242 ER PT J AU Merchant, RM Abotsi, EJ Long, JA Trudeau, ME Groeneveld, PW Becker, LB Abella, BS Asch, DA AF Merchant, Raina M. Abotsi, Edam J. Long, Judith A. Trudeau, Marti E. Groeneveld, Peter W. Becker, Lance B. Abella, Benjamin S. Asch, David A. TI Real Time Cardiopulmonary Resuscitation Instructions via Cellular Phone SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Merchant, Raina M.; Abotsi, Edam J.; Long, Judith A.; Groeneveld, Peter W.; Becker, Lance B.; Abella, Benjamin S.; Asch, David A.] Univ Penn, Philadelphia, PA 19104 USA. [Trudeau, Marti E.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 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 0009-7322 J9 CIRCULATION JI Circulation PD NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S1455 EP S1456 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831505066 ER PT J AU Miller, PS Evangelista, LS Giger, JN Martinez-Maza, O Corvera-Tindel, T Esmailian, F Doering, LV AF Miller, Pamela S. Evangelista, Lorraine S. Giger, Joyce N. Martinez-Maza, Otoniel Corvera-Tindel, Teresita Esmailian, Fardad Doering, Lynn V. TI Running on Exhaustion: Pathogen Burden, Immune Dysregulation, and Endothelial Activation After Coronary Artery Bypass Graft Surgery SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Miller, Pamela S.; Evangelista, Lorraine S.; Giger, Joyce N.; Martinez-Maza, Otoniel; Esmailian, Fardad; Doering, Lynn V.] Univ Calif Los Angeles, Los Angeles, CA USA. [Corvera-Tindel, Teresita] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 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 0009-7322 J9 CIRCULATION JI Circulation PD NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S416 EP S416 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831500466 ER PT J AU Mitchell, K Gupte, S Wright, J Minae, A Sasson, J Kehoe, K Fiocchi, F Oetgen, W Rumsfeld, JS AF Mitchell, Kristi Gupte, Sunil Wright, Janet Minae, Ashley Sasson, Joe Kehoe, Katie Fiocchi, Fran Oetgen, William Rumsfeld, John S. TI Electronic Medical Record Adoption in Cardiology Practices: A 2009 Snapshot From the American College of Cardiology's IC3 (Improving Continuous Cardiac Care) Program SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Mitchell, Kristi; Gupte, Sunil; Wright, Janet; Minae, Ashley; Kehoe, Katie; Fiocchi, Fran] Amer Coll Cardiol, Washington, DC USA. [Sasson, Joe] MedAxiom, Tallahassee, FL USA. [Oetgen, William] Georgetown Univ, Washington, DC USA. [Rumsfeld, John S.] Univ Colorado, Denver, CO 80202 USA. [Rumsfeld, John S.] Denver VA Med Ctr, Denver, CO 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 0009-7322 J9 CIRCULATION JI Circulation PD NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S438 EP S438 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831500550 ER PT J AU Nabavi, V Ahmadi, N Saeed, A Hajsadeghi, F Flores, F Sourayanezhad, S Mendoza, H Ebrahimi, R Ahmdi, A Levenstein, S Budoff, M AF Nabavi, Vahid Ahmadi, Naser Saeed, Anila Hajsadeghi, Fereshteh Flores, Ferdinand Sourayanezhad, Souraya Mendoza, Helen Ebrahimi, Ramin Ahmdi, Ahmad Levenstein, Susan Budoff, Matthew TI Association of the Extent of Perceived Mental Stress and Physical Inactivity, and the Extent of Coronary Artery Disease Diagnosed by Computed Tomography SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Nabavi, Vahid; Ahmadi, Naser; Saeed, Anila; Hajsadeghi, Fereshteh; Flores, Ferdinand; Sourayanezhad, Souraya; Mendoza, Helen; Ahmdi, Ahmad; Budoff, Matthew] Harbor UCLA Med Ctr, Los Angeles Biomed Res Inst, Torrance, CA 90509 USA. [Ebrahimi, Ramin] Univ Calif Los Angeles, Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. [Levenstein, Susan] Aventino Med Grp, Rome, Italy. 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 0009-7322 J9 CIRCULATION JI Circulation PD NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S494 EP S494 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831500778 ER PT J AU Riegel, B Potashnik, S Goldberg, L Weaver, T Weintraub, W Fleck, D Sayers, S AF Riegel, Barbara Potashnik, Sheryl Goldberg, Lee Weaver, Terri Weintraub, William Fleck, Desiree Sayers, Steven TI Is There a Better Way to Screen for Sleep Disordered Breathing in Adults With Heart Failure? SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Riegel, Barbara; Potashnik, Sheryl; Goldberg, Lee; Weaver, Terri; Fleck, Desiree] Univ Penn, Philadelphia, PA 19104 USA. [Weintraub, William] Christiana Care Hlth Syst, Newark, DE USA. [Sayers, Steven] Philadelphia VA Med Ctr, Philadelphia, PA 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 0009-7322 J9 CIRCULATION JI Circulation PD NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S864 EP S864 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831502678 ER PT J AU Stolker, JM McGuire, DK Spertus, JA Inzucchi, SE Rathore, SS Maddox, TM Masoudi, FA Tang, F Jones, PG Kosiborod, M AF Stolker, Joshua M. McGuire, Darren K. Spertus, John A. Inzucchi, Silvio E. Rathore, Saif S. Maddox, Thomas M. Masoudi, Frederick A. Tang, Fengming Jones, Philip G. Kosiborod, Mikhail TI In-Hospital Assessment of Hemoglobin A(1c) in Patients With Diabetes Treated for Myocardial Infarction: Variability Between Hospitals and Relationship With Established Quality Indicators SO CIRCULATION LA English DT Meeting Abstract CT 82nd National Conference and Exhibitions and Annual Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Stolker, Joshua M.; Spertus, John A.; Tang, Fengming; Jones, Philip G.; Kosiborod, Mikhail] St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO 64111 USA. [McGuire, Darren K.] Univ Texas Southwestern Sch Med, Dallas, TX USA. [Inzucchi, Silvio E.; Rathore, Saif S.] Yale Univ, Sch Med, New Haven, CT USA. [Maddox, Thomas M.; Masoudi, Frederick A.] Univ Colorado, Denver VAMC, Denver, CO 80202 USA. [Masoudi, Frederick A.] Denver Hlth Med Ctr, Denver, CO 80202 USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0009-7322 EI 1524-4539 J9 CIRCULATION JI Circulation PD NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S485 EP S485 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831500744 ER PT J AU Tsai, TT Maddox, TM Roe, MT Dai, D Casserly, IP Ho, PM Messenger, JC Nallamothu, BK Peterson, ED Rumsfeld, JS AF Tsai, Thomas T. Maddox, Thomas M. Roe, Matthew T. Dai, David Casserly, Ivan P. Ho, P. Michael Messenger, John C. Nallamothu, Brahmajee K. Peterson, Eric D. Rumsfeld, John S. TI Contemporary Risk of In-Hospital Events in Dialysis Patients Undergoing Percutaneous Coronary Interventions: Insights From the NCDR Cath-PCI Registry SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Tsai, Thomas T.; Maddox, Thomas M.; Casserly, Ivan P.; Ho, P. Michael; Rumsfeld, John S.] Univ Colorado, Denver VAMC, Denver, CO 80202 USA. [Roe, Matthew T.; Dai, David; Peterson, Eric D.] Duke Univ, Med Cntr, Durham, NC USA. [Nallamothu, Brahmajee K.] Univ Michigan Hosp, Ann Arbor, MI 48109 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S1101 EP S1101 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831504029 ER PT J AU Wang, CC Lu, L Xu, Y Grayson, C Jacobs, S Reusch, JE Gianani, R Draznin, B Schwartz, GG AF Wang, Cecilia C. Lu, Li Xu, Ya Grayson, Clifford Jacobs, Susanna Reusch, Jane E. Gianani, Roberto Draznin, Boris Schwartz, Gregory G. TI Diet-Induced Insulin Resistance Causes Isoform-Specific Abnormalities of Akt Signaling in Arterial Wall of Pigs SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Wang, Cecilia C.; Lu, Li; Xu, Ya; Grayson, Clifford; Jacobs, Susanna; Reusch, Jane E.; Draznin, Boris; Schwartz, Gregory G.] Denver VA Med Ctr, Denver, CO USA. [Wang, Cecilia C.; Lu, Li; Xu, Ya; Grayson, Clifford; Jacobs, Susanna; Reusch, Jane E.; Gianani, Roberto; Draznin, Boris; Schwartz, Gregory G.] Univ Colorado, Denver, CO 80202 USA. [Gianani, Roberto] Childrens Hosp, Denver, CO 80218 USA. NR 0 TC 0 Z9 0 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 NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S443 EP S444 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831500570 ER PT J AU Zahid, M Single, I Good, C Stone, RA Kim, S Fine, MJ Sonel, AF AF Zahid, Maliha Single, Ish Good, Chester Stone, Roslyn A. Kim, Sunghee Fine, Michael J. Sonel, Ali F. TI Association Between Pneumococcal Vaccination and Fewer Adverse Outcomes in Patients Hospitalized With Acute Coronary Syndromes SO CIRCULATION LA English DT Meeting Abstract CT 82nd Scientific Session of the American-Heart-Association CY NOV 14-18, 2009 CL Orlando, FL SP Amer Heart Assoc C1 [Zahid, Maliha; Single, Ish; Good, Chester; Stone, Roslyn A.; Kim, Sunghee; Fine, Michael J.; Sonel, Ali F.] Univ Pittsburgh, Pittsburgh, PA USA. [Good, Chester; Stone, Roslyn A.; Kim, Sunghee; Fine, Michael J.; Sonel, Ali F.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Rsch & Promot, Pittsburgh, PA 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 0009-7322 J9 CIRCULATION JI Circulation PD NOV 3 PY 2009 VL 120 IS 18 SU 2 BP S1173 EP S1173 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 520GV UT WOS:000271831504349 ER PT J AU Liao, SL Luthra, M Rogers, KM AF Liao, Steve L. Luthra, Munish Rogers, Kevin M. TI Leriche Syndrome SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Editorial Material C1 [Liao, Steve L.; Luthra, Munish] James J Peters Vet Affairs Med Ctr, Dept Med, Bronx, NY USA. [Rogers, Kevin M.] James J Peters Vet Affairs Med Ctr, Dept Radiol, Bronx, NY USA. [Liao, Steve L.] Mt Sinai Sch Med, Dept Med Cardiol, New York, NY USA. RP Liao, SL (reprint author), James J Peters Vet Affairs Med Ctr, Dept Med, Bronx, NY USA. NR 0 TC 2 Z9 2 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD NOV 3 PY 2009 VL 54 IS 19 BP E11 EP E11 DI 10.1016/j.jacc.2009.06.037 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 512OO UT WOS:000271259700013 PM 19874987 ER PT J AU Collinger, JL Gagnon, D Jacobson, J Impink, BG Boninger, ML AF Collinger, Jennifer L. Gagnon, Dany Jacobson, Jon Impink, Bradley G. Boninger, Michael L. TI Reliability of Quantitative Ultrasound Measures of the Biceps and Supraspinatus Tendons SO ACADEMIC RADIOLOGY LA English DT Article DE Ultrasound; reliability; tendon; biceps; supraspinatus ID ROTATOR CUFF; SONOGRAPHY; SHOULDER; TENDINOPATHY; CHILDREN; MUSCLES; DISEASE; IMAGES; INDEX AB Rationale and Objectives. Ultrasound is a proven method for examining soft tissue structures, including tendons, and recently quantitative ultrasound has become more prevalent in research settings. However, limited reliability data have been published for these new quantitative ultrasound measures. The main objective of this study was to quantify the reliability and measurement error of multiple quantitative ultrasound imaging protocols for the biceps and supraspinatus tendons. Materials and Methods. Two examiners captured ultrasound images of the non-dominant long head of the biceps tendon and supraspinatus tendon from 15 able-bodied participants and five manual wheelchair users. Each examiner captured two images per subject under two different preparations, which included subject positioning and reference marker placement. Image processing (reading) was performed twice to compute nine quantitative ultrasound measures of grayscale tendon appearance using first-order statistics and texture analysis. Generalizability theory was applied to compute interrater and intrarater reliability using the coefficient of dependability (Phi) for multiple study design protocols. Results. Interrater reliability was generally low (0.26 < Phi < 0.82), and it is recommended that a single evaluator capture all images for quantitative ultrasound protocols. Most of the quantitative ultrasound measures (n = 14 of 18) exhibited at least moderate (Phi > 0.50) intrarater reliability for a single image captured under one preparation and read once. Conclusion. By following a protocol designed to minimize measurement error, one can increase the reliabdity of quantitative ultrasound measures. An appropriately designed protocol will allow quantitative ultrasound to be used as an outcome measure to identify structural changes within tendons. C1 [Collinger, Jennifer L.; Gagnon, Dany; Impink, Bradley G.; Boninger, Michael L.] VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA 15206 USA. [Collinger, Jennifer L.; Gagnon, Dany; Boninger, Michael L.] Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA USA. [Collinger, Jennifer L.; Impink, Bradley G.; Boninger, Michael L.] Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. [Gagnon, Dany] Univ Montreal, Fac Med, Sch Rehabil, Montreal, PQ H3C 3J7, Canada. [Jacobson, Jon] Univ Michigan, Dept Radiol, Ann Arbor, MI 48109 USA. RP Boninger, ML (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, 7180 Highland Dr,Bldg 4,151R-1, Pittsburgh, PA 15206 USA. EM boninger@pitt.edu OI Jacobson, Jon/0000-0002-3676-6628; Boninger, Michael/0000-0001-6966-919X FU Office of Research and Development, Rehabilitation Research & Development Service, US Department of Veterans Affairs (Washington, DC) [B3142C]; National Institutes of Health (Bethesda, MD) [R21HD054529]; National Institute on Disability and Rehabilitation Research's Rehabilitation Engineering Research Center on Spinal Cord Injury (Arlington, VA) [H133E070024]; National Science Foundation; Fonds de la Recherche en Sante du Quebec (Montreal, QC, Canada) FX This material is based on work supported by grant B3142C from the Office of Research and Development, Rehabilitation Research & Development Service, US Department of Veterans Affairs (Washington, DC); grant R21HD054529 from the National Institutes of Health (Bethesda, MD); grant H133E070024 the National Institute on Disability and Rehabilitation Research's Rehabilitation Engineering Research Center on Spinal Cord Injury (Arlington, VA); and a National Science Foundation graduate research fellowship. D.G. held a postdoctoral scholarship from Fonds de la Recherche en Sante du Quebec (Montreal, QC, Canada) at the time of this study. NR 22 TC 22 Z9 23 U1 1 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1076-6332 J9 ACAD RADIOL JI Acad. Radiol. PD NOV PY 2009 VL 16 IS 11 BP 1424 EP 1432 DI 10.1016/j.acra.2009.05.001 PG 9 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 513EA UT WOS:000271304000017 PM 19596592 ER PT J AU Johansen, KL AF Johansen, Kirsten L. TI Anabolic and Catabolic Mechanisms in End-Stage Renal Disease SO ADVANCES IN CHRONIC KIDNEY DISEASE LA English DT Article DE Muscle catabolism; End-Stage Renal Disease (ESRD); Catabolism ID INTRADIALYTIC PARENTERAL-NUTRITION; MALNOURISHED HEMODIALYSIS-PATIENTS; UBIQUITIN-PROTEASOME PATHWAY; SKELETAL-MUSCLE HYPERTROPHY; HUMAN GROWTH-HORMONE; BODY PROTEIN-DEGRADATION; CHRONIC KIDNEY-DISEASE; P70 S6 KINASE; AMINO-ACID; WHOLE-BODY AB Muscle wasting is a prominent feature of end-stage renal disease and is associated with muscle weakness and poor physical functioning. Potential reasons for muscle wasting include advancing age, sedentary behavior, inflammation, poor nutritional intake, androgen deficiency, oxidative stress, metabolic acidosis, and insulin resistance. Each of these conditions can be associated with decreased protein synthesis, increased protein degradation, or both. The primary muscle protein synthesis pathway is the insulin insulin-like growth factor-1/phosphatidyl inositol-3 kinase/Akt pathway, which results in the phosphorylation of the mammalian target of rapamycin and subsequent increased protein synthesis. The major protein degradation pathway is the ubiquitin-proteasome system. This review discusses the ways in which end-stage renal disease tips the balance of protein turnover towards catabolism and the mechanisms by which various interventions may work to mitigate wasting or even cause anabolism. (C) 2009 by the National Kidney Foundation, Inc. All rights reselved. C1 [Johansen, Kirsten L.] San Francisco VA Med Ctr, Nephrol Sect, San Francisco, CA 94121 USA. [Johansen, Kirsten L.] Univ Calif San Francisco, Div Nephrol, San Francisco, CA 94143 USA. RP Johansen, KL (reprint author), San Francisco VA Med Ctr, Nephrol Sect, Box 111J,4150 Clement St, San Francisco, CA 94121 USA. EM Kirsten.johansen@ucsf.edu NR 68 TC 12 Z9 13 U1 0 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1548-5595 J9 ADV CHRONIC KIDNEY D JI Adv. Chronic Kidney Dis. PD NOV PY 2009 VL 16 IS 6 BP 501 EP 510 DI 10.1053/j.ackd.2009.07.007 PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 508LJ UT WOS:000270932500010 PM 19801138 ER PT J AU Lawrence, I Moy, R AF Lawrence, Ira Moy, Ronald TI An Evaluation of Neutralizing Antibody Induction During Treatment of Glabellar Lines with a New US Formulation of Botulinum Neurotoxin Type A SO AESTHETIC SURGERY JOURNAL LA English DT Article AB BACKGROUND: The induction of neutralizing antibodies during the aesthetic application of botulinum neurotoxin type A is rare, but of potential clinical concern. Phase III studies of a new US formulation of botulinum neurotoxin type A, Dysport (BoNTA-ABO [abobotulinumtoxinA]; Medicis Aesthetics, Scottsdale, AZ), have not identified any cases of neutralizing antibody formation during the treatment of glabellar lines in patients who received up to nine treatments. OBJECTIVE: To provide an in-depth analysis of the potential for induction of neutralizing antibodies in the study population enrolled in phase III trials of BoNTA-ABO in the treatment of glabellar lines. METHODS: First and last available serum samples from patients in the BoNTA-ABO Glabellar Lines Development Program were screened for BoNTA-ABO antibodies with a radioimmunoprecipitation assay (RIPA), followed by a confirmatory competitive assay (RIPA-C). Confirmed RIPA-C-positive samples were further evaluated for the presence of neutralizing antibodies using a mouse protection assay (MPA), a highly specific bioassay for neutralizing antibodies. We conducted safety and efficacy evaluations, including day 30 responder rate (a rating of no or mild glabellar lines) and duration of response in the last treatment cycle. RESULTS: Of 1554 patients who received at least one BoNTA-ABO treatment (10 units at five injection points, for a total dose of 50 units/treatment; range one to nine treatments), five (0.32%) were antibody positive on the RIPA-C assay-two at baseline and three at the last treatment cycle. None of the RIPA-C-positive samples tested positive for neutralizing antibodies upon further evaluation using the highly specific MPA. Of note, the RIPA-C-positive group had a responder rate of 100% and a mean response of 103.3 days, while the RIPA-C-negative group had a responder rate of 90% and a mean response of 89.4 days. The safety of BoNTA-ABO did not appear to be altered in the RIPA-C-positive group. CONCLUSIONS: At the dose and treatment interval used in the correction of glabellar lines, induction of neutralizing antibodies to BoNTA-ABO was not observed. None of the five samples that initially gave positive results in a RIPA-C assay were positive when further evaluated using the MPA. Clinically, RIPA-C-positive status did not correlate with any reduction in efficacy or an altered safety profile, although the small numbers prevent definitive conclusions. These data suggest that the five RIPA-C-positive samples represented false positives. (Aesthetic Surg J 2009;29:S66-S71.) C1 [Lawrence, Ira] Medicis Pharmaceut Corp, Res & Dev, Scottsdale, AZ USA. [Moy, Ronald] W Los Angeles Vet Affairs Med Ctr, Fincher Med Grp, Los Angeles, CA 90073 USA. [Moy, Ronald] Univ Calif Los Angeles, David Geffen Sch Med, Moy Fincher Med Grp, Los Angeles, CA 90024 USA. RP Moy, R (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Moy Fincher Med Grp, 100 UCLA Med Plaza,Suite 590, Los Angeles, CA 90024 USA. EM rmoy@ucla.edu FU Medicis Aesthetics (Scottsdale, AZ) FX The authors were compensated for their contributions in preparing this manuscript and as investigators for this study. The writing of this manuscript was funded by Medicis Aesthetics (Scottsdale, AZ). Dr. Lawrence is employed by Medicis Pharmaceutical, the distributor of Dysport for aesthetic use in the United States. Dr. Moy was a paid investigator for Inamed (Santa Barbara, CA). He has no financial arrangements with Medicis Aesthetics. NR 22 TC 8 Z9 8 U1 0 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1090-820X J9 AESTHET SURG J JI Aesthet. Surg. J. PD NOV PY 2009 VL 29 IS 6 SU S BP S66 EP S71 DI 10.1016/j.asj.2009.09.009 PG 6 WC Surgery SC Surgery GA V20LB UT WOS:000208140400007 PM 19945007 ER PT J AU Federman, AD Cole, H Sano, M AF Federman, Alex D. Cole, Helen Sano, Mary TI Cognitive performance in community-dwelling English- and Spanish-speaking seniors SO AGE AND AGEING LA English DT Article DE elderly; cognition; language; Spanish ID NEUROPSYCHOLOGICAL TEST-PERFORMANCE; MINI-MENTAL-STATE; VERBAL FLUENCY; NORMATIVE DATA; EDUCATION; ELDERS; AGE; IMPAIRMENT; DISABILITY; AMERICAN AB Design: cross-sectional. Setting: community-based settings in New York City, including senior centres and residential complexes. Subjects: four hundred and twenty independently living adults aged 60 or older (mean 73.8 years). Methods: participants completed the Mini-Mental State Exam (MMSE), animal naming test (ANT) and Wechsler Memory Scale III (WMS) Story A immediate and delayed subtests. Scores were examined by strata of language, age or education and for different thresholds of the MMSE. We tested the association of language and cognitive test performance using multivariable linear regression. Results: twenty-one per cent of subjects were interviewed in Spanish and 16.2% reported poor-fair English proficiency. The mean WMS scores were not statistically different between English and Spanish groups (immediate recall, 9.9 vs 9.5, P = 0.44; delayed recall, 8.0 vs 7.6, P = 0.36, respectively), whereas ANT scores did differ (16.6 vs 14.3, P < 0.0001). These associations were consistent across MMSE thresholds. The association of language and ANT score was not significant after accounting for education. Conclusions: we found little difference in performance on the Story A subtests from the WMS suggesting that this test may be used for both English- and Spanish-speaking populations. Results suggest that variations in ANT performance may be accounted for by adjusting for the level of education. These results have important implications for the generalisability of test scores among diverse older populations. C1 [Federman, Alex D.; Cole, Helen] Mt Sinai Sch Med, Div Gen Internal Med, New York, NY 10029 USA. [Sano, Mary] Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. [Sano, Mary] Bronx Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. RP Federman, AD (reprint author), Mt Sinai Sch Med, Div Gen Internal Med, 1 Gustave L Levy Pl,Box 1087, New York, NY 10029 USA. EM alex.federman@mssm.edu FU National Institute on Aging [1K23AG028955-01]; Mount Sinai School of Medicine Alzheimer's Disease Research Center (NIH) [AG0051318] FX This study was supported by a Paul B. Beeson Career Development Award in Aging from the National Institute on Aging (Dr. Federman, 1K23AG028955-01). Additional support was provided by the Mount Sinai School of Medicine Alzheimer's Disease Research Center (NIH AG0051318). NR 29 TC 4 Z9 4 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0002-0729 J9 AGE AGEING JI Age Ageing PD NOV PY 2009 VL 38 IS 6 BP 669 EP 675 DI 10.1093/ageing/afp127 PG 7 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 510QQ UT WOS:000271106000006 PM 19651699 ER PT J AU Griffin, WC Lopez, MF Becker, HC AF Griffin, William C., III Lopez, Marcelo F. Becker, Howard C. TI Intensity and Duration of Chronic Ethanol Exposure Is Critical for Subsequent Escalation of Voluntary Ethanol Drinking in Mice SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE Dependence; Excessive Drinking; Alcohol; Mouse ID ALCOHOL-USE DISORDERS; C57BL/6J MICE; REPEATED CYCLES; ANIMAL-MODELS; INTERMITTENT; DEPENDENCE; WITHDRAWAL; CONSUMPTION; ANTAGONIST; ALLOSTASIS AB Background: Excessive alcohol drinking continues to be an important health problem. Recent studies from our laboratory and others have demonstrated that animal models of ethanol dependence and relapse can contribute to understanding factors that contribute to excessive drinking. In this study, we tested the hypothesis that the amount and duration of ethanol exposure is critical for promoting the escalation in drinking by mice given access to ethanol in a limited access paradigm. Methods: We used several methods of chronic intermittent ethanol exposure in male C57BL/6J mice that would vary in the amount and duration of exposure to ethanol as indicated by blood ethanol concentrations (BEC). After establishing baseline drinking in the mice using a 2 hours, 2 bottle choice drinking paradigm, each study involved alternating between periods of ethanol exposure and periods of limited access to ethanol (1 cycle) for a total of 3 cycles. In Study 1, mice were allowed extended access (16 hours) to ethanol for oral consumption or remained in the home cage. In Study 2, the ethanol exposure consisted of intragastric gavage of increasing doses of ethanol or isocaloric sucrose as the control. Study 3 compared intragastric gavage combined with pyrazole, an alcohol dehydrogenase inhibitor, with vapor inhalation of ethanol using procedures known to lead to increased drinking in mice. Finally, Study 4 was a retrospective review of several studies conducted in our laboratory using inhalation procedures. The retrospective review encompassed a range of postvapor chamber BEC values and ethanol intakes that would allow a relationship between increased drinking and BEC to be examined. Results: Allowing mice to drink for longer periods of time did not cause increased drinking in subsequent limited access sessions. Likewise, gastric intubation of ethanol which produced high BEC (> 300 mg/dl) with or without pyrazole did not increase drinking. Only the vapor inhalation procedure, which was associated with sustained BEC above 175 mg/dl for the entire exposure period resulted in increased drinking. The retrospective study provided further evidence that sustained BEC levels above 175 mg/dl was critical to the escalation in drinking. Conclusions: We found that the intensity (amount) and duration of ethanol exposure, indexed by BEC, is critical to produce increased drinking in mice. Specifically, BEC must regularly exceed 175 mg/dl for the escalation in drinking to occur. Future studies will examine neurobiological adaptations that may underlie the increased drinking behavior caused by chronic intermittent ethanol exposure. C1 [Griffin, William C., III; Lopez, Marcelo F.; Becker, Howard C.] Med Univ S Carolina, Ctr Drug & Alcohol Programs, Dept Psychiat & Behav Sci, Charleston Alcohol Res Ctr, Charleston, SC 29425 USA. [Becker, Howard C.] Med Univ S Carolina, Dept Neurosci, Charleston, SC 29425 USA. [Becker, Howard C.] Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Griffin, WC (reprint author), Med Univ S Carolina, Ctr Drug & Alcohol Programs, Dept Psychiat & Behav Sci, Charleston Alcohol Res Ctr, MSC 861, Charleston, SC 29425 USA. EM griffinw@musc.edu FU NIH [AA10716, AA14095, AA13885] FX This work was supported by NIH grants AA10716, AA14095, and AA13885. The authors acknowledge the expert technical assistance of Melissa Overstreet, Laura Ralston, and Kay Fernandes in conducting these studies. NR 25 TC 60 Z9 61 U1 2 U2 2 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD NOV PY 2009 VL 33 IS 11 BP 1893 EP 1900 DI 10.1111/j.1530-0277.2009.01027.x PG 8 WC Substance Abuse SC Substance Abuse GA 509YA UT WOS:000271054000006 PM 19673744 ER PT J AU Mavandadi, S Nazem, S Ten Have, TR Siderowf, AD Duda, JE Stern, MB Weintraub, D AF Mavandadi, Shahrzad Nazem, Sarra Ten Have, Thomas R. Siderowf, Andrew D. Duda, John E. Stern, Matthew B. Weintraub, Daniel TI Use of Latent Variable Modeling to Delineate Psychiatric and Cognitive Profiles in Parkinson Disease SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE Parkinson disease; neuropsychology; psychiatry; cognition; depression ID QUALITY-OF-LIFE; NEUROPSYCHIATRIC DISTURBANCES; DEPRESSION; SYMPTOMS; DEMENTIA; PREVALENCE; INVENTORY; SCALE; COMORBIDITY; DISORDERS AB Objectives: A range of psychiatric symptoms and cognitive deficits occur in Parkinson disease (PD), and symptom overlap and comorbidity complicate the classification of nonmotor symptoms. The objective of this study was to use analytic-based approaches to classify psychiatric and cognitive symptoms in PD. Design: Cross-sectional evaluation of a convenience sample of patients in specialty care. Setting: Two outpatient movement disorders centers at the University of Pennsylvania and Philadelphia Veterans Affairs Medical Center. Participants: One hundred seventy-seven patients with mild-moderate idiopathic PD and without significant global cognitive impairment. Measurements: Subjects were assessed with an extensive psychiatric, neuropsychological, and neurological battery. Latent class analysis (LCA) was used to statistically delineate group-level symptom profiles across measures of psychiatric and cognitive functioning. Predictors of class membership were also examined. Results: Results from the LCA indicated that a four-class solution best fit the data. The 32.3% of the sample had good psychiatric and normal cognitive functioning, 17.5% had significant psychiatric comorbidity but normal cognition, 26.0% had few psychiatric symptoms but had poorer cognitive functioning across a range of cognitive domains, and 24.3% had both significant psychiatric comorbidity and poorer cognitive functioning. Age, disease severity, and medication use predicted class membership. Conclusions: LCA delineates four classes of patients in mild-moderate PD, three of which experience significant nonmotor impairments and comprise over two thirds of patients. Neuropsychiatric symptoms and cognitive deficits follow distinct patterns in PD, and further study is needed to determine whether these classes are generalizable, stable, predict function, quality of life, and long-term outcomes and are amenable to treatment at a class level. (Am J Geriatr Psychiatry 2009; 17:986-995) C1 [Mavandadi, Shahrzad; Weintraub, Daniel] Philadelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. [Mavandadi, Shahrzad; Weintraub, Daniel] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. [Ten Have, Thomas R.] Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. [Siderowf, Andrew D.; Duda, John E.; Stern, Matthew B.; Weintraub, Daniel] Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. [Duda, John E.; Stern, Matthew B.; Weintraub, Daniel] Philadelphia VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA USA. RP Weintraub, D (reprint author), 3615 Chestnut St,Room 330, Philadelphia, PA 19104 USA. EM daniel.weintraub@uphs.upenn.edu FU National Institute of Mental Health (NIMH) [067894] FX This work was supported by National Institute of Mental Health (NIMH) grant no. 067894. NR 42 TC 15 Z9 15 U1 1 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD NOV PY 2009 VL 17 IS 11 BP 986 EP 995 PG 10 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 517ZG UT WOS:000271657200009 PM 19855199 ER PT J AU Romley, JA Hussey, PS de Vries, H Wang, MC Shekelle, PG McGlynn, EA AF Romley, John A. Hussey, Peter S. de Vries, Han Wang, Margaret C. Shekelle, Paul G. McGlynn, Elizabeth A. TI Efficiency and Its Measurement: What Practitioners Need to Know SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID HEALTH-CARE; QUALITY AB Objective: To help health professionals understand and evaluate the concept of efficiency and its measurement in practice. Study Design: We reviewed conceptual and practical analyses of healthcare efficiency and its measurement and describe our findings. Methods: We searched the following 3 sources: the MEDLINE and EconLit databases for articles published from 1990 to 2008 using the keywords efficiency, inefficiency, productivity, and economic profiling; seminal economic studies of efficiency identified in MEDLINE or EconLit or in economics reference materials; and the "gray literature" on efficiency measures developed by private organizations. Results: An essential element of efficiency is that healthcare outputs are as large as possible given their inputs. An efficiency measure specifies outputs and inputs appropriate to the goals of the assessment. Participants in the healthcare system have differing perspectives about the goals of efficiency assessments, relevant outputs and inputs, and validity of measures. Conclusion: The broad meaning and the value of healthcare efficiency seem uncontroversial, yet any particular application may be confronted with conflicting perspectives and with practical challenges. (Am J Manag Care. 2009;15(11):842-845) C1 [Romley, John A.; Hussey, Peter S.; Wang, Margaret C.; Shekelle, Paul G.; McGlynn, Elizabeth A.] RAND Corp, Santa Monica, CA 90407 USA. [Romley, John A.] Occidental Coll, Dept Econ, Los Angeles, CA 90041 USA. [de Vries, Han] RAND Europe, Cambridge, England. [Shekelle, Paul G.] Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RP Romley, JA (reprint author), RAND Corp, 1776 Main St,POB 2138, Santa Monica, CA 90407 USA. EM romley@rand.org FU Agency for Healthcare research and Quality [282-00-0005-21] FX This research was funded by the Agency for Healthcare research and Quality, contract number 282-00-0005-21. NR 13 TC 2 Z9 2 U1 0 U2 1 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD NOV PY 2009 VL 15 IS 11 BP 842 EP 845 PG 4 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 521QI UT WOS:000271936800010 PM 19895189 ER PT J AU Mani, SK Balasubramanian, S Zavadzkas, JA Jeffords, LB Rivers, WT Zile, MR Mukherjee, R Spinale, FG Kuppuswamy, D AF Mani, Santhosh K. Balasubramanian, Sundaravadivel Zavadzkas, Juozas A. Jeffords, Laura B. Rivers, William T. Zile, Michael R. Mukherjee, Rupak Spinale, Francis G. Kuppuswamy, Dhandapani TI Calpain inhibition preserves myocardial structure and function following myocardial infarction SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE cardiomyocytes; cell death ID ENDOPLASMIC-RETICULUM STRESS; CARDIAC MYOCYTE APOPTOSIS; SMOOTH-MUSCLE-CELLS; HEART-FAILURE; DEGRADED COLLAGEN; CROSS-TALK; ACTIVATION; DEATH; PATHOGENESIS; HYPERTROPHY AB Mani SK, Balasubramanian S, Zavadzkas JA, Jeffords LB, Rivers WT, Zile MR, Mukherjee R, Spinale FG, Kuppuswamy D. Calpain inhibition preserves myocardial structure and function following myocardial infarction. Am J Physiol Heart Circ Physiol 297: H1744-H1751, 2009. First published September 4, 2009; doi:10.1152/ajpheart.00338.2009.-Cardiac pathology, such as myocardial infarction (MI), activates intracellular proteases that often trigger programmed cell death and contribute to maladaptive changes in myocardial structure and function. To test whether inhibition of calpain, a Ca(2+)-dependent cysteine protease, would prevent these changes, we used a mouse MI model. Calpeptin, an aldehydic inhibitor of calpain, was intravenously administered at 0.5 mg/kg body wt before MI induction and then at the same dose subcutaneously once per day. Both calpeptin-treated (n = 6) and untreated (n = 6) MI mice were used to study changes in myocardial structure and function after 4 days of MI, where end-diastolic volume (EDV) and left ventricular ejection fraction (EF) were measured by echocardiography. Calpain activation and programmed cell death were measured by immunohistochemistry, Western blotting, and TdT-mediated dUTP nick-end labeling (TUNEL). In MI mice, calpeptin treatment resulted in a significant improvement in EF [EF decreased from 67 +/- 2% pre-MI to 30 +/- 4% with MI only vs. 41 +/- 2% with MI + calpeptin] and attenuated the increase in EDV [EDV increased from 42 +/- 2 mu l pre-MI to 73 +/- 4 mu l with MI only vs. 55 +/- 4 mu l with MI + calpeptin]. Furthermore, calpeptin treatment resulted in marked reduction in calpain-and caspase-3-associated changes and TUNEL staining. These studies indicate that calpain contributes to MI-induced alterations in myocardial structure and function and that it could be a potential therapeutic target in treating MI patients. C1 [Mani, Santhosh K.; Balasubramanian, Sundaravadivel; Zile, Michael R.; Kuppuswamy, Dhandapani] Med Univ S Carolina, Dept Med, Div Cardiol, Charleston, SC 29425 USA. [Zavadzkas, Juozas A.; Jeffords, Laura B.; Rivers, William T.; Mukherjee, Rupak; Spinale, Francis G.] Med Univ S Carolina, Dept Surg, Div Cardiothorac Surg, Charleston, SC 29425 USA. [Zile, Michael R.; Spinale, Francis G.; Kuppuswamy, Dhandapani] Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC USA. RP Kuppuswamy, D (reprint author), Med Univ S Carolina, Gazes Cardiac Res Inst, 114 Doughty St, Charleston, SC 29425 USA. EM kuppusd@musc.edu FU National Heart, Lung, and Blood Institute (NHLBI) [PPG HL-48788, R01 HL-092124]; Research Service of the Department of Veterans Affairs FX This study was supported by National Heart, Lung, and Blood Institute (NHLBI) Grant PPG HL-48788, a Merit Award from the Research Service of the Department of Veterans Affairs, and NHLBI Grant R01 HL-092124 (to D. Kuppuswamy). NR 59 TC 28 Z9 32 U1 0 U2 4 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD NOV PY 2009 VL 297 IS 5 BP H1744 EP H1751 DI 10.1152/ajpheart.00338.2009 PG 8 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 511DF UT WOS:000271143400024 PM 19734364 ER PT J AU Johnson, M Allen, L Dobbs, L AF Johnson, Meshell Allen, Lennell Dobbs, Leland TI Characteristics of Cl- uptake in rat alveolar type I cells SO AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY LA English DT Article DE chloride transport; cystic fibrosis transmembrane regulator; CLC5 ID TRANSMEMBRANE CONDUCTANCE REGULATOR; POSTNATAL LUNG DEVELOPMENT; NASAL EPITHELIAL-CELLS; CHLORIDE-CHANNEL; ION-TRANSPORT; TRACHEAL EPITHELIUM; ANION-EXCHANGERS; SODIUM-CHANNELS; XENOPUS OOCYTES; FETAL LAMB AB Johnson M, Allen L, Dobbs L. Characteristics of Cl- uptake in rat alveolar type I cells. Am J Physiol Lung Cell Mol Physiol 297: L816-L827, 2009. First published August 14, 2009; doi: 10.1152/ajplung.90466.2008. Although Cl- transport in fetal lung is important for fluid secretion and normal lung development, the role of Cl- transport in adult lung is not well understood. In physiological studies, the cystic fibrosis transmembrane regulator (CFTR) plays a role in fluid absorption in the distal air spaces of adult lung, and alveolar type II cells cultured for 5 days have the capacity to transport Cl-. Although both alveolar type I and type II cells express CFTR, it has previously not been known whether type I cells transport Cl-. We studied Cl- uptake in isolated type I cells directly, using either radioisotopic tracers or halide-sensitive fluorescent indicators. By both methods, type I cells take up Cl-. In the presence of beta-adrenergic agonist stimulation, Cl- uptake can be inhibited by CFTR antagonists. Type I cells express both the Cl-/HCO3- anion exchanger AE2 and the voltage-gated Cl- channels CLC5 and CLC2. Inhibitors of AE2 also block Cl- uptake in type I cells. Together, these results demonstrate that type I cells are capable of Cl- uptake and suggest that the effects seen in whole lung studies establishing the importance of Cl- movement in alveolar fluid clearance may be, in part, the result of Cl- transport across type I cells. C1 [Johnson, Meshell; Dobbs, Leland] Univ Calif San Francisco, Dept Med, San Francisco, CA 94118 USA. [Allen, Lennell; Dobbs, Leland] Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco, CA 94118 USA. [Dobbs, Leland] Univ Calif San Francisco, Dept Pediat, San Francisco, CA 94118 USA. [Johnson, Meshell] San Francisco VA Med Ctr, San Francisco, CA USA. RP Johnson, M (reprint author), Univ Calif San Francisco, Dept Med, 3333 Calif St,Suite 150,Box 1245, San Francisco, CA 94118 USA. EM meshell.johnson@ucsf.edu FU National Heart, Lung, and Blood Institute [HL-24075, HL-57426, HL-088025]; Robert Wood Johnson Foundation Amos Medical Faculty Development Program FX This study was supported by National Heart, Lung, and Blood Institute Grants HL-24075 and HL-57426 (L. Dobbs) and HL-088025 (M. Johnson) and the Robert Wood Johnson Foundation Amos Medical Faculty Development Program (M. Johnson). NR 65 TC 8 Z9 8 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1040-0605 J9 AM J PHYSIOL-LUNG C JI Am. J. Physiol.-Lung Cell. Mol. Physiol. PD NOV PY 2009 VL 297 IS 5 BP L816 EP L827 DI 10.1152/ajplung.90466.2008 PG 12 WC Physiology; Respiratory System SC Physiology; Respiratory System GA 511CN UT WOS:000271141600005 PM 19684200 ER PT J AU Williams, DL Baskin, DG Schwartz, MW AF Williams, Diana L. Baskin, Denis G. Schwartz, Michael W. TI Hindbrain leptin receptor stimulation enhances the anorexic response to cholecystokinin SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE nucleus of the solitary tract; satiety signals; adiposity signals; food intake ID CENTRAL-NERVOUS-SYSTEM; CAUDAL BRAIN-STEM; FOOD-INTAKE; MEAL SIZE; SOLITARY TRACT; GENE-EXPRESSION; BLOOD-GLUCOSE; OB PROTEIN; LEAN MICE; C-FOS AB Williams DL, Baskin DG, Schwartz MW. Hindbrain leptin receptor stimulation enhances the anorexic response to cholecystokinin. Am J Physiol Regul Integr Comp Physiol 297: R1238-R1246, 2009. First published September 2, 2009; doi: 10.1152/ajpregu.00182.2009.-Leptin is thought to reduce food intake, in part, by increasing sensitivity to satiation signals, including CCK. Leptin action in both forebrain and hindbrain reduces food intake, and forebrain leptin action augments both the anorexic and neuronal activation responses to CCK. Here, we asked whether leptin signaling in hindbrain also enhances these responses to CCK. We found that food intake was strongly inhibited at 30 min after a combination of 4th-intracerebroventricular (4th-icv) leptin injection and intraperitoneal CCK administration, whereas neither hormone affected intake during this period when given alone. Leptin injections targeted directly at the dorsal vagal complex (DVC) similarly enhanced the anorexic response to intraperitoneal CCK. Intra-DVC leptin injection also robustly increased the number of neurons positive for phospho-STAT3 staining in the area surrounding the site of injection, confirming local leptin receptor activation. Conversely, the anorexic response to 4th-icv leptin was completely blocked by IP devazepide, a CCKA-R antagonist, suggesting that hindbrain leptin reduces intake via a mechanism requiring endogenous CCK signaling. We then asked whether hindbrain leptin treatment enhances the dorsomedial hindbrain, hypothalamus, or amygdala c-Fos responses to IP CCK. We found that, in contrast to the effects of forebrain leptin administration, 4th-icv leptin injection had no effect on CCK-induced c-Fos in any structures examined. We conclude that leptin signaling in either forebrain or hindbrain areas can enhance the response to satiation signals and that multiple distinct neural circuits likely contribute to this interaction. C1 [Williams, Diana L.] Florida State Univ, Dept Psychol, Tallahassee, FL 32306 USA. [Williams, Diana L.] Florida State Univ, Program Neurosci, Tallahassee, FL 32306 USA. [Baskin, Denis G.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Baskin, Denis G.; Schwartz, Michael W.] Univ Washington, Dept Med, Ctr Excellence, Seattle, WA USA. [Baskin, Denis G.] Univ Washington, Dept Biol Struct, Ctr Excellence, Seattle, WA 98195 USA. [Baskin, Denis G.; Schwartz, Michael W.] Univ Washington, Dept Diabet & Obes, Ctr Excellence, Seattle, WA 98195 USA. RP Williams, DL (reprint author), Florida State Univ, Dept Psychol, POB 3064301, Tallahassee, FL 32306 USA. EM williams@psy.fsu.edu RI Schwartz, Michael/H-9950-2012; Williams, Diana/C-1699-2014 OI Williams, Diana/0000-0002-3548-7440 FU NIH [K99DK078779, DK52989, NS032273, DK68384, P30DK035816, P30DK17047]; Office of Research and Development Medical Research Service, Department of Veterans Affairs FX These studies were supported by NIH grants K99DK078779 to DLW and DK52989, NS032273 and DK68384 to MWS. This material is also based upon work supported in part by the Office of Research and Development Medical Research Service, Department of Veterans Affairs. Dr. Baskin is Senior Research Career Scientist, Research and Development Service, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA. This research was also supported by the Clinical Nutrition Research Unit at the University of Washington, supported by NIH grant P30DK035816, and the facilities of the Cellular and Molecular Imaging Core of the University of Washington NIH Diabetes Endocrinology Research Center, supported by NIH grant P30DK17047. NR 30 TC 23 Z9 23 U1 0 U2 4 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6119 J9 AM J PHYSIOL-REG I JI Am. J. Physiol.-Regul. Integr. Comp. Physiol. PD NOV PY 2009 VL 297 IS 5 BP R1238 EP R1246 DI 10.1152/ajpregu.00182.2009 PG 9 WC Physiology SC Physiology GA 514CR UT WOS:000271371900003 PM 19726710 ER PT J AU Rashid, JR Spengler, RF Wagner, RM Melanson, C Skillen, EL Mays, RA Heurtin-Roberts, S Long, JA AF Rashid, Jamila R. Spengler, Robert F. Wagner, Robin M. Melanson, Cindi Skillen, Elizabeth L. Mays, Robert A., Jr. Heurtin-Roberts, Suzanne Long, Judith A. TI Eliminating Health Disparities Through Transdisciplinary Research, Cross-Agency Collaboration, and Public Participation SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Editorial Material ID UNITED-STATES; TRENDS; SCIENCE; DISEASE AB Despite efforts to the contrary, disparities in health and health care persist in the United States. To solve this problem, federal agencies representing different disciplines and perspectives are collaborating on a variety of transdisciplinary research initiatives. The most recent of these initiatives was launched in 2006 when the Centers for Disease Control and Prevention's Office of Public Health Research and the Department of Health and Human Services' Office of Minority Health brought together federal partners representing a variety of disciplines to form the Federal Collaboration on Health Disparities Research (FCHDR). FCHDR collaborates with a wide variety of federal and nonfederal partners to support and disseminate research that aims to reduce or eliminate disparities in health and health care. Given the complexity involved in eliminating health disparities, there is a need for more transdisciplinary, collaborative research, and facilitating that research is FCHDR's mission. (Am J Public Health. 2009;99:1955-1961. doi:10.2105/AJPH.2009.167932) C1 [Rashid, Jamila R.; Spengler, Robert F.; Wagner, Robin M.; Melanson, Cindi; Skillen, Elizabeth L.] Ctr Dis Control & Prevent, Atlanta, GA USA. [Heurtin-Roberts, Suzanne] Off Minor Hlth, Dept Hlth & Human Serv, Rockville, MD USA. [Mays, Robert A., Jr.] NIH, Bethesda, MD 20892 USA. [Long, Judith A.] Philadelphia VA Ctr Hlth Equ Res & Promot, Dept Vet Affairs, Philadelphia, PA USA. RP Rashid, JR (reprint author), HHS, Off Minor Hlth, 1101 Wootton Pkwy,Suite 600, Rockville, MD 20852 USA. EM jamila.rashid@hhs.gov RI Heurtin-Roberts, Suzanne/D-7274-2013 NR 31 TC 16 Z9 16 U1 0 U2 9 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 NOV PY 2009 VL 99 IS 11 BP 1955 EP 1961 DI 10.2105/AJPH.2009.167932 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 511ZD UT WOS:000271209900012 PM 19762652 ER PT J AU Dhaliwal, AS Chu, D Huh, J Ghadir, M Sansgiry, S Atluri, P LeMaire, SA Coselli, JS Bakaeen, FG AF Dhaliwal, Amandeep S. Chu, Danny Huh, Joseph Ghadir, Mued Sansgiry, Shubhada Atluri, Prasad LeMaire, Scott A. Coselli, Joseph S. Bakaeen, Faisal G. TI Prognostic impact of intra-aortic balloon pump insertion before versus after cardiac surgical intervention in a veteran population SO AMERICAN JOURNAL OF SURGERY LA English DT Article DE Intra-aortic balloon pump; Morbidity; Mortality; Cardiac surgery; Outcomes ID CORONARY-BYPASS SURGERY; GRAFT-SURGERY; RISK; OUTCOMES AB BACKGROUND: The relative prognostic impact of intra-aortic balloon pump (IABP) placement before versus after cardiac surgery is not well defined. METHODS: We reviewed data from all cardiac surgical patients who received perioperative IABP support at a veterans' hospital between April 1992 and April 2008. We compared outcomes between patients who received an IABP before surgery (BS, n = 36) and after surgery (AS, n = 28). RESULTS: The AS group had higher operative morbidity (71% vs 42%) and mortality (43% vs 14%) rates than the BS aroup (P < .02 for both). Furthermore, survival rates were lower in the AS group than in the BS group at 1 year (50% vs 83%) and 3 years (46% vs 80%) (log-rank test, P < .004). CONCLUSIONS: Patients who require IABP after cardiac surgery may have worse outcomes than patients who receive IABP support before surgery. In both groups, after an early peak in mortality, the midterm outcomes were characterized by a reassuring plateau in the survival rates. Published by Elsevier Inc. C1 [Chu, Danny; Huh, Joseph; Ghadir, Mued; LeMaire, Scott A.; Coselli, Joseph S.; Bakaeen, Faisal G.] Baylor Coll Med, Michael E DeBakey Dept Surg, Div Cardiothorac Surg, Houston, TX 77030 USA. [Dhaliwal, Amandeep S.] Baylor Coll Med, Dept Med, Div Cardiol, Houston, TX 77030 USA. [Chu, Danny; Huh, Joseph; Sansgiry, Shubhada; Atluri, Prasad; Bakaeen, Faisal G.] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Chu, Danny; Huh, Joseph; LeMaire, Scott A.; Coselli, Joseph S.; Bakaeen, Faisal G.] St Lukes Episcopal Hosp, Texas Heart Inst, Houston, TX USA. RP Bakaeen, FG (reprint author), Baylor Coll Med, Michael E DeBakey Dept Surg, Div Cardiothorac Surg, Houston, TX 77030 USA. EM fbakaeen@bcm.edu NR 14 TC 6 Z9 8 U1 0 U2 0 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD NOV PY 2009 VL 198 IS 5 BP 628 EP 632 DI 10.1016/j.amjsurg.2009.07.011 PG 5 WC Surgery SC Surgery GA 522KY UT WOS:000271997900010 PM 19887190 ER PT J AU Kougias, P Chen, A Cagiannos, C Bechara, CF Huynh, TT Lin, PH AF Kougias, Panagiotis Chen, Aaron Cagiannos, Catherine Bechara, Carlos F. Huynh, Tam T. Lin, Peter H. TI Subintimal placement of covered stent versus subintimal balloon angioplasty in the treatment of long-segment superficial femoral artery occlusion SO AMERICAN JOURNAL OF SURGERY LA English DT Article DE Subintimal angioplasty; Covered stent; Superficial femoral artery; Endovascular ID PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY; FEMOROPOPLITEAL ARTERY; LIMB ISCHEMIA; DISEASE; GRAFT; ENDOPROSTHESIS; OBSTRUCTIONS; MULTICENTER; EXPERIENCE; BYPASS AB BACKGROUND: Subintimal endovascular intervention has been used widely in the treatment of symptomatic superficial femoral artery (SFA) Occlusion. The relative effectiveness of subintimal placement of a covered stent (CS) versus balloon-only subintimal angioplasty (SIA) remains uncertain. METHODS: We performed a retrospective cohort study of consecutive patients with symptomatic SFA occlusions (> 15 cm) who underwent subintimal endovascular intervention, either CS or SIA, in a single institution. Primary patency was the primary outcome. Secondary outcomes included complication rates, freedom from re-intervention, and limb salvage rates. Patency was ascertained with followup duplex or clinically. RESULTS: We evaluated 57 patients in the SIA group and 31 patients in the CS group. At 1 year the SFA primary patency for the SIA and CS groups was 28% versus 75% (P < .001), whereas the primary assisted patency was 37% versus 84% (P < .001), respectively. Need for bypass was 13% versus 0% (P = .05) in the SIA and CS groups, respectively. CONCLUSIONS: Placement of a covered stent improves patency after subintimal intervention for long SFA Occlusion. Published by Elsevier Inc. C1 [Kougias, Panagiotis; Chen, Aaron; Cagiannos, Catherine; Bechara, Carlos F.; Huynh, Tam T.; Lin, Peter H.] Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg, Houston VAMC, Houston, TX 77030 USA. RP Kougias, P (reprint author), Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg, Houston VAMC, 2002 Holcombe Blvd 112, Houston, TX 77030 USA. EM pkougias@bcm.edu NR 16 TC 18 Z9 20 U1 1 U2 1 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD NOV PY 2009 VL 198 IS 5 BP 645 EP 649 DI 10.1016/j.amjsurg.2009.07.017 PG 5 WC Surgery SC Surgery GA 522KY UT WOS:000271997900013 PM 19887193 ER PT J AU Leong, M Chike-Obi, CJ Basu, CB Lee, EI Albo, D Netscher, DT AF Leong, Mimi Chike-Obi, Chuma J. Basu, C. Bob Lee, Edward I. Albo, Daniel Netscher, David T. TI Effective breast reconstruction in female veterans SO AMERICAN JOURNAL OF SURGERY LA English DT Article DE Breast reconstruction; Female veterans; Multidisciplinary teams ID PATIENT SATISFACTION; CANCER; OUTCOMES; AFFAIRS; IMPACT; MASTECTOMY; IMMEDIATE; CARE AB BACKGROUND: Despite increasing female veteran numbers, literature regarding reconstruction after breast cancer is lacking. The purpose of this study was to examine breast reconstruction referral rates and reconstruction outcomes at a tertiary Veterans Affairs hospital. METHODS: Female breast cancer patients (1997-2008) were identified. Demographics, tumor stage, oncologic therapies, reconstructive timings and procedures, and complications were noted. RESULTS: Eighty-two women underwent mastectomy (46%) or breast conservation (43%). The referral rates to plastic surgery were 61% (mastectomy) and 32% (overall). Reconstruction rates were 42% (mastectomy) and 22% (overall). Sixty-nine percent were suitable candidates and chose immediate (67%) or delayed (33%) reconstruction, with implant-based (44%), autologous (39%), or autologous plus implants (17%). There were complications (28%) but no mortalities. Comorbidifies were not correlated with outcomes. CONCLUSIONS: Breast reconstruction can be effectively delivered within the Veterans Affairs system. It is essential that sufficient Veterans Affairs resources be deployed to address the increasing reconstructive needs of female veterans. Published by Elsevier Inc. C1 [Leong, Mimi; Netscher, David T.] Michael E DeBakey Vet Affairs Med Ctr, Sect Plast Surg, Houston, TX USA. [Albo, Daniel] Michael E DeBakey Vet Affairs Med Ctr, Sect Gen Surg, Houston, TX USA. [Leong, Mimi; Chike-Obi, Chuma J.; Lee, Edward I.; Netscher, David T.] Baylor Coll Med, Div Plast Surg, Houston, TX 77030 USA. [Basu, C. Bob] Inst Adv Breast Reconstruct, Houston, TX USA. RP Leong, M (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Sect Plast Surg, Houston, TX USA. EM mimi.leong@va.gov NR 19 TC 1 Z9 1 U1 0 U2 0 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD NOV PY 2009 VL 198 IS 5 BP 658 EP 663 DI 10.1016/j.amjsurg.2009.07.020 PG 6 WC Surgery SC Surgery GA 522KY UT WOS:000271997900015 PM 19887195 ER PT J AU Wilks, JA Balentine, CJ Berger, DH Anaya, D Awad, S Lee, L Haderxhanaj, K Albo, D AF Wilks, Jonathan A. Balentine, Courtney J. Berger, David H. Anaya, Daniel Awad, Samir Lee, Liz Haderxhanaj, Kujtim Albo, Daniel TI Establishment of a minimally invasive program at a Veterans' Affairs Medical Center leads to improved care in colorectal cancer patients SO AMERICAN JOURNAL OF SURGERY LA English DT Article DE Colorectal cancer; Minimally invasive; Laparoscopic surgery; Veterans; Clinical outcomes; Hand-assisted laparoscopic surgery ID MRC CLASICC TRIAL; LAPAROSCOPIC-ASSISTED COLECTOMY; COST STUDY-GROUP; RANDOMIZED-TRIAL; COLON-CANCER; LEARNING-CURVE; SURGERY; RESECTION; OUTCOMES; METAANALYSIS AB BACKGROUND: Despite significant advantages to patients, less than 5% of all colorectal Surgeries for cancer are performed laparoscopically. A minimally invasive colorectal cancer program was created in our Veterans' Affairs hospital with the intent of increasing access and improving quality of patient care while maintaining patient safety and oncologic standards. METHODS: Sixty consecutive laparoscopic colorectal cancer resections and 60 age-matched open resections were identified. Our prospective database was queried for demographic, clinical outcomes, and oncologic data. RESULTS: Patients undergoing laparoscopic resections experienced a shorter hospital stay and a quicker return of bowel function. Both groups had similar intraoperative blood loss and surgical times. Laparoscopic resections achieved equivalent lymph node retrieval and resection completeness compared with open resections. Laparoscopic resections resulted in fewer wounds and fewer complications requiring reoperation. CONCLUSIONS: Establishment of a minimally invasive colorectal cancer program in a Veterans Affairs Medical Center leads to increased access to laparoscopic colorectal resections and improved patient care while maintaining patient safety. Published by Elsevier Inc. C1 [Wilks, Jonathan A.; Balentine, Courtney J.; Berger, David H.; Anaya, Daniel; Awad, Samir; Lee, Liz; Haderxhanaj, Kujtim; Albo, Daniel] Michael E DeBakey Vet Affairs Med Ctr, Div Gen Surg & Surg Oncol, Houston, TX 77030 USA. [Wilks, Jonathan A.; Balentine, Courtney J.; Berger, David H.; Anaya, Daniel; Awad, Samir; Lee, Liz; Albo, Daniel] Baylor Coll Med, Michael E DeBakey Dept Surg, Houston, TX 77030 USA. RP Albo, D (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Div Gen Surg & Surg Oncol, 2002 Holcombe Blvd,OCL 112-A, Houston, TX 77030 USA. EM dalbo@bcm.edu NR 27 TC 9 Z9 9 U1 0 U2 1 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD NOV PY 2009 VL 198 IS 5 BP 685 EP 692 DI 10.1016/j.amjsurg.2009.07.016 PG 8 WC Surgery SC Surgery GA 522KY UT WOS:000271997900020 PM 19887200 ER PT J AU Bush, RL DePalma, RG Itani, KMF Henderson, WG Smith, TS Gunnar, WP AF Bush, Ruth L. DePalma, Ralph G. Itani, Kamal M. F. Henderson, William G. Smith, Tracy S. Gunnar, William P. TI Outcomes of care of abdominal aortic aneurysm in Veterans Health Administration facilities: results from the National Surgical Quality Improvement Program SO AMERICAN JOURNAL OF SURGERY LA English DT Article DE Abdominal aortic aneurysm; Endovascular aneurysm repair; EVAR; Veterans; NSQIP; Ruptured abdominal aneurysm; Quality improvement ID RANDOMIZED CONTROLLED-TRIAL; ENDOVASCULAR REPAIR; OPERATIVE MORTALITY; PROVIDER VOLUME; LEARNING-CURVE; AAA REPAIRS; RISK; PERFORMANCE; EXPERIENCE; SURVIVAL AB This-report describes outcomes of care for abdominal aortic aneurysms (AAAs), along with methods used by the Veterans Affairs (VA) National Surgical Quality Improvement Program (NSQIP) in tracking, monitoring, and improving surgical results in VA facilities. Since the inception of NSQIP in 1994, a continual drop in overall surgical mortality, along with decreased morbidity, has occurred. A parallel improvement in results of vascular surgery and AAA repair was also observed. Soon after introduction of endovascular aneurysm repair (EVAR), with Food and Drug Administration device approval in 1999, robust electronic NSQIP records immediately began to capture individual facility performances and outcomes for both types of AAA repair. The NSQIP data center provided actual and risk-adjusted analyses for both procedures semiannually. These analyses have been used by its executive board to provide recommendations, often based on site visits, to improve outcomes. Requirements for reporting of facility-specific data and feedback, paper audits, and site visits appear to relate directly to improved AAA care. Veterans Health Administration (VHA) outcomes of AAA repair are comparable to those reported nationally and internationally and have continued to improve in recent years. National VHA initiatives, based on data feedback and active oversight, relate to some of the lowest AAA mortality rates available. This review describes past, present, and possible future NSQIP strategies to improve outcomes for AAA repair with general comments about recent alternative proposals. (C) 2009 Published by Elsevier Inc. C1 [Bush, Ruth L.] Texas A&M Hlth Sci Ctr, Olin E Teague Vet Affairs Med Ctr, Temple, TX USA. [DePalma, Ralph G.; Gunnar, William P.] Affairs Cent Off, Dept Vet, Washington, DC USA. [Itani, Kamal M. F.] Boston Univ, Vet Affairs Boston Hlth Care Syst, Boston, MA 02215 USA. [Itani, Kamal M. F.] Harvard Univ, Sch Med, Boston, MA USA. [Henderson, William G.] Univ Colorado, Med Ctr, Denver, CO 80202 USA. [Smith, Tracy S.] Denver Vet Affairs Med Ctr, Denver, CO USA. RP Bush, RL (reprint author), Texas A&M Hlth Sci Ctr, Olin E Teague Vet Affairs Med Ctr, Temple, TX USA. EM ruth.bush@va.gov NR 31 TC 4 Z9 5 U1 0 U2 0 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD NOV PY 2009 VL 198 IS 5A BP S41 EP S48 DI 10.1016/j.amjsurg.2009.08.005 PG 8 WC Surgery SC Surgery GA 522KZ UT WOS:000271998000007 PM 19874934 ER PT J AU Kelly, JX O'Neil, M Melendez, V Harris, E Ager, A Smilkstein, M Forquer, I Dodean, R Winter, R Hinrichs, D Riscoe, M AF Kelly, Jane X. O'Neil, Michael Melendez, Victor Harris, Erin Ager, Arba Smilkstein, Martin Forquer, Isaac Dodean, Rosie Winter, Rolf Hinrichs, Dave Riscoe, Mike TI A NOVEL ANTIMALARIAL CHEMOTYPE WITH EFFICACY AGAINST BOTH EXOERYTHROCYTIC AND ERYTHROCYTIC STAGES SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Meeting Abstract CT 58th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene CY NOV 18-22, 2009 CL Washington, DC SP Amer Soc Trop Med & Hyg C1 [Kelly, Jane X.; Forquer, Isaac; Dodean, Rosie; Winter, Rolf; Hinrichs, Dave; Riscoe, Mike] Portland VA Med Ctr, Portland, OR USA. [O'Neil, Michael; Melendez, Victor; Harris, Erin] Walter Reed Army Inst Res, Div Expt Therapeut, Silver Spring, MD USA. [Ager, Arba] Univ Miami, Sch Med, Miami, FL USA. [Smilkstein, Martin] Oregon Translat Res & Drug Dev Inst, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DR, STE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD NOV PY 2009 VL 81 IS 5 SU S MA 295 BP 83 EP 83 PG 1 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 521WK UT WOS:000271956700295 ER PT J AU Anstead, GM Zhang, Q Melby, PC AF Anstead, Gregory M. Zhang, Qiong Melby, Peter C. TI INSULIN-LIKE GROWTH FACTOR-1 ENHANCES THE INNATE IMMUNE RESPONSE OF MACROPHAGES FROM WELL-NOURISHED MICE BUT CAN NOT RECTIFY THE DEFECTIVE IMMUNE RESPONSE OF MACROPHAGES FROM MALNOURISHED MICE SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Meeting Abstract CT 58th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene CY NOV 18-22, 2009 CL Washington, DC SP Amer Soc Trop Med & Hyg C1 [Anstead, Gregory M.; Zhang, Qiong; Melby, Peter C.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DR, STE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD NOV PY 2009 VL 81 IS 5 SU S MA 480 BP 137 EP 137 PG 1 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 521WK UT WOS:000271956700479 ER PT J AU Osorio, EY Zhao, WG Espitia, CM Saldarriaga, OA Hawel, L Byus, CV Travi, BL Melby, PC AF Osorio, Elvia Y. Zhao, Weiguo Espitia, Claudia M. Saldarriaga, Omar A. Hawel, Leo Byus, Craig V. Travi, Bruno L. Melby, Peter C. TI DOMINANT ALTERNATIVE MACROPHAGE ACTIVATION IN PROGRESSIVE VISCERAL LEISHMANIASIS IS MEDIATED BY PARASITE-INDUCED STAT6 ACTIVATION AND ARGINASE EXPRESSION SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Meeting Abstract CT 58th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene CY NOV 18-22, 2009 CL Washington, DC SP Amer Soc Trop Med & Hyg C1 [Osorio, Elvia Y.; Zhao, Weiguo; Espitia, Claudia M.; Saldarriaga, Omar A.; Travi, Bruno L.; Melby, Peter C.] Univ Texas Hlth Sci Ctr San Antonio, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. [Hawel, Leo; Byus, Craig V.] Univ Calif Riverside, Riverside, CA 92521 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DR, STE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD NOV PY 2009 VL 81 IS 5 SU S BP 189 EP 189 PG 1 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 521WK UT WOS:000271956701077 ER PT J AU Hayden, KM Zandi, PP West, NA Tschanz, JT Norton, MC Corcoran, C Breitner, JCS Welsh-Bohmer, KA AF Hayden, Kathleen M. Zandi, Peter P. West, Nancy A. Tschanz, JoAnn T. Norton, Maria C. Corcoran, Chris Breitner, John C. S. Welsh-Bohmer, Kathleen A. CA Cache Cty Study Grp TI Effects of Family History and Apolipoprotein E epsilon 4 Status on Cognitive Decline in the Absence of Alzheimer Dementia The Cache County Study SO ARCHIVES OF NEUROLOGY LA English DT Article ID APOE GENOTYPE; DISEASE LOCUS; POPULATION-SAMPLE; TYPE-4 ALLELE; ONSET; PERFORMANCE; MEMORY; RISK; AGE; APOE-EPSILON-4 AB Objective: To evaluate the influences of a family history of Alzheimer dementia (FHxAD) and the apolipoprotein E epsilon 4 genotype (APOE epsilon 4) on cognitive decline. Design, Setting, and Participants: Residents of Cache County, Utah, aged 65 years or older, were invited to participate. At baseline, 2957 participants provided DNA for genotyping of APOE and a detailed FHxAD. They also completed the Modified Mini-Mental State Examination. Cognitive status was reexamined after 3 and 7 years. We used mixed-effects models to examine the association among FHxAD, APOE epsilon 4, and cognitive trajectories. Main Outcome Measure: Modified Mini-Mental State Examination score trajectories over time. Results: Compared with participants who did not have APOE epsilon 4 or an FHxAD, those with APOE epsilon 4 scored lower on the Modified Mini-Mental State Examination at base-line (-0.70 points; 95% confidence interval [CI], -1.15 to -0.24). Participants with an FHxAD and APOE epsilon 4 differed less, if at all, in baseline score (-0.46 points; 95% CI, -1.09 to 0.16) but declined faster during the 7-year study (-9.75 points [95% CI, -10.82 to -8.67] vs -2.91 points [95% CI, -3.37 to -2.44]). After exclusion of participants who developed prodromal AD or incident dementia, the group with an FHxAD and APOE epsilon 4 declined much less during the 7-year study (-1.54; 95% CI, -2.59 to -0.50). Conclusions: Much of the association among FHxAD, APOE epsilon 4, and cognitive decline may be attributed to undetected incipient (latent) disease. In the absence of latent disease, the 2 factors do not appear individually to be associated with cognitive decline, although they may be additive. C1 [Hayden, Kathleen M.; Welsh-Bohmer, Kathleen A.] Duke Univ, Med Ctr, Joseph & Kathleen Bryan Alzheimers Dis Res Ctr, Dept Med,Div Neurol, Durham, NC 27705 USA. [Hayden, Kathleen M.; Welsh-Bohmer, Kathleen A.] Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC 27705 USA. [Zandi, Peter P.] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental Hlth, Baltimore, MD USA. [West, Nancy A.] Univ Colorado, Dept Epidemiol, Denver, CO 80202 USA. [Norton, Maria C.] Utah State Univ, Dept Family Consumer & Human Dev, Logan, UT 84322 USA. [Tschanz, JoAnn T.; Norton, Maria C.] Utah State Univ, Dept Psychol, Logan, UT 84322 USA. [Corcoran, Chris] Utah State Univ, Dept Math & Stat, Logan, UT 84322 USA. [Breitner, John C. S.] Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. [Breitner, John C. S.] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Hayden, KM (reprint author), Duke Univ, Med Ctr, Joseph & Kathleen Bryan Alzheimers Dis Res Ctr, Dept Med,Div Neurol, 2200 W Main St,Ste A-200, Durham, NC 27705 USA. EM khayden@duke.edu RI Corcoran, Chris/F-2155-2010; Tschanz, JoAnn/E-5986-2010; Norton, Maria/E-6994-2013 FU National Institutes of Health [R01-AG-11380, K01-AG-029336] FX This work was supported by grants R01-AG-11380 (Dr Welsh-Bohmer) and K01-AG-029336 (Dr Hayden) from the National Institutes of Health. NR 49 TC 22 Z9 22 U1 4 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD NOV PY 2009 VL 66 IS 11 BP 1378 EP 1383 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 517AF UT WOS:000271584400011 PM 19901170 ER PT J AU Saunders, LL Selassie, AW Hill, EG Horner, MD Nicholas, JS Lackland, DT Corrigan, JD AF Saunders, Lee L. Selassie, Anbesaw W. Hill, Elizabeth G. Horner, Michael D. Nicholas, Joyce S. Lackland, Daniel T. Corrigan, John D. TI Pre-existing Health Conditions and Repeat Traumatic Brain Injury SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE Brain injuries; Epilepsy; Rehabilitation; Seizures ID PROFESSIONAL FOOTBALL PLAYERS; RECURRENT CONCUSSION; SOCIOECONOMIC-STATUS; UNITED-STATES; HEAD-INJURY; ALCOHOL-USE; POPULATION; EPILEPSY; SEIZURES; PREVALENCE AB Objective: To assess and compare the effect of Pre-existing epilepsy/seizure disorder and drug/alcohol problem on the hazard of repeat traumatic brain injury (TBI) in persons with TBI who participated in a follow-up study. Design: Retrospective cohort. Setting: Acute care hospitals in South Carolina. Participants: Participants were from the South Carolina Traumatic Brain Injury Follow-up Registry cohort of persons (N=2118) who were discharged from an acute care hospital in South Carolina and who participated in a year-1 follow-up interview. Interventions: Not applicable. Main Outcome Measures: Repeat TBI was defined by 2 isolated events of TBI in the same person at least 72 hours apart and recorded in hospital discharge or emergency department records from 1999 through 2005. Results: A Cox proportional hazards model was used to assess the associations of Pre-existing epilepsy/seizure disorder and drug/alcohol problem with time to repeat TBI, controlling for other confounding factors. There were 2099 persons with information on both Pre-existing conditions. There were 147 (7%) persons who sustained repeat TBI after recruitment to the follow-up study, and 82 (3.9%) had a previous TBI before recruitment for which they were seen in the hospital discharge or emergency department since 1996. The hazard of repeat TBI for persons with Pre-existing epilepsy/seizure disorder was 2.3 times the hazard for those without (hazard ratio, 2.3; 95% confidence interval, 1.2-4.4; P=.011). Pre-existing drug/alcohol problem was not associated with repeat TBI. Other variables significantly associated with repeat TBI were having a prior TBI. being insured under Medicaid, and having no insurance. Conclusions: Pre-existing epilepsy/seizure disorder predisposes to repeat TBI. Appropriate management of seizure control may be an important strategy to allay the occurrence of repeat TBI. C1 [Saunders, Lee L.] Med Univ S Carolina, Dept Hlth Sci & Res, Charleston, SC 29425 USA. [Selassie, Anbesaw W.; Hill, Elizabeth G.; Nicholas, Joyce S.; Lackland, Daniel T.] Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, Charleston, SC 29425 USA. [Horner, Michael D.] Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. [Horner, Michael D.] Ralph H Johnson Dept Vet Affairs, Med Ctr, Mental Hlth Serv, Charleston, SC USA. [Corrigan, John D.] Ohio State Univ, Dept Phys Med & Rehabil, Columbus, OH 43210 USA. RP Saunders, LL (reprint author), Med Univ S Carolina, Dept Rehabil Sci, 77 President St,Ste 117,MSC 700, Charleston, SC 29425 USA. EM saundel@musc.edu FU Division of Injury Response [U17/CCU421926]; National Center for Injury Prevention and Control (NCIPC); Centers for Disease Control and Prevention (CDC); Social Security Administration (SSA); Office of Disability Income and Support Programs FX Supported by the Division of Injury Response (grant no. U17/CCU421926), National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC). The study was performed pursuant to a jointly financed cooperative arrangement between the NCIPC, the National Center for Chronic Discase Prevention and Health Promotion, CDC, and the Social Security Administration (SSA), Office of Disability Income and Support Programs. NR 39 TC 3 Z9 3 U1 3 U2 8 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 2009 VL 90 IS 11 BP 1853 EP 1859 DI 10.1016/j.apmr.2009.05.020 PG 7 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 520XC UT WOS:000271881900006 PM 19887208 ER PT J AU Koontz, AM Roche, BM Collinger, JL Cooper, RA Boninger, ML AF Koontz, Alicia M. Roche, Bailey M. Collinger, Jennifer L. Cooper, Rory A. Boninger, Michael L. TI Manual Wheelchair Propulsion Patterns on Natural Surfaces During Start-Up Propulsion SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE Biomechanics; Kinetics; Rehabilitation; Wheelchairs ID STROKE PATTERN; BIOMECHANICS; EFFICIENCY; SPEEDS AB Objectives: To classify propulsion patterns over surfaces encountered in the natural environment during start-up and compare selected biomechanical variables between pattern types. Design: Case series. Setting: National Veterans Wheelchair Games, Minneapolis, MN, 2005. Participants: Manual wheelchair users (N=29). Intervention: Subjects pushed their wheelchairs from a resting position over high-pile carpet, over linoleum, and up a ramp with a 5 degrees incline while propulsion kinematics and kinetics were recorded with a motion capture system and an instrumented wheel. Main Outcome Measures: Three raters classified the first 3 strokes as 1 of 4 types on each surf-ace: arc, semicircular (SC), single looping over propulsion (SC), and double looping over propulsion (DC). The Fisher exact test was used to assess pattern changes between strokes and surface type. A multiple analysis of variance test was used to compare peak and average resultant force and moment about the hub, average wheel velocity, stroke frequency, contact angle, and distance traveled between stroke patterns. Results: SL was the most common pattern used during start-up propulsion (44.9%), followed by arc (35.9%), DL (14.1%), and SC (5.1%). Subjects who dropped their hands below the rim during recovery achieved faster velocities and covered greater distances (.016 <= P <=.075) during start-up on linoleum and carpet and applied more force during start-up on the ramp compared with those who used an arc pattern (P=.066). Conclusions: Classifying propulsion patterns is a difficult task that should use multiple raters. In addition, propulsion patterns change during start-up, with an arc pattern most prevalent initially. The biomechanical findings in this study agree with current clinical guidelines that recommend training users to drop the hand below the pushrim during recovery. C1 [Koontz, Alicia M.; Roche, Bailey M.; Collinger, Jennifer L.; Cooper, Rory A.; Boninger, Michael L.] Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. [Collinger, Jennifer L.; Cooper, Rory A.; Boninger, Michael L.] Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA USA. [Koontz, Alicia M.; Cooper, Rory A.; Boninger, Michael L.] Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. [Koontz, Alicia M.; Roche, Bailey M.; Collinger, Jennifer L.; Cooper, Rory A.; Boninger, Michael L.] VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA 15206 USA. RP Koontz, AM (reprint author), VA Pittsburgh Hlth Care Syst, Human Engn Res Labs 151R1 H, 7180 Highland Dr,151R1-H, Pittsburgh, PA 15206 USA. EM akoontz@pitt.edu OI Boninger, Michael/0000-0001-6966-919X FU Department of Veterans Affairs Rehabilitation Research and Development Service [B3142C]; National Science Foundation [EEC 0552351]; Paralyzed veterans of America FX Supported by the Department of Veterans Affairs Rehabilitation Research and Development Service (project no. B3142C), the National Science Foundation (project no. EEC 0552351), and the Paralyzed veterans of America. NR 22 TC 14 Z9 14 U1 3 U2 9 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD NOV PY 2009 VL 90 IS 11 BP 1916 EP 1923 DI 10.1016/j.apmr.2009.05.022 PG 8 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 520XC UT WOS:000271881900015 PM 19887217 ER PT J AU Burnett, J Dyer, CB Naik, AA AF Burnett, Jason Dyer, Carmel B. Naik, Aanand A. TI Convergent Validation of the Kohlman Evaluation of Living Skills as a Screening Tool of Older Adults' Ability to Live Safely and Independently in the Community SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE Activities of daily living; Comprehensive geriatric assessment; Older persons or elders; Rehabilitation; Restorative care ID COGNITIVE IMPAIRMENT; PHYSICAL-PERFORMANCE; SELF-NEGLECT; INSTRUMENTAL ACTIVITIES; EXECUTIVE DYSFUNCTION; FUNCTIONAL DECLINE; DWELLING ELDERS; FREEDOM HOUSE; FOLLOW-UP; DISABILITY AB Objective: To evaluate the convergent validity of the Kohlman Evaluation of Living Skills (KELS) to screen older adults' ability to live safely and independently. Design: Cross-sectional study correlating KELS with components of a Comprehensive Geriatric Assessment. Setting: Participants' homes. Participants: Community-dwelling older adults (N=200) 65 years and older including 100 persons referred by Adult Protective Services (APS) and 100 ambulatory patients matched on age, race, sex, and socioeconomic status. Interventions: In-home comprehensive assessment. Main Outcome Measures: KELS, Geriatric Depression Scale (GDS), modified Physical Performance Test (mPPT), Mini-Mental State Examination (MMSE), Knee Extensor Break Test, Executive Cognitive Test (EXIT25). executive clock-drawing test (CLOX) 1 and 2, and an 8-foot walk test. Results: Older adults with abnormal KELS scores performed significantly worse on all tests except for the Knee Extensor Break Test. Accordingly, among the entire group, the KELS correlated with measures of executive function (EXIT25, r=.705, P<.001; CLOX 1, r=-.629, P<.001), cognitive function (MMSE, r=-.508, P<.001), affect (GDS, r=.318, P<.001), and physical function (mPPT, r=-.472, P<.001) but did not correlate with the Knee Extensor Break Test (r=-.068, P=.456). Among those referred by APS, the KELS failed to correlate with only the 8-foot walk test (r=.175, P=.153) and GDS (r=.080, P=.450). Conclusions: This study demonstrated the convergent validity of KELS with a battery of cognitive, affective, executive, and functional measures often used to determine older adults' ability to live safely and independently in the community. KELS may be a valid and pragmatic alternative to screen for the capacity to live safely and independently among older adults. C1 [Naik, Aanand A.] Baylor Coll Med, Alkek Dept Med, Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. [Burnett, Jason; Dyer, Carmel B.] Univ Texas Hlth Sci Ctr Houston, Div Geriatr & Palliat Med, Dept Internal Med, Houston, TX USA. [Burnett, Jason; Dyer, Carmel B.; Naik, Aanand A.] Consortium Res Elder Self Neglect Texas, Houston, TX USA. [Burnett, Jason; Dyer, Carmel B.; Naik, Aanand A.] Harris Cty Hosp Dist, Houston, TX USA. RP Naik, AA (reprint author), Michael E DeBakey VAMC 152, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe, Houston, TX 77030 USA. EM anaik@bcm.tmc.edu FU Houston Center for Quality of Care & Utilization Studies [HFP90-020]; Michael E. DeBakey Veterans Affairs Medical Center; Consortium for Research in Elder Self-Neglect of Texas [NIH P20-RR020626]; Greenwall Foundation; National Institute of Aging [K23AG027144]; Doris Duke Charitable Foundation FX Supported by the Houston Center for Quality of Care & Utilization Studies (grant no. HFP90-020) with resources and the use of facilities; Michael E. DeBakey Veterans Affairs Medical Center, the Consortium for Research in Elder Self-Neglect of Texas (grant no. NIH P20-RR020626): a bioethics grant from the Greenwall Foundation: and the National Institute of Aging (grant no. K23AG027144) and a Doris Duke Charitable Foundation Clinical Scientist Development Award. NR 30 TC 10 Z9 10 U1 4 U2 11 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 2009 VL 90 IS 11 BP 1948 EP 1952 DI 10.1016/j.apmr.2009.05.021 PG 5 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 520XC UT WOS:000271881900020 PM 19887222 ER PT J AU Bentrem, DJ Cohen, ME Hynes, DM Ko, CY Bilimoria, KY AF Bentrem, David J. Cohen, Mark E. Hynes, Denise M. Ko, Clifford Y. Bilimoria, Karl Y. TI Identification of Specific Quality Improvement Opportunities for the Elderly Undergoing Gastrointestinal Surgery SO ARCHIVES OF SURGERY LA English DT Article ID SURGICAL OUTCOMES; UNITED-STATES; COLORECTAL-CANCER; GASTRIC-CANCER; POPULATION; RISK; CARE; RESECTION; OCTOGENARIANS; ESOPHAGUS AB Hypothesis: Specific complications occur more frequently in elderly patients undergoing major gastrointestinal (GI) tract operations that may represent opportunities for quality improvement. Design: Retrospective cohort study. Setting: One hundred twenty-one hospitals participating in American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Patients: Using the ACS-NSQIP participant use file (2005-2006), patients undergoing upper gastrointestinal tract (n=4115), hepatobiliary or pancreatic (n=3364), and colorectal (n=17 268) operations at 121 hospitals were examined. Main Outcome Measures: Risk-adjusted 30-day outcomes were assessed using regression modeling adjusting for patient characteristics, comorbidities, and surgical procedures. The elderly were defined as those older than 75 years. Results: Between January 1, 2005, and December 31, 2006, a total of 54 747 patients who underwent major GI tract operations were identified from the ACS-NSQIP data file. In the elderly, overall perioperative morbidity was 1.2 to 2 times higher and mortality was 2.9 to 6.7 times higher than in younger patients after adjusting for differences in preoperative comorbidities. Irrespective of procedure type, the elderly were significantly more likely to experience cardiac ( acute myocardial infarction and cardiac arrest), pulmonary ( pneumonia, pulmonary embolism, and respiratory failure), and urologic ( urinary tract infection and renal failure) complications. However, surgical site infections, postoperative bleeding events, deep venous thromboses, and rates of return to the operating room did not differ significantly by age. Conclusions: Morbidity and mortality are markedly higher in older patients. Quality measures for the elderly currently address only myocardial infarction, surgical site infection, and deep venous thrombosis. If care for the elderly is to be improved, quality improvement initiatives need to be expanded to include postoperative pulmonary and renal complications. C1 [Cohen, Mark E.; Ko, Clifford Y.; Bilimoria, Karl Y.] Amer Coll Surg, Div Res & Optimal Patient Care, Chicago, IL 60611 USA. [Hynes, Denise M.] Univ Illinois, Coll Med, Dept Med, Sch Publ Hlth, Chicago, IL USA. [Hynes, Denise M.] Univ Illinois, Sch Publ Hlth, Dept Hlth Policy Adm, Chicago, IL USA. [Hynes, Denise M.] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Ctr Management Complex Chron Care, Hines, IL 60141 USA. [Ko, Clifford Y.] Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. [Ko, Clifford Y.] Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Bentrem, David J.; Bilimoria, Karl Y.] Northwestern Univ, Dept Surg, Sch Med, Chicago, IL 60611 USA. RP Bilimoria, KY (reprint author), Amer Coll Surg, Div Res & Optimal Patient Care, 633 N St Clair St,22nd Floor, Chicago, IL 60611 USA. EM k-bilimoria@northwestern.edu FU American Cancer Society Illinois Division and by the Barnum Foundation [ACSIRG 93-037-12]; Department of Veterans Affairs Health Services Research and Development Service Research Career Scientist Award; American College of Surgeons Clinical Scholars FX This study was funded in part by grant ACSIRG 93-037-12 from the American Cancer Society Illinois Division and by the Barnum Foundation ( Dr Bentrem). Dr Hynes is supported by the Department of Veterans Affairs Health Services Research and Development Service Research Career Scientist Award. Dr Bilimoria is supported by the American College of Surgeons Clinical Scholars in Residence program. NR 41 TC 49 Z9 53 U1 0 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD NOV PY 2009 VL 144 IS 11 BP 1013 EP 1020 PG 8 WC Surgery SC Surgery GA 521AG UT WOS:000271890500007 PM 19917937 ER PT J AU Paterson, AD Lopes-Virella, MF Waggott, D Boright, AP Hosseini, SM Carter, RE Shen, EQ Mirea, L Bharaj, B Sun, L Bull, SB AF Paterson, Andrew D. Lopes-Virella, Maria F. Waggott, Daryl Boright, Andrew P. Hosseini, S. Mohsen Carter, Rickey E. Shen, Enqing Mirea, Lucia Bharaj, Bhupinder Sun, Lei Bull, Shelley B. CA Diabet Control Complications Trial TI Genome-Wide Association Identifies the ABO Blood Group as a Major Locus Associated With Serum Levels of Soluble E-Selectin SO ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY LA English DT Article DE E-selectin; ABO blood group; genome-wide association; SNP ID PLASMODIUM-FALCIPARUM MALARIA; CELLULAR ADHESION MOLECULES; LEUKOCYTE-ENDOTHELIAL ADHESION; VON-WILLEBRAND-FACTOR; RISK-FACTORS; CARDIOVASCULAR-DISEASE; MACROVASCULAR COMPLICATIONS; DIABETES-MELLITUS; VASCULAR-DISEASE; MARKERS AB Background-Elevated serum soluble E-selectin levels have been associated with a number of diseases. Although E-selectin levels are heritable, little is known about the specific genetic factors involved. E-selectin levels have been associated with the ABO blood group phenotype. Methods and Results-We performed a high-resolution genome-wide association study of serum soluble E-selectin levels in 685 white individuals with type 1 diabetes from the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Intervention and Complications (EDIC) study to identify major loci influencing levels. Highly significant evidence for association (P = 10(-29)) was observed for rs579459 near the ABO blood group gene, accounting for 19% of the variance in E-selectin levels. Levels of E-selectin were higher in O/O than O/A heterozygotes, which were likewise higher than A/A genotypes. Analysis of subgroups of A alleles reveals heterogeneity in the association, and even after this was accounted for, an intron 1 SNP remained significantly associated. We replicate the ABO association in nondiabetic individuals. Conclusion-ABO is a major locus for serum soluble E-selectin levels. We excluded population stratification, fine-mapped the association to sub-A alleles, and also document association with additional variation in the ABO region. (Arterioscler Thromb Vasc Biol. 2009; 29: 1958-1967.) C1 [Paterson, Andrew D.; Hosseini, S. Mohsen; Bharaj, Bhupinder] Hosp Sick Children, Program Genet & Genome Biol, Toronto, ON M5G 1L7, Canada. [Waggott, Daryl; Shen, Enqing; Mirea, Lucia; Bull, Shelley B.] Mt Sinai Hosp, Samuel Lunenfeld Res Inst, Prosserman Ctr Hlth Res, Toronto, ON M5G 1X5, Canada. [Boright, Andrew P.] Univ Toronto, Dept Med, Univ Hlth Network, Toronto, ON M5S 1A1, Canada. [Paterson, Andrew D.; Mirea, Lucia; Sun, Lei; Bull, Shelley B.] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON M5S 1A1, Canada. [Lopes-Virella, Maria F.] Med Univ S Carolina, Dept Med & Lab Serv, Charleston, SC USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. [Carter, Rickey E.] Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, Charleston, SC USA. RP Paterson, AD (reprint author), Hosp Sick Children, Program Genet & Genome Biol, TMDT Bldg E Tower,Rm 15-707,101 Coll St, Toronto, ON M5G 1L7, Canada. EM andrew.paterson@utoronto.ca RI Bull, Shelley/A-1920-2013; Hosseini, Mohsen/K-7133-2013; Paterson, Andrew/A-4088-2011 OI Hosseini, Mohsen/0000-0003-3626-9928; Paterson, Andrew/0000-0002-9169-118X FU Department of Veterans Affairs; National Institutes of Health; Juvenile Diabetes Research Foundation [PO1 HL55782]; National Institute of Diabetes and Digestive and Kidney Diseases [N01-DK-6-2204, R01-DK-077510]; Canadian Network of Centers of Excellence in Mathematics; Canadian Institutes of Health Research (CIHR) FX This research was supported by funding of the Merit Review Program of the Department of Veterans Affairs, by joint funding of the National Institutes of Health and Juvenile Diabetes Research Foundation (PO1 HL55782), National Institute of Diabetes and Digestive and Kidney Diseases Contract N01-DK-6-2204, National Institute of Diabetes and Digestive and Kidney Diseases Grant R01-DK-077510, and support from the Canadian Network of Centers of Excellence in Mathematics. The DCCT/EDIC Research Group is sponsored through research contracts from the National Institute of Diabetes, Endocrinology, and Metabolic Diseases of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institutes of Health. A. D. P. holds a Canada Research Chair in the Genetics of Complex Diseases. S. B. B. was a recipient of a Canadian Institutes of Health Research (CIHR) Senior Investigator award (2002-7). L. M. is a recipient of a CIHR Research Scholarship. NR 53 TC 78 Z9 79 U1 0 U2 2 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 2009 VL 29 IS 11 BP 1958 EP U609 DI 10.1161/ATVBAHA.109.192971 PG 26 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 509EE UT WOS:000270996300039 PM 19729612 ER PT J AU Cavusoglu, E Marmur, JD Chhabra, S Chopra, V Eng, C Jiang, XC AF Cavusoglu, Erdal Marmur, Jonathan D. Chhabra, Sandeep Chopra, Vineet Eng, Calvin Jiang, Xian-Cheng TI Relation of baseline plasma phospholipid transfer protein (PLTP) activity to left ventricular systolic dysfunction in patients referred for coronary angiography SO ATHEROSCLEROSIS LA English DT Article DE Phospholipid transfer protein; Inflammation; Left ventricular systolic dysfunction; Atherosclerosis ID CONGESTIVE-HEART-FAILURE; TYPE-2 DIABETES-MELLITUS; DENSITY-LIPOPROTEIN; PROGNOSTIC PREDICTOR; INSULIN-RESISTANCE; RISK-FACTOR; VITAMIN-E; DEFICIENCY; MICE; ATHEROSCLEROSIS AB Phospholipid transfer protein (PLTP) is an important modulator of phospholipid transfer and exchange among proteins. It also plays a role in inflammation and oxidative stress. Accordingly, PLTP has been implicated in the development of atherosclerosis. Left ventricular (LV) systolic dysfunction is common in patients with atherosclerosis, and both inflammation and oxidative stress have also been implicated in its development and progression. The goal of the present study was to examine the relation between plasma PLTP activity and LV systolic function. Baseline plasma PLTP activity was measured in 389 male patients referred for coronary angiography for a variety of indications. Detailed clinical, angiographic and laboratory characteristics were available for the patients. Compared to those patients with normal LV function ( defined as an ejection fraction of >= 55% on ventriculography), patients with any degree of LV dysfunction had elevated PLTP activity ( median PLTP 17.8 pmol/mu l/h versus 15.9 pmol/mu l/h, p = 0.0038). Using multivariate analysis, and adjusting for a variety of confounding variables known to affect both LV function and PLTP activity, PLTP activity was an independent predictor of the presence of any left ventricular systolic dysfunction in the entire population (OR 1.47, 95% CI 1.12-1.93, p = 0.0052). Furthermore, PLTP activity was an independent predictor of the presence of LV dysfunction in both patients with and without myocardial infarction on presentation ( OR 2.39, 95% CI 1.18-4.86, p = 0.0161 and OR 1.41, 95% CI 1.05-1.89, p = 0.0206, respectively). In conclusion, PLTP activity may represent a novel marker of LV systolic dysfunction in patients with known or suspected coronary artery disease. (C) 2009 Elsevier Ireland Ltd. All rights reserved. C1 [Cavusoglu, Erdal; Marmur, Jonathan D.; Chhabra, Sandeep] Suny Downstate Med Ctr, Div Cardiol, Dept Med, Brooklyn, NY 11203 USA. [Cavusoglu, Erdal; Chopra, Vineet; Eng, Calvin] Bronx Vet Affairs Med Ctr, Div Cardiol, Dept Med, Bronx, NY USA. [Jiang, Xian-Cheng] Suny Downstate Med Ctr, Dept Anat & Cell Biol, Brooklyn, NY 11203 USA. RP Cavusoglu, E (reprint author), SUNY Hlth Sci Ctr, 450 Clarkson Ave,Box 1199, Brooklyn, NY 11203 USA. EM ECavusoglu@aol.com FU National Institutes of Health ( Bethesda, Maryland) [HL-69817] FX This study was supported in part by grant HL-69817 (XCJ) from the National Institutes of Health ( Bethesda, Maryland). NR 35 TC 11 Z9 15 U1 0 U2 0 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0021-9150 J9 ATHEROSCLEROSIS JI Atherosclerosis PD NOV PY 2009 VL 207 IS 1 BP 261 EP 265 DI 10.1016/j.atherosclerosis.2009.04.011 PG 5 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 528QE UT WOS:000272460700042 PM 19446293 ER PT J AU Koenigsberg, HW Fan, J Ochsner, KN Liu, X Guise, KG Pizzarello, S Dorantes, C Guerreri, S Tecuta, L Goodman, M New, A Siever, LJ AF Koenigsberg, Harold W. Fan, Jin Ochsner, Kevin N. Liu, Xun Guise, Kevin G. Pizzarello, Scott Dorantes, Christine Guerreri, Stephanie Tecuta, Lucia Goodman, Marianne New, Antonia Siever, Larry J. TI Neural Correlates of the Use of Psychological Distancing to Regulate Responses to Negative Social Cues: A Study of Patients with Borderline Personality Disorder SO BIOLOGICAL PSYCHIATRY LA English DT Article DE Cognitive reappraisal; emotion; emotion regulation; fMRI; psychological distancing; social cognitive neuroscience ID EVENT-RELATED FMRI; ANTERIOR CINGULATE CORTEX; EMOTION REGULATION; PREFRONTAL CORTEX; VOLUNTARY SUPPRESSION; AFFECTIVE INSTABILITY; COGNITIVE CONTROL; PARIETAL CORTEX; FUNCTIONAL MRI; AMYGDALA AB Background: Emotional instability is a defining feature of borderline personality disorder (BPD); yet, little is understood about its underlying neural correlates. One possible contributing factor to emotional instability is a failure to adequately employ adaptive cognitive regulatory strategies such as psychological distancing. Methods: To determine whether there are differences in neural dynamics underlying this control strategy between BPD patients and healthy control (HC) subjects, blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging signals were acquired as 18 BPD and 16 HC subjects distanced from or simply looked at pictures depicting social interactions. Contrasts in signal between distance and look conditions were compared between groups. Results: Borderline personality disorder patients showed a different pattern of activation compared with HC subjects when looking at negative versus neutral pictures. When distancing versus looking at negative pictures, both groups showed decreased negative affect ratings and increased activation of the dorsolateral prefrontal cortex, areas near/along the intraparietal sulcus (IPS), ventrolateral prefrontal cortex, and posterior cingulate/precuneus regions. However, the BPD group showed less BOLD signal change in dorsal anterior cingulate cortex and IPS, less deactivation in the amygdala, and greater activation in the superior temporal sulcus and superior frontal gyrus. Conclusions: Borderline personality disorder and HC subjects display different neural dynamics while passively viewing social emotional stimuli. In addition, BPD patients do not engage the cognitive control regions to the extent that HCs do when employing a distancing strategy to regulate emotional reactions, which may be a factor contributing to the affective instability of BPD. C1 [Koenigsberg, Harold W.] Mt Sinai Sch Med, James J Peters VA Med Ctr, Mental Hlth Patient Care Ctr, Bronx, NY 10468 USA. [Koenigsberg, Harold W.; Fan, Jin; Liu, Xun; Guise, Kevin G.; Dorantes, Christine; Guerreri, Stephanie; Tecuta, Lucia; Goodman, Marianne; New, Antonia] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. [Ochsner, Kevin N.] Columbia Univ, Dept Psychol, New York, NY 10027 USA. [Pizzarello, Scott] Florida State Univ, Dept Psychol, Tallahassee, FL 32306 USA. RP Koenigsberg, HW (reprint author), Mt Sinai Sch Med, James J Peters VA Med Ctr, Mental Hlth Patient Care Ctr, 130 W Kingsbridge Rd,116A, Bronx, NY 10468 USA. EM HWarrenK@nyc.rr.com RI Fan, Jin/A-6716-2009; Frank, David/E-8213-2012; Liu, Xun/C-2400-2009 OI Fan, Jin/0000-0001-9630-8330; Liu, Xun/0000-0003-1366-8926; TECUTA, LUCIA/0000-0002-7984-3064 FU National Institute of Mental Health [RO1 MH077813]; HWK [MH076137]; National Center for Research Rasources, National institutes of Health for the Mount Sinai General Clinical Research Center [5MO1 RR00071] FX This work was supported in part by grants from, the National Institute of Mental Health (RO1 MH077813, Principal Investigator: HWK; MH076137. Principal Investigator: KNO) and from the National Center for Research Rasources, National institutes of Health for the Mount Sinai General Clinical Research Center (5MO1 RR00071). NR 76 TC 97 Z9 98 U1 4 U2 18 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 EI 1873-2402 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD NOV 1 PY 2009 VL 66 IS 9 BP 854 EP 863 DI 10.1016/j.biopsych.2009.06.010 PG 10 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 512BH UT WOS:000271216800007 PM 19651401 ER PT J AU Freytes, CO Lazarus, HM AF Freytes, C. O. Lazarus, H. M. TI Second hematopoietic SCT for lymphoma patients who relapse after autotransplantation: another autograft or switch to allograft? SO BONE MARROW TRANSPLANTATION LA English DT Review DE second transplants; lymphoma; relapse ID STEM-CELL TRANSPLANTATION; NON-HODGKINS-LYMPHOMA; BONE-MARROW TRANSPLANTATION; MONOCLONAL-ANTIBODY THERAPY; PRIOR AUTOLOGOUS TRANSPLANT; HIGH-DOSE CHEMOTHERAPY; ALLOGENEIC TRANSPLANTATION; PROGRESSIVE DISEASE; FOLLICULAR LYMPHOMA; HEMATOLOGICAL MALIGNANCIES AB Although autologous hematopoietic SCT (auto-HSCT) is the only potentially curative treatment for lymphoma that has relapsed after conventional chemotherapy, the prognosis of patients with disease recurrence after auto-HSCT is poor. Some highly selected patients can benefit from second transplants. One-third with late recurrence after initial auto-HSCT may attain a prolonged remission after second auto-HSCT. Non-myeloablative or reduced-intensity conditioning (RIC) allogeneic hematopoietic SCT (allo-HSCT) has been used successfully after auto-HSCT failures, especially in subjects who have an HLA-compatible donor, chemosensitive disease and good performance status. Patients with chemosenstive disease recurrence who have completed at least 1 year after their first auto-HSCT should be considered for a second auto-HSCT. Patients who have chemoresistant disease are best served by participation in a well-designed clinical trial examining novel antitumor agents. Bone Marrow Transplantation (2009) 44, 559-569; doi:10.1038/bmt.2009.214; published online 24 August 2009 C1 [Freytes, C. O.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med Hematol & Med Oncol, BMTU 111, San Antonio, TX 78229 USA. [Freytes, C. O.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Lazarus, H. M.] Univ Hosp Case Med Ctr, Ireland Canc Ctr, Cleveland, OH USA. [Lazarus, H. M.] Case Western Reserve Univ, Case Comprehens Canc Ctr, Cleveland, OH 44106 USA. RP Freytes, CO (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Med Hematol & Med Oncol, BMTU 111, Mail Code 7880,7400 Merton Minter, San Antonio, TX 78229 USA. EM Freytes@uthscsa.edu NR 63 TC 6 Z9 8 U1 1 U2 2 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 NOV PY 2009 VL 44 IS 9 BP 559 EP 569 DI 10.1038/bmt.2009.214 PG 11 WC Biophysics; Oncology; Hematology; Immunology; Transplantation SC Biophysics; Oncology; Hematology; Immunology; Transplantation GA 518AO UT WOS:000271661700001 PM 19701250 ER PT J AU Ghosh-Choudhury, T Mandal, CC Woodruff, K St Clair, P Fernandes, G Choudhury, GG Ghosh-Choudhury, N AF Ghosh-Choudhury, Triparna Mandal, Chandi C. Woodruff, Kathleen St Clair, Patricia Fernandes, Gabriel Choudhury, Goutam G. Ghosh-Choudhury, Nandini TI Fish oil targets PTEN to regulate NF kappa B for downregulation of anti-apoptotic genes in breast tumor growth SO BREAST CANCER RESEARCH AND TREATMENT LA English DT Review DE PTEN; NF kappa B; DHA; EPA; Breast tumor growth; Apoptotic signal ID PROTEIN-KINASE B; PHOSPHATIDYLINOSITOL 3-KINASE/AKT PATHWAY; PROMOTES CELL-SURVIVAL; CANCER-CELLS; PHOSPHOINOSITIDE 3-KINASE; SIGNALING PATHWAY; PROSTATE-CANCER; BMP-2 GENE; OSTEOBLAST DIFFERENTIATION; TRANSCRIPTION FACTOR AB The molecular mechanism for the beneficial effect of fish oil on breast tumor growth is largely undefined. Using the xenograft model in nude mice, we for the first time report that the fish oil diet significantly increased the level of PTEN protein in the breast tumors. In addition, the fish oil diet attenuated the PI 3 kinase and Akt kinase activity in the tumors leading to significant inhibition of NF kappa B activation. Fish oil diet also prevented the expression of anti-apoptotic proteins Bcl-2 and Bcl-XL in the breast tumors with concomitant increase in caspase 3 activity. To extend these findings we tested the functional effects of DHA and EPA, the two active x-3 fatty acids of fish oil, on cultured MDA MB-231 cells. In agreement with our in vivo data, DHA and EPA treatment increased PTEN mRNA and protein expression and inhibited the phosphorylation of p65 subunit of NF kappa B in MDA MB-231 cells. Furthermore, DHA and EPA reduced expression of Bcl-2 and Bcl-XL. NF kappa B DNA binding activity and NF kappa B-dependent transcription of Bcl-2 and Bcl-XL genes were also prevented by DHA and EPA treatment. Finally, we showed that PTEN expression significantly inhibited NF kappa B-dependent transcription of Bcl-2 and Bcl-XL genes. Taken together, our data reveals a novel signaling pathway linking the fish oil diet to increased PTEN expression that attenuates the growth promoting signals and augments the apoptotic signals, resulting in breast tumor regression. C1 [Ghosh-Choudhury, Triparna; Mandal, Chandi C.; Woodruff, Kathleen; St Clair, Patricia; Ghosh-Choudhury, Nandini] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. [Choudhury, Goutam G.] Educ & Clin Ctr, San Antonio, TX USA. [Choudhury, Goutam G.; Ghosh-Choudhury, Nandini] S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Ghosh-Choudhury, N (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. EM choudhury@uthscsa.edu FU NIH [RO1 AR52425, RO1 DK 50190, RO1 AG023648]; DOD Breast cancer Concept Award; Morrison Trust Fund; VA Merit Review grants; Juvenile Diabetes Research Foundation; Department of Veterans Affairs FX This work was supported by the NIH RO1 AR52425, DOD Breast cancer Concept Award, Morrison Trust Fund and VA Merit Review grants to NGC. GGC is supported by NIH RO1 DK 50190, VA Merit Review and Juvenile Diabetes Research Foundation Regular Research Grants. GGC is recipient of the Research Career Scientist Award from the Department of Veterans Affairs. GF is supported by NIH RO1 AG023648. NR 118 TC 46 Z9 47 U1 0 U2 6 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0167-6806 J9 BREAST CANCER RES TR JI Breast Cancer Res. Treat. PD NOV PY 2009 VL 118 IS 1 BP 213 EP 228 DI 10.1007/s10549-008-0227-7 PG 16 WC Oncology SC Oncology GA 505YI UT WOS:000270737800023 PM 18953692 ER PT J AU Menes, TS Kerlikowske, K Jaffer, S Seger, D Miglioretti, DL AF Menes, Tehillah S. Kerlikowske, Karla Jaffer, Shabnam Seger, Deborah Miglioretti, Diana L. TI Rates of Atypical Ductal Hyperplasia Have Declined with Less Use of Postmenopausal Hormone Treatment: Findings from the Breast Cancer Surveillance Consortium SO CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION LA English DT Article ID ESTROGEN PLUS PROGESTIN; SCREENING MAMMOGRAPHY; RISK-FACTORS; FOLLOW-UP; DISEASE; FREQUENCY; THERAPY; WOMEN; POPULATION; BIOPSIES AB Aim: To examine risk factors and rates of atypical ductal hyperplasia (ADH) with and without associated breast cancer over time and tumor characteristics of breast cancer with and without associated ADH in women previously screened with mammography. Methods: Data on screening mammograms done between 1996 and 2005 were collected from mammography registries that participate in the Breast Cancer Surveillance Consortium. Associations between age, family history of breast cancer, postmenopausal hormone treatment (HT), and final pathology result (ADH or cancer with or without ADH in the same breast) were examined. Rates of different outcomes were calculated per exam year. Tumor characteristics of cancers with and without associated ADH were compared. Results: A total of 2,453,483 screening mammograms were associated with 1,064 biopsies with ADH, 833 breast cancers with ADH, and 8,161 cancers with no ADH. Postmenopausal HT use decreased significantly from 35% to 11% during the study period. Rates of ADH decreased from a peak of 5.5/10,000 mammograms in 1999 to 2.4/10,000 in 2005. Rates of cancer with ADH decreased from a peak of 4.3/10,000 mammograms in 2003 to 3.3/10,000 in 2005. ADH and breast cancer were significantly associated with use of postmenopausal HT. Cancer associated with ADH was of lower grade and stage and more estrogen receptor positive than cancer with no ADH. Summary: Postmenopausal HT is associated with an increased risk of ADH with or without cancer. Rates of ADH have decreased over the past decade, which may be partially explained by the significant reduction in use of postmenopausal HT. (Cancer Epidemiol Biomarkers Prev 2009;18(11):2822-8) C1 [Menes, Tehillah S.] Elmhurst Hosp Ctr, Dept Surg, Elmhurst, NY 11373 USA. [Menes, Tehillah S.] Mt Sinai Sch Med, New York, NY USA. [Kerlikowske, Karla] Univ Calif San Francisco, Dept Med, San Francisco Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA 94143 USA. [Kerlikowske, Karla] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA 94143 USA. [Jaffer, Shabnam] Mt Sinai Med Ctr, Mt Sinai Sch Med, Dept Pathol, New York, NY 10029 USA. [Miglioretti, Diana L.] Univ Washington, Dept Biostat, Seattle, WA 98195 USA. RP Menes, TS (reprint author), Elmhurst Hosp Ctr, Dept Surg, 79-01 Broadway, Elmhurst, NY 11373 USA. EM menest@nychhc.org FU National Cancer Institute [U01CA63740, U01CA86076, U01CA86082, U01CA63736, U01CA70013, U01CA69976, U01CA63731, U01CA70040] FX The National Cancer Institute-funded Breast Cancer Surveillance Consortium co-operative agreement (U01CA63740, U01CA86076, U01CA86082, U01CA63736, U01CA70013, U01CA69976, U01CA63731, and U01CA70040). NR 27 TC 11 Z9 11 U1 1 U2 1 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1055-9965 EI 1538-7755 J9 CANCER EPIDEM BIOMAR JI Cancer Epidemiol. Biomarkers Prev. PD NOV PY 2009 VL 18 IS 11 BP 2822 EP 2828 DI 10.1158/1055-9965.EPI-09-0745 PG 7 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 516SJ UT WOS:000271562600004 PM 19900937 ER PT J AU Sugimoto, M Ohno, T Graham, DY Yamaoka, Y AF Sugimoto, Mitsushige Ohno, Tomoyuki Graham, David Y. Yamaoka, Yoshio TI Gastric mucosal interleukin-17 and-18 mRNA expression in Helicobacter pylori-induced Mongolian gerbils SO CANCER SCIENCE LA English DT Article ID INTESTINAL METAPLASIA; INCREASED RISK; GENE POLYMORPHISMS; VIRULENCE FACTORS; JAPANESE SUBJECTS; IMMUNE-RESPONSE; PEPTIC-ULCER; CANCER RISK; INFECTION; INFLAMMATION AB Helicobacter pylori infection causes characteristic mucosal infiltration of inflammatory cells, resulting in the development of peptic ulcers and gastric cancer in approximately 10% of cases. Different clinical expressions of the infection may reflect different patterns of cytokine expression. Interleukin (IL)-1 ss, tumor necrosis factor (TNF)-alpha, IL-17, and IL-18 have been reported to be involved in H. pylori-induced gastric mucosal inflammation, but the details and relation to different patterns of inflammation remain unclear. Moreover, the proinflammatory virulence factor outer inflammatory protein (OipA) was reported to be associated with gastric mucosal inflammatory cytokine levels. To clarify these findings, Mongolian gerbils were infected for up to 12 months with wild-type H. pylori 7.13 or with isogenic oipA mutants for 3 months, and mucosal cytokines (IL-1 ss, IL-17, IL-18, and TNF-alpha) mRNA levels were then assessed using real-time RT-PCR. Antral mucosal IL-1 beta and IL-18 mRNA levels peaked 1 month after infection, whereas the peak of TNF-alpha mRNA was at 6-12 months; IL-17 levels peaked at 12 months. The inflammatory cell infiltration and mRNA levels of all cytokines studied were significantly lower in oipA mutants than in wild-type-infected gerbils. Mucosal IL-1 ss, IL-17, and TNF-alpha expression, but not that of IL-18, were significantly associated with the grade of inflammatory cell infiltration. The pattern of increased inflammatory cytokines differed relative to the phase of the infection and pattern of inflammation. OipA appears to play a role in IL-1 ss, IL-17, and TNF-alpha expression and the resulting inflammation. (Cancer Sci 2009). C1 [Sugimoto, Mitsushige; Ohno, Tomoyuki; Graham, David Y.; Yamaoka, Yoshio] Michael E DeBakey Vet Affairs Med Ctr, Dept Med Gastroenterol, Houston, TX USA. [Sugimoto, Mitsushige; Ohno, Tomoyuki; Graham, David Y.; Yamaoka, Yoshio] Baylor Coll Med, Houston, TX 77030 USA. [Yamaoka, Yoshio] Oita Univ, Fac Med, Dept Environm & Prevent Med, Oita 87011, Japan. RP Yamaoka, Y (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med Gastroenterol, Houston, TX USA. EM yyamaoka@bcm.tmc.edu FU NIH [DK62813] FX This material is based upon work supported in part by the Office of Research and Development Medical Research Service Department of Veterans Affairs and by Public Health Service grant DK56338, which funds the Texas Medical Center Digestive Diseases Center. Dr Yamaoka is supported in part by a grant from the NIH (DK62813). The contents are solely the responsibility of die authors and do not necessarily represent the official views of the VA or NIH. NR 46 TC 42 Z9 44 U1 0 U2 3 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1347-9032 J9 CANCER SCI JI Cancer Sci. PD NOV PY 2009 VL 100 IS 11 BP 2152 EP 2159 DI 10.1111/j.1349-7006.2009.01291.x PG 8 WC Oncology SC Oncology GA 505VV UT WOS:000270728200021 PM 19694753 ER PT J AU Sharma, SD Meeran, SM Katiyar, N Tisdale, GB Yusuf, N Xu, H Elmets, CA Katiyar, SK AF Sharma, Som D. Meeran, Syed M. Katiyar, Nandan Tisdale, George B. Yusuf, Nabiha Xu, Hui Elmets, Craig A. Katiyar, Santosh K. TI IL-12 deficiency suppresses 12-O-tetradecanoylphorbol-13-acetate-induced skin tumor development in 7,12-dimethylbenz(a)anthracene-initiated mouse skin through inhibition of inflammation SO CARCINOGENESIS LA English DT Article ID TEA POLYPHENOL (-)-EPIGALLOCATECHIN-3-GALLATE; NECROSIS-FACTOR-ALPHA; IFN-GAMMA PRODUCTION; SKH-1 HAIRLESS MICE; OXIDATIVE STRESS; CELL CARCINOMAS; HIGH-RISK; T-CELLS; IN-VIVO; INTERLEUKIN-12 AB Interleukin (IL)-12 deficiency exacerbates tumorigenesis in ultraviolet (UV) radiation-induced skin. Here, we assessed the effects of IL-12 deficiency on 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced tumor promotion in 7,12-dimethylbenz(a)anthracene (DMBA)-initiated mouse skin. Using this two-stage chemical carcinogenesis protocol, we found that the development of DMBA/TPA-induced skin tumors was diminished in IL-12p40-knockout mice than in their wild-type counterparts. At the termination of the experiment (at 24 weeks), the skin tumor incidence and tumor multiplicity were significantly lower (P < 0.005) in interleukin-12-knockout (IL-12 KO) mice than in their wild-type counterparts, as was the malignant transformation of DMBA/TPA-induced papillomas to carcinomas (P < 0.01). Analysis of samples collected at the termination of the experiments for biomarkers of inflammation by immunohistochemical analysis, western blotting, enzyme-linked immunosorbent assay and real-time polymerase chain reaction revealed significantly lower levels of cyclooxygenase-2 (COX-2), prostaglandin (PG) E(2), proliferating cell nuclear antigen, cyclin D1 and the proinflammatory cytokines (tumor necrosis factor-alpha, IL-1 beta and IL-6) in the DMBA/TPA-treated tumors and tumor-uninvolved skin of IL-12 KO mice than the skin and tumors of DMBA/TPA-treated wild-type mice. Analysis of the skin 6 h after TPA treatment showed that the TPA-induced promotion of skin edema, inflammatory leukocyte infiltration, COX-2 expression and PGE(2) production was significantly lower in the skin of the IL-12-KO mice than their wild-type counterparts. These results indicate that DMBA/TPA-induced skin tumor development differs from UVB-induced skin tumor development in that endogenous IL-12 acts to inhibit UVB-induced skin tumor development and malignant progression of the skin tumors to carcinoma. In the case of DMBA/TPA-induced skin tumor development, the endogenous IL-12 modulates the tumor promoter stimulation of inflammatory responses. C1 [Sharma, Som D.; Meeran, Syed M.; Katiyar, Nandan; Tisdale, George B.; Yusuf, Nabiha; Xu, Hui; Elmets, Craig A.; Katiyar, Santosh K.] Univ Alabama, Dept Dermatol, Birmingham, AL 35294 USA. [Yusuf, Nabiha; Xu, Hui; Elmets, Craig A.; Katiyar, Santosh K.] Univ Alabama, UAB Skin Dis Res Ctr, Birmingham, AL 35294 USA. [Yusuf, Nabiha; Elmets, Craig A.; Katiyar, Santosh K.] Univ Alabama, UAB Comprehens Canc Ctr, Birmingham, AL 35294 USA. [Elmets, Craig A.; Katiyar, Santosh K.] Birmingham Vet Affairs Med Ctr, Birmingham, AL 35294 USA. RP Katiyar, SK (reprint author), Univ Alabama, Dept Dermatol, 1670 Univ Blvd,Volker Hall 557, Birmingham, AL 35294 USA. EM skatiyar@uab.edu RI Xu, Hui/A-8167-2009 FU Veterans Administration Merit Review Award; National Institutes of Health [P30-AR050948, P30-CA013148] FX Veterans Administration Merit Review Award to S. K. K. and C. A. E.; National Institutes of Health (P30-AR050948, P30-CA013148). NR 42 TC 11 Z9 11 U1 0 U2 2 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0143-3334 J9 CARCINOGENESIS JI Carcinogenesis PD NOV PY 2009 VL 30 IS 11 BP 1970 EP 1977 DI 10.1093/carcin/bgp228 PG 8 WC Oncology SC Oncology GA 524YB UT WOS:000272179200021 PM 19759192 ER PT J AU Chen, CY Chai, H Wang, XW Lin, PH Yao, QZ AF Chen, Changyi Chai, Hong Wang, Xinwen Lin, Peter H. Yao, Qizhi TI Chlamydia heat shock protein 60 decreases expression of endothelial nitric oxide synthase in human and porcine coronary artery endothelial cells (vol 83, pg 768, 2009) SO CARDIOVASCULAR RESEARCH LA English DT Correction C1 [Chen, Changyi; Chai, Hong; Wang, Xinwen; Lin, Peter H.; Yao, Qizhi] Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg R413, Mol Surg Res Ctr, Houston, TX 77030 USA. [Chen, Changyi; Lin, Peter H.; Yao, Qizhi] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Chen, CY (reprint author), Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg R413, Mol Surg Res Ctr, 1 Baylor Plaza,Mail Stop BCM390, Houston, TX 77030 USA. EM jchen@bcm.tmc.edu RI Chai, Hong/H-5438-2011 NR 2 TC 0 Z9 0 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0008-6363 J9 CARDIOVASC RES JI Cardiovasc. Res. PD NOV 1 PY 2009 VL 84 IS 2 BP 336 EP 336 DI 10.1093/cvr/cvp316 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 514VD UT WOS:000271422900022 ER PT J AU Klein, AJ Chen, SJ Messenger, JC Hansgen, AR Plomondon, ME Carroll, JD Casserly, IP AF Klein, Andrew J. Chen, S. James Messenger, John C. Hansgen, Adam R. Plomondon, Mary E. Carroll, John D. Casserly, Ivan P. TI Quantitative Assessment of the Conformational Change in the Femoropopliteal Artery with Leg Movement SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE peripheral vascular disease; superficial femoral artery; popliteal artery ID SUPERFICIAL FEMORAL-ARTERY; SUBINTIMAL ANGIOPLASTY; STENT IMPLANTATION; NATURAL-HISTORY; NITINOL STENTS; KNEE FLEXION; DISEASE; LESIONS; TRIAL; LONG AB Background: The unique physical forces exerted on the femoropopliteal (FP) artery during movement have been implicated in the high rates of restenosis and stent fracture in this artery. Conformational changes in the FP artery during movement are important surrogates of these forces. This study sought to quantify the conformational change in the FP artery between the straight-leg (SL) and crossed-leg (CL) positions. Methods: Using paired angiographic images of overlapping segments of the FP artery in SL and CL positions from patients with peripheral arterial disease, 3-D models of individual segments were generated and subsequently fused to create a 3-D model of the entire FP artery in both leg positions. Based on these 3-D models, the following parameters in the SL and CL positions were quantitatively assessed for the superficial femoral artery (SFA), popliteal artery (PA), and FP artery (i.e., SFA and PA): length, curvature, torsion, twist angle, and development of new flexion angles =15 degrees. Results: In nine male patients with a mean age of 57 +/- 10.2 years, anglography was performed in 10 FP arteries, with successful generation of 3-D models for all vessels. Movement from the SL to the CL position for the SFA, PA, and FP artery was associated with (a) a mean shortening of 18.2 mm (P = 0.002), 32.2 mm (P < 0.001), and 50.3 mm (P < 0.001), respectively; (b) a mean increase in curvature of 0.04 cm(-1) (P = 0.012), 0.2 cm(-1) (P < 0.001), and 0.11 cm(-1) (P < 0.001), respectively; (c) and small absolute changes in mean torsion of 0.034 cm(-1) (P = 0.48), 0.006 cm(-1) (P < 0.001), and 0.057 cm(-1) (P < 0.001), respectively. The same leg movement was associated with a mean twist angle of 45.6 degrees +/- 27.9 degrees (range of 17.4 degrees-103.4 degrees) and 61.1 degrees +/- 31.9 degrees (range of 20.5 degrees-101.1 degrees) for the SFA and PA, respectively. Compared to the SL position, the CL position induced a single flexion point (FxP) =15 degrees in the SFA in two patients, and a mean of 2.4 FxPs =15 degrees (range 1-5) in the PA. Conclusions: Significant changes in length, curvature, and twist occur in the PA and significant but more modest changes in length and twist occur in the SFA during movement from the SL to the CL position. This data has important implications for endovascular therapies that are used to treat disease in the FP artery. (C) 2009 Wiley-Liss, Inc. C1 [Klein, Andrew J.; Chen, S. James; Messenger, John C.; Hansgen, Adam R.; Carroll, John D.; Casserly, Ivan P.] Univ Colorado Hosp, Aurora, CO USA. [Plomondon, Mary E.] Denver VA Med Ctr, Denver, CO USA. RP Casserly, IP (reprint author), Univ Colorado Denver, Anschutz Med Campus,Leprino Off Bldg,12401 E 17th, Aurora, CO 80045 USA. EM ivan.casserly@ucdenver.edu FU Boston Scientific FX Grant sponsor: Boston Scientific. NR 18 TC 40 Z9 42 U1 1 U2 7 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1522-1946 J9 CATHETER CARDIO INTE JI Catheter. Cardiovasc. Interv. PD NOV 1 PY 2009 VL 74 IS 5 BP 787 EP 798 DI 10.1002/ccd.22124 PG 12 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 515UD UT WOS:000271497500018 PM 19521998 ER PT J AU Bradley, SM Levy, WC Veenstra, DL AF Bradley, Steven M. Levy, Wayne C. Veenstra, David L. TI Cost-Consequences of Ultrafiltration for Acute Heart Failure A Decision Model Analysis SO CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES LA English DT Article DE heart failure; ultrafiltration; diuretics; costs and cost analysis ID HEPARIN-INDUCED THROMBOCYTOPENIA; MOLECULAR-WEIGHT HEPARIN; CONTINUOUS VENOVENOUS HEMOFILTRATION; DISEASE MANAGEMENT PROGRAMS; BLOOD-STREAM INFECTIONS; UNFRACTIONATED HEPARIN; HOSPITALIZED-PATIENTS; READMISSION RATES; CONTROLLED-TRIAL; OLDER PATIENTS AB Background-Ultrafiltration for heart failure may reduce costs associated with acute heart failure by decreasing rehospitalization rates compared to intravenous diuretics. Methods and Results-We developed a decision-analytic model to explore the clinical outcomes and associated costs of ultrafiltration compared to intravenous diuretics for index and subsequent acute heart failure hospitalizations to 90 days from index hospitalization. We evaluated the model from societal, Medicare, and hospital payer perspectives. Base-case probabilities and costs were derived from the Ultrafiltration versus Intravenous Diuretics for Patients Hospitalized for Acute Decompensated Congestive Heart Failure clinical trial, Medicare reimbursement schedules, and published data. From a societal perspective, treatment with ultrafiltration had an 86% probability of being more expensive than intravenous diuretics in probabilistic sensitivity analysis, with a base-case estimate of $13 469 per patient treated with ultrafiltration compared to $11 610 per patient treated with intravenous diuretics. Cost estimates were most influenced by length of index hospitalization, daily cost of rehospitalization, number of days rehospitalized, and number and cost of ultrafiltration filters. From a Medicare payer perspective, ultrafiltration had a >99% probability of being cost saving. From a hospital perspective, there was a 97% probability ultrafiltration was more expensive. Our model suggested similar 90-day mortality rates between treatment arms. Conclusion-Despite a reduction in rehospitalization rates, it is unlikely ultrafiltration results in cost savings from a societal perspective. The discordance in cost between societal, Medicare, and hospital perspectives underscores the importance of payer perspective in formulating strategies and reimbursement structures to reduce heart failure hospitalizations. (Circ Cardiovasc Qual Outcomes. 2009; 2: 566-573.) C1 [Bradley, Steven M.] VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Dept Vet Affairs, Seattle, WA 98101 USA. [Bradley, Steven M.; Levy, Wayne C.] Univ Washington, Dept Med, Div Cardiol, Seattle, WA USA. [Veenstra, David L.] Univ Washington, Dept Pharm, Pharmaceut Outcomes Res & Policy Program, Seattle, WA 98195 USA. RP Bradley, SM (reprint author), VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Dept Vet Affairs, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM Steve.Bradley@va.gov FU Department of Veterans Affairs; Veterans Health Administration; Office of Research and Development; Health Services Research and Development FX This material is based on work supported by the Department of Veterans Affairs, the Veterans Health Administration, the Office of Research and Development, and Health Services Research and Development. NR 47 TC 22 Z9 23 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1941-7713 J9 CIRC-CARDIOVASC QUAL JI Circ.-Cardiovasc. Qual. Outcomes PD NOV PY 2009 VL 2 IS 6 BP 566 EP U99 DI 10.1161/CIRCOUTCOMES.109.853556 PG 13 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 575PD UT WOS:000276078500009 PM 20031894 ER PT J AU Spatz, ES Ross, JS AF Spatz, Erica S. Ross, Joseph S. TI Mis-SHAPEing Public Health Policy SO CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES LA English DT Editorial Material DE atherosclerosis; imaging; prevention; legislative mandates ID CARE; BENEFICIARIES; GUIDELINES; MEDICARE; SERVICES C1 [Spatz, Erica S.] Yale Univ, Sch Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT 06520 USA. [Ross, Joseph S.] Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY USA. [Ross, Joseph S.] James J Peters VA Med Ctr, Hlth Serv Res & Dev Res Enhancement Award Program, Bronx, NY USA. [Ross, Joseph S.] James J Peters VA Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. RP Spatz, ES (reprint author), Yale Univ, Sch Med, Robert Wood Johnson Clin Scholars Program, IE 61,333 Cedar St, New Haven, CT 06520 USA. EM erica.spatz@yale.edu FU NIA NIH HHS [K08 AG032886, K08 AG032886-01] NR 15 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1941-7713 J9 CIRC-CARDIOVASC QUAL JI Circ.-Cardiovasc. Qual. Outcomes PD NOV PY 2009 VL 2 IS 6 BP 681 EP 683 DI 10.1161/CIRCOUTCOMES.109.890715 PG 3 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 575PD UT WOS:000276078500024 PM 20031909 ER PT J AU Jensen, BC Swigart, PM De Marco, T Hoopes, C Simpson, PC AF Jensen, Brian C. Swigart, Philip M. De Marco, Teresa Hoopes, Charles Simpson, Paul C. TI alpha 1-Adrenergic Receptor Subtypes in Nonfailing and Failing Human Myocardium SO CIRCULATION-HEART FAILURE LA English DT Article DE receptors, adrenergic, alpha; receptors, adrenergic, beta; heart failure; myocardium ID SUSTAINED-RELEASE MOXONIDINE; ARTERIAL BLOOD-PRESSURE; ALPHA(1B)-ADRENERGIC RECEPTOR; HEART-FAILURE; ALPHA(1)-ADRENERGIC RECEPTORS; DILATED CARDIOMYOPATHY; CARDIAC-HYPERTROPHY; TRANSGENIC MICE; ADRENERGIC-RECEPTORS; GENE-EXPRESSION AB Background-alpha 1-adrenergic receptors (alpha 1-ARs) play adaptive roles in the heart and protect against the development of heart failure. The 3 alpha 1-AR subtypes, alpha 1A, alpha 1B, and alpha 1D, have distinct physiological roles in mouse heart, but very little is known about alpha 1 subtypes in human heart. Here, we test the hypothesis that the alpha 1A and alpha 1B subtypes are present in human myocardium, similar to the mouse, and are not downregulated in heart failure. Methods and Results-Hearts from transplant recipients and unused donors were failing (n = 12; mean ejection fraction, 24%) or nonfailing (n = 9; mean ejection fraction, 59%) and similar in age (approximate to 44 years) and sex (approximate to 70% male). We measured the alpha 1-AR subtypes in multiple regions of both ventricles by quantitative real-time reverse-transcription polymerase chain reaction and radioligand binding. All 3 alpha 1-AR subtype mRNAs were present, and alpha 1A mRNA was most abundant (approximate to 65% of total alpha 1-AR mRNA). However, only alpha 1A and alpha 1B binding were present, and the alpha 1B was most abundant (60% of total). In failing hearts, alpha 1A and alpha 1B binding was not downregulated, in contrast with beta 1-ARs. Conclusions-Our data show for the first time that the alpha 1A and alpha 1B subtypes are both present in human myocardium, but alpha 1D binding is not, and the alpha 1 subtypes are not downregulated in heart failure. Because alpha 1 subtypes in the human heart are similar to those in the mouse, where adaptive and protective effects of alpha 1 subtypes are most convincing, it might become feasible to treat heart failure with a drug targeting the alpha 1A and/or alpha 1B. (Circ Heart Fail. 2009; 2: 654-663.) C1 [Jensen, Brian C.; Swigart, Philip M.; Simpson, Paul C.] San Francisco VA Med Ctr, Cardiol Sect, San Francisco, CA USA. [Jensen, Brian C.; Swigart, Philip M.; Simpson, Paul C.] San Francisco VA Med Ctr, Res Serv, San Francisco, CA USA. [Jensen, Brian C.; De Marco, Teresa; Simpson, Paul C.] Univ Calif San Francisco, Div Cardiol, San Francisco, CA 94143 USA. [Simpson, Paul C.] Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco, CA 94143 USA. [Hoopes, Charles] Univ Calif San Francisco, Div Cardiothorac Surg, San Francisco, CA 94143 USA. RP Simpson, PC (reprint author), VA Med Ctr 111C8, 4150 Clement St, San Francisco, CA 94121 USA. EM paul.simpson@ucsf.edu FU Department of Veterans Affairs; National Institutes of Health; GlaxoSmithKline Research and Education Foundation; UCSF Foundation FX This study was supported by the Department of Veterans Affairs and the National Institutes of Health (P.C.S.), a Young Investigators Award from the GlaxoSmithKline Research and Education Foundation for Cardiovascular Disease (to B.C.J.), and the UCSF Foundation for Cardiac Research (B.C.J.). NR 50 TC 29 Z9 31 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1941-3289 J9 CIRC-HEART FAIL JI Circ.-Heart Fail. PD NOV PY 2009 VL 2 IS 6 BP 654 EP 663 DI 10.1161/CIRCHEARTFAILURE.108.846212 PG 10 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 521BD UT WOS:000271893100017 PM 19919991 ER PT J AU Schlesinger, N Hassett, AL Neustadter, L Schumacher, HR AF Schlesinger, N. Hassett, A. L. Neustadter, L. Schumacher, H. R., Jr. TI Does acute synovitis (pseudogout) occur in patients with chronic pyrophosphate arthropathy (pseudo-osteoarthritis)? SO CLINICAL AND EXPERIMENTAL RHEUMATOLOGY LA English DT Article DE Pseudogout; pyrophosphate arthropathy ID DIHYDRATE CRYSTAL DEPOSITION; OSTEO-ARTHRITIS; CALCIUM; KNEE; CHONDROCALCINOSIS; DISEASE; PREVALENCE; JOINTS; SIZE AB Objective Pyrophosphate arthropathy has been linked to diverse clinical subtypes. The two most common are: acute synovitis (pseudogout) and chronic pyrophosphate arthropathy ("pseudo-osteoarthritis"). We have conducted a study to examine whether these are overlapping syndromes. Methods We reviewed all synovial fluid (SF) analyses performed in our laboratory from January 1988 to May 1997 to determine if patterns of SF leukocyte counts and Alizarin red stains in patients with repeated samples suggest that some patients were prone to acute attacks and some to chronic pyrophosphate arthropathy and whether acute attacks superimposed on chronic symptoms were common. Joint x-rays were screened for osteoarthritis (OA) and chondrocalcinosis. Results We identified 67 patients who had Calcium pyrophosphate dehydrate (CPPD) in their SF and had more than one SF examined (185 SF). We divided the patients into 2 groups. Group A (n=25) had at least one SF leukocyte count > than 2000 per mm(3) and group B (n=42) had SF leukocyte counts always < than 2000 per mm'. Chondrocalcinosis detected on x-ray was more common in group A versus group B, 48% versus 19% (p<0.05, Fisher's exact test). OA was mild (grades 0-1) in 39% of group A versus 12.5% of group B patients, but the difference between groups was not significant. CPPD crystals were not detected in 13.5% SFs previously having CPPD crystals. Alizarin red staining for suspected hydroxyapatite was more often 2+ to 3+ in group B (31.6%) compared to group A (15.5%; p<0.05, Fisher's exact test). Conclusion Acute synovitis and chronic pyrophosphate arthropathy are often two distinctive syndromes with some patients never having inflammatory attacks. Acute synovitis is more common in patients with chondrocalcinosis while chronic pyrophosphate arthropathy is associated with increased alizarin red staining and a trend suggestive of increased severity of OA. C1 [Schlesinger, N.; Hassett, A. L.] UMDNJ, Robert Wood Johnson Med Sch, Div Rheumatol, Dept Med, New Brunswick, NJ 08903 USA. [Neustadter, L.] S Jersey Healthcare Reg Med Ctr, Vineland, NJ USA. [Schumacher, H. R., Jr.] Univ Penn, Sch Med, Div Rheumatol, Philadelphia, PA 19104 USA. [Schumacher, H. R., Jr.] Vet Affairs Med Ctr, Director Arthrit Immunol Ctr, Philadelphia, PA USA. RP Schlesinger, N (reprint author), UMDNJ, Robert Wood Johnson Med Sch, Div Rheumatol, Dept Med, MEB 468,POB 19, New Brunswick, NJ 08903 USA. EM schlesna@umdnj.edu NR 30 TC 4 Z9 5 U1 0 U2 0 PU CLINICAL & EXPER RHEUMATOLOGY PI PISA PA VIA SANTA MARIA 31, 56126 PISA, ITALY SN 0392-856X J9 CLIN EXP RHEUMATOL JI Clin. Exp. Rheumatol. PD NOV-DEC PY 2009 VL 27 IS 6 BP 940 EP 944 PG 5 WC Rheumatology SC Rheumatology GA 552CO UT WOS:000274264700008 PM 20149309 ER PT J AU Graham, DY AF Graham, David Y. TI Endoscopic Ulcers Are Neither Meaningful Nor Validated as a Surrogate for Clinically Significant Upper Gastrointestinal Harm SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Editorial Material ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; ANTI-INFLAMMATORY AGENTS; CORONARY HEART-DISEASE; DOUBLE-BLIND; BLOOD-PRESSURE; END-POINTS; COMPLICATIONS; ASPIRIN; RISK; MISOPROSTOL C1 [Graham, David Y.] Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX USA. [Graham, David Y.] Baylor Coll Med, Houston, TX 77030 USA. RP Graham, DY (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX USA. FU NCI NIH HHS [R01 CA116845]; NIDDK NIH HHS [P30 DK056338, DK56338, P30 DK056338-07] NR 35 TC 15 Z9 15 U1 0 U2 1 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 NOV PY 2009 VL 7 IS 11 BP 1147 EP 1150 DI 10.1016/j.cgh.2009.06.006 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 519GM UT WOS:000271753000006 PM 19559818 ER PT J AU Chan, MY Cohen, H Spiegel, BMR AF Chan, Michael Y. Cohen, Hartley Spiegel, Brennan M. R. TI Fewer Polyps Detected by Colonoscopy as the Day Progresses at a Veteran's Administration Teaching Hospital SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article ID COLORECTAL-CANCER; ADENOMA DETECTION; TECHNICAL PERFORMANCE; SCREENING COLONOSCOPY; SLEEP-DEPRIVATION; COLONIC NEOPLASIA; ENDOSCOPY; QUALITY; RATES; POLYPECTOMY AB BACKGROUND & AIMS: One objective of colonoscopy is to identify and remove polyps-this process requires attention to detail and prolonged concentration. Providers are predisposed to cognitive errors because the procedure is often performed repetitively throughout the day. We measured the adjusted relationship between colonoscopy start time and polyp yield. METHODS: We performed a prospective Study of 477 patients that received screening, Surveillance, or diagnostic colonoscopies at a Veteran's Administration (VA) reaching hospital. The primary outcome measure was polyp yield. We collected data on colonoscopy start times, which were analyzed both as a dichotomous time period ("early-morning case" vs "later case") and as a continuous variable (start time). We identified significant risk factors using univariate analysis and performed Poisson multivariable regression to measure the independent effect of colonoscopy start time on polyp yield. We evaluated evidence of decreasing polyp yield as the day progressed throughout pre-specified time intervals. RESULTS: In univariate analysis, early-morning cases yielded 27% more polyps per patient than later cases (95% confidence interval, 11%-45%; P < .001). The total numbers of, hyperplastic and adenomatous polyps found decreased hour-by-hour as the day progressed. Multivariable analysis demonstrated that early-morning cases yielded 20% more polyps per patient than later cases (95% confidence interval, 5%-38%; P = .007). CONCLUSIONS: At a VA medical center, more polyps were detected in patients that received colonoscopies early in the morning compared with later in the day. Moreover, adenoma detection reduced as the day progressed. Providers might be most adept at detecting polyps at the beginning of the day; further validation in other practice settings is required. C1 [Cohen, Hartley; Spiegel, Brennan M. R.] VA Greater Los Angeles Healthcare Syst, Dept Gastroenterol, Los Angeles, CA USA. [Chan, Michael Y.; Spiegel, Brennan M. R.] Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, Los Angeles, CA 90095 USA. [Spiegel, Brennan M. R.] Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. [Spiegel, Brennan M. R.] CURE Digest Dis Res Ctr, Los Angeles, CA USA. [Spiegel, Brennan M. R.] Univ Calif Los Angeles, VA Ctr Outcomes Res & Educ, Los Angeles, CA USA. RP Spiegel, BMR (reprint author), 11301 Wilshire Blvd,Bldg 115,Room 215, Los Angeles, CA 90073 USA. EM bspiegel@mednet.ucla.edu FU Veteran's Affairs Health Services Research and Development (HSR&D) Career Development Transition Award [RCD 03-179-2] FX Dr Spiegel is supported by a Veteran's Affairs Health Services Research and Development (HSR&D) Career Development Transition Award (RCD 03-179-2). NR 28 TC 41 Z9 42 U1 0 U2 5 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 NOV PY 2009 VL 7 IS 11 BP 1217 EP 1223 DI 10.1016/j.cgh.2009.07.013 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 519GM UT WOS:000271753000019 PM 19631284 ER PT J AU Khalid, A AF Khalid, Asif TI Differentiating Neoplastic From Benign Lesions of the Pancreas: Translational Techniques SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article CT 5th Joint Meeting of the Japanese-Society-of-Gastroenterology/American-Gastroenterological-Associ ation CY MAY 07-08, 2009 CL Sapporo, JAPAN SP Japanese Soc Gastroenterol, Amer Gastroenterol Assoc ID FINE-NEEDLE-ASPIRATION; PAPILLARY-MUCINOUS TUMORS; CYSTIC NEOPLASMS; BRUSH CYTOLOGY; TELOMERASE ACTIVITY; DIAGNOSTIC-ACCURACY; MOLECULAR ANALYSIS; MALIGNANCY; STRICTURES; ADENOCARCINOMA AB There has been substantial recent progress in our ability to image and sample the pancreas leading to the improved recognition of benign and premalignant conditions of the pancreas such as autoimmune pancreatitis (AIP) and mucinous lesions (mucinous cystic neoplasms [MCN] and intraductal papillary mucinous neoplasms [IPMN]), respectively. Clinically relevant and difficult situations that continue to be faced in this context include differentiating MCN and IPMN from nonmucinous pancreatic cysts, the early detection of malignant degeneration in MCN and IPMN, and accurate differentiation between pancreatic cancer and inflammatory masses, especially Alp. These challenges arise primarily due to the less than perfect sensitivity for malignancy utilizing cytological samples obtained via EUS and ERCP. Aspirates from pancreatic cysts are often paucicellular further limiting the accuracy of cytology. One approach to improve the diagnostic yield from these very small samples is through the use of molecular techniques. Because the development of pancreatic cancer and malignant degeneration in MCN and IPMN is associated with well studied genetic insults including oncogene activation (eg, k-ras), tumor suppressor gene losses (eg, p53, p16, and DPC4), and genome maintenance gene mutations (eg, BRCA2 and telomerase), detecting these molecular abnormalities may aid in improving our diagnostic accuracy. A number of studies have shown the utility of testing clinical samples from pancreatic lesions and bile duct strictures for these molecular markers of malignancy to differentiate between cancer and inflammation. The information from these studies will be discussed with emphasis on how to use this information in clinical practice. C1 [Khalid, Asif] Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15213 USA. [Khalid, Asif] VA Pittsburgh Hlth Care Syst, Dept Med, Pittsburgh, PA USA. RP Khalid, A (reprint author), Univ Pittsburgh, Med Ctr, M2,C Wing,PUH,200 Lothrop St, Pittsburgh, PA 15213 USA. EM khalida@upmc.edu NR 35 TC 3 Z9 3 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1542-3565 J9 CLIN GASTROENTEROL H JI Clin. Gastroenterol. Hepatol. PD NOV PY 2009 VL 7 IS 11 BP S55 EP S58 DI 10.1016/j.cgh.2009.07.033 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 519GN UT WOS:000271753100012 PM 19896100 ER PT J AU Pandol, S Edderkaoui, M Gukovsky, I Lugea, A Gukovskaya, A AF Pandol, Stephen Edderkaoui, Mouad Gukovsky, Ilya Lugea, Aurelia Gukovskaya, Anna TI Desmoplasia of Pancreatic Ductal Adenocarcinoma SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article CT 5th Joint Meeting of the Japanese-Society-of-Gastroenterology/American-Gastroenterological-Associ ation CY MAY 07-08, 2009 CL Sapporo, JAPAN SP Japanese Soc Gastroenterol, Amer Gastroenterol Assoc ID CANCER CELL-SURVIVAL; STELLATE CELLS; NADPH OXIDASE; EXTRACELLULAR-MATRIX; TUMOR PROGRESSION; MICROENVIRONMENT; PROLIFERATION; EXPRESSION; PHENOTYPE; CARCINOMA AB Pancreatic ductal adenocarcinoma (PDAC) is the most common form of pancreatic cancer and is characterized by remarkable desmoplasia. The desmoplasia is composed of extracellular matrix (ECM) proteins, myofibroblastic pancreatic stellate cells, and immune cells associated with a multitude of cytokines, growth factors, and ECM metabolizing enzymes. The mechanisms of participation of this complex matrix process in carcinogenesis are only starting to be appreciated. Recent studies showed key roles for stellate cells in the production of ECM proteins as well as cytokines and growth factors that promote the growth of the cancer cells all present in the desmoplastic parts of PDAC. In addition, interactions of ECM proteins and desmoplastic secreted growth factors with the cancer cells of PDAC activate intracellular signals including reactive oxygen species that act to make the cancer cells resistant to dying. These findings suggest that the desmoplasia of PDAC is a key factor in regulating carcinogenesis of PDAC as well as responses to therapies. A better understanding of the biology of desmoplasia in the mechanism of PDAC will likely provide significant opportunities for better treatments for this devastating cancer. C1 [Pandol, Stephen] VA Greater Los Angeles Hlth Care Syst, Pancreat Res Grp, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. RP Pandol, S (reprint author), VA Greater Los Angeles Hlth Care Syst, Pancreat Res Grp, Dept Med, Bldg 258,Room 340,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM stephen.pandol@va.gov FU NCCIH NIH HHS [P01 AT003960, P01AT003960]; NCI NIH HHS [R01CA119025, R01 CA119025]; NIAAA NIH HHS [P50 AA011999, P60 AA11999, R03 AA016008, R21AA016840] NR 32 TC 59 Z9 60 U1 2 U2 11 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 NOV PY 2009 VL 7 IS 11 BP S44 EP S47 DI 10.1016/j.cgh.2009.07.039 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 519GN UT WOS:000271753100010 PM 19896098 ER PT J AU Levine, BS Kleeman, CR Felsenfeld, AJ AF Levine, Barton S. Kleeman, Charles R. Felsenfeld, Arnold J. TI The Journey From Vitamin D-Resistant Rickets to the Regulation of Renal Phosphate Transport SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Review ID FIBROBLAST GROWTH FACTOR-23; X-LINKED HYPOPHOSPHATEMIA; MATRIX EXTRACELLULAR PHOSPHOGLYCOPROTEIN; CHRONIC KIDNEY-DISEASE; 25-HYDROXYVITAMIN D-1-ALPHA-HYDROXYLASE ACTIVITY; SERUM PARATHYROID-HORMONE; HYP MOUSE PHENOTYPE; KLOTHO MUTANT MICE; D METABOLISM; SECONDARY HYPERPARATHYROIDISM AB In 1937, Fuller Albright first described two rare genetic disorders: Vitamin D resistant rickets and polyostotic fibrous dysplasia, now respectively known as X-linked hypophosphatemic rickets (XLH) and the McCune-Albright syndrome. Albright carefully characterized and meticulously analyzed one patient, W.M., with vitamin D-resistant rickets. Albright subsequently reported additional carefully performed balance studies on W.M. In this review, which evaluates the journey from the initial description of vitamin D-resistant rickets (XLH) to the regulation of renal phosphate transport, we (1) trace the timeline of important discoveries in unraveling the pathophysiology of XLH, (2) cite the recognized abnormalities in mineral metabolism in XLH, (3) evaluate factors that may affect parathyroid hormone values in XLH, (4) assess the potential interactions between the phosphate-regulating gene with homology to endopeptidase on the X chromosome and fibroblast growth factor 23 (FGF23) and their resultant effects on renal phosphate transport and vitamin D metabolism, (5) analyze the complex interplay between FGF23 and the factors that regulate FGF23, and (6) discuss the genetic and acquired disorders of hypophosphatemia and hyperphosphatemia in which FGF23 plays a role. Although Albright could not measure parathyroid hormone, he concluded on the basis of his studies that showed calcemic resistance to parathyroid extract in W.M. that hyperparathyroidism was present. Using a conceptual approach, we suggest that a defect in the skeletal response to parathyroid hormone contributes to hyperparathyroidism in XLH. Finally, at the end of the review, abnormalities in renal phosphate transport that are sometimes found in patients with polyostotic fibrous dysplasia are discussed. Clin J Am Soc Nephrol 4: 1866-1877, 2009. doi: 10.2215/CJN.03000509 C1 VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Felsenfeld, AJ (reprint author), W Los Angeles VA Med Ctr, Nephrol Sect 111L, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM arnold.felsenfeld@va.gov NR 109 TC 9 Z9 11 U1 0 U2 8 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1555-9041 J9 CLIN J AM SOC NEPHRO JI Clin. J. Am. Soc. Nephrol. PD NOV PY 2009 VL 4 IS 11 BP 1866 EP 1877 DI 10.2215/CJN.03000509 PG 12 WC Urology & Nephrology SC Urology & Nephrology GA 517PN UT WOS:000271628400025 PM 19808223 ER PT J AU Cusi, K AF Cusi, Kenneth TI Role of Insulin Resistance and Lipotoxicity in Non-Alcoholic Steatohepatitis SO CLINICS IN LIVER DISEASE LA English DT Article DE Insulin resistance; Lipotoxicity; NAFLD; NASH; Type 2 diabetes mellitus ID FATTY LIVER-DISEASE; PLASMA ADIPONECTIN CONCENTRATIONS; INDUCED HEPATIC LIPOTOXICITY; TYPE-2 DIABETIC-PATIENTS; HUMAN SKELETAL-MUSCLE; BODY-MASS INDEX; FACTOR-KAPPA-B; GLUCOSE-TOLERANCE; ADIPOSE-TISSUE; RESONANCE-SPECTROSCOPY AB It is well established that the development of NAFLD and NASH are closely linked to an excess flow of free fatty acids (FFA) arising from dysfunctional/insulin resistant adipose tissue causing ectopic fat deposition in many organs. In the liver, when chronic lipid supply surpasses the metabolic ability to adapt it will induce hepatocellular damage as FFA are redirected into harmful pathways of non-oxidative metabolism with intracellular accumulation of toxic lipid-derived metabolites. Multiple mechanisms have been implicated including mitochondrial dysfunction, endoplasmic reticulum stress, and activation of multiple inflammatory pathways. Understanding the role of insulin resistance and lipotoxicity in NASH as part of a broader metabolic disorder is likely to assist practitioners in the successful management of these challenging patients. C1 [Cusi, Kenneth] Univ Texas Hlth Sci Ctr San Antonio, Diabet Div, San Antonio, TX 78284 USA. [Cusi, Kenneth] Audie L Murphy Vet Adm Med Ctr, San Antonio, TX 78284 USA. RP Cusi, K (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Diabet Div, Room 3-390S,7703 Floyd Curl Dr, San Antonio, TX 78284 USA. EM cusi@uthscsa.edu NR 99 TC 67 Z9 74 U1 1 U2 13 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1089-3261 J9 CLIN LIVER DIS JI Clin. Liver Dis. PD NOV PY 2009 VL 13 IS 4 BP 545 EP + DI 10.1016/j.cld.2009.07.009 PG 20 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 514JJ UT WOS:000271390100004 PM 19818304 ER PT J AU Chou, JCY AF Chou, James C. -Y TI MIXED EPISODES WITH PSYCHOTIC FEATURES SO CNS SPECTRUMS LA English DT Article ID BIPOLAR-I DISORDER; PLACEBO-CONTROLLED TRIAL; DOUBLE-BLIND; SUICIDAL IDEATION; ACUTE MANIA; DEPRESSION; LITHIUM; DIVALPROEX; OLANZAPINE; QUETIAPINE C1 [Chou, James C. -Y] Mt Sinai Sch Med, New York, NY USA. [Chou, James C. -Y] James J Peters VA Med Ctr, Bronx, NY USA. RP Chou, JCY (reprint author), Mt Sinai Sch Med, New York, NY USA. FU AstraZeneca; Bristol-Myers Squibb; Eli Lilly; GlaxoSmithKline; Janssen; Pfizer FX Dr. Chou has received honoraria from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen, and Pfizer. NR 16 TC 0 Z9 0 U1 0 U2 1 PU M B L COMMUNICATIONS, INC PI NEW YORK PA 333 HUDSON ST, 7TH FLOOR, NEW YORK, NY 10013 USA SN 1092-8529 J9 CNS SPECTRUMS JI CNS Spectr. PD NOV PY 2009 VL 14 IS 11 SU 11 BP 6 EP 8 PG 3 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 540TW UT WOS:000273363500002 PM 20173694 ER PT J AU Mendez, MF AF Mendez, Mario F. TI The Neurobiology of Moral Behavior: Review and Neuropsychiatric Implications SO CNS SPECTRUMS LA English DT Review ID VENTROMEDIAL PREFRONTAL CORTEX; FRONTOTEMPORAL LOBAR DEGENERATION; ANTISOCIAL PERSONALITY-DISORDER; POSITRON-EMISSION-TOMOGRAPHY; MIRROR NEURON SYSTEM; SOCIAL COGNITION; DECISION-MAKING; ORBITOFRONTAL CORTEX; ACQUIRED SOCIOPATHY; FRONTAL-CORTEX AB Morality may be innate to the human brain. This review examines the neurobiological evidence from research involving functional magnetic resonance imaging of normal subjects, developmental sociopathy, acquired sociopathy from brain lesions, and frontotemporal dementia. These studies indicate a "neuromoral" network for responding to moral dilemmas centered in the ventromedial prefrontal cortex and its connections, particularly on the right. The neurobiological evidence indicates the existence of automatic "prosocial" mechanisms for identification with others that are part of the mora brain. Patients with disorders involving this moral network have attenuated emotional reactions to the possibility of harming others and may perform sociopathic acts. The existence of this neuromoral system has major clinical implications for the management of patients with dysmoral behavior from brain disorders and for forensic neuropsychiatry. CNS Spectr. 2009;14(11):608-620 C1 [Mendez, Mario F.] VA Greater Los Angeles Healthcare Ctr, Neurobehav Unit 691 116AF, Los Angeles, CA 90073 USA. [Mendez, Mario F.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. [Mendez, Mario F.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. RP Mendez, MF (reprint author), VA Greater Los Angeles Healthcare Ctr, Neurobehav Unit 691 116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@UCLA.edu FU [R01AG03449902] FX This work was supported by grant # R01AG03449902. NR 169 TC 38 Z9 38 U1 5 U2 33 PU M B L COMMUNICATIONS, INC PI NEW YORK PA 333 HUDSON ST, 7TH FLOOR, NEW YORK, NY 10013 USA SN 1092-8529 J9 CNS SPECTRUMS JI CNS Spectr. PD NOV PY 2009 VL 14 IS 11 BP 608 EP 620 PG 13 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 529HV UT WOS:000272507600003 PM 20173686 ER PT J AU Morland, LA Greene, CJ Rosen, C Mauldin, PD Frueh, BC AF Morland, Leslie A. Greene, Carolyn J. Rosen, Craig Mauldin, Patrick D. Frueh, B. Christopher TI Issues in the design of a randomized noninferiority clinical trial of telemental health psychotherapy for rural combat veterans with PTSD SO CONTEMPORARY CLINICAL TRIALS LA English DT Article DE Posttraumatic stress disorder (PTSD); Rural; Military veterans; Telemedicine; Noninferiority trial ID POSTTRAUMATIC-STRESS-DISORDER; COGNITIVE-PROCESSING THERAPY; QUALITY-OF-LIFE; URBAN DISPARITIES; EXPOSURE THERAPY; TELEPSYCHIATRY; VALIDATION; INVENTORY; VICTIMS; SERVICE AB This methodological article provides a description of the design, methods, and rationale of the first prospective, noninferiority designed randomized clinical trial evaluating the clinical and cost implications of delivering an evidence-based cognitive-behavioral group intervention specifically treating posttraumatic stress disorder (PTSD) with a trauma-focused intervention via video teleconferencing (VTC). PTSD is a prevalent mental health problem found among returning Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) military populations. These returning military personnel often live in rural areas and therefore have limited access to care and specialized psychological treatments. In the field of mental health, telemental health (TMH) technology has introduced a potential solution to the persistent problem of access to care in remote areas. This study is enrolling approximately 126 returning veterans with Current combat-related PTSD who are receiving services through the Veteran Administration (VA) mental health care clinics on 4 Hawaiian Islands. Cognitive Processing Therapy (CPT), an empirically supported manualized treatment for PTSD, is being delivered across 9 cohorts. Participants are assigned to either the experimental VTC condition or the in-person control condition. Assessments measuring clinical, process, and cost outcomes are being conducted at baseline, mid-treatment, post-treatment, and 3 and 6 months post-treatment. The study employs a noninferiority design to determine if the group treatment delivered via VTC is as good as the traditional in-person modality. In addition, a cost analysis will be performed in order to compare the cost of the 2 modalities. Novel aspects of this trial and specific challenges are discussed. (C) 2009 Published by Elsevier Inc. C1 [Morland, Leslie A.] Natl Ctr PTSD, Pacific Isl Div, Dept Vet Affairs Pacific Isl Healthcare Syst, Honolulu, HI 96819 USA. [Greene, Carolyn J.; Rosen, Craig] Natl Ctr PTSD, Disseminat & Training Div, Dept Vet Affairs Palo Alto Healthcare Syst, Palo Alto, CA USA. [Greene, Carolyn J.; Rosen, Craig] Stanford Univ, Sch Med, Palo Alto, CA 94304 USA. [Mauldin, Patrick D.] S Carolina Coll Pharm, Dept Clin Pharm & Outcome Sci, Charleston, SC USA. [Mauldin, Patrick D.] Ralph H Johnson VA Med Ctr, Charleston, SC USA. [Frueh, B. Christopher] Menninger Clin, Houston, TX USA. [Frueh, B. Christopher] Baylor Coll Med, Houston, TX 77030 USA. RP Morland, LA (reprint author), Natl Ctr PTSD, Pacific Isl Div, Dept Vet Affairs Pacific Isl Healthcare Syst, 3375 Koapaka St, Honolulu, HI 96819 USA. EM Leslie.Morland@va.gova FU Department of Defense [PT074516]; Office of Research and Development, Medical Research Service, Department of Veterans Affairs FX This work is partially supported by Grant PT074516 from the Department of Defense. This work is also supported by the Office of Research and Development, Medical Research Service, Department of Veterans Affairs. All views and opinions expressed herein are those of the authors and do not necessarily reflect those of our respective institutions or the Department of Veterans Affairs. NR 67 TC 24 Z9 24 U1 3 U2 11 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1551-7144 J9 CONTEMP CLIN TRIALS JI Contemp. Clin. Trials PD NOV PY 2009 VL 30 IS 6 BP 513 EP 522 DI 10.1016/j.cct.2009.06.006 PG 10 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 523YM UT WOS:000272111000003 PM 19576299 ER PT J AU Renaud, B Santin, A Coma, E Camus, N Van Pelt, D Hayon, J Gurgui, M Roupie, E Herve, J Fine, MJ Brun-Buisson, C Labarere, J AF Renaud, Bertrand Santin, Aline Coma, Eva Camus, Nicolas Van Pelt, Dave Hayon, Jan Gurgui, Merce Roupie, Eric Herve, Jerome Fine, Michael J. Brun-Buisson, Christian Labarere, Jose TI Association between timing of intensive care unit admission and outcomes for emergency department patients with community-acquired pneumonia SO CRITICAL CARE MEDICINE LA English DT Article DE pneumonia; community-acquired infection; emergency department; intensive care; severity of illness index; time to admission ID SYSTEMIC INFLAMMATORY RESPONSE; QUALITY-OF-LIFE; SEVERE SEPSIS; SEPTIC SHOCK; PREDICTION RULE; SEVERITY-INDEX; GUIDELINES; MANAGEMENT; DECISION; MULTICENTER AB Objective: To compare the 28-day mortality and hospital length of stay of patients with community-acquired pneumonia who were transferred to an intensive care unit on the same day of emergency department presentation (direct-transfer patients) with those subsequently transferred within 3 days of presentation (delayed-transfer patients). Design: Secondary analysis of the original data from two North American and two European prospective, multicenter, cohort studies of adult patients with community-acquired pneumonia. Patients: In all, 453 non-institutionalized patients transferred within 3 days of emergency department presentation to an intensive care unit were included in the analysis. Supplementary analysis was restricted to patients without an obvious indication for immediate transfer to an intensive care unit. Interventions: None. Measurements and Main Results: The sample consisted of 138 delayed-transfer and 315 direct-transfer patients, among whom 150 (33.1%) were considered to have an obvious indication for immediate intensive care unit admission. After adjusting for the quintile of propensity score, delayed intensive care unit transfer was associated with an increased odds ratio for 28-day mortality (2.07; 95% confidence interval, 1.12-3.85) and a decreased odds ratio for discharge from hospital for survivors (0.53; 95% confidence interval, 0.39-0.71). In a propensity-matched analysis, delayed-transfer patients had a higher 28-day mortality rate (23.4% vs. 11.7%; p = 0.02) and a longer median hospital length of stay (13 days vs. 7 days; p <.001) than direct-transfer patients. Similar results were found after excluding the 150 patients with an obvious indication for immediate intensive care unit admission. Conclusions: Our findings suggest that some patients without major criteria for severe community-acquired pneumonia, according to the recent Infectious Diseases Society of America/American Thoracic Society consensus guideline, may benefit from direct transfer to the intensive care unit. Further studies are needed to prospectively identify patients who may benefit from direct intensive care unit admission despite a lack of major severity criteria for community-acquired pneumonia based on the current guidelines. (Crit Care Med 2009; 37:2867-2874) C1 [Renaud, Bertrand; Santin, Aline; Camus, Nicolas; Hayon, Jan] Grp Hosp Henri Mondor Albert Chenevier, AP HP, Dept Emergency Med, Creteil, France. [Coma, Eva] Hosp Duran & Reynals, Serv Atencio Continuada USAC, Inst Catala Oncol, Barcelona, Spain. [Camus, Nicolas; Brun-Buisson, Christian] Univ Paris 12, Fac Med, Creteil, France. [Van Pelt, Dave] Med Ctr, Dept Crit Care & Pulm Consultants, Aurora, CO USA. [Hayon, Jan] Ctr Hosp Intercommunal Poissy St Germain, Dept Crit Care Med, St Germain En Laye, France. [Gurgui, Merce] Hosp Santa Creu & Sant Pau, Dept Emergency Med, Barcelona, Spain. [Roupie, Eric] Hop Cote Nacre, CHU Caen, Dept Emergency Med, Caen, France. [Roupie, Eric] Univ Caen Basse Normandie, Fac Med, Caen, France. [Fine, Michael J.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Fine, Michael J.] Univ Pittsburgh, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. [Labarere, Jose] CHU Grenoble, Qual Care Unit, F-38043 Grenoble, France. RP Renaud, B (reprint author), Grp Hosp Henri Mondor Albert Chenevier, AP HP, Dept Emergency Med, Creteil, France. EM bertrand.renaud@hmn.aphp.fr RI Labarere, Jose/N-1688-2014 OI Labarere, Jose/0000-0001-7621-6586 FU Departement de la Formation Continue des Medecins de I'Assistance Publique des Hopitaux de Paris; ARMUR; AQUARE; GIaxoSmithKline France; Direction de la Recherche Clinique d'lle de France [AOM 89-145] FX Dr. Renaud has received grants from GIaxoSmithKline. Dr. Labarere was supported by a grant from the Egide Foundation, Paris, France (Programme Lavoisier) and from the Direction de la Recherche Clinique at Grenoble University Hospital. The remaining authors have not disclosed any potential conflicts of interest. NR 36 TC 68 Z9 69 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD NOV PY 2009 VL 37 IS 11 BP 2867 EP 2874 DI 10.1097/CCM.0b013e3181b02dbb PG 8 WC Critical Care Medicine SC General & Internal Medicine GA 517IP UT WOS:000271607000001 PM 19770748 ER PT J AU Mehta, NK Chang, VW AF Mehta, Neil K. Chang, Virginia W. TI MORTALITY ATTRIBUTABLE TO OBESITY AMONG MIDDLE-AGED ADULTS IN THE UNITED STATES SO DEMOGRAPHY LA English DT Article ID BODY-MASS-INDEX; ALL-CAUSE MORTALITY; WAIST-HIP RATIO; US ADULTS; HEALTH RESEARCH; EXCESS DEATHS; CONFIDENCE-INTERVALS; SOCIOECONOMIC-STATUS; PROSPECTIVE COHORT; CIGARETTE-SMOKING AB Obesity is considered a major cause of premature mortality and a potential threat to the long-standing secular decline in mortality in the United States. We measure relative and attributable risks associated with obesity among middle-aged adults using data from the Health and Retirement Study (1992-2004). Although class II/III obesity (BMI >= 35.0 kg/m(2)) increases mortality by 40% in females and 62% in males compared with normal BMI (BMI = 18.5-24.9), class I obesity (BMI = 30.0-34.9) and being overweight (BM] = 25.0-29.9) are not associated with excess mortality. With respect to attributable mortality, class II/III obesity (BMI >= 35.0) is responsible for approximately 4% of deaths among females and 3% of deaths among males. Obesity is often compared with cigarette smoking as a major source of avoidable mortality. Smoking-attributable mortality is much larger in this cohort: about 36% in females and 50% in males. Results are robust to confounding by preexisting diseases, multiple dimensions of socioeconomic status (SES), smoking, and other correlates. These findings challenge the viewpoint that obesity will stem the long-term secular decline in U.S. mortality C1 [Mehta, Neil K.] Univ Michigan, Robert Wood Johnson Fdn Hlth & Soc, Sch Publ Hlth, Ann Arbor, MI 48109 USA. [Chang, Virginia W.] Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. [Chang, Virginia W.] Univ Penn, Dept Sociol, Philadelphia, PA 19104 USA. [Chang, Virginia W.] Univ Penn, Ctr Populat Studies, Philadelphia, PA 19104 USA. [Chang, Virginia W.] Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RP Mehta, NK (reprint author), Univ Michigan, Robert Wood Johnson Fdn Hlth & Soc, Sch Publ Hlth, 3628 SPH Tower,1415 Washington Hts, Ann Arbor, MI 48109 USA. EM nkmehta@umich.edu FU NIA NIH HHS [T32 AG000177]; NICHD NIH HHS [K12 HD043459, K12HD043459] NR 81 TC 49 Z9 49 U1 1 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0070-3370 EI 1533-7790 J9 DEMOGRAPHY JI Demography PD NOV PY 2009 VL 46 IS 4 BP 851 EP 872 PG 22 WC Demography SC Demography GA 526SE UT WOS:000272312800010 PM 20084832 ER PT J AU Li, RL O'Sullivan, MJ Robinson, J Safford, MM Curb, D Johnson, KC AF Li, Rongling O'Sullivan, Mary J. Robinson, Jennifer Safford, Monika M. Curb, David Johnson, Karen C. TI Family history of myocardial infarction predicts incident coronary heart disease in postmenopausal women with diabetes: the Women's Health Initiative Observational Study SO DIABETES-METABOLISM RESEARCH AND REVIEWS LA English DT Article DE family history; CHD; diabetes; women's health ID CARDIOVASCULAR RISK-FACTORS; ATHEROSCLEROSIS RISK; PARENTAL HISTORY; ARTERY DISEASE; MENOPAUSE; AGE; EPIDEMIOLOGY; FRAMINGHAM; COHORT AB Background Diabetes is a risk factor for coronary heart disease (CHD) but CHD does not occur in all diabetic individuals. The goal of this study was to assess the relationship between family history of myocardial infarction (MI) and incident CHD in diabetic postmenopausal women. Methods We conducted a prospective cohort study among 2642 diabetic postmenopausal women without CHD at baseline in the Women's Health Initiative Observational Study. Family history was defined as a proband report of MI in first-degree relatives. Incident CHD was defined as non-fatal MI, coronary revascularization, or CHD death. Results During 7.3 (+/- 1.8) years of follow-up, 14.3% of the participants had incident CHD. The risk of incident CHD was 50% higher (HR = 1.50, 95% Cl: 1.20-1.87, p = 0.0003) in those with a family history of an MI in at least one first-degree relative, and 79% higher (HR = 1.79, 95% Cl: 1.36-2.35, P < 0.0001) if two or more first-degree relatives had an MI, compared to participants without a family history, after adjustment for covariates. The CHD risk increased with elevated systolic blood pressure (SBP) (HR = 1.01, 95% Cl: 1.003-1.02, p = 0.001) but decreased with elevated diastolic BP (HR = 0.98, 95% Cl: 0.97-0-999, p = 0.005) and with two or more episodes per week of physical activity (HR = 0.70, 95% Cl: 0.52-0.93, p = 0.02). Conclusions The results suggest that a family history of MI predicts CHD in diabetic postmenopausal women. Close attention should be paid to BP control and physical activity in these women. Copyright (C) 2009 John Wiley & Sons Ltd,. C1 [Li, Rongling; Johnson, Karen C.] Univ Tennessee, Ctr Hlth Sci, Dept Prevent Med, Memphis, TN 38163 USA. [O'Sullivan, Mary J.] Univ Miami, Miller Sch Med, Dept Obstet & Gynecol, Miami, FL 33136 USA. [Robinson, Jennifer] Univ Iowa, Coll Publ Hlth, Dept Epidemiol, Iowa City, IA USA. [Safford, Monika M.] Univ Alabama, Birmingham, AL USA. [Safford, Monika M.] Birmingham VA Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. [Curb, David] Pacific Hlth Res Inst, Honolulu, HI USA. RP Li, RL (reprint author), NHGRI, OPG, NIH, 5635 Fishers Lane,Suite 4076,MSC 9305, Bethesda, MD 20892 USA. EM lir2@mail.nih.gov FU National Heart, Lung, and Blood Institute, NIH [NO1-WH-3-2100, NO1-WH-3-2101, NO1-WH-3-2102, NO1-WH-3-2105, NO1-WH-3-2106, NO1-WH-3-2108, NO1-WH-3-2109, NO1-WH-3-2110, NO1-WH-3-2111, NO1-WH-3-2112, NO1-WH-3-2113, NO1-WH-3-2115, NO1-WH-3-2118, NO1-WH-3-2119, NO1-WH-3-2120, NO1-WH-3-2122, NO1-WH-4-2107, NO1-WH-4-2108] FX We acknowledge all WHI-OS participants and NIH for making the funds available for the study. The WHI program is funded by NIH Contracts: NO1-WH-3-2100, NO1-WH-3-2101, NO1-WH-3-2102, NO1-WH-3-2105, NO1-WH-3-2106, NO1-WH-3-2108, NO1-WH-3-2109, NO1-WH-3-2110, NO1-WH-3-2111, NO1-WH-3-2112, NO1-WH-3-2113, NO1-WH-3-2115, NO1-WH-3-2118, NO1-WH-3-2119, NO1-WH-3-2120, NO1-WH-3-2122, NO1-WH-4-2107, NO1-WH-4-2108, NO1-WH-4-2109, NO1-WH-4-2110, NO1-WH-4-2111, NO1-WH-4-2112, NO1-WH-4-2113, NO1-WH-4-2114, NO1-WH-4-2115, NO1-WH-4-2116, NO1-WH-4-2117, NO1-WH-4-2118, NO1-WH-4-2119, NO1-WH-4-2120, NO1-WH-4-2121, NO1-WH-4-2122, NO1-WH-4-2123, NO1-WH-4-2124, NO1-WH-4-2125, NO1-WH-4-2126, NO1-WH-4-2129, NO1-WH-4-2130, NO1-WH-4-2131, and NO1-WH-4-2132 from the National Heart, Lung, and Blood Institute, NIH. NR 26 TC 1 Z9 2 U1 0 U2 1 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1520-7552 J9 DIABETES-METAB RES JI Diabetes-Metab. Res. Rev. PD NOV PY 2009 VL 25 IS 8 BP 725 EP 732 DI 10.1002/dmrr.1010 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 522RP UT WOS:000272016300005 PM 19780066 ER PT J AU Kaunitz, JD AF Kaunitz, Jonathan D. TI GRG Update: DDW 2009 and Upcoming GRG-Sponsored Meetings SO DIGESTIVE DISEASES AND SCIENCES LA English DT Editorial Material C1 [Kaunitz, Jonathan D.] W Los Angeles Vet Affairs Med Ctr, Dept Med, Los Angeles, CA 90073 USA. [Kaunitz, Jonathan D.] Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90073 USA. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, Dept Med, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jake@ucla.edu NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD NOV PY 2009 VL 54 IS 11 BP 2301 EP 2302 DI 10.1007/s10620-009-0987-x PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 507FI UT WOS:000270836900001 ER PT J AU Sonnenberg, A AF Sonnenberg, Amnon TI Demographic Characteristics of Hospitalized IBD Patients SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE Environmental risk factors; Epidemiology of IBD; Geographic variation; Hospital statistics; Socio-economic status; Time trends ID INFLAMMATORY-BOWEL-DISEASE; EPIDEMIOLOGY; AMERICANS; MORTALITY; VOLUME AB The Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project (HCUP) was used to study the recent demographic characteristics of patients with Crohn's disease (CD) or ulcerative colitis (UC). HCUP data of the period 1997-2006 were extracted. The data were stratified by the categories pertaining to patient demographics, such as age-group, sex, race, insurance type, income group, residence in metropolitan area and region of the United States, as well as categories pertaining to hospital characteristics, such as type of ownership, teaching status, location, and bed-size. The distributions of inpatients among different categories were compared between CD or UC and all other diagnoses, using odds ratios and their 95% confidence intervals for comparison. The data revealed a slight female predominance in CD (1.08, 1.09-1.09) and a slight male predominance in UC (1.15, 1.14-1.15). Compared to patients with other diagnoses, patients with inflammatory bowel disease tended to be white (CD: 2.47, 2.45-2.50; UC: 2.13, 2.10-2.15), more affluent (CD: 1.44, 1.43-1.45; UC: 1.59, 1.58-1.61), live in metropolitan areas (CD: 1.09, 1.08-1.10; UC: 1.26, 1.25-1.27) and in the Northeast of the United States (CD: 1.27, 1.27-1.28; UC: 1.44, 1.43-1.45). These patterns confirm previously described characteristics of patients with inflammatory bowel disease and show that such characteristics still apply to present patient populations. C1 Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97239 USA. RP Sonnenberg, A (reprint author), Oregon Hlth & Sci Univ, Portland VA Med Ctr, P3 GI,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM sonnenbe@ohsu.edu NR 22 TC 13 Z9 13 U1 0 U2 1 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD NOV PY 2009 VL 54 IS 11 BP 2449 EP 2455 DI 10.1007/s10620-009-0973-3 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 507FI UT WOS:000270836900023 PM 19760158 ER PT J AU Stengel, A Goebel, M Wang, LX Rivier, J Kobelt, P Monnikes, H Lambrecht, NWG Tache, Y AF Stengel, Andreas Goebel, Miriam Wang, Lixin Rivier, Jean Kobelt, Peter Moennikes, Hubert Lambrecht, Nils W. G. Tache, Yvette TI Central Nesfatin-1 Reduces Dark-Phase Food Intake and Gastric Emptying in Rats: Differential Role of Corticotropin-Releasing Factor(2) Receptor SO ENDOCRINOLOGY LA English DT Article ID CAUDAL BRAIN-STEM; BODY-WEIGHT; CRF; CHOLECYSTOKININ; NUCLEUS; NEURONS; LEPTIN; IMMUNOREACTIVITY; HYPOTHALAMUS; INHIBITION AB Nesfatin-1, derived from nucleobindin2, is expressed in the hypothalamus and reported in one study to reduce food intake (FI) in rats. To characterize the central anorexigenic action of nesfatin-1 and whether gastric emptying (GE) is altered, we injected nesfatin-1 into the lateral brain ventricle (intracerebroventricular, icv) or fourth ventricle (4v) in chronically cannulated rats or into the cisterna magna (intracisternal, ic) under short anesthesia and compared with ip injection. Nesfatin-1 (0.05 mu g/rat, icv) decreased 2-3 h and 3-6 h dark-phase FI by 87 and 45%, respectively, whereas ;ip administration (2 mu g/rat) had no effect. The corticotropin-releasing factor (CRF)(1)/CRF2 antagonist astressin-B or the CRF2 antagonist astressin(2)-B abolished icv nesfatin-1's anorexigenic action, whereas an astressin(2)-B analog, devoid of CRF-receptor binding affinity, did not. Nesfatin-1 icv induced a dose-dependent reduction of GE by 26 and 43% that was not modified by icv astressin(2)-B. Nesfatin-1 into the 4v (0.05 mu g/rat) or ic (0.5 mu g/rat) decreased cumulative dark-phase FI by 29 and 60% at 1 h and by 41 and 37% between 3 and 5 h, respectively. This effect was neither altered by ic astressin(2)-B nor associated with changes in GE. Cholecystokinin (ip) induced Fos expression in 43% of nesfatin-1 neurons in the paraventricular hypothalamic nucleus and 24% of those in the nucleus tractus solitarius. These data indicate that nesfatin-1 acts centrally to reduce dark phase FI through CRF2-receptor-dependent pathways after forebrain injection and CRF2-receptor-independent pathways after hindbrain injection. Activation of nesfatin-1 neurons by cholecystokinin at sites regulating food intake may suggest a role in gut peptide satiation effect. (Endocrinology 150: 4911-4919, 2009) C1 [Stengel, Andreas; Goebel, Miriam; Wang, Lixin; Lambrecht, Nils W. G.; Tache, Yvette] Univ Calif Los Angeles, Vet Adm Greater Los Angeles Healthcare Syst, Dept Med, Ctr Neurobiol Stress,Digest Dis Div,CURE, Los Angeles, CA 90073 USA. [Rivier, Jean] Salk Inst Biol Studies, Peptide Biol Labs, La Jolla, CA 92037 USA. [Kobelt, Peter] Charite, Clin Psychosomat Med, D-10117 Berlin, Germany. [Moennikes, Hubert] Martin Luther Hosp, Dept Med, D-14193 Berlin, Germany. [Moennikes, Hubert] Martin Luther Hosp, Inst Neurogastroenterol, D-14193 Berlin, Germany. RP Tache, Y (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, Ctr Neurovisceral Sci & Womens Hlth CURE, Bldg 115,Room 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM ytache@mednet.ucla.edu OI Lambrecht, Nils/0000-0002-1275-1384 FU German Research Foundation [STE 1765/1-1, GO1718/1-1]; Veterans Administration Research Career Scientist Award; Veterans Administration Merit Award [NIHDK 33061]; Center Grant [DK-41301]; [DK PO1-26741] FX We thank Mrs. Honghui Liang for her excellent technical support, and we thank Ms. Eugenia Hu for reviewing the manuscript.; Address all correspondence and requests for reprints to: Yvette Tache, Ph.D., Center for Neurovisceral Sciences and Women's Health CURE, Building 115, Room 117, Veterans Administration Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, California 90073. E-mail: ytache@mednet.ucla.edu.; This work was supported by German Research Foundation Grants STE 1765/1-1 (A.S.), GO1718/1-1 (M.G.), Veterans Administration Research Career Scientist Award, Veterans Administration Merit Award, NIHDK 33061, Center Grant DK-41301 (Animal Core) (Y.T.), and DK PO1-26741 (J.R.).; Disclosure Summary: A.S., M.G., L.W., P.K., H.M., N.W. G.L., and Y.T. have nothing to disclose. J.R. is Founder of Sentia Medical Sciences, Inc. No conflicts of interest exist. NR 49 TC 140 Z9 156 U1 0 U2 7 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD NOV PY 2009 VL 150 IS 11 BP 4911 EP 4919 DI 10.1210/en.2009-0578 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 509ID UT WOS:000271007700011 PM 19797401 ER PT J AU Mandal, CC Choudhury, GG Ghosh-Choudhury, N AF Mandal, Chandi C. Choudhury, Goutam Ghosh Ghosh-Choudhury, Nandini TI Phosphatidylinositol 3 Kinase/Akt Signal Relay Cooperates with Smad in Bone Morphogenetic Protein-2-Induced Colony Stimulating Factor-1 (CSF-1) Expression and Osteoclast Differentiation SO ENDOCRINOLOGY LA English DT Article ID TUMOR-SUPPRESSOR PTEN; INDUCED DNA-SYNTHESIS; TGF-BETA RECEPTOR; KAPPA-B LIGAND; OSTEOBLAST DIFFERENTIATION; MESANGIAL CELLS; PROTEIN-KINASE; C2C12 CELLS; BMP-2 GENE; C-FOS AB Murine spleen cells produce mature osteoclasts when cocultured with osteoblastic cells. Colony-stimulating factor (CSF)-1 is the growth factor required for differentiating the monocyte-macrophage precursor cells into preosteoclasts. Bone morphogenic protein (BMP) signaling in osteoblasts regulates bone mass in mice, suggesting a role of BMP in osteoclastogenesis along with osteoblast activity. The intracellular signal transduction cross talk regulating the osteoblastic production of CSF-1 as a mechanism of BMP-induced osteoclastogenesis is described in this report. We have recently described the involvement of Smad 1/5 in BMP-2-induced CSF-1 expression and osteoclast formation. In this study, using the pharmacological inhibitors and the adenovirus (Ad) vectors expressing dominant-negative (DN) phosphatidylinositol 3 kinase (PI3K), the PI3K-signaling inhibitor, phosphatase and tensin homolog deleted in chromosome 10 (PTEN) or DN Akt kinase in the in vitro coculture assay, we show an essential role of the lipid kinase cascade in BMP-2-mediated multinucleated osteoclast formation and CSF-1 mRNA expression, transcription, and secretion. Inhibition of PI3K/Akt signaling blocked the binding of Smads 1/5 to the CSF-1 BMP-responsive element present in the CSF-1 promoter, resulting in attenuation of Smad-dependent CSF-1 transcription. Furthermore, PI3K inhibition and DN Akt prevented association of the transcriptional coactivator, CREB (cAMP response element binding protein) binding protein (CBP), with Smads 1/5. Together, these data for the first time demonstrate that PI3K-dependent Akt activation regulates BMP-2-induced CSF-1 expression and provides a mechanism for osteoblastic cell-assisted osteoclast differentiation. (Endocrinology 150: 4989-4998, 2009) C1 [Mandal, Chandi C.; Ghosh-Choudhury, Nandini] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. [Choudhury, Goutam Ghosh] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. [Choudhury, Goutam Ghosh; Ghosh-Choudhury, Nandini] S Texas Vet Hlth Care Syst, Dept Vet Affairs Res, San Antonio, TX USA. [Choudhury, Goutam Ghosh] S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Ghosh-Choudhury, N (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM choudhury@uthscsa.edu FU National Institutes of Health (NIH) [RO1AR52425, RO1 DK50190]; Department of Veterans Affairs (VA) Research Service Merit Review; VA Merit Review; Juvenile Diabetes Research Foundation [1-2008-185] FX Disclosure Summary: The authors have nothing to disclose. NR 52 TC 26 Z9 29 U1 0 U2 3 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD NOV PY 2009 VL 150 IS 11 BP 4989 EP 4998 DI 10.1210/en.2009-0026 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 509ID UT WOS:000271007700019 PM 19819979 ER PT J AU Stengel, A Keire, D Goebel, M Evilevitch, L Wiggins, B Tache, Y Reeve, JR AF Stengel, Andreas Keire, David Goebel, Miriam Evilevitch, Lena Wiggins, Brian Tache, Yvette Reeve, Joseph R., Jr. TI The RAPID Method for Blood Processing Yields New Insight in Plasma Concentrations and Molecular Forms of Circulating Gut Peptides SO ENDOCRINOLOGY LA English DT Article ID PANCREATIC-SECRETION; ENZYME-SECRETION; DESACYL GHRELIN; RATS; CHOLECYSTOKININ; DEGRADATION; HORMONE; CCK-58; FOOD; STABILITY AB The correct identification of circulating molecular forms and measurement of peptide levels in blood entails that the endocrine peptide being studied is stable and recovered in good yields during blood processing. However, it is not clear whether this is achieved in studies using standard blood processing. Therefore, we compared peptide concentration and form of 12 (125)I-labeled peptides using the standard procedure (EDTA-blood on ice) and a new method employing Reduced temperatures, Acidification, Protease inhibition, Isotopic exogenous controls, and Dilution (RAPID). During standard processing there was at least 80% loss for calcitonin-gene-related peptide and cholecystokinin-58 (CCK-58) and more than 35% loss for amylin, insulin, peptide YY forms (PYY((1-36)) and PYY((3-36))), and somatostatin-28. In contrast, the RAPID method significantly improved the recovery for 11 of 12 peptides (P < 0.05) and eliminated the breakdown of endocrine peptides occurring after standard processing as reflected in radically changed molecular forms for CCK-58, gastrin-releasing peptide, somatostatin-28, and ghrelin. For endogenous ghrelin, this led to an acyl/total ghrelin ratio of 1: 5 instead of 1: 19 by the standard method. These results show that the RAPID method enables accurate assessment of circulating gut peptide concentrations and forms such as CCK-58, acylated ghrelin, and somatostatin-28. Therefore, the RAPID method represents an efficacious means to detect circulating variations in peptide concentrations and form relevant to the understanding of physiological function of endocrine peptides. (Endocrinology 150: 5113-5118, 2009) C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Reeve, Joseph R., Jr.] Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. RP Reeve, JR (reprint author), Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Bldg 115,Room 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM JReeve@mednet.ucla.edu FU German Research Foundation [STE 1765/1-1, GO 1718/1-1]; National Institutes of Health Center [DK-41301, RO1 DK 33850, DK 56805]; Veterans Administration Research Services FX Disclosure Summary: The authors have nothing to disclose. NR 30 TC 58 Z9 59 U1 0 U2 3 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD NOV PY 2009 VL 150 IS 11 BP 5113 EP 5118 DI 10.1210/en.2009-0697 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 509ID UT WOS:000271007700032 PM 19819958 ER PT J AU Myrskyla, M Chang, VW AF Myrskylae, Mikko Chang, Virginia W. TI Weight Change, Initial BMI, and Mortality Among Middle- and Older-aged Adults SO EPIDEMIOLOGY LA English DT Article ID BODY-MASS INDEX; LONG-TERM MORTALITY; ALL-CAUSE MORTALITY; US ADULTS; PROSPECTIVE COHORT; ELDERLY-MEN; LOSE WEIGHT; FOLLOW-UP; OVERWEIGHT; OBESITY AB Background: It is not known how the relationship between weight change and mortality is influenced by initial body mass index (BMI) or the magnitude of weight change. Methods: We use the nationally representative Health and Retirement Study (n = 13,104; follow-up 1992-2006) and Cox regression analysis to estimate relative mortality risks for 2-year weight change by initial BMI among 50- to-70-year-old Americans. We defined small weight loss or gain as a change of 1-2.9 BMI units and large weight loss or gain as a change of 3-5 BMI units. Results: Large and small weight losses were associated with excess mortality for all initial BMI levels below 32 kg/m(2) (eg, hazard ratio [HR] for large weight loss from BMI of 30 = 1.61 [95% confidence interval = 1.31-1.98]; HR for small : weight loss from BMI of 30 = 1.19 [1.06-1.28]). Large weight gains were associated with excess mortality only at high BMIs (eg, HR for large weight gain from BMI of 35 = 1.33 (1.00-1.77]). Small weight gains were not associated with excess mortality for any initial BMI level. The weight loss-mortality association was robust to adjustments for health status and to sensitivity analyses considering unobserved confounders. Conclusions: Weight loss is associated with excess mortality among normal, overweight, and mildly obese middle- and older-aged adults. The excess risk increases for larger losses and lower initial BMI. These results suggest that the potential benefits of a lower BMI may be offset by the negative effects associated with weight loss. Weight gain may be associated with excess mortality only among obese people with an initial BMI over 35. C1 [Myrskylae, Mikko] Max Planck Inst Demog Res, D-18057 Rostock, Germany. [Chang, Virginia W.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. [Chang, Virginia W.] Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. [Chang, Virginia W.] Univ Penn, Dept Sociol, Philadelphia, PA 19104 USA. [Chang, Virginia W.] Univ Penn, Ctr Populat Studies, Philadelphia, PA 19104 USA. RP Myrskyla, M (reprint author), Max Planck Inst Demog Res, Konrad Zuse Str 1, D-18057 Rostock, Germany. EM myrskyla@demogr.mpg.de FU National Institute of Child Health and Human Development [K12-HD043459] FX Supported by National Institute of Child Health and Human Development, K12-HD043459 (to VW.C.). NR 40 TC 42 Z9 43 U1 1 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD NOV PY 2009 VL 20 IS 6 BP 840 EP 848 DI 10.1097/EDE.0b013e3181b5f520 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 507SD UT WOS:000270874000010 PM 19806061 ER PT J AU Frost, JD Lee, CL Hrachovy, RA Swann, JW AF Frost, James D. Lee, C. L. Hrachovy, R. A. Swann, J. W. TI HIGH FREQUENCY EEG ACTIVITY ASSOCIATED WITH ICTAL EVENTS IN THE TTX MODEL OF INFANTILE SPASMS SO EPILEPSIA LA English DT Meeting Abstract CT 63rd Annual Meeting of the American-Epilepsy-Society CY DEC 04-08, 2009 CL Boston, MA SP Amer Epilepsy Soc C1 [Lee, C. L.; Swann, J. W.] Baylor Coll Med, Cain Fdn Labs, Houston, TX 77030 USA. [Hrachovy, R. A.] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD NOV PY 2009 VL 50 BP 28 EP 29 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 503PP UT WOS:000270550500052 ER PT J AU Pugh, MJV Copeland, LA VanCott, AC Mortensen, E Zeber, J Wang, C Cramer, JA AF Pugh, Mary Jo V. Copeland, L. A. VanCott, A. C. Mortensen, E. Zeber, J. Wang, C. Cramer, J. A. TI SUICIDALITY AND NEW AED EXPOSURE IN OLDER PATIENTS: IS THE FDA WARNING APPROPRIATE FOR ALL DRUGS IN ALL POPULATIONS? SO EPILEPSIA LA English DT Meeting Abstract CT 63rd Annual Meeting of the American-Epilepsy-Society CY DEC 04-08, 2009 CL Boston, MA SP Amer Epilepsy Soc C1 [Pugh, Mary Jo V.; Copeland, L. A.; Mortensen, E.; Zeber, J.; Wang, C.] S Texas Vet Hlth Care Syst, VERDICT11C6, San Antonio, TX USA. [VanCott, A. C.] Pittsburgh VA Hlth Care Syst, Pittsburgh, PA USA. [Cramer, J. A.] Yale Univ, Sch Med, New Haven, CT USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD NOV PY 2009 VL 50 BP 109 EP 109 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 503PP UT WOS:000270550500222 ER PT J AU Van Cott, AC Pugh, MJV AF Van Cott, A. C. Pugh, Mary Jo V. TI TRENDS IN ANTIEPILEPTIC DRUG PRESCRIBING FOR OLDER PATIENTS WITH NEW-ONSET EPILEPSY: 2004-2006 SO EPILEPSIA LA English DT Meeting Abstract CT 63rd Annual Meeting of the American-Epilepsy-Society CY DEC 04-08, 2009 CL Boston, MA SP Amer Epilepsy Soc C1 [Pugh, Mary Jo V.] S Texas Vet Hlth Care Syst, VERDICT 11C6, San Antonio, TX USA. [Van Cott, A. C.] VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. [Van Cott, A. C.] Univ Pittsburgh, Pittsburgh, PA USA. [Pugh, Mary Jo V.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD NOV PY 2009 VL 50 BP 112 EP 112 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 503PP UT WOS:000270550500227 ER PT J AU Salinsky, MC AF Salinsky, Martin C. TI PSYCHOGENIC NON-EPILEPTIC SEIZURES AT A VETERANS ADMINISTRATION MEDICAL CENTER SO EPILEPSIA LA English DT Meeting Abstract CT 63rd Annual Meeting of the American-Epilepsy-Society CY DEC 04-08, 2009 CL Boston, MA SP Amer Epilepsy Soc C1 [Salinsky, Martin C.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Salinsky, Martin C.] Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD NOV PY 2009 VL 50 BP 195 EP 195 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 503PP UT WOS:000270550500413 ER PT J AU Van Cott, AC Pramuka, M AF Van Cott, Anne C. Pramuka, M. TI SURVEY OF INTERNET AND COMPUTER USE IN VETERANS WITH EPILEPSY SO EPILEPSIA LA English DT Meeting Abstract CT 63rd Annual Meeting of the American-Epilepsy-Society CY DEC 04-08, 2009 CL Boston, MA SP Amer Epilepsy Soc C1 [Van Cott, Anne C.] VA Pittsburgh Healthcare Syst, Div Neurol, Pittsburgh, PA USA. [Van Cott, Anne C.; Pramuka, M.] Univ Pittsburgh, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD NOV PY 2009 VL 50 BP 274 EP 275 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 503PP UT WOS:000270550500590 ER PT J AU Pena, A AF Pena, Adolfo TI Personal Epistemology and Uncertainty SO FAMILY MEDICINE LA English DT Letter C1 Birmingham VA Med Ctr, Ctr Surg Med Acute Care Res & Transit C SMART, Vet Affairs Natl Qual Scholars VAQS Fellowship Pr, Birmingham, AL USA. RP Pena, A (reprint author), Birmingham VA Med Ctr, Ctr Surg Med Acute Care Res & Transit C SMART, Vet Affairs Natl Qual Scholars VAQS Fellowship Pr, Birmingham, AL USA. NR 4 TC 1 Z9 1 U1 0 U2 0 PU SOC TEACHERS FAMILY MEDICINE PI LEAWOOD PA 11400 TOMAHAWK CREEK PARKWAY, STE 540, LEAWOOD, KS 66207 USA SN 0742-3225 J9 FAM MED JI Fam. Med. PD NOV-DEC PY 2009 VL 41 IS 10 BP 691 EP 691 PG 1 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 520DR UT WOS:000271820700002 PM 19882388 ER PT J AU Brooks, TC Burlingame, M Burk, M Tortorice, K Dong, D Glassman, PA Lynch, JA Good, CB Rickman, HS Claborn, M Appleman, D Jones, W Shaverd, L AF Brooks, Traci C. Burlingame, Mark Burk, Muriel Tortorice, Kathy Dong, Diane Glassman, Peter A. Lynch, Jennie A. Good, Chester B. Rickman, Holly S. Claborn, Melanie Appleman, Duva Jones, William Shaverd, Lanita TI Travoprost A prostaglandin analogue for the treatment of glaucoma SO FORMULARY LA English DT Article ID OPEN-ANGLE GLAUCOMA; LATANOPROST AB In August 2003, the US Department of Veterans Affairs (VA) awarded a contract for prostaglandin ophthalmic agents with travoprost as the agent of choice. Although there was no national mandate to switch patients from existing therapy, many VA facilities had agreements from their local ophthalmology and optometry departments to conduct a therapeutic interchange of patients from existing prostaglandins (eg, latanoprost) to travoprost. The primary purpose of this report is to describe the experience of conversion to travoprost after this contract. Medical records of converted patients were evaluated for change in intraocular pressure (IOP), change in visual field, adverse events, and whether or not a change back to the original therapy or alternative therapy was required. Of 578 patients evaluated, most (84%) had been using latanoprost before the conversion. After conversion, mean IOP was significantly reduced by 1.64 +/- 4.95 mm Hg (P<.0001). Of 188 patients with documented visual field assessment, 89.9% had no change or improvement in visual field after conversion. Adverse events occurred in 44 (7.6%) patients, with hyperemia occurring in 13 (2.2%) patients. Discontinuation of travoprost was attributed to an adverse event in 29 (5.0%) patients and attributed to ineffectiveness in 17 (2.9%) patients. Adverse drug event rates were significantly less than those reported in the literature. Travoprost was effective and well tolerated in most patients after therapeutic interchange. This evaluation provides additional information regarding outcomes associated with the therapeutic interchange. (Formulary. 2009; 44:322-328.) C1 [Brooks, Traci C.] Womack Army Med Ctr, Ft Bragg, NC USA. [Brooks, Traci C.; Burlingame, Mark] N Florida S Georgia Vet Hlth Syst, Gainesville, FL USA. [Burk, Muriel; Dong, Diane] VA Ctr Medicat Safety, VACO PBM Serv, Hines, IL USA. [Tortorice, Kathy] VACO Pharm Benefits Management Serv, Hines, IL USA. [Glassman, Peter A.] Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90095 USA. [Lynch, Jennie A.] VISN 2 VA Healthcare Network Upstate New York, Syracuse, NY USA. [Good, Chester B.] Univ Pittsburgh, Sch Med, VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Good, Chester B.] Univ Pittsburgh, Sch Pharm, Pittsburgh, PA USA. [Rickman, Holly S.; Shaverd, Lanita] Cent Arkansas Vet Healthcare Syst, Little Rock, AR USA. [Claborn, Melanie] Univ Arkansas Med Sci, Vet Healthcare Syst Ozarks, Fayetteville, AR USA. [Appleman, Duva] Univ Calif, No Calif Vet Healthcare Syst, Davis Mather, CA USA. [Jones, William] SW Consolidated Mail Outpatient Pharm, Tucson, AZ USA. [Jones, William] VACO PBM Serv, Tucson, AZ USA. RP Brooks, TC (reprint author), Womack Army Med Ctr, Ft Bragg, NC USA. NR 8 TC 4 Z9 4 U1 0 U2 0 PU ADVANSTAR COMMUNICATIONS INC PI WOODLAND HILLS PA 6200 CANOGA AVE, 2ND FLR, WOODLAND HILLS, CA 91367 USA SN 1082-801X J9 FORMULARY JI Formulary PD NOV PY 2009 VL 44 IS 11 BP 322 EP 328 PG 9 GA 521PK UT WOS:000271934000001 ER PT J AU Jensen, DM Machicado, GA AF Jensen, Dennis M. Machicado, Gustavo A. TI Hemoclipping of chronic canine ulcers: a randomized, prospective study of initial deployment success, clip retention rates, and ulcer healing SO GASTROINTESTINAL ENDOSCOPY LA English DT Article ID HEATER PROBE THERMOCOAGULATION; BLEEDING PEPTIC-ULCERS; ENDOSCOPIC HEMOCLIP; GASTRIC-ULCERS; HIGH-RISK; HEMOSTASIS; INJECTION; HEMORRHAGE; TRIAL AB Background: Several different hemoclips are marketed for endoscopic hemostasis of nonvariceal upper GI (UGI) bleeding. No previous reports have compared Success rates of clip deployment onto bases of chronic gastric ulcers (GUs), clip retention rates, or their influence on ulcer healing. Objectives: For the treatment of chronic GUs, to compare 3 different hemoclips with multipolar electrocoagulation (MPEC) and control. Design: Randomized, controlled study Subjects: Seven adult dogs with prehepatic portal hypertension had GUs created by rubber band ligation. Animals received oral proton pump inhibitors daily and underwent weekly endoscopies to quantitate clip retention and ulcer healing. Interventions: One week after banding, 10 chronic ulcers were randomized in pairs to control (no endoscopic treatment), MPEC, or different hemoclips (QuickClip2 [QC], TriClip [TC], or Resolution Clip [RC]). Main Outcome Measurements: Times and success of hemoclip deployment, clip retention rates, and ulcer healing rates on weekly endoscopies. Results: Success rates of clip deployment were 100% for the RC, 93.1% for the TC, and 83.3% for the QC. Clip retention rates were significantly higher with the RC than the QC or TC at I to 3 weeks. Retained clips did not delay GU healing compared with MPEC or control. Conclusions: Hemoclipping time was similar with all 3 clips; the RC was retained significantly longer than the QC or TC, hemoclips did not delay ulcer healing compared with control or MPEC, and all 3 hemoclips were safe and no complications Such as bleeding and weight loss were noted. (Gastrointest Endosc 2009;70:969-75.) C1 [Jensen, Dennis M.] VA Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Hemostasis Res Grp, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Jensen, DM (reprint author), VA Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Hemostasis Res Grp, Bldg 115,Room 318,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU Boston Scientific Corp; Olympus America Inc; Pentax Corp; NIH [K24 DK02650] FX The following anthors received research support for this from Boston Scientific Corp and Olympus America Inc (for the bemoclips, partial funding for the animals, technical support, and supplies) and Pentax Corp (for the endoscope): D. M. Jensen, G. A. Machicado. Supported by a NIH grant (K24 DK02650) to D. M. Jensen. NR 22 TC 18 Z9 18 U1 0 U2 3 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD NOV PY 2009 VL 70 IS 5 BP 969 EP 975 DI 10.1016/j.gie.2009.04.052 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 521BK UT WOS:000271893900022 PM 19640519 ER PT J AU Shergill, AK Asundi, KR Barr, A Shah, JN Ryan, JC McQuaid, KR Rempel, D AF Shergill, Amandeep K. Asundi, Krishna R. Barr, Alan Shah, Janak N. Ryan, James C. McQuaid, Kenneth R. Rempel, David TI Extension of an excellent pilot study to a quantitative analysis of the pathophysiology of de Quervain disease associated with colonoscopy Response SO GASTROINTESTINAL ENDOSCOPY LA English DT Letter C1 [Shergill, Amandeep K.; Shah, Janak N.; Ryan, James C.; McQuaid, Kenneth R.] Univ Calif San Francisco, Dept Med, Div Gastroenterol, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. [Asundi, Krishna R.] Harvard Univ, Sch Publ Hlth, Dept Environm Hlth, Boston, MA 02115 USA. [Barr, Alan; Rempel, David] Univ Calif Berkeley, Dept Bioengn, Berkeley, CA 94720 USA. [Barr, Alan; Rempel, David] Univ Calif San Francisco, Dept Med, Div Occupat Med, San Francisco, CA USA. RP Shergill, AK (reprint author), Univ Calif San Francisco, Dept Med, Div Gastroenterol, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. RI Rempel, David/E-8424-2013 NR 0 TC 0 Z9 0 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD NOV PY 2009 VL 70 IS 5 BP 1050 EP 1051 DI 10.1016/j.gie.2009.04.021 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 521BK UT WOS:000271893900047 ER PT J AU Grubaugh, AL Magruder, KM Zinzow, HM Frueh, BC AF Grubaugh, Anouk L. Magruder, Kathryn M. Zinzow, Heidi M. Frueh, B. Christopher TI Use of dual health care services among veterans seen in Veterans Affairs primary care clinics SO GENERAL HOSPITAL PSYCHIATRY LA English DT Letter C1 [Grubaugh, Anouk L.; Magruder, Kathryn M.] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. [Grubaugh, Anouk L.; Magruder, Kathryn M.; Zinzow, Heidi M.] Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. [Frueh, B. Christopher] Univ Hawaii, Dept Psychol, Hilo, HI 96720 USA. RP Grubaugh, AL (reprint author), Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. EM grubaugh@musc.edu NR 10 TC 3 Z9 3 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0163-8343 J9 GEN HOSP PSYCHIAT JI Gen. Hosp. Psych. PD NOV-DEC PY 2009 VL 31 IS 6 BP 589 EP 591 DI 10.1016/j.genhosppsych.2009.04.007 PG 3 WC Psychiatry SC Psychiatry GA 523IN UT WOS:000272066300015 PM 19892220 ER PT J AU Lamprecht, R Dracheva, S Assoun, S LeDoux, JE AF Lamprecht, R. Dracheva, S. Assoun, S. LeDoux, J. E. TI Fear conditioning induces distinct patterns of gene expression in lateral amygdala SO GENES BRAIN AND BEHAVIOR LA English DT Article DE Fear conditioning; gene expression; lateral amygdala; memory; microarray ID LONG-TERM POTENTIATION; VISININ-LIKE PROTEIN-2; SYNAPTIC PLASTICITY; MESSENGER-RNA; MEMORY CONSOLIDATION; CA(V)2.1 CHANNELS; MEMBRANE-PROTEIN; GROWTH CONE; RECEPTOR; HIPPOCAMPUS AB The lateral nucleus of the amygdala (LA) has been implicated in the formation of long-term associative memory (LTM) of stimuli associated with danger through fear conditioning. The current study aims to detect genes that are expressed in LA following associative fear conditioning. Using oligonucleotide microarrays, we monitored gene expression in rats subjected to paired training where a tone co-terminates with a footshock, or unpaired training where the tone and footshock are presented in a non-overlapping manner. The paired protocol consistently leads to auditory fear conditioning memory formation, whereas the unpaired protocol does not. When the paired group was compared with the unpaired group 5 h after training, the expression of genes coding for the limbic system-associated membrane protein (Lsamp), kinesin heavy chain member 2 (Kif2), N-ethylmaleimide-sensitive fusion protein (NSF) and Hippocalcin-like 4 protein (Hpcal4) was higher in the paired group. These genes encode proteins that regulate neuronal axonal morphology (Lsamp, Kif2), presynaptic vesicle cycling and release (Hpcal4 and NSF), and AMPA receptor maintenance in synapses (NSF). Quantitative real-time PCR (qPCR) showed that Kif2 and Lsamp are expressed hours following fear conditioning but minutes after unpaired training. Hpcal4 is induced by paired stimulation only 5 h after the training. These results show that fear conditioning induces a unique temporal activation of molecular pathways involved in regulating synaptic transmission and axonal morphology in LA, which is different from non-associative stimulation. C1 [Lamprecht, R.] Univ Haifa, Dept Neurobiol & Ethol, Fac Sci & Sci Educ, IL-31905 Haifa, Israel. [Lamprecht, R.; LeDoux, J. E.] Univ Haifa, Dept Biol, Fac Sci & Sci Educ, IL-31905 Haifa, Israel. [Dracheva, S.] Bronx Vet Affairs Med Ctr, Bronx, NY USA. [Dracheva, S.] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. [Assoun, S.] Univ Paris 06, Paris, France. [LeDoux, J. E.] NYU, Ctr Neural Sci, New York, NY USA. RP Lamprecht, R (reprint author), Univ Haifa, Dept Neurobiol & Ethol, Fac Sci & Sci Educ, IL-31905 Haifa, Israel. EM rlamp@research.haifa.ac.il FU National Institute of Health [P50 MH058911, R01 MH046516]; National Science Foundation [IBN-0131433]; VISN3 Mental Illness Research and Education Clinical Center FX This research was supported by grants to J. E. L. (National Institute of Health Grants P50 MH058911, R01 MH046516 and National Science Foundation Grant IBN-0131433) and to S. D. (VISN3 Mental Illness Research and Education Clinical Center). Wethank the Memorial Sloan-Kettering Cancer Center Genomics Core laboratory for microarray assay and analysis. NR 60 TC 20 Z9 20 U1 0 U2 4 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1601-1848 J9 GENES BRAIN BEHAV JI Genes Brain Behav. PD NOV PY 2009 VL 8 IS 8 BP 735 EP 743 DI 10.1111/j.1601-183X.2009.00515.x PG 9 WC Behavioral Sciences; Neurosciences SC Behavioral Sciences; Neurosciences & Neurology GA 517QY UT WOS:000271633300001 PM 19689454 ER PT J AU Glasser, SP Basile, JN Lackland, DT AF Glasser, Stephen P. Basile, Jan N. Lackland, Daniel T. TI Does Prehypertension Represent an Increased Risk for Incident Hypertension and Adverse Cardiovascular Outcome? SO HYPERTENSION LA English DT Editorial Material ID BLOOD-PRESSURE; FOLLOW-UP; MORTALITY; COHORT; ADULTS; HEALTH C1 [Glasser, Stephen P.] Univ Alabama, Div Prevent Med, Birmingham, AL 35205 USA. [Basile, Jan N.] Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. [Lackland, Daniel T.] Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. RP Glasser, SP (reprint author), Univ Alabama, Div Prevent Med, 1717 11th Ave S MT 638, Birmingham, AL 35205 USA. EM sglasser@uab.edu OI Glasser, Stephen/0000-0001-9620-6406 FU NHLBI NIH HHS [K30 HL004104] NR 13 TC 4 Z9 4 U1 0 U2 2 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 2009 VL 54 IS 5 BP 954 EP 955 DI 10.1161/HYPERTENSIONAHA.109.138545 PG 2 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 509CW UT WOS:000270992100004 PM 19720951 ER PT J AU Granado, NS Smith, TC Swanson, GM Harris, RB Shahar, E Smith, B Boyko, EJ Wells, TS Ryan, MAK AF Granado, Nisara S. Smith, Tyler C. Swanson, G. Marie Harris, Robin B. Shahar, Eyal Smith, Besa Boyko, Edward J. Wells, Timothy S. Ryan, Margaret A. K. CA Millennium Cohort Study Team TI Newly Reported Hypertension After Military Combat Deployment in a Large Population-Based Study SO HYPERTENSION LA English DT Article DE hypertension; incidence; stressful events; cohort studies; military personnel ID AMERICAN-HEART-ASSOCIATION; BLOOD-PRESSURE CONTROL; GULF-WAR VETERANS; BODY-MASS INDEX; MILLENNIUM COHORT; CARDIOVASCULAR-DISEASE; RESISTANCE EXERCISE; US MILITARY; ARTERIAL STIFFNESS; CIGARETTE-SMOKING AB High-stress situations, such as combat deployments, are a potential risk factor for hypertension. Although stress is postulated to increase blood pressure, the underlying role of stress on hypertension is not well established. We sought to determine the relations between combat deployment-induced stress and hypertension. The Millennium Cohort baseline questionnaire (2001-2003) was completed by 77 047 US active-duty and Reserve/National Guard members. Follow-up was completed by 55 021 responders approximate to 3 years later (2004-2006). Multivariable logistic regression was used to estimate the 3-year risk of newly reported hypertension, adjusting for general and mental health, demographics, and occupational and behavioral characteristics. After applying exclusion criteria, our analyses included 36 061 service members. Subanalyses of deployers included 8829 participants. Newly reported hypertension was identified in 6.9% of the cohort between baseline and follow-up, many of whom had deployed on military operations in support of the conflicts in Iraq and Afghanistan. After adjusting, deployers who experienced no combat exposures were less likely to report hypertension than nondeployers (odds ratio: 0.77; 95% CI: 0.67 to 0.89). Among deployers, those reporting multiple combat exposures were 1.33 times more likely to report hypertension compared with noncombat deployers (95% CI: 1.07 to 1.65). Although military deployers, in general, had a lower incidence of hypertension than nondeployers, deployment with multiple stressful combat exposures appeared to be a unique risk factor for newly reported hypertension. (Hypertension. 2009; 54: 966-973.) C1 [Granado, Nisara S.; Smith, Tyler C.; Smith, Besa] USN, Hlth Res Ctr, Dept Def Ctr Deployment Hlth Res, San Diego, CA 92106 USA. [Swanson, G. Marie] Indiana Univ, Sch Med, Dept Publ Hlth, Indianapolis, IN USA. [Harris, Robin B.; Shahar, Eyal] Univ Arizona, Mel & Enid Zuckerman Coll Publ Hlth, Tucson, AZ USA. [Boyko, Edward J.] Vet Affairs Puget Sound Hlth Care Syst, Seattle Epidemiol Res & Informat Ctr, Seattle, WA USA. [Smith, Tyler C.] USAF, Res Lab, Dayton, OH USA. [Ryan, Margaret A. K.] USN, Hosp Camp Pendleton, Dept Occupat Hlth, Camp Pendleton, CA USA. RP Granado, NS (reprint author), USN, Hlth Res Ctr, Dept Def Ctr Deployment Hlth Res, 140 Sylvester Rd, San Diego, CA 92106 USA. EM nisara.granado@med.navy.mil OI Boyko, Edward/0000-0002-3695-192X FU Military Operational Medicine Research Program; United States Army Medical Research and Material Command FX The Millennium Cohort Study is funded through the Military Operational Medicine Research Program, United States Army Medical Research and Material Command (Fort Detrick, MD). NR 43 TC 36 Z9 37 U1 0 U2 0 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 2009 VL 54 IS 5 BP 966 EP 973 DI 10.1161/HYPERTENSIONAHA.109.132555 PG 8 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 509CW UT WOS:000270992100010 PM 19752293 ER PT J AU Kawakami, T Urakami, S Hirata, H Tanaka, Y Nakajima, K Enokida, H Shiina, H Ogishima, T Tokizane, T Kawamoto, K Miura, K Ishii, N Dahiya, R AF Kawakami, T. Urakami, S. Hirata, H. Tanaka, Y. Nakajima, K. Enokida, H. Shiina, H. Ogishima, T. Tokizane, T. Kawamoto, K. Miura, K. Ishii, N. Dahiya, R. TI Superoxide dismutase analog (Tempol: 4-hydroxy-2, 2, 6, 6-tetramethylpiperidine 1-oxyl) treatment restores erectile function in diabetes-induced impotence SO INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH LA English DT Article DE oxidative stress; nitric oxide; superoxide; diabetes; erectile dysfunction ID NITRIC-OXIDE; ENDOTHELIAL DYSFUNCTION; ANTIOXIDANT THERAPY; PENILE CRURA; RATS; STREPTOZOTOCIN; APOPTOSIS; COMPLICATIONS; EXPRESSION; DAMAGE AB We hypothesized that the administration of the superoxide dismutase (SOD) mimetic Tempol (4-hydroxy-2, 2, 6, 6-tetramethylpiperidine 1-oxyl) may reverse diabetes-induced erectile dysfunction. To test this hypothesis, reactive oxygen species-related genes (SOD1, SOD2, GP x 1, CAT, NOS2, NOS3) were tested, erectile functional studies and immunohistochemical analysis were carried out in diabetic rats treated with or without Tempol. Thirty Sprague-Dawley (3-4months old) rats were divided into three groups (n = 10 each), 20 with diabetes (diabetic control and Tempol treatment) and 10 healthy controls. At 12 weeks after the induction of diabetes by streptozotocin and Tempol treatment, all groups underwent in vivo cavernous nerve stimulation. Rat crura were harvested and the expression of antioxidative defense enzymes were examined by semi-quantitative reverse transcriptase PCR (RT-PCR). To confirm the RT-PCR results, we carried out immunohistochemistry (IHC) for catalase (CAT) and iNOS (NOS2). Nitration of tyrosine groups in proteins was also examined by IHC. Mean intracavernous pressure in the diabetic group was significantly lower than in the healthy controls (P < 0.001) and was reversed by Tempol treatment (P < 0.0108). NOS2 protein expression was significantly increased in diabetic animals compared with healthy controls and Tempol restored NOS2 protein level. Nitrotyrosine was also higher in diabetic animals and although Tempol treatment decreased its formation, it remained higher than that found in healthy controls. This study suggests that Tempol treatment increased erectile function through modulating oxidative stress-related genes in diabetic rats. This is the first report about the relationship between diabetes-induced erectile dysfunction and oxidative stress, and antioxidative therapy using the superoxide dismutase mimetic, Tempol, to restore erectile function. International Journal of Impotence Research (2009) 21, 348-355; doi:10.1038/ijir.2009.28; published online 25 June 2009 C1 [Kawakami, T.; Urakami, S.; Hirata, H.; Tanaka, Y.; Enokida, H.; Shiina, H.; Ogishima, T.; Tokizane, T.; Kawamoto, K.; Dahiya, R.] San Francisco VA Med Ctr, Dept Urol, San Francisco, CA USA. [Kawakami, T.; Urakami, S.; Hirata, H.; Tanaka, Y.; Enokida, H.; Shiina, H.; Ogishima, T.; Tokizane, T.; Kawamoto, K.; Dahiya, R.] Univ Calif San Francisco, San Francisco, CA 94121 USA. [Kawakami, T.; Nakajima, K.; Miura, K.; Ishii, N.] Toho Univ, Fac Med, Dept Urol, Tokyo, Japan. RP Dahiya, R (reprint author), Vet Affairs Med Ctr, Dept Urol, Urol Res Ctr 112F, 4150 Clement St, San Francisco, CA 94121 USA. EM rdahiya@urology.ucsf.edu FU NIH [RO1DK075524, T32DK007790] FX We thank Dr Roger Erickson for his support and assistance with the preparation of the paper. This study was supported by Grants RO1DK075524, T32DK007790 from the NIH. NR 29 TC 9 Z9 12 U1 0 U2 3 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0955-9930 J9 INT J IMPOT RES JI Int. J. Impot. Res. PD NOV-DEC PY 2009 VL 21 IS 6 BP 348 EP 355 DI 10.1038/ijir.2009.28 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 517OV UT WOS:000271626400004 PM 19554009 ER PT J AU Yong, PL Werner, RM AF Yong, Pierre L. Werner, Rachel M. TI Process quality measures and asthma exacerbations in the Medicaid population SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Article DE Asthma; quality of care; Healthcare Effectiveness Data and Information Set; Medicaid ID PLAN EMPLOYER DATA; INHALED CORTICOSTEROIDS; OF-CARE; ADMINISTRATIVE DATA; PERSISTENT ASTHMA; INFORMATION SET; RISK; VALIDATION; PREVENTION; OUTCOMES AB Background: Asthma quality assessment often focuses on controller medication use, yet claims-based studies find conflicting associations between this care process and clinical outcomes. Objective: We sought to compare the association between 3 controller-based quality measures and asthma exacerbations to gain better understanding of how processes of care are related to clinical outcomes. Methods: Identifying a cohort of Medicaid beneficiaries with persistent asthma by using Healthcare Effectiveness Data and Information Set (HEDIS) criteria for asthma in 2001-2002 in California and New York, we assessed 3 asthma quality metrics in 2002: (1) the current HEDIS measure of at least I controller medication filling; (2) at least 4 controller medication prescription fillings; and (3) a controller-to-total asthma medication ratio of at least 0.5. We calculated the odds of having an asthma exacerbation in 2003 as a function of performance on each quality metric, adjusting for race, sex, age, and prior outpatient and acute care use for asthma. Results: Of 90,909 subjects with persistent asthma in California (48.1%) and New York (51.9%), those who obtained at least I or at least 4 controller medications had increased likelihood of poor outcomes (adjusted odds ratios, 1.80 [95% CI, 1.73-1.87] and 1.44 [95% CI 1.40-1.48], respectively). Beneficiaries meeting the controller-to-total asthma medication ratio measure were 23.0% less likely to have exacerbations (adjusted odds ratio, 0.77 [95% CI, 0.75-0.80]). Conclusions: A higher controller medication ratio indicated a lower likelihood of asthma exacerbations, whereas assessing the number of controller medication-dispensing events was associated with a higher odds of exacerbation. (J Allergy Clin Immunol 2009;124:961-6.) C1 [Yong, Pierre L.] Univ Penn, Robert Wood Johnson Clin Scholars Program, Sch Med, Philadelphia, PA 19106 USA. [Yong, Pierre L.; Werner, Rachel M.] Philadelphia Vet Affairs Med Ctr, Dept Med, Philadelphia, PA USA. [Yong, Pierre L.] Hosp Univ Penn, Dept Pulm Allergy & Crit Care, Philadelphia, PA 19104 USA. [Yong, Pierre L.; Werner, Rachel M.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19106 USA. [Yong, Pierre L.] Univ Penn, Ctr Publ Hlth Initiat, Philadelphia, PA 19106 USA. RP Yong, PL (reprint author), Univ Penn, Robert Wood Johnson Clin Scholars Program, Sch Med, 1303A Blockley Hall,423 Guardian Dr, Philadelphia, PA 19106 USA. EM pyong@nas.edu FU Philadelphia Veterans Affairs Medical Center; Robert Wood Johnson Clinical Scholars; Veterans Affairs HSR&D Career Development; Clinical and Translational Science [UL1-RR024134] FX P. L. Y. is supported by a training grant from the Philadelphia Veterans Affairs Medical Center and the Robert Wood Johnson Clinical Scholars Program. R. M. W is supported in part by a Veterans Affairs HSR&D Career Development Award. The study was supported by pilot grant funding from the Leonard Davis Institute of Health Economics and resources supported by the Clinical and Translational Science Awards (UL1-RR024134). NR 26 TC 20 Z9 20 U1 1 U2 5 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0091-6749 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD NOV PY 2009 VL 124 IS 5 BP 961 EP 966 DI 10.1016/j.jaci.2009.07.027 PG 6 WC Allergy; Immunology SC Allergy; Immunology GA 523XI UT WOS:000272108000013 PM 19748660 ER PT J AU Kellogg, DL Zhao, JL Wu, YB AF Kellogg, Dean L., Jr. Zhao, Joan L. Wu, Yubo TI Roles of nitric oxide synthase isoforms in cutaneous vasodilation induced by local warming of the skin and whole body heat stress in humans SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE skin; nitric oxide; nitric oxide synthase 1; nitric oxide synthase 3; microdialysis ID HUMAN CARDIOVASCULAR ADJUSTMENTS; FEMALE REPRODUCTIVE HORMONES; BLOOD-FLOW; REFLEX CONTROL; SELECTIVE-INHIBITION; ACTIVE VASODILATION; CONTROL MECHANISMS; CORE TEMPERATURE; L-ARGININE; IN-VIVO AB Kellogg DL, Jr, Zhao JL, Wu Y. Roles of nitric oxide synthase isoforms in cutaneous vasodilation induced by local warming of the skin and whole body heat stress in humans. J Appl Physiol 107: 1438-1444, 2009. First published September 10, 2009; doi: 10.1152/japplphysiol.00690.2009.Nitric oxide (NO) participates in the cutaneous vasodilation caused by increased local skin temperature (Tloc) and whole body heat stress in humans. In forearm skin, endothelial NO synthase (eNOS) participates in vasodilation due to elevated Tloc and neuronal NO synthase (nNOS) participates in vasodilation due to heat stress. To explore the relative roles and interactions of these isoforms, we examined the effects of a relatively specific eNOS inhibitor, N(omega)-amino-L-arginine (LNAA), and a specific nNOS inhibitor, N(omega)-propyl-L-arginine (NPLA), both separately and in combination, on skin blood flow (SkBF) responses to increased Tloc and heat stress in two protocols. In each protocol, SkBF was monitored by laser-Doppler flowmetry (LDF) and mean arterial pressure (MAP) by Finapres. Cutaneous vascular conductance (CVC) was calculated (CVC = LDF/MAP). Intradermal microdialysis was used to treat one site with 5 mM LNAA, another with 5 mM NPLA, a third with combined 5 mM LNAA and 5 mM NPLA (Mix), and a fourth site with Ringer only. In protocol 1, Tloc was controlled with combined LDF/local heating units. Tloc was increased from 34 degrees C to 41.5 degrees C to cause local vasodilation. In protocol 2, after a period of normothermia, whole body heat stress was induced (water-perfused suits). At the end of each protocol, all sites were perfused with 58 mM nitroprusside to effect maximal vasodilation for data normalization. In protocol 1, at Tloc = 34 degrees C, CVC did not differ between sites (P > 0.05). LNAA and Mix attenuated CVC increases at Tloc = 41.5 degrees C to similar extents (P < 0.05, LNAA or Mix vs. untreated or NPLA). In protocol 2, in normothermia, CVC did not differ between sites (P > 0.05). During heat stress, NPLA and Mix attenuated CVC increases to similar extents, but no significant attenuation occurred with LNAA (P > 0.05, NPLA or Mix vs. untreated or LNAA). In forearm skin, eNOS mediates the vasodilator response to increased Tloc and nNOS mediates the vasodilator response to heat stress. The two isoforms do not appear to interact during either response. C1 [Kellogg, Dean L., Jr.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Div Geriatr & Gerontol, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Hosp Div, Geriatr Res Educ & Clin Ctr, Dept Vet Affairs, San Antonio, TX USA. RP Kellogg, DL (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Div Geriatr & Gerontol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM kelloggd@uthscsa.edu FU National Heart, Lung, and Blood Institute [HL-065599] FX This work was supported in part by National Heart, Lung, and Blood Institute Grant HL-065599. NR 60 TC 62 Z9 65 U1 2 U2 6 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD NOV PY 2009 VL 107 IS 5 BP 1438 EP 1444 DI 10.1152/japplphysiol.00690.2009 PG 7 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 515KO UT WOS:000271468900011 PM 19745188 ER PT J AU Mayhew, DL Kim, JS Cross, JM Ferrando, AA Bamman, MM AF Mayhew, David L. Kim, Jeong-su Cross, James M. Ferrando, Arny A. Bamman, Marcas M. TI Translational signaling responses preceding resistance training-mediated myofiber hypertrophy in young and old humans SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE translation initiation; protein synthesis; muscle fiber; aging ID MUSCLE PROTEIN-SYNTHESIS; HUMAN SKELETAL-MUSCLE; EXERCISE-INDUCED INCREASE; P70 S6 KINASE; CLUSTER-ANALYSIS; MIXED MUSCLE; MYONUCLEAR ADDITION; GENE-EXPRESSION; MEN; PHOSPHORYLATION AB Mayhew DL, Kim J-S, Cross JM, Ferrando AA, Bamman MM. Translational signaling responses preceding resistance training-mediated myofiber hypertrophy in young and old humans. J Appl Physiol 107: 1655-1662, 2009. First published July 9, 2009; doi:10.1152/japplphysiol.91234.2008.-While skeletal muscle protein accretion during resistance training (RT)-mediated myofiber hypertrophy is thought to result from upregulated translation initiation signaling, this concept is based on responses to a single bout of unaccustomed resistance exercise (RE) with no measure of hypertrophy across RT. Further, aging appears to affect acute responses to RE, but whether age differences in responsiveness persist during RT leading to impaired RT adaptation is unclear. We therefore tested whether muscle protein fractional synthesis rate (FSR) and Akt/mammalian target of rapamycin (mTOR) signaling in response to unaccustomed RE differed in old vs. young adults, and whether age differences in acute responsiveness were associated with differences in muscle hypertrophy after 16 wk of RT. Fifteen old and 21 young adult subjects completed the 16-wk study. The phosphorylation states of Akt, S6K1, ribosomal protein S6 (RPS6), eukaryotic initiation factor 4E (eIF4E) binding protein (4EBP1), eIF4E, and eIF4G were all elevated (23-199%) 24 h after a bout of unaccustomed RE. A concomitant 62% increase in FSR was found in a subset (6 old, 8 young). Age x time interaction was found only for RPS6 phosphorylation (+335% in old subjects only), while there was an interaction trend (P = 0.084) for FSR (+96% in young subjects only). After 16 wk of RT, gains in muscle mass, type II myofiber size, and voluntary strength were similar in young and old subjects. In conclusion, at the level of translational signaling, we found no evidence of impaired responsiveness among older adults, and for the first time, we show that changes in translational signaling after unaccustomed RE were associated with substantial muscle protein accretion (hypertrophy) during continued RT. C1 [Bamman, Marcas M.] Univ Alabama, Dept Physiol & Biophys, Core Muscle Res Lab, Birmingham, AL 35294 USA. [Cross, James M.] Univ Alabama, Dept Surg, Birmingham, AL 35294 USA. [Mayhew, David L.] Univ Alabama, Med Scientist Training Program, Birmingham, AL 35294 USA. [Mayhew, David L.; Kim, Jeong-su; Bamman, Marcas M.] Birmingham Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Birmingham, AL USA. [Ferrando, Arny A.] Univ Arkansas Med Sci, Ctr Translat Res Aging & Longev, Little Rock, AR 72205 USA. [Ferrando, Arny A.] Univ Arkansas Med Sci, Dept Geriatr, Little Rock, AR 72205 USA. RP Bamman, MM (reprint author), Univ Alabama, Dept Physiol & Biophys, Core Muscle Res Lab, 966 McCallum Basic Hlth Sci Bldg,1530 3rd Ave S, Birmingham, AL 35294 USA. EM mbamman@uab.edu RI Ferrando, Adolfo /Q-7026-2016 FU National Institute on Aging [R01-AG-017896, F30-AG-031623]; Veterans Affairs Merit Grant; General Clinical Research Center [M01-RR-00032] FX Funding for this work was provided by National Institute on Aging Grants R01-AG-017896 (M. M. Bamman) and F30-AG-031623 (D. L. Mayhew), a Veterans Affairs Merit Grant (M. M. Bamman), and General Clinical Research Center Grant M01-RR-00032. NR 47 TC 86 Z9 88 U1 0 U2 5 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD NOV PY 2009 VL 107 IS 5 BP 1655 EP 1662 DI 10.1152/japplphysiol.91234.2008 PG 8 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 515KO UT WOS:000271468900036 PM 19589955 ER PT J AU Ix, JH Wassel, CL Chertow, GM Koster, A Johnson, KC Tylavsky, FA Cauley, JA Cummings, SR Harris, TB Shlipak, MG AF Ix, Joachim H. Wassel, Christina L. Chertow, Glenn M. Koster, Annemarie Johnson, Karen C. Tylavsky, Frances A. Cauley, Jane A. Cummings, Steven R. Harris, Tamara B. Shlipak, Michael G. CA Hlth Aging Body Composition Study TI Fetuin-A and Change in Body Composition in Older Persons SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID INCIDENT DIABETES-MELLITUS; TYROSINE KINASE INHIBITOR; INSULIN-RECEPTOR; MYOCARDIAL-INFARCTION; RESISTANCE; PLASMA; ADULTS; ADIPOCYTOKINES; GLYCOPROTEIN; ASSOCIATION AB Context: Fetuin-A inhibits the insulin receptor in vitro. Higher serum fetuin-A concentrations are associated with type 2 diabetes longitudinally and greater adiposity in cross-sectional analyses. Whether higher fetuin-A concentrations are associated with accumulation of adiposity over time is unknown. Objective: To determine the association of fetuin-A levels with changes in body composition over 5 yr. Study Design: Observational cohort study nested in the Health Aging and Body Composition Study. Predictor: Serum fetuin-A levels. Outcomes: Visceral adipose tissue (VAT), abdominal sc adipose tissue, and thigh muscle area by computed tomography, and waist circumference and body mass index were measured at baseline and again after 5 yr. Percent change and extreme change (>1.5 SDs) in each measure were calculated. Results: Over 5 yr, subjects lost body mass in each measure, including 6% decline in VAT. Yet each SD (0.42 g/liter) higher fetuin-A concentration was associated with a 5.5% increase in VAT over 5 yr (95% confidence interval 1.9-9.2%; P = 0.003) in models adjusted for age, sex, race, clinical site, diabetes, physical activity, triglycerides, kidney function, and the baseline VAT score. Similarly, higher fetuin-A concentrations were associated with extreme VAT gain (relative risk 1.70, 95% confidence interval 1.12-2.60, P = 0.01). Fetuin-A concentrations were not statistically significant associated with change in any other measures of body composition (P > 0.20). Conclusions: Higher fetuin-A concentrations are associated with the accumulation of VAT in well-functioning, community-living older persons. The mechanisms linking fetuin-A, VAT, and insulin resistance remain to be determined. (J Clin Endocrinol Metab 94: 4492-4498, 2009) C1 [Ix, Joachim H.] Univ Calif San Diego, Div Nephrol, Dept Med, San Diego, CA 92161 USA. [Ix, Joachim H.; Wassel, Christina L.] Univ Calif San Diego, Div Prevent Med, Dept Family & Prevent Med, San Diego, CA 92161 USA. [Ix, Joachim H.] Vet Affairs San Diego Healthcare Syst, Nephrol Sect, San Diego, CA 92161 USA. [Chertow, Glenn M.] Stanford Univ, Dept Med, Div Nephrol, Stanford, CA 94305 USA. [Koster, Annemarie; Harris, Tamara B.] NIA, Intramural Res Program, Lab Epidemiol Demog & Biometry, Bethesda, MD 20892 USA. [Johnson, Karen C.; Tylavsky, Frances A.] Univ Tennessee, Hlth Sci Ctr, Dept Prevent Med, Memphis, TN 38163 USA. [Cauley, Jane A.] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15260 USA. [Cummings, Steven R.] Calif Pacific Med Ctr, Dept Med, San Francisco, CA 94120 USA. [Cummings, Steven R.] San Francisco Coordinating Ctr, San Francisco, CA 94107 USA. [Cummings, Steven R.; Shlipak, Michael G.] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. [Shlipak, Michael G.] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. [Shlipak, Michael G.] San Francisco VA Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. RP Ix, JH (reprint author), Univ Calif San Diego, Dept Med, Div Nephrol & Hypertens, 3350 La Jolla Village Dr,Mail Code 111-H, San Diego, CA 92161 USA. EM joeix@ucsd.edu RI Koster, Annemarie/E-7438-2010; Cauley, Jane/N-4836-2015 OI Cauley, Jane/0000-0003-0752-4408 FU American Diabetes Association (ADA); Association of Subspecialty Professors (ASP); Atlantic Philanthropies; John A. Hartford Foundation; American Heart Association; National Institutes of Health, National Institute on Aging (NIA); [N01-AG-6-2101]; [N01-AG6-2103]; [N01-AG-6-2106] FX This study was supported by an American Diabetes Association (ADA) -Association of Subspecialty Professors (ASP) Young Investigator Innovation Award in Geriatric Endocrinology sponsored by the Atlantic Philanthropies, ADA, the John A. Hartford Foundation, and ASP, an American Heart Association Fellow to Faculty Transition Award (J. H. I.). The Health ABC study was supported by contracts N01-AG-6-2101, N01-AG6-2103, and N01-AG-6-2106 and by the Intramural Research Program of the National Institutes of Health, National Institute on Aging (NIA). The funding sources played no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data, nor in the preparation of the manuscript. The NIA reviewed and approved this manuscript prior to submission. NR 27 TC 25 Z9 25 U1 0 U2 1 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD NOV PY 2009 VL 94 IS 11 BP 4492 EP 4498 DI 10.1210/jc.2009-0916 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 515LD UT WOS:000271470800048 PM 19820014 ER PT J AU Cefalu, AB Noto, D Arpi, ML Yin, F Spina, R Hilden, H Barbagallo, CM Carroccio, A Tarugi, P Squatrito, S Vigneri, R Taskinen, MR Peterfy, M Averna, MR AF Cefalu, Angelo B. Noto, Davide Arpi, Maria Luisa Yin, Fen Spina, Rossella Hilden, Hannele Barbagallo, Carlo M. Carroccio, Antonio Tarugi, Patrizia Squatrito, Sebastiano Vigneri, Riccardo Taskinen, Marja-Riitta Peterfy, Miklos Averna, Maurizio R. TI Novel LMF1 Nonsense Mutation in a Patient with Severe Hypertriglyceridemia SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID ANGIOPOIETIN-LIKE PROTEIN-4; COMBINED LIPASE DEFICIENCY; LIPOPROTEIN-LIPASE; ENDOPLASMIC-RETICULUM; MICE; CLD; DYSLIPIDEMIA; MATURATION AB Context: Lipase maturation factor 1 (LMF1) gene is a novel candidate gene in severe hypertriglyceridemia. Lmf1 is involved in the maturation of lipoprotein lipase (LPL) and hepatic lipase in endoplasmic reticulum. To date only one patient with severe hypertriglyceridemia and related disorders was found to be homozygous for a nonsense mutation in LMF1 gene (Y439X). Objective: The objective of the study was to investigate LMF1 gene in hypertriglyceridemic patients in whom mutations in LPL, APOC2, and APOA5 genes had been excluded. Results: The resequencing of LMF1 gene led to the discovery of a novel homozygous nonsense mutation in one patient with severe hypertriglyceridemia and recurrent episodes of pancreatitis. The mutation causes a G > A substitution in exon 9 (c. 1395G > A), leading to a premature stop codon (W464X). LPL activity and mass were reduced by 76 and 50%, respectively, compared with normolipidemic controls. The proband over the years has shown a good response to treatment. The proband's son, heterozygous for the W464X, shows normal plasma triglyceride levels. Conclusions: We identified the second novel pathogenic mutation in LMF1 gene in a patient with severe hypertriglyceridemia. LPL deficiency in our patient was milder than in the carrier of the Y439X previously described. (J Clin Endocrinol Metab 94: 4584-4590, 2009) C1 [Averna, Maurizio R.] Univ Palermo, Policlin Paolo Giaccone, Dept Clin Med & Emerging Dis, I-90127 Palermo, Italy. [Arpi, Maria Luisa; Squatrito, Sebastiano; Vigneri, Riccardo] Univ Catania, Dept Internal Med, Endocrinol Unit, I-95125 Catania, Italy. [Yin, Fen; Peterfy, Miklos] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. [Yin, Fen; Peterfy, Miklos] Vet Affairs Greater Los Angeles Healthcare Syst, Lipid Res Lab, Los Angeles, CA 90073 USA. [Yin, Fen; Peterfy, Miklos] Cedars Sinai Med Ctr, Inst Med Genet, Los Angeles, CA 90048 USA. [Hilden, Hannele; Taskinen, Marja-Riitta] Helsinki Univ Hosp, Dept Med, FI-00029 Helsinki, Finland. [Tarugi, Patrizia] Univ Modena & Reggio Emilia, Dept Biomed Sci, I-41100 Modena, Italy. RP Averna, MR (reprint author), Univ Palermo, Policlin Paolo Giaccone, Dept Clin Med & Emerging Dis, Via Vespro 141, I-90127 Palermo, Italy. EM avernam@unipa.it RI Tarugi, Patrizia/D-2179-2015; Carroccio, Antonio/K-4484-2016 OI Tarugi, Patrizia/0000-0001-6864-7853; Carroccio, Antonio/0000-0001-8913-7916; Noto, Davide/0000-0002-5346-2829; Cefalu', Angelo Baldassare/0000-0003-1259-8284; Averna, Maurizio/0000-0003-3558-9209; Barbagallo, Carlo M./0000-0002-4114-038X FU University of Palermo; Cedars-Sinai Medical Center; National Institutes of Health [HL28481] FX This work was supported by contract grants from the University of Palermo (60% to M. R. A. and C. M. B.), the Cedars-Sinai Medical Center, and Grant HL28481 from the National Institutes of Health (to M. P.). NR 27 TC 27 Z9 27 U1 0 U2 5 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD NOV PY 2009 VL 94 IS 11 BP 4584 EP 4590 DI 10.1210/jc.2009-0594 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 515LD UT WOS:000271470800059 PM 19820022 ER PT J AU Mareninova, OA Hermann, K French, SW O'Konski, MS Pandol, SJ Webster, P Erickson, AH Katunuma, N Gorelick, FS Gukovsky, I Gukovskaya, AS AF Mareninova, Olga A. Hermann, Kip French, Samuel W. O'Konski, Mark S. Pandol, Stephen J. Webster, Paul Erickson, Ann H. Katunuma, Nobuhiko Gorelick, Fred S. Gukovsky, Ilya Gukovskaya, Anna S. TI Impaired autophagic flux mediates acinar cell vacuole formation and trypsinogen activation in rodent models of acute pancreatitis SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID CERULEIN-INDUCED PANCREATITIS; CATHEPSIN-B; HEREDITARY PANCREATITIS; LYSOSOMAL-ENZYMES; EARLY EVENTS; MONITORING AUTOPHAGY; ZYMOGEN ACTIVATION; RAT HEPATOCYTES; IN-VITRO; DISEASE AB The pathogenic mechanisms underlying acute pancreatitis are not clear. Two key pathologic acinar cell responses of this disease are vacuole accumulation and trypsinogen activation. We show here that both result from defective autophagy, by comparing the autophagic responses in rodent models of acute pancreatitis to physiologic autophagy triggered by fasting. Pancreatitis-induced vacuoles in acinar cells were greater in number and much larger than those induced with fasting. Degradation of long-lived proteins, a measure of autophagic efficiency, was markedly inhibited in in vitro pancreatitis, while it was stimulated by acinar cell starvation. Further, processing of the lysosomal proteases cathepsin L (CatL) and CatB into their fully active, mature forms was reduced in pancreatitis, as were their activities in the lysosome-enriched subcellular fraction. These findings indicate that autophagy is retarded in pancreatitis due to deficient lysosomal degradation caused by impaired cathepsin processing. Trypsinogen activation occurred in pancreatitis but not with fasting and was prevented by inhibiting autophagy. A marker of trypsinogen activation partially localized to autophagic vacuoles, and pharmacologic inhibition of CatL increased the amount of active trypsin in acinar cells. The results suggest that retarded autophagy is associated with an imbalance between CatL, which degrades trypsinogen and trypsin, and CatB, which converts trypsinogen into trypsin, resulting in intra-acinar accumulation of active trypsin in pancreatitis. Thus, deficient lysosomal degradation may be a dominant mechanism for increased intra-acinar trypsin in pancreatitis. C1 [Mareninova, Olga A.; Hermann, Kip; Pandol, Stephen J.; Gukovsky, Ilya; Gukovskaya, Anna S.] Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Mareninova, Olga A.; Hermann, Kip; Pandol, Stephen J.; Gukovsky, Ilya; Gukovskaya, Anna S.] Univ Calif Los Angeles, Los Angeles, CA USA. [French, Samuel W.] Harbor UCLA Med Ctr, Torrance, CA 90509 USA. [O'Konski, Mark S.] Digest Hlth Phys, Ft Myers, FL USA. [Webster, Paul] House Ear Res Inst, Los Angeles, CA USA. [Erickson, Ann H.] Univ N Carolina, Chapel Hill, NC USA. [Katunuma, Nobuhiko] Tokushima Bunri Univ, Tokushima, Japan. [Gorelick, Fred S.] Vet Affairs Med Ctr, West Haven, CT USA. [Gorelick, Fred S.] Yale Univ, West Haven, CT USA. RP Gukovskaya, AS (reprint author), UCLA Vet Affairs Greater Los Angeles Healthcare S, W Los Angeles Vet Affairs Healthcare Ctr, 11301 Wilshire Blvd,Blg 258,Rm 340, Los Angeles, CA 90073 USA. EM igukovsk@ucla.edu; agukovsk@ucla.edu FU Department of Veterans Affairs; NIH [DK59936, P60 AA11999]; American Gastroenterology Association Foundation Designated Research Scholar Award in Pancreaeitis FX This study was supported by the Department of Veterans Affairs, the NIH grants DK59936 (to A.S. Gukovskaya) and P60 AA11999 (to A.S. Gukovskaya and SJ. Pandol), and, in part, by the American Gastroenterology Association Foundation Designated Research Scholar Award in Pancreaeitis (to O.A. Mareninova). The authors thank Noboru Mizushima (Tokyo Medical and Dental University, Tokyo, Japan) and RIKEN BioResourse Center (Koyadai, Japan) for providing the GFP-LC3 transgenic mice and D.S. Longnecker (Dartmouth Medical School, USA) for providing H&E images of pancreatic tissue from patients with acute pancreatitis. The authors also thank the UCLA Microscopic Techniques Core (Marianne Cilluffo) for expert help with immunolabeling, Moses A. Lee for help with Western blot densicometry, and Tina Feng for help with quantification of vacuoles. NR 69 TC 92 Z9 99 U1 1 U2 8 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD NOV PY 2009 VL 119 IS 11 BP 3340 EP 3355 DI 10.1172/JCI38674 PG 16 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 517CC UT WOS:000271589400018 PM 19805911 ER PT J AU Castellon, SA Ganz, PA AF Castellon, Steven A. Ganz, Patricia A. TI Exploring the Impact of the Hormonal Milieu on Cognitive Functioning SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Editorial Material ID STAR P-2 TRIAL; BREAST-CANCER; TAMOXIFEN; CHEMOTHERAPY; PERFORMANCE; RALOXIFENE; THERAPY; BRAIN; NSABP C1 [Castellon, Steven A.] Univ Calif Los Angeles, David Geffen Sch Med, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA 90095 USA. [Ganz, Patricia A.] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Sch Med, Los Angeles, CA 90024 USA. [Ganz, Patricia A.] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Sch Publ Hlth, Los Angeles, CA 90024 USA. RP Castellon, SA (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA 90095 USA. NR 13 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD NOV 1 PY 2009 VL 27 IS 31 BP 5119 EP 5121 DI 10.1200/JCO.2009.24.3329 PG 5 WC Oncology SC Oncology GA 512TS UT WOS:000271274300003 PM 19770364 ER PT J AU Liebig, C Ayala, G Wilks, J Verstovsek, G Liu, H Agarwal, N Berger, DH Albo, D AF Liebig, Catherine Ayala, Gustavo Wilks, Jonathan Verstovsek, Gordana Liu, Hao Agarwal, Neeti Berger, David H. Albo, Daniel TI Perineural Invasion Is an Independent Predictor of Outcome in Colorectal Cancer SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID PROSTATE-CANCER; NEURAL INVASION; HIGH-RISK; PANCREATIC-CANCER; COLON-CANCER; PROGNOSTIC-SIGNIFICANCE; RECTAL-CANCER; NEEDLE-BIOPSY; CARCINOMA; STAGE AB Purpose Perineural invasion (PNI) is associated with decreased survival in several malignancies, but its significance in colorectal cancer (CRC) remains to be clearly defined. We evaluated PNI as a potential prognostic indicator in CRC, focusing on its significance in node-negative patients. Patients and Methods We identified 269 consecutive patients who had CRC resected at our institution. Tumors were rereviewed for PNI by a pathologist blinded to the patients' outcomes. Overall and disease-free survivals were determined using the Kaplan-Meier method, with differences determined by multivariate analysis using the Cox multiple hazards model. Results were compared using the log-rank test. Results PNI was identified in less than 0.5% of the initial pathology reports. On rereview, 22% of tumors in our series were found to be PNI positive. The 5-year disease-free survival rate was four-fold greater for patients with PNI-negative tumors versus those with PNI-positive tumors (65% v 16%, respectively; P < .0001). The 5-year overall survival rate was 72% for PNI-negative tumors versus 25% for PNI-positive tumors. On multivariate analysis, PNI was an independent prognostic factor for both cancer-specific overall and disease-free survival. In a subset analysis comparing patients with node-negative disease with patients with stage III disease, the 5-year disease-free survival rate was 56% for stage III patients versus 29% for patients with node-negative, PNI-positive tumors (P = .0002). Similar results were seen for overall survival. Conclusion PNI is grossly underreported in CRC and could serve as an independent prognostic factor of outcomes in these patients. PNI should be considered when stratifying CRC patients for adjuvant treatment. C1 [Albo, Daniel] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Micheal E DeBakey Dept Surg, Dept Pathol, Houston, TX 77030 USA. Baylor Coll Med, Div Biostat, Dan L Duncan Canc Ctr, Houston, TX 77030 USA. RP Albo, D (reprint author), Michael E DeBakey Vet Affairs Med Ctr, 2002 Holcombe Blvd,OCL 112-A, Houston, TX 77030 USA. EM dalbo@bcm.edu NR 45 TC 113 Z9 128 U1 0 U2 5 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD NOV 1 PY 2009 VL 27 IS 31 BP 5131 EP 5137 DI 10.1200/JCO.2009.22.4949 PG 7 WC Oncology SC Oncology GA 512TS UT WOS:000271274300006 PM 19738119 ER PT J AU Marvizon, JCG Chen, WL Murphy, N AF Marvizon, Juan Carlos G. Chen, Wenling Murphy, Niall TI Enkephalins, Dynorphins, and beta-Endorphin in the Rat Dorsal Horn: An Immunofluorescence Colocalization Study SO JOURNAL OF COMPARATIVE NEUROLOGY LA English DT Article DE calcitonin gene-related peptide; dorsal root ganglia; mu-opioid receptor; prodynorphin; spinal cord; substance P ID MU-OPIOID RECEPTOR; CENTRAL-NERVOUS-SYSTEM; GENE-RELATED PEPTIDE; ACTIVITY MODIFYING PROTEIN-1; SPINAL-CORD; SUBSTANCE-P; ROOT-GANGLIA; IMMUNOHISTOCHEMICAL LOCALIZATION; IMMUNOREACTIVE DYNORPHIN; METHIONINE-ENKEPHALIN AB To characterize neuronal pathways that release opioid peptides in the rat dorsal horn, multiple-label immunohistochemistry, confocal microscopy, and computerized colocalization measures were used to characterize opioid-containing terminals and cells. An antibody that selectively recognized beta-endorphin labeled fibers and neurons in the ventral horn as well as fibers in the lateral funiculus and lamina X, but practically no fibers in the dorsal horn. An anti-enkephalin antibody, which recognized Leu-, Met-, and Phe-Arg-Met-enkephalin, labeled the dorsolateral funiculus and numerous puncta in laminae I-III and V of the dorsal horn. An antibody against Phe-Arg-Met-enkephalin, which did not recognize Leu- and Met-enkephalin, labeled the same puncta. Antibodies against dynorphin and prodynorphin labeled puncta and fibers in laminae I, II, and V, as well as some fibers in the rest of the dorsal horn. Dynorphin and prodynorphin immunoreactivities colocalized in some puncta and fibers, but the prodynorphin antibody additionally labeled cell bodies. There was no colocalization of dynorphin (or prodynorphin) with enkephalin (or Phe-Arg-Met-enkephalin). Enkephalin immunoreactivity did not colocalize with the C-fiber markers calcitonin gene-related peptide (CGRP), substance P, and isolectin B4. In contrast, there was some colocalization of dynorphin and prodynorphin with CGRP and substance P, but not with isolectin B4. Both enkephalin and dynorphin partly colocalized with vesicular glutamate transporter 2, a marker of glutamatergic terminals. The prodynorphin-positive neurons in the dorsal horn were distinct from neurons expressing mu-opioid receptors, neurokinin 1 receptors, and protein kinase C-gamma. These results show that enkephalins and dynorphins are present in different populations of dorsal horn neurons. In addition, dynorphin is present in some C-fibers. J. Comp. Neurol. 517:51-68, 2009. Published 2009 Wiley-Liss, Inc. C1 [Marvizon, Juan Carlos G.] VA Greater Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Marvizon, Juan Carlos G.; Chen, Wenling] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Ctr Neurobiol Stress,Div Digest Dis, Los Angeles, CA 90095 USA. [Murphy, Niall] RIKEN, Brain Sci Inst, Mol Neuropathol Grp, Wako, Saitama 3510198, Japan. RP Marvizon, JCG (reprint author), VA Greater Angeles Healthcare Syst, Bldg 115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM marvizon@ucla.edu FU National Institutes of Health [R01-DA-012609]; Department of Veterans Affairs [B47661] FX Grant sponsor: the National Institutes of Health; Grant number: R01-DA-012609 to (J.C.M.); Grant sponsor: the Department of Veterans Affairs; Grant number: B47661 (to J.C.M.). NR 74 TC 31 Z9 31 U1 0 U2 7 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0021-9967 J9 J COMP NEUROL JI J. Comp. Neurol. PD NOV 1 PY 2009 VL 517 IS 1 BP 51 EP 68 DI 10.1002/cne.22130 PG 18 WC Neurosciences; Zoology SC Neurosciences & Neurology; Zoology GA 494VV UT WOS:000269848300004 PM 19711397 ER PT J AU Chen, JL Luviano, DM Chen, JC Yu, F Sarraf, D AF Chen, Jessica L. Luviano, Damien M. Chen, John C. Yu, Fei Sarraf, David TI Comparison of diabetic retinopathy phenotype between Latinos and Blacks SO JOURNAL OF DIABETES AND ITS COMPLICATIONS LA English DT Article CT Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology CY MAY 06-10, 2007 CL Ft Lauderdale, FL SP Assoc Res Vis & Ophthalmol DE Diabetic retinopathy phenotype; Latino; Black ID VEGF GENE; MACULAR DEGENERATION; UNITED-STATES; PREVALENCE; ASSOCIATION; POLYMORPHISM; POPULATION; WHITES; ADULTS; RISK AB Objective: The objective of this study was to delineate the difference in the phenotype of diabetic retinopathy (DR) in Latinos versus Blacks using characteristics shown on fundus photography (FP) and fluorescein angiography (FA). Research Design and Methods: This was a retrospective chart review of 203 adult Black and Latino diabetic patients from the King-Drew Medical Center eye clinic from January 1998 to March 2005. Systemic risk factors such as HbA(1c) and kidney function data were collected. FP and FA were analyzed and graded according to Early Treatment of Diabetic Retinopathy Study criteria. Statistical analysis was performed to determine whether a given lesion type was more characteristic of a particular racial group. Results: Gender, age, median microalbumin-to-creatinine ratio (ACR), and aver-age HbA(1c) values were not significantly different between the groups. The presence of clinically significant macular edema (CSME), focal or diffuse, was very high in both groups (44% in Latinos and 46% in Blacks), and the overall DR grades were similar. However, upon individual lesion analysis, the Latinos were noted to have more prevalent intraretinal hemorrhages involving a greater area of the retina (P=.046). Conclusions: Although Latinos and Blacks of comparable age and glycemic control are equally at risk for CSME and proliferative retinopathy, Latinos may be at greater risk for a specific phenotype of DR characterized by extravasation of intraretinal hemorrhages, which is associated with poor prognosis. Further prospective studies may uncover racial differences that may have implications for prognosis and therapy. Published by Elsevier Inc. C1 [Yu, Fei; Sarraf, David] Univ Calif Los Angeles, Jules Stein Eye Inst, Los Angeles, CA 90095 USA. [Chen, Jessica L.] Drew UCLA Med Educ Program, Los Angeles, CA USA. [Luviano, Damien M.; Sarraf, David] Charles R Drew Univ Med & Sci, Dept Ophthalmol, Los Angeles, CA 90059 USA. [Chen, John C.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Sarraf, David] Greater Los Angeles Vet Adm Healthcare Syst, Los Angeles, CA USA. RP Sarraf, D (reprint author), Univ Calif Los Angeles, Jules Stein Eye Inst, Oph Box 957006,1-165 JSEI, Los Angeles, CA 90095 USA. EM dsarraf@ucla.edu NR 23 TC 4 Z9 4 U1 0 U2 0 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 NOV-DEC PY 2009 VL 23 IS 6 BP 371 EP 375 DI 10.1016/j.jdiacomp.2008.05.001 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 519TM UT WOS:000271791300001 PM 18599323 ER PT J AU Singh, B AF Singh, Bramah TI Atrial fibrillation: from ion channels to bedside treatment options SO JOURNAL OF ELECTROCARDIOLOGY LA English DT Review DE Atrial fibrillation; Ion channels; Antiarrhythmic ID PEPTIDE ROTIGAPTIDE ZP123; GAP-JUNCTION MODIFIER; ANTIARRHYTHMIC COMPOUND AZD7009; STERILE PERICARDITIS MODEL; REDUCES INFARCT SIZE; TORSADES-DE-POINTES; OPEN-CHEST DOGS; CLASS IC DRUGS; SINUS RHYTHM; IN-VITRO AB Atrial fibrillation is now the most common arrhythmia in clinical practice. Recent understanding of the abnormalities in ion flow that underlie atrial fibrillation has led to the search for new treatment options with improved efficacy and tolerability. The purpose of this article is to review the role of ion channels in the development of atrial fibrillation and discuss the nature of their inhibition by investigational antiarrhythmic agents. Novel treatments include the benzofuran derivative dronedarone, atrial-selective compounds (eg, vernakalant), multichannel blocking agents (eg, tedisamil), and gap junction modifiers (eg, rotigaptide). Targeted antiarrhythmic therapies have the potential to provide safer and more effective management options for patients with atrial fibrillation. (C) 2009 Published by Elsevier Inc. C1 Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. RP Singh, B (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Hlth Care Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM bsingh@ucla.edu FU Sanofi-Aventis US; Bridgewater, New Jersey, USA FX Funding for editorial support was provided by Sanofi-Aventis US, Bridgewater, New Jersey, USA. NR 102 TC 6 Z9 7 U1 0 U2 12 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 0022-0736 J9 J ELECTROCARDIOL JI J. Electrocardiol. PD NOV-DEC PY 2009 VL 42 IS 6 BP 660 EP 670 DI 10.1016/j.jelectrocard.2009.04.002 PG 11 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 515SZ UT WOS:000271494500032 PM 19520377 ER PT J AU Sugimoto, M Furuta, T Yamaoka, Y AF Sugimoto, Mitsushige Furuta, Takahisa Yamaoka, Yoshio TI Influence of inflammatory cytokine polymorphisms on eradication rates of Helicobacter pylori SO JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY LA English DT Review DE eradication therapy; Helicobacter pylori; IL-1 beta; inflammatory cytokine; polymorphism; TNF-alpha ID NECROSIS-FACTOR-ALPHA; INTERLEUKIN-1-BETA GENETIC-POLYMORPHISM; RANDOMIZED CONTROLLED-TRIAL; GASTRIC-ACID INHIBITION; PROTON PUMP INHIBITOR; TRIPLE THERAPY; GENOTYPIC DIFFERENCES; INCREASED RISK; CURE RATES; ENDOSCOPIC RESECTION AB Pro-inflammatory cytokines and anti-inflammatory cytokines are produced in gastric mucosa from inflammatory cells activated by Helicobacter pylori (H. pylori) infection. Of the inflammatory cytokines, interleukin (IL)-1 beta and tumor necrosis factor (TNF)-alpha have a potent inhibitive effect on gastric acid production. Polymorphisms in these genes are associated with individual differences in cytokine messenger RNA levels, which result in different gastric mucosal inflammation, different acid inhibition and different gastroduodenal disease risks in response to H. pylori infection. The sustained higher intragastric pH during an eradication therapy is known to be one of the therapeutic determinants of the H. pylori eradication as well as antibiotics resistance and poor compliance. The IL-1B-511 polymorphism is related to eradication rate, and, in combined analysis of previous reports, the eradication rate in patients with the IL-1B-511 C/C genotype (77.4%, 209/270), low IL-1 beta producer genotype, is lower than that of the IL-1B-511 C/T and T/T genotypes (87.2%, 631/724) (Odds ratio for eradication failure: 1.98, 95% confidence interval: 1.38-2.84, P = 0.0002). Moreover, the odds ratio of combined CYP2C19 rapid metabolizer-IL-1B-511 C/C type for eradication failure is 11.15 (5.23-23.78) times that of the CYP2C19 poor metabolizer-IL-1B-511 non-C/C type. However, there is no positive data indicating the role of other inflammatory cytokine polymorphisms (e.g. IL-1RN, TNF-A or IL-10) in eradication therapy. Nevertheless, the studies show that inflammatory cytokine polymorphisms, especially the IL-1B-511 T/T genotype, are the determinants of eradication by affecting gastric acid secretion and mucosal inflammation. Therefore, the tailored eradication therapy, considering inflammatory cytokine polymorphisms, may be effective for the higher eradication rates. C1 [Sugimoto, Mitsushige] Hamamatsu Univ Sch Med, Clin Res Ctr, Higashi Ku, Hamamatsu, Shizuoka 4313192, Japan. [Sugimoto, Mitsushige; Yamaoka, Yoshio] Michael E DeBakey Vet Affairs Med Ctr, Dept Med Gastroenterol, Houston, TX USA. [Sugimoto, Mitsushige; Yamaoka, Yoshio] Baylor Coll Med, Houston, TX 77030 USA. [Yamaoka, Yoshio] Oita Univ, Dept Environm & Prevent Med, Fac Med, Yufu, Japan. RP Sugimoto, M (reprint author), Hamamatsu Univ Sch Med, Clin Res Ctr, Higashi Ku, 1-20-1 Handayama, Hamamatsu, Shizuoka 4313192, Japan. EM mitsuhamamed@yahoo.co.jp FU National Institute of Health [R01 DK62813] FX We thank Jared Pinkston for his advice and grammatical editing of this paper. This study is supported by Grant Number R01 DK62813 (National Institute of Health). None of the authors had conflicts of interest related to this study. NR 74 TC 21 Z9 22 U1 0 U2 1 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0815-9319 J9 J GASTROEN HEPATOL JI J. Gastroenterol. Hepatol. PD NOV PY 2009 VL 24 IS 11 BP 1725 EP 1732 DI 10.1111/j.1440-1746.2009.06047.x PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 512KQ UT WOS:000271248000007 PM 20136959 ER PT J AU McQueen, A Bartholomew, LK Greisinger, AJ Medina, GG Hawley, ST Haidet, P Bettencourt, JL Shokar, NK Ling, BS Vernon, SW AF McQueen, Amy Bartholomew, L. Kay Greisinger, Anthony J. Medina, Gilda G. Hawley, Sarah T. Haidet, Paul Bettencourt, Judith L. Shokar, Navkiran K. Ling, Bruce S. Vernon, Sally W. TI Behind Closed Doors: Physician-Patient Discussions About Colorectal Cancer Screening SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE colorectal cancer screening; physician-patient communication; shared decision-making; qualitative research; interventions ID INFORMED DECISION-MAKING; SELF-EXEMPTING BELIEFS; SERVICES TASK-FORCE; FECAL OCCULT BLOOD; PRIMARY-CARE; RANDOMIZED-TRIAL; UNITED-STATES; HEALTH; RECOMMENDATION; COLONOSCOPY AB Despite the availability of multiple effective screening tests for colorectal cancer, screening rates remain suboptimal. The literature documents patient preferences for different test types and recommends a shared decision-making approach for physician-patient colorectal cancer screening (CRCS) discussions, but it is unknown whether such communication about CRCS preferences and options actually occurs in busy primary-care settings. Describe physician-patient CRCS discussions during a wellness visit. Cross-sectional; patients audio-recorded with physicians. A subset of patients (N = 64) participating in a behavioral intervention trial designed to increase CRCS who completed a wellness visit during the trial with a participating physician (N = 8). Transcripts were analyzed using qualitative methods. Physicians in this sample consistently recommended CRCS, but focused on colonoscopy. Physicians did not offer a fecal occult blood test alone as a screening choice, which may have created missed opportunities for some patients to get screened. In this single visit, physicians' communication processes generally precluded discussion of patients' test preferences and did not facilitate shared decision-making. Patients' questions indicated their interest in different CRCS test types and appeared to elicit more information from physicians. Some patients remained resistant to CRCS after discussing it with a physician. If a preference for colonoscopy is widespread among primary-care physicians, the implications for intervention are either to prepare patients for this preference or to train physicians to offer options when recommending screening to patients. C1 [McQueen, Amy] Washington Univ, Sch Med, Div Hlth Behav Res, St Louis, MO 63108 USA. [Bartholomew, L. Kay; Medina, Gilda G.; Bettencourt, Judith L.; Vernon, Sally W.] Univ Texas Houston, Sch Publ Hlth, Houston, TX USA. [Greisinger, Anthony J.] Kelsey Res Fdn, Houston, TX USA. [Hawley, Sarah T.] Univ Michigan, Sch Med, Ann Arbor, MI USA. [Haidet, Paul] DeBakey VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. [Haidet, Paul] Baylor Coll Med, Houston, TX 77030 USA. [Shokar, Navkiran K.] Univ Texas Med Branch, Galveston, TX USA. [Ling, Bruce S.] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. RP McQueen, A (reprint author), Washington Univ, Sch Med, Div Hlth Behav Res, 4444 Forest Pk Ave, St Louis, MO 63108 USA. EM amcqueen@dom.wustl.edu FU National Cancer Institute [097263]; American Cancer Society Mentored Research Scholar [CPPB113766] FX This research was supported by a National Cancer Institute R01 grant (no. 097263; PI: Sally W. Vernon) and an American Cancer Society Mentored Research Scholar Grant (CPPB113766; PI: Amy McQueen). We gratefully acknowledge the support of the physicians and patients in the Family Medicine and Internal Medicine Departments at Kelsey-Seybold Clinic. We also thank Nicholas Solomos, MD, for his insightful comments on the manuscript. NR 61 TC 57 Z9 57 U1 0 U2 2 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD NOV PY 2009 VL 24 IS 11 BP 1228 EP 1235 DI 10.1007/s11606-009-1108-4 PG 8 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 514VA UT WOS:000271422600009 PM 19763699 ER PT J AU Thierman, S Dhaliwal, G Sooriash, L Baudendistel, T AF Thierman, Sara Dhaliwal, Gurpreet Sooriash, Lailey Baudendistel, Thomas TI Flushing Out the Diagnosis SO JOURNAL OF HOSPITAL MEDICINE LA English DT Editorial Material ID ANTICONVULSANT-HYPERSENSITIVITY-SYNDROME; SYSTEMIC SYMPTOMS; PHYSICAL-EXAMINATION; DRESS SYNDROME; DRUG RASH; MANAGEMENT; EOSINOPHILIA; HISTORY C1 [Thierman, Sara; Sooriash, Lailey] Calif Pacific Med Ctr, Dept Med, San Francisco, CA 94115 USA. [Thierman, Sara] SUNY Downstate Med Ctr, Dept Dermatol, Brooklyn, NY 11203 USA. [Dhaliwal, Gurpreet] San Francisco VA Med Ctr, Dept Med, San Francisco, CA USA. [Baudendistel, Thomas] Kaiser Permanente, Dept Med, Oakland, CA USA. RP Thierman, S (reprint author), Calif Pacific Med Ctr, Dept Med, 2333 Buchanan, San Francisco, CA 94115 USA. NR 14 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1553-5592 J9 J HOSP MED JI J. Hosp. Med. PD NOV-DEC PY 2009 VL 4 IS 9 BP 569 EP 573 DI 10.1002/jhm.603 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 540FD UT WOS:000273315800008 PM 20013860 ER PT J AU Stephen, TL Tikhonova, A Riberdy, JM Laufer, TM AF Stephen, Tom Li Tikhonova, Anastasia Riberdy, Janice M. Laufer, Terri M. TI The Activation Threshold of CD4(+) T Cells Is Defined by TCR/Peptide-MHC Class II Interactions in the Thymic Medulla SO JOURNAL OF IMMUNOLOGY LA English DT Article ID PROMISCUOUS GENE-EXPRESSION; ANTIGEN PRESENTATION; THYMOCYTE SENSITIVITY; TYROSINE-PHOSPHATASE; POSITIVE SELECTION; CENTRAL TOLERANCE; EPITHELIAL-CELLS; PROTEIN-KINASE; IN-VIVO; SELF AB Immature thymocytes that are positively selected based upon their response to self-peptide-MHC complexes develop into mature T cells that are not overtly reactive to those same complexes. Developmental tuning is the active process through which TCR-associated signaling pathways of single-positive thymocytes are attenuated to respond appropriately to the peptide-MHC molecules that will be encountered in the periphery. In this study, we explore the mechanisms that regulate the tuning of CD4(+) single-positive T cells to MHC class II encountered in the thymic medulla. Experiments with murine BM chimeras demonstrate that tuning can be mediated by MHC class II expressed by either thymic medullary epithelial cells or thymic dendritic cells. Tuning does not require the engagement of CD4 by MHC class II on stromal cells. Rather, it is mediated by interactions between MHC class 11 and the TCR. To understand the molecular changes that distinguish immature hyperactive T cells from tuned mature CD4(+) T cells, we compared their responses to TCR stimulation. The altered response of mature CD4 single-positive thymocytes is characterized by the inhibition of ERK activation by low-affinity self-ligands and increased expression of the inhibitory tyrosine phosphatase SHP-1. Thus, persistent TCR engagement by peptide-MHC class II on thymic medullary stroma inhibits reactivity to self-Ags and prevents autoreactivity in the mature repertoire. The Journal of Immunology, 2009,183: 5554-5562. C1 [Stephen, Tom Li; Tikhonova, Anastasia; Laufer, Terri M.] Univ Penn, Dept Med, Sch Med, Philadelphia, PA 19104 USA. [Riberdy, Janice M.] St Jude Childrens Hosp, Memphis, TN 38105 USA. [Laufer, Terri M.] Philadelphia Vet Affairs Med Ctr, Dept Med, Philadelphia, PA 19104 USA. RP Laufer, TM (reprint author), Univ Penn, Dept Med, Sch Med, 753 Biomed Res Bldg 2-3,421 Curie Blvd, Philadelphia, PA 19104 USA. EM tlaufer@mail.med.upenn.edu RI Tikhonova, Anastasia/F-1186-2015 FU National Institutes of Health [R01 AI068819]; Arthritis Foundation postdoctoral fellowship FX This work was supported by National Institutes of Health Grant R01 AI068819 (to T.M.L.) and an Arthritis Foundation postdoctoral fellowship (to T.L.S.). NR 48 TC 11 Z9 11 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 2009 VL 183 IS 9 BP 5554 EP 5562 DI 10.4049/jimmunol.0901104 PG 9 WC Immunology SC Immunology GA 515QU UT WOS:000271488500017 PM 19843939 ER PT J AU Zuleger, CL Bostwick, BL Macklin, MD Pei, QL Newton, MA Albertini, MR AF Zuleger, Cindav L. Bostwick, Biet L. Macklin, Michael D. Pei, Qinglin Newton, Michael A. Albertini, Mark R. TI Similar T-cell Receptor-beta Sequences Identified in Melanoma-reactive T Cells and In Vivo 6-thioguanine-resistant T Cells From Melanoma Patients SO JOURNAL OF IMMUNOTHERAPY LA English DT Meeting Abstract CT 24th Annual Meeting of the International-Society-for-Biology-Therapy-of-Cancer CY OCT 29-31, 2009 CL Washington, DC SP Int Soc Biol Therapy Canc C1 [Zuleger, Cindav L.; Macklin, Michael D.; Newton, Michael A.; Albertini, Mark R.] Univ Wisconsin, Carboae Comprehens Canc Ctr, Madison, WI USA. Univ Wisconsin, Sch Med & Publ Hlth, Madison, WI USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 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 2009 VL 32 IS 9 BP 986 EP 986 PG 1 WC Oncology; Immunology; Medicine, Research & Experimental SC Oncology; Immunology; Research & Experimental Medicine GA 510RX UT WOS:000271110100144 ER PT J AU Meffert, SM Marmar, CR AF Meffert, Susan M. Marmar, Charles R. TI Darfur Refugees in Cairo Mental Health and Interpersonal Conflict in the Aftermath of Genocide SO JOURNAL OF INTERPERSONAL VIOLENCE LA English DT Article DE refugee; trauma; violence; Sudan; Darfur ID POSTTRAUMATIC-STRESS-DISORDER; MALE VIETNAM VETERANS; QUALITATIVE RESEARCH; PTSD SYMPTOMS; TRAUMA; RECONCILIATION; DEPRESSION; ATTITUDES AB Hundreds of thousands of Darfur people affected by the Sudanese genocide have fled to Cairo, Egypt, in search of assistance. Collaborating with Africa and Middle East Refugee Assistance (AMERA), the authors conducted a mental health care needs assessment among Darfur refugees in Cairo. Information was collected using individual and focus group interviews to identify gaps in mental health care and develop understandings of emotional and relationship problems. The refugee mental health care system has a piecemeal structure with gaps in outpatient services. There is moderate to severe emotional distress among many Darfur refugees, including symptoms of depression and trauma, and interpersonal conflict, both domestic violence and broader community conflict, elevated relative to pregenocide levels. Given the established relationships between symptoms of depression/traumatic stress and interpersonal violence, improving mental health is important for both preventing mental health decompensation and stemming future cycles of intra- and intergroup conflict. C1 [Meffert, Susan M.; Marmar, Charles R.] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. [Marmar, Charles R.] San Francisco Vet Adm Med Ctr, San Francisco, CA USA. RP Meffert, SM (reprint author), Univ Calif San Francisco, Dept Psychiat, VAMC Bldg 8,Box 116P, San Francisco, CA 94143 USA. EM smeffert@lppi.ucsf.edu OI meffert, susan/0000-0002-5882-7102 FU NIMH NIH HHS [K23 MH098767, R25 MH060482] NR 26 TC 10 Z9 11 U1 0 U2 7 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0886-2605 J9 J INTERPERS VIOLENCE JI J. Interpers. Violence PD NOV PY 2009 VL 24 IS 11 BP 1835 EP 1848 DI 10.1177/0886260508325491 PG 14 WC Criminology & Penology; Family Studies; Psychology, Applied SC Criminology & Penology; Family Studies; Psychology GA 500TI UT WOS:000270327400004 PM 18945917 ER PT J AU Yin, F Doolittle, MH Peterfy, M AF Yin, Fen Doolittle, Mark H. Peterfy, Miklos TI A quantitative assay measuring the function of lipase maturation factor 1 SO JOURNAL OF LIPID RESEARCH LA English DT Article DE combined lipase deficiency; hypertriglyceridemia; lipoprotein lipase; genetic complementation ID LIPOPROTEIN-LIPASE; ENDOPLASMIC-RETICULUM; DEFICIENCY; MUTATIONS; LETHAL; MICE; CLD AB Newly synthesized lipoprotein lipase (LPL) and related members of the lipase gene family require an endoplasmic reticulum maturation factor for attainment of enzyme activity. This factor has been identified as lipase maturation factor 1 (Lmf1), and mutations affecting its function and/or expression result in combined lipase deficiency (cld) and hypertriglyceridemia. To assess the functional impact of Lmf1 sequence variations, both naturally occurring and induced, we report the development of a cell-based assay using LPL activity as a quantitative reporter of Lmf1 function. The assay uses a cell line homozygous for the cld mutation, which renders endogenous Lmf1 nonfunctional. LPL transfected into the mutant cld cell line fails to attain activity; however, cotransfection of LPL with wildtype Lmf1 restores its ability to support normal lipase maturation. In this report, we describe optimized conditions that ensure the detection of a complete range of Lmf1 function ( full, partial, or complete loss of function) using LPL activity as the quantitative reporter. To illustrate the dynamic range of the assay, we tested several novel mutations in mouse Lmf1. Our results demonstrate the ability of the assay to detect and analyze Lmf1 mutations having a wide range of effects on Lmf1 function and protein expression.Yin, F., M. H. Doolittle, and M. Peterfy. A quantitative assay measuring the function of lipase maturation factor 1. J. Lipid Res. 2009. 50: 2265-2269. C1 [Yin, Fen; Doolittle, Mark H.; Peterfy, Miklos] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. [Yin, Fen; Doolittle, Mark H.; Peterfy, Miklos] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Yin, Fen; Peterfy, Miklos] Cedars Sinai Med Ctr, Inst Med Genet, Los Angeles, CA 90048 USA. RP Doolittle, MH (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. EM markdool@ucla.edu; mpeterfy@ucla.edu FU Cedars-Sinai Medical Center, the Department of Veterans Affairs; National Institutes of Health [HL-24841] FX This work was supported by the Cedars-Sinai Medical Center, the Department of Veterans Affairs, and Grant HL-24841 from the National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. NR 10 TC 9 Z9 9 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0022-2275 J9 J LIPID RES JI J. Lipid Res. PD NOV PY 2009 VL 50 IS 11 BP 2265 EP 2269 DI 10.1194/jlr.M900196-JLR200 PG 5 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 507NJ UT WOS:000270860900015 PM 19471043 ER PT J AU Germano, PM Lieu, SN Xue, JJ Cooke, HJ Christofi, FL Lu, YX Pisegna, JR AF Germano, Patrizia M. Lieu, Sandy N. Xue, Janjing Cooke, Helen J. Christofi, Fievos L. Lu, Yuxin Pisegna, Joseph R. TI PACAP Induces Signaling and Stimulation of 5-Hydroxytryptamine Release and Growth in Neuroendocrine Tumor Cells SO JOURNAL OF MOLECULAR NEUROSCIENCE LA English DT Article DE BON cell; Carcinoid tumor; PACAP ID CYCLASE-ACTIVATING POLYPEPTIDE; LUNG-CANCER CELLS; VASOACTIVE INTESTINAL POLYPEPTIDE; CARCINOID BON CELLS; PROTEIN-KINASE-C; ADENYLATE-CYCLASE; FUNCTIONAL EXPRESSION; NEUROTENSIN SECRETION; RECEPTOR ANTAGONIST; CHROMAFFIN CELLS AB Neuroendocrine tumors, although rare, are currently diagnosed with increasing frequency, owing to improved imaging techniques and a greater clinical awareness of this condition. To date, BON is a very well established and characterized human pancreatic neuroendocrine tumor cell line used to study the signal transduction and genetic regulation of neuroendocrine tumors secretion and growth. The secretory activity of BON cells is known to release peptides, such as chromogranin A, neurotensin, and biogenic amines, as 5-HT, permitting an assessment of their biological activity. The neuropeptide pituitary adenylate cyclase activating polypeptide (PACAP), released from the enteric neurons in the gastrointestinal tract by binding to its high affinity receptor PAC1, has been previously shown to regulate the secretory activity and growth of the neuroendocrine-derived enterochromaffin-like cells in the stomach. This led us to speculate that PACAP might also play an important role in regulating the growth of human neuroendocrine tumors. Accordingly, in the current study, we have shown that BON cells express PAC1 receptors, which are rapidly internalized upon PACAP activation. Furthermore, PAC1 receptor activation, in BON cells, couple to intracellular Ca(2+) as well as cAMP responses and induce the release of intracellular 5-HT, activate mitogen activated protein kinases, and stimulate cellular growth. These data indicate that PACAP functionally can stimulate 5-HT release and promote the growth of the BON neuroendocrine tumor cell line. Therefore, PACAP and its receptors regulate neuroendocrine tumor secretory activity and growth in vivo, and this knowledge will permit the development of novel diagnostic and therapeutic targets for managing neuroendocrine tumors in humans. C1 [Germano, Patrizia M.; Lieu, Sandy N.; Lu, Yuxin; Pisegna, Joseph R.] Univ Calif Los Angeles, CURE Digest Dis Res Ctr, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90073 USA. [Xue, Janjing; Cooke, Helen J.; Christofi, Fievos L.] Ohio State Univ, Dept Neurosci, Columbus, OH 43210 USA. [Xue, Janjing; Cooke, Helen J.; Christofi, Fievos L.] Ohio State Univ, Dept Anesthesiol, Columbus, OH 43210 USA. RP Germano, PM (reprint author), Univ Calif Los Angeles, CURE Digest Dis Res Ctr, VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 115,Room 316, Los Angeles, CA 90073 USA. EM pgermano@ucla.edu FU Department of Veterans Affairs; National Institutes of Health [DK37240] FX This work was supported by the Department of Veterans Affairs Merit Review Grant (JRP) and National Institutes of Health DK37240 (HJC). NR 51 TC 9 Z9 9 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. PD NOV PY 2009 VL 39 IS 3 BP 391 EP 401 DI 10.1007/s12031-009-9283-7 PG 11 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 505YZ UT WOS:000270739700012 PM 19701709 ER PT J AU Dickey, MW Thompson, CK AF Dickey, Michael Walsh Thompson, Cynthia K. TI Automatic processing of wh- and NP-movement in agrammatic aphasia: Evidence from eyetracking SO JOURNAL OF NEUROLINGUISTICS LA English DT Article DE Aphasia; Agrammatism; Eyetracking; Filler-gap dependencies; NP-movement; Sentence comprehension; wh-movement ID EMPTY CATEGORIES; EYE-MOVEMENTS; TIME-COURSE; SENTENCE COMPREHENSION; BROCAS APHASIA; ALTERED SPEECH; DEPENDENCIES; TRACKING; ASSIGNMENT; PREFERENCE AB Individuals with agrammatic Broca's aphasia show deficits in comprehension of non-canonical wh-movement and NP-movement sentences. Previous work using eyetracking has found that agrammatic and unimpaired listeners show very similar patterns of automatic processing for wh-movement sentences. The current study attempts to replicate this finding for sentences with wh-movement (in object relatives in the Current study) and to extend it to sentences with NP-movement (passives). For wh-movement sentences, aphasic and control participants' eye-movements differed most dramatically in late regions of the sentence and post-offset, with aphasic participants exhibiting lingering attention to a salient but grammatically impermissible competitor. The eye-movement differences between correct and incorrect trials for wh-movement sentences were similar. with incorrect trials also exhibiting competition from an impermissible interpretation late in the sentence. Furthermore, the two groups exhibited similar eye-movement patterns in response to passive NP-movement sentences, but showed little evidence of gap-filling for passives. The results suggest that aphasic and unimpaired individuals may generate similar representations during comprehension, but that aphasics are highly vulnerable to interference from alternative interpretations (Ferreira, F. (2003). The misinterpretation of non-canonical sentences. Cognitive Psychology, 47(2),164-203). (C) 2009 Elsevier Ltd. All rights reserved. C1 [Dickey, Michael Walsh] Univ Pittsburgh, Dept Commun Sci & Disorders, Pittsburgh, PA 15260 USA. [Dickey, Michael Walsh] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Thompson, Cynthia K.] Northwestern Univ, Aphasia & Neurolinguist Res Lab, Evanston, IL USA. [Thompson, Cynthia K.] Northwestern Univ, Dept Commun Sci & Disorders, Evanston, IL USA. [Thompson, Cynthia K.] Northwestern Univ, Dept Neurol, Evanston, IL USA. [Thompson, Cynthia K.] Northwestern Univ, Cognit Neurol & Alzheimers Dis Ctr, Evanston, IL USA. RP Dickey, MW (reprint author), Univ Pittsburgh, Dept Commun Sci & Disorders, 4032 Forbes Tower, Pittsburgh, PA 15260 USA. EM mdickey@pitt.edu OI Dickey, Michael Walsh/0000-0002-9068-3313 FU NIDCD NIH HHS [R01 DC001948, R01 DC001948-14] NR 56 TC 25 Z9 26 U1 2 U2 12 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0911-6044 J9 J NEUROLINGUIST JI J. Neurolinguist. PD NOV PY 2009 VL 22 IS 6 BP 563 EP 583 DI 10.1016/j.jneuroling.2009.06.004 PG 21 WC Linguistics; Neurosciences; Psychology, Experimental SC Linguistics; Neurosciences & Neurology; Psychology GA 500PN UT WOS:000270315700004 PM 20161014 ER PT J AU Tilden, LB Williams, BR Tucker, RO MacLennan, PA Ritchie, CS AF Tilden, Lauren B. Williams, Beverly R. Tucker, Rodney O. MacLennan, Paul A. Ritchie, Christine S. TI Surgeons' Attitudes and Practices in the Utilization of Palliative and Supportive Care Services for Patients with a Sudden Advanced Illness SO JOURNAL OF PALLIATIVE MEDICINE LA English DT Article ID OUTCOMES; UNIT AB Background: There is growing interest in the interface between palliative care and other medical specialties, yet little is known about decision-making processes characterizing such collaborations. At the University of Alabama at Birmingham (UAB), the trauma-burn surgery and neurosurgery services frequently request consults from the palliative care team for patients with a sudden advanced illness from catastrophic injuries or physiologic insult. Objective: We explored surgeons' attitudes and decision-making practices regarding utilization of palliative and supportive care for patients with a sudden advanced illness from traumatic injury or physiologic insult at UAB Hospital, an American College of Surgeons certified level 1 trauma center. Design and Analysis: We conducted face-to-face, open-ended interviews with nine attending trauma-burn surgeons and neurosurgeons at UAB, utilizing a grounded theory approach to discover salient themes in surgeons' accounts of the palliative care consultative process. Surgeons' descriptions of exemplary cases provided the context for elucidating the larger dynamic involved in assessing patients' situations and identifying the need for palliative and supportive care services. Results: We organized the data using decision-making diagrams, identifying multiple pathways within the larger consultative framework. Although case-based responses exhibited variations in surgeons diagnostic or prognostic criteria, patient's location in the illness/injury trajectory, and surgeon's goals/desired outcomes; a general decision-making pathway emerged. Conclusions: Through collaboration with the palliative care service at UAB, trauma-burn surgeons and neurosurgeons are better equipped to manage the multidimensional nature of suffering and provide a holistic approach to care for patients and families dealing with a sudden advanced illness. C1 [Williams, Beverly R.; Ritchie, Christine S.] Birmingham VA Med Ctr, Birmingham Atlanta VA Geriatr Res Educ & Clin Ctr, Birmingham, AL 35233 USA. [Tilden, Lauren B.; Williams, Beverly R.; Tucker, Rodney O.; Ritchie, Christine S.] Univ Alabama, Dept Gerontol Geriatr Palliat Care, Birmingham, AL USA. [Tilden, Lauren B.; Williams, Beverly R.; Tucker, Rodney O.; Ritchie, Christine S.] Univ Alabama, Ctr Palliat Care, Birmingham, AL USA. [MacLennan, Paul A.] Univ Alabama, Dept Surg, Birmingham, AL 35294 USA. RP Williams, BR (reprint author), Birmingham VA Med Ctr, Birmingham Atlanta VA Geriatr Res Educ & Clin Ctr, 700 19th St S, Birmingham, AL 35233 USA. EM beverly.williams3@va.gov NR 13 TC 10 Z9 10 U1 3 U2 4 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1096-6218 J9 J PALLIAT MED JI J. Palliat. Med. PD NOV PY 2009 VL 12 IS 11 BP 1037 EP 1042 DI 10.1089/jpm.2009.0120 PG 6 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 521IS UT WOS:000271914900011 PM 19663713 ER PT J AU Wang, LY Martin, B Brenneman, R Luttrell, LM Maudsley, S AF Wang, Liyun Martin, Bronwen Brenneman, Randall Luttrell, Louis M. Maudsley, Stuart TI Allosteric Modulators of G Protein-Coupled Receptors: Future Therapeutics for Complex Physiological Disorders SO JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS LA English DT Review ID BETA(2) ADRENERGIC-RECEPTOR; MUSCARINIC ACETYLCHOLINE-RECEPTORS; AGONIST-DIRECTED TRAFFICKING; DELTA-OPIOID RECEPTORS; SIGNAL-TRANSDUCTION; BETA(2)-ADRENERGIC RECEPTOR; DRUG DISCOVERY; IN-VIVO; FUNCTIONAL SELECTIVITY; MOLECULAR-MECHANISM AB G protein-coupled receptors (GPCRs) are one of the most important classes of proteins in the genome, not only because of their tremendous molecular diversity but because they are the targets of nearly 50% of current pharmacotherapeutics. The majority of these drugs affect GPCR activity by binding to a similar molecular site as the endogenous cognate ligand for the receptor. These "orthosterically" targeted drugs currently dominate the existing pharmacopeia. Over the past two decades, novel opportunities for drug discovery have risen from a greater understanding of the complexity of GPCR signaling. A striking example of this is the appreciation that many GPCRs possess functional allosteric binding sites. Allosteric modulator ligands bind receptor domains topographically distinct from the orthosteric site, altering the biological activity of the orthosteric ligand by changing its binding affinity, functional efficacy, or both. This additional receptor signaling complexity can be embraced and exploited for the next generation of GPCR-targeted therapies. Despite the challenges associated with detecting and quantifying the myriad of possible allosteric effects on GPCR activity, allosteric ligands offer the prospect of engendering a facile stimulus-bias in orthosteric ligand signaling, paving the way for not only receptor-selective but also signaling pathway-selective therapies. Allosteric modulators possess specific advantages when considering the treatment of multifactorial syndromes, such as metabolic diseases or age-related cognitive impairment, because they may not greatly affect neurotransmitter or hormone release patterns, thus maintaining the integrity of complex signaling networks that underlie perception, memory patterns, or neuroendocrinological axes while introducing therapeutically beneficial signal bias. C1 [Maudsley, Stuart] NIA, Biomed Res Ctr, Receptor Pharmacol Unit, NIH, Baltimore, MD 21224 USA. [Martin, Bronwen] NIA, Metab Unit, NIH, Baltimore, MD 21224 USA. [Brenneman, Randall] Univ Miami, Miller Sch Med, Canc Biol Program, Miami, FL 33136 USA. [Luttrell, Louis M.] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. [Luttrell, Louis M.] Med Univ S Carolina, Dept Med, Div Endocrinol, Charleston, SC 29425 USA. RP Maudsley, S (reprint author), NIA, Biomed Res Ctr, Receptor Pharmacol Unit, NIH, Room 5C228,251 Bayview Blvd, Baltimore, MD 21224 USA. EM maudsleyst@mail.nih.gov FU National Institutes of Health National Institute on Aging; National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases [R01-DK055524]; Research Service of the Ralph H. Johnson Veterans Affairs Medical Center FX This research was supported in part by the Intramural Research Program of the National Institutes of Health National Institute on Aging; the National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases [Grant R01-DK055524] (L. M. L.); and the Research Service of the Ralph H. Johnson Veterans Affairs Medical Center (L. M. L.). NR 109 TC 56 Z9 56 U1 0 U2 5 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 NOV PY 2009 VL 331 IS 2 BP 340 EP 348 DI 10.1124/jpet.109.156380 PG 9 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 509HR UT WOS:000271006200001 PM 19667132 ER PT J AU Boynton, L Bentley, J Strachan, E Barbato, A Raskind, M AF Boynton, Lorin Bentley, Jacob Strachan, Eric Barbato, Anna Raskind, Murray TI Preliminary Findings Concerning the Use of Prazosin for the Treatment of Posttraumatic Nightmares in a Refugee Population SO JOURNAL OF PSYCHIATRIC PRACTICE LA English DT Article DE posttraumatic stress disorder; prazosin; nightmares; refugees; global concern ID STRESS-DISORDER; SLEEP DISTURBANCE; TRAUMA NIGHTMARES; COMBAT VETERANS; PTSD; SYMPTOMS AB Prazosin, a centrally active alpha-1 adrenergic receptor antagonist, has reduced nightmares and sleep disturbances in placebo-controlled studies involving patients with combat and civilian related posttraumatic stress disorder (PTSD). In this retrospective chart review, we analyzed data from 23 refugees diagnosed with chronic PTSD who were treated with prazosin. The recurrent distressing dreams item of the Clinician Administered PTSD Scale (CAPS) was used to quantify nightmare severity. A Clinical Global Impressions-Change (CGI-C) score assessed change in overall PTSD severity exclusive of nightmares. Using a paired-samples t-test, we found that CAPS scores decreased significantly (p < 0.0005) from baseline after 8 weeks of treatment with a stable dose of prazosin. Overall PTSD severity was "markedly improved" in 6 patients, "moderately improved" in 11 patients, and "minimally improved" in 6 patients. These data provide preliminary support for the use of prazosin in targeting reduction of trauma-related nightmares and promoting improvement of global clinical status within an international sample of severely traumatized refugee patients. (Journal of Psychiatric Practice 2009;15:454-459) C1 [Boynton, Lorin] Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA. [Bentley, Jacob] Seattle Pacific Univ, Seattle, WA USA. [Barbato, Anna] Univ Hawaii, Hilo, HI 96720 USA. [Raskind, Murray] VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Boynton, L (reprint author), Univ Washington, Harborview Med Ctr, 325 9Th Ave,Box 359896, Seattle, WA 98104 USA. EM loring@u.washington.edu NR 17 TC 15 Z9 15 U1 2 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1527-4160 J9 J PSYCHIATR PRACT JI J. Psychiatr. Pract. PD NOV PY 2009 VL 15 IS 6 BP 454 EP 459 PG 6 WC Psychiatry SC Psychiatry GA 525GZ UT WOS:000272204400005 PM 19934720 ER PT J AU Riedl, A Maass, J Fliege, H Stengel, A Schmidtmann, M Klapp, BF Monnikes, H AF Riedl, Andrea Maass, Julia Fliege, Herbert Stengel, Andreas Schmidtmann, Marco Klapp, Burghard F. Moennikes, Hubert TI Subjective theories of illness and clinical and psychological outcomes in patients with irritable bowel syndrome SO JOURNAL OF PSYCHOSOMATIC RESEARCH LA English DT Article DE IBS; Quality of life; Subjective theories of illness ID QUALITY-OF-LIFE; SYNDROME IBS; SYMPTOMS; IMPACT; REPRESENTATION; ATTRIBUTIONS; PERSONALITY; PERCEPTION; DISORDERS; DISEASES AB Objectives: Patients' ideas about the nature, cause, and treatment of their illnesses are pail of the complex process of coping with illness. To date, limited research on subjective theories of illness in patients with irritable bowel syndrome (IBS) has been performed. The aim of the study was to investigate patients' subjective theories of illness and how these are related to clinical and psychological outcome criteria, in particular IBS symptom severity and quality of life. Methods: Eighty-eight patients with IBS, as defined by Rome III criteria, were administered a battery of questionnaires to collect the following data: sociodemographic variables, subjective theories of illness (Subjektive Krankheitstheorien, Cause Questionnaire), anxiety (Hospital Anxiety and Depression Scale), depression (Beck Depression Inventory), quality of life (SF-12), and IBS symptoms (Questionnaire for Gastrointestinal Symptoms). Results: Almost all patients reported theories of illness reflecting their subjective causal assumptions. The most frequently mentioned causal factors were physical illness, intrapsychic factors, and stress. Patients with mainly somatic attributions had higher IBS symptoms scores (P<.05) and reduced physical quality of life. Intrapsychic attributions were associated with reduced mental quality of life and enhanced physical quality of life (P<.01). All correlations were independent of gender, age, and irritable bowel subgroups. Conclusions: Subjective theories of illness can have significant implications for IBS symptom severity, as well as for physical and mental quality of life. (C) 2009 Elsevier Inc. All rights reserved. C1 [Riedl, Andrea; Fliege, Herbert; Schmidtmann, Marco] Charite, Dept Med, Div Psychosomat Med & Psychotherapy, D-10117 Berlin, Germany. [Riedl, Andrea; Maass, Julia; Schmidtmann, Marco; Klapp, Burghard F.] Charite, Dept Med, Div Hepatol Gastroenterol & Endocrinol, D-10117 Berlin, Germany. [Stengel, Andreas] Univ Calif Los Angeles, David Geffen Sch Med, CURE Digest Dis Res Ctr, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90095 USA. [Stengel, Andreas] Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurobiol Stress, Digest Dis Div,Dept Med,VA Greater Los Angeles He, Los Angeles, CA 90095 USA. [Moennikes, Hubert] Martin Luther Hosp, Dept Med, Berlin, Germany. [Moennikes, Hubert] Martin Luther Hosp, Inst Neurogastroenterol, Berlin, Germany. RP Riedl, A (reprint author), Charite, Dept Med, Div Psychosomat Med & Psychotherapy, Luisenstr 13A, D-10117 Berlin, Germany. EM andrea.riedl@charite.de NR 37 TC 14 Z9 14 U1 4 U2 11 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0022-3999 J9 J PSYCHOSOM RES JI J. Psychosomat. Res. PD NOV PY 2009 VL 67 IS 5 BP 449 EP 455 DI 10.1016/j.jpsychores.2009.02.001 PG 7 WC Psychiatry SC Psychiatry GA 513TZ UT WOS:000271348000011 PM 19837208 ER PT J AU Campbell, R Cooper, GS Gilkeson, GS AF Campbell, Robert, Jr. Cooper, Glinda S. Gilkeson, Gary S. TI The Impact of Systemic Lupus Erythematosus on Employment SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE JOB LOSS; LOST WAGES; SYSTEMIC LUPUS ERYTHEMATOSUS; CAROLINA LUPUS STUDY; ARTHRITIS; PLEURITIS ID RHEUMATOID-ARTHRITIS PATIENTS; SOUTHEASTERN UNITED-STATES; WORK DISABILITY; REVISED CRITERIA; RISK-FACTORS; CLASSIFICATION; POPULATION; COSTS; RACE AB Objective. Our primary objective was to examine work status (e.g., job loss, changes in amount worked) and predictors of job loss in patients with systemic lupus erythematosus (SLE). Methods. Recently diagnosed SLE patients were enrolled in the Carolina Lupus Study between 1997 and 1999: ail age-, sex-, and state-matched control group selected through driver's license registries for the 60-county study area was also enrolled. In 2001, a followup study of both groups was conducted (median 4 yrs since diagnosis). Work history data were obtained in ail in-person interview at enrollment and a telephone interview at followup. Results. Fifty-one patients (26%) and 26 controls (9%) (p < 0.0001) who were working the year before diagnosis (or for controls, it corresponding reference year) were no longer working at followup; 92% of patients compared with 40% of controls who were no longer working indicated that they had stopped working because of their health (p < 0.0001). College graduates were less likely to quit their jobs due to health compared to non-college graduates (adjusted OR = 0.27, 95% CI 0.09, 0.84). SLE patients with arthritis were 3 times more likely to have left their jobs due to health reasons compared to those who didn't have arthritis (adjusted OR = 3.3. 95% CI 1.2, 8.8); ail association was also seen with pleuritis (adjusted OR 2.3, 95% CI 1.1, 4.6). Conclusion. The burden expressed as work cessation due to health, especially among lesser educated patients and those with arthritis or pleuritis, is significant even early in the disease process. (First Release Oct 1 2009; J Rheumatol 2009;36:2470-5, doi: 10.3899/jrheum.080586) C1 [Campbell, Robert, Jr.] Med Univ S Carolina, Dept Med, Div Rheumatol & Immunol, Charleston, SC 29425 USA. NIEHS, NIH, Epidemiol Branch, Res Triangle Pk, NC 27709 USA. [Cooper, Glinda S.] US EPA, Washington, DC 20460 USA. [Gilkeson, Gary S.] Ralph H Johnson Vet Adm Med Ctr, Charleston, SC USA. RP Campbell, R (reprint author), Med Univ S Carolina, Dept Med, Div Rheumatol & Immunol, 96 Jonathan Lucas St,Suite 912, Charleston, SC 29425 USA. EM campber@musc.edu FU Intramural NIH HHS; NIAMS NIH HHS [1T32-AR050958, 2R01-AR045476, P60-AR049459] NR 28 TC 12 Z9 12 U1 0 U2 0 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD NOV PY 2009 VL 36 IS 11 BP 2470 EP 2475 DI 10.3899/jrheum.080586 PG 6 WC Rheumatology SC Rheumatology GA 517DP UT WOS:000271593700016 PM 19273454 ER PT J AU La Fountaine, MF Radulovic, M Cardozo, CP Spungen, AM DeMeersman, RE Bauman, WA AF La Fountaine, Michael F. Radulovic, Miroslav Cardozo, Christopher P. Spungen, Ann M. DeMeersman, Ronald E. Bauman, William A. TI Effects of Acute Nitric Oxide Synthase Inhibition on Lower Leg Vascular Function in Chronic Tetraplegia SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE Spinal cord injuries; L-NAME; Nitric oxide synthase; Tetraplegia; Vascular resistance; Vasoregulation ID SPINAL-CORD-INJURY; BLOOD-PRESSURE; L-NAME; PLASMA-CATECHOLAMINES; SKELETAL-MUSCLE; NERVOUS-SYSTEM; RESPONSES; HUMANS; TONE; PLETHYSMOGRAPHY AB Background/Objective: To improve our understanding of the lower-leg vascular responses of nitric oxide synthase inhibition in persons with tetraplegia. Participants: Six people with chronic tetraplegia and 6 age-matched controls. Methods: Lower-leg relative vascular resistance and venous volume variation were obtained by venous occlusion plethysmography and blood pressure by auscultation at baseline. Postintravenous infusion of the nitric oxide synthase inhibitor N(G)-nitro-L-arginine-methyl-ester (1 mg.kg(-1)) or placebo on separate days. Results: At baseline in the group with tetraplegia compared with controls, mean arterial pressure and relative vascular resistance of the leg were significantly lower. After nitric oxide synthase inhibition, mean arterial pressure and lower leg vascular resistance were significantly elevated in both groups. There were no group or intervention differences in venous volume variation. Conclusion: These preliminary results suggest that nitric oxide synthase inhibition with I mg.kg-1 N(G)-nitro-L-arginine-methyl-ester normalizes seated blood pressure and lower leg vascular resistance to control group baseline levels. C1 [La Fountaine, Michael F.; Radulovic, Miroslav; Cardozo, Christopher P.; Spungen, Ann M.; Bauman, William A.] James J Peters VA Med Ctr, VA Ctr Excellence Med Consequences Spinal Cord In, Bronx, NY 10468 USA. [DeMeersman, Ronald E.] Columbia Univ, Teachers Coll, Dept Biobehav Sci, New York, NY 10027 USA. RP La Fountaine, MF (reprint author), James J Peters VA Med Ctr, VA Ctr Excellence Med Consequences Spinal Cord In, SCI Room 1E-02,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM michael.lafountaineg@gmail.com FU Veterans Affairs Rehabilitation Research and Development Service [B4335V, 3755, B4162C]; James J. Peters VA Medical Center; VIDDA Foundation FX This research was supported by the Veterans Affairs Rehabilitation Research and Development Service (#B4335V, ARCD #3755 and #B4162C), James J. Peters VA Medical Center, and VIDDA Foundation. NR 44 TC 2 Z9 2 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. PD NOV PY 2009 VL 32 IS 5 BP 538 EP 544 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 534JX UT WOS:000272893500004 PM 20025149 ER PT J AU Merkow, RP Bilimoria, KY Cohen, ME Richards, K Ko, CY Hall, BL AF Merkow, Ryan P. Bilimoria, Karl Y. Cohen, Mark E. Richards, Karen Ko, Clifford Y. Hall, Bruce L. TI Variability in Reoperation Rates at 182 Hospitals: A Potential Target for Quality Improvement SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Article ID OPERATING-ROOM; UNPLANNED RETURN; SURGICAL CARE; SURGERY; OUTCOMES; RISK; INDICATOR; PROGRAM; FUTURE; NSQIP AB BACKGROUND: Reoperation rate has gained increasing attention as a potential indicator of surgical quality. Objectives of this study were to examine the feasibility of assessing reoperation rates at 182 hospitals to identify institutions with Outlying performance, to examine potentially modifiable factors that are associated with reoperations, and to determine if a more parsimonious logistic regression model effectively predicts reoperations. STUDY DESIGN: Patients were identified who underwent colorectal procedures at 182 hospitals participating in the American College of Surgeon's National Surgical Quality Improvement Program in 2006-2007. Risk-adjusted regression models for reoperation were developed to identify hospitals that had ratios of observed-to-expected events that were substantial outliers. RESULTS: Of 23,098 patients identified, 1,320 (5.7%) required reoperations. Reoperation occurred significantly more often than expected in 16 hospitals and less often than expected in 7 hospitals (P 0.05). Factors that were associated with all increased risk of reoperation were advanced American Society of Anesthesiologists class, male gender, contaminated wounds, surgical extent, Surgical indication, smoking, poor functional status, disseminated cancer, COPD, steroid dependence, anemia, body mass index (calculated as kg/m(2)) >35 or <= 18.5, and hypertension. Compared with the full logistic regression model, there was a high degree of correlation with the more parsimonious logistic model containing only the first six variables (r = 0.996). CONCLUSIONS: There is considerable variability in reoperation rates at American College of Surgeon's National Surgical Quality Improvement Program hospitals. American College of Surgeon's National Surgical Quality Improvement Program data call be used to provide individual hospitals with risk-adjusted self-assessment data on reoperations to potentially identify quality-improvement opportunities. (J Am Coll Surg 2009;209:557-564. (C) 2009 by the American College of Surgeons) C1 [Bilimoria, Karl Y.; Cohen, Mark E.; Richards, Karen; Ko, Clifford Y.] Amer Coll Surg, Div Res & Optimal Patient Care, Chicago, IL 60611 USA. [Merkow, Ryan P.] Univ Colorado, Denver Sch Med, Dept Surg, Aurora, CO USA. [Bilimoria, Karl Y.] Northwestern Univ, Feinberg Sch Med, Dept Surg, Chicago, IL 60611 USA. [Ko, Clifford Y.] Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. [Ko, Clifford Y.] Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Hall, Bruce L.] Washington Univ, Sch Med, Dept Surg, John Cochran St Louis Vet Affairs Med Ctr,Ctr Hlt, St Louis, MO 63110 USA. [Hall, Bruce L.] Washington Univ, John M Olin Sch Business, St Louis, MO 63130 USA. RP Bilimoria, KY (reprint author), Amer Coll Surg, Div Res & Optimal Patient Care, 633 N St Clair St,22nd Fl, Chicago, IL 60611 USA. EM kbilimoria@facs.org NR 26 TC 28 Z9 29 U1 1 U2 1 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 2009 VL 209 IS 5 BP 557 EP 564 DI 10.1016/j.jamcollsurg.2009.07.003 PG 8 WC Surgery SC Surgery GA 520VB UT WOS:000271876400002 PM 19854394 ER PT J AU Itani, KMF Fitzgibbons, R Awad, SS Duh, QY Ferzli, GS AF Itani, Kamal M. F. Fitzgibbons, Robert, Jr. Awad, Samir S. Duh, Quan-Yang Ferzli, George S. TI Management of Recurrent Inguinal Hernias SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Review ID LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL; PROSPECTIVE RANDOMIZED-TRIAL; MESH PLUG MIGRATION; GROIN HERNIA; FEMORAL HERNIA; CLINICAL-TRIAL; REPAIR; HERNIORRHAPHY; REOPERATION; EXPERIENCE AB The ultimate measure of success of inguinal hernia repair is the rate of recurrence. Although other procedure-related complications are important and have been shown to affect health-related quality-of-life parameters,(1) recurrence is more challenging for the patients and the surgeon. From the patients' perspective, the initial physical and mental investment in the operation has failed. A new investment has to be made, with fewer guarantees for success, more risks for more serious complications, and more time off from work. For the surgeon, repair of a recurrent inguinal hernia is technically more demanding because scar tissue causes the inguinal canal to be obscured and distorted. In addition, the tissue tends to be weaker than at the time of primary repair, resulting in a substantially higher risk for complications or development: of another recurrence. Although much has been published about primary repair of inguinal hernias, less is known about the best approach to address a recurrent hernia. In this review, we address the "pros and cons" of popular surgical approaches and watchful waiting for recurrent inguinal hernias and indications for each. In the absence of best evidence in this field, the authors present an opinion based on their experience and a review of the available literature primarily extracted from large trials and large cohorts for inguinal hernia repair in general. C1 [Itani, Kamal M. F.] Boston Vet Affairs Hlth Care Syst, Dept Surg, Boston, MA USA. [Itani, Kamal M. F.] Boston Univ, Boston, MA 02215 USA. [Fitzgibbons, Robert, Jr.] Creighton Univ, Dept Surg, Omaha, NE 68178 USA. [Awad, Samir S.] Michael E DeBakey Vet Affairs Med Ctr, Dept Surg, Houston, TX USA. [Awad, Samir S.] Baylor Coll Med, Houston, TX 77030 USA. [Duh, Quan-Yang] San Francisco VA Med Ctr, Dept Surg, San Francisco, CA USA. [Duh, Quan-Yang] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Ferzli, George S.] SUNY Hlth Sci Ctr, Dept Surg, Brooklyn, NY 11203 USA. [Ferzli, George S.] Lutheran Med Ctr, Brooklyn, NY USA. RP Itani, KMF (reprint author), Boston Vet Affairs Hlth Care Syst 112A, 1400 VFW Pkwy, W Roxbury, MA 02132 USA. EM kitani@va.gov OI Ferzli, George/0000-0003-0095-6216 FU Lifecell Corporation FX Dr Irani received research support from Lifecell Corporation. Dr Fitzgibbons is a consultant and receives research support from Lifecell Corporation and royalties from Cook Surgical for the Fitzgibbons-Jenkins Multi Purpose Common Bile Duct Catheter. Dr Duh is on the clinical advisory board of Covidien. Dr Awad is a speaker and ad hoc consultant and has received research support from Lifecell Corporation. Dr Ferzli has nothing to disclose. NR 49 TC 12 Z9 18 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1072-7515 J9 J AM COLL SURGEONS JI J. Am. Coll. Surg. PD NOV PY 2009 VL 209 IS 5 BP 653 EP 658 DI 10.1016/j.jamcollsurg.2009.07.015 PG 6 WC Surgery SC Surgery GA 520VB UT WOS:000271876400016 PM 19854408 ER PT J AU Friedlander, AH AF Friedlander, Arthur H. TI ANTIBIOTIC PROPHYLAXIS SO JOURNAL OF THE AMERICAN DENTAL ASSOCIATION LA English DT Letter C1 [Friedlander, Arthur H.] Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. [Friedlander, Arthur H.] Univ Calif Los Angeles, Med Ctr, Dent Serv, Los Angeles, CA 90024 USA. [Friedlander, Arthur H.] VA Greater Los Angeles Healthcare Syst, Grad Med Educ, Los Angeles, CA USA. RP Friedlander, AH (reprint author), Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. NR 2 TC 1 Z9 1 U1 0 U2 0 PU AMER DENTAL ASSOC PI CHICAGO PA 211 E CHICAGO AVE, CHICAGO, IL 60611 USA SN 0002-8177 J9 J AM DENT ASSOC JI J. Am. Dent. Assoc. PD NOV PY 2009 VL 140 IS 11 BP 1347 EP 1348 PG 2 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 518VY UT WOS:000271724800005 PM 19884389 ER PT J AU Wang, LY Larson, EB Sonnen, JA Shofer, JB McCormick, W Bowen, JD Montine, TJ Li, G AF Wang, Lucy Y. Larson, Eric B. Sonnen, Joshua A. Shofer, Jane B. McCormick, Wayne Bowen, James D. Montine, Thomas J. Li, Ge TI Blood Pressure and Brain Injury in Older Adults: Findings from a Community-Based Autopsy Study SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE dementia; blood pressure; hypertension; neuropathology; autopsy ID ALZHEIMERS-DISEASE; RISK-FACTORS; NEUROFIBRILLARY TANGLES; CARDIOVASCULAR HEALTH; ATHEROSCLEROSIS RISK; CEREBRAL INFARCTION; PROSPECTIVE COHORT; DEMENTIA; POPULATION; PATHOLOGY AB OBJECTIVES To examine correlations between blood pressure (BP) and dementia-related pathological brain changes in a community-based autopsy sample. DESIGN Prospective cohort study. SETTING A large health maintenance organization in Seattle, Washington. PARTICIPANTS A cohort of 250 participants aged 65 and older and cognitively normal at time of enrollment in the Adult Changes in Thought (ACT) Study and who underwent autopsy. MEASUREMENTS BP and history of antihypertensive treatment were taken at enrollment. A linear regression model was used to examine the relationship between BP (systolic (SBP) and diastolic (DBP)) at enrollment and pathological changes in the cerebrum (cystic macroscopic infarcts, microinfarcts, neuritic plaques, neurofibrillary tangles, and cortical Lewy bodies). RESULTS The presence of more than 2 microinfarcts, but not any other pathological change, was independently associated with SBP in younger participants (65-80, n=137) but not in older participants (> 80, n=91). The relative risk (RR) for more than two microinfarcts with each 10-mmHg increase in SBP was 1.15 (95% confidence interval (CI)=1.00-1.33) in the younger participants, adjusted for age at entry, sex, and time to death. This RR was particularly strong in younger participants not taking antihypertensive medications (RR=1.48, 95% CI=1.21, 1.81); significant associations were not observed in participants treated for hypertension. Findings for DBP were negative. CONCLUSION The association between high SBP and cerebrovascular damage in untreated older adults (65-80) suggests that adequate hypertension treatment may reduce dementia risk by minimizing microvascular injury to cerebrum. C1 [Wang, Lucy Y.; Li, Ge] Vet Affairs Puget Sound Healthcare Syst, Mental Illness Res & Educ Clin Ctr, Seattle, WA USA. [Wang, Lucy Y.; Shofer, Jane B.; Li, Ge] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Larson, Eric B.; McCormick, Wayne] Univ Washington, Dept Med, Seattle, WA USA. [Sonnen, Joshua A.; Montine, Thomas J.] Univ Washington, Dept Pathol, Seattle, WA 98195 USA. [Bowen, James D.] Univ Washington, Dept Neurol, Seattle, WA 98195 USA. [Larson, Eric B.] Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. RP Wang, LY (reprint author), 1660 S Columbian Way,S-116-6E, Seattle, WA 98108 USA. EM wanglucy@u.washington.edu RI Sonnen, 37382016/H-3738-2016 OI Sonnen, 37382016/0000-0001-9267-8705 FU National Institute on Aging [AG020020, AG006781, AG023801, AG005136]; Nancy and Buster Alvord Endowment; Department of Veterans Affairs Mental Illness Research, Education, and Clinical Center Special Fellowship in Advanced Psychiatry FX We thank all of the faculty and staff who worked on this study and made this article possible. Specifically, we gratefully acknowledge Mary Lou Thompson, PhD, for providing statistical consultation. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. This material is the result of work supported by resources from the Veterans Affairs Puget Sound Health Care System, Seattle, Washington. This work was supported by Grants AG020020, AG006781, AG023801, and AG005136 from the National Institute on Aging, the Nancy and Buster Alvord Endowment, and the Department of Veterans Affairs Mental Illness Research, Education, and Clinical Center Special Fellowship in Advanced Psychiatry. Author Contributions: Study concept and design: LY Wang, JA Sonnen, TJ Montine, G Li, EB Larson, acquisition of study participants and data: JD Bowen, W McCormick, EB Larson, JA Sonnen, TJ Montine, analysis and interpretation of data: JB Shofer, preparation of manuscript: LY Wang, JA Sonnen, TJ Montine, G Li, and critical review of the manuscript: LY Wang, EB Larson, JA Sonnen, JB Shofer, W McCormick, JD Bowen, TJ Montine, G Li. Sponsor's Role: The funding sources had no role in the design, methodology, data analysis, or preparation of this manuscript. NR 46 TC 27 Z9 29 U1 1 U2 5 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD NOV PY 2009 VL 57 IS 11 BP 1975 EP 1981 DI 10.1111/j.1532-5415.2009.02493.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 512KU UT WOS:000271248500001 PM 19793158 ER PT J AU Min, L Yoon, W Mariano, J Wenger, NS Elliott, MN Kamberg, C Saliba, D AF Min, Lillian Yoon, William Mariano, Jeff Wenger, Neil S. Elliott, Marc N. Kamberg, Caren Saliba, Debra TI The Vulnerable Elders-13 Survey Predicts 5-Year Functional Decline and Mortality Outcomes in Older Ambulatory Care Patients SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE vulnerable elder; functional decline; survival ID QUALITY INDICATORS; ELDERLY-PATIENTS; PEOPLE; DISABILITY; COMMUNITY; CANCER; INTERVENTION; DEMENTIA; DEATH; LIFE AB OBJECTIVES To test the predictive properties of the Vulnerable Elders-13 Survey (VES-13) a short tool that predicts functional decline and mortality over a 1- to 2-year follow-up interval over a 5-year interval. DESIGN Longitudinal evaluation with mean follow-up of 4.5 years. SETTING Two managed-care organizations. PARTICIPANTS Six hundred forty-nine community-dwelling older adults (>= 75) enrolled in the Assessing Care of Vulnerable Elders observational study who screened positive for symptoms of falls or fear of falling, bothersome urinary incontinence, or memory problems. MEASUREMENTS VES-13 score (range 1-10, higher score indicates worse prognosis), functional decline (decline in count of 5 activities of daily living or nursing home entry), and deaths. RESULTS Higher VES-13 scores were associated with greater predicted probability of death and decline in older patients over a mean observation period of 4.5 years. For each additional VES-13 point, the odds of the combined outcome of functional decline or death was 1.37 (95% confidence interval (CI)=1.25-1.50), and the area under the receiver operating curve was 0.75 (95% CI=0.71-0.80). In the Cox proportional hazards model predicting time to death, the hazard ratio was 1.23 (95% CI=1.19-1.27) per additional VES-13 point. CONCLUSION This study extends the utility of the VES-13 to clinical decisions that require longer-term prognostic estimates of functional status and survival. C1 [Min, Lillian; Mariano, Jeff; Saliba, Debra] Univ Calif Los Angeles, Div Geriatr, Los Angeles, CA USA. [Wenger, Neil S.] Univ Calif Los Angeles, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA USA. [Yoon, William] Virginia Commonwealth Univ, Sch Med, Richmond, VA 23284 USA. [Wenger, Neil S.; Elliott, Marc N.; Kamberg, Caren; Saliba, Debra] RAND Corp, Santa Monica, CA USA. [Saliba, Debra] Vet Affairs Greater Los Angeles Healthcare Syst, Geriatr Res Educ & Clin Care Ctr, Los Angeles, CA USA. [Saliba, Debra] Univ Calif Los Angeles, Jewish Homes Borun Ctr Gerontol Res, Los Angeles, CA USA. RP Min, L (reprint author), 10945 Le Conte Ave,Suite 2339,Box 951687, Los Angeles, CA 90095 USA. EM lmin@mednet.ucla.edu FU Agency for Healthcare Research and Quality [R21 HS017621-01]; National Institute on Aging (NIA)-UCLA [K12 AG001004]; Donald W. Reynolds Foundation; University of California at Los Angeles (UCLA) Older Americans Independence Center (Pepper Center) FX Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Dr. Min is supported by grants from the Agency for Healthcare Research and Quality (R21 HS017621-01) and National Institute on Aging (NIA)-UCLA (K12 AG001004). Mr. Yoon was a NIA/American Federation for Aging Research and Lillian R. Gleitsman Medical Student Training in Aging Research Program Scholar in 2008. Dr. Mariano was supported by a Faculty Development to Advance Geriatric Education award from the Donald W. Reynolds Foundation. This project also received support from the University of California at Los Angeles (UCLA) Older Americans Independence Center (Pepper Center). This paper was presented as an abstract at the 2009 American Geriatrics Society Scientific Meeting. Author Contributions: Lillian Min, Neil S. Wenger, and Debra Saliba: concept and design, acquisition of subjects and data, analysis and interpretation of data, and preparation of manuscript. William Yoon: acquisition of subjects and data, analysis and interpretation of data, and preparation of manuscript. Jeff Mariano: concept and design, acquisition of subjects and data, and preparation of manuscript. Marc Elliot: concept and design, analysis and interpretation of data, and preparation of manuscript. Caren Kamberg: concept and design, acquisition of subjects and data. Sponsor's Role: Pfizer Inc. supported the recruitment of the original ACOVE-2 cohort but had no role in obtaining outcomes data, data analysis, or preparation of this manuscript. The UCLA Older Americans Independence Center (Pepper Center) provided support for statistical analysis. NR 22 TC 51 Z9 53 U1 1 U2 7 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD NOV PY 2009 VL 57 IS 11 BP 2070 EP 2076 DI 10.1111/j.1532-5415.2009.02497.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 512KU UT WOS:000271248500013 PM 19793154 ER PT J AU Kirk, JB Goetz, MB AF Kirk, Jason B. Goetz, Matthew Bidwell TI Human Immunodeficiency Virus in an Aging Population, a Complication of Success SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE human immunodeficiency virus; acquired immunodeficiency syndrome; antiretroviral therapy; immune activation ID HIV-INFECTED PATIENTS; ACTIVE ANTIRETROVIRAL THERAPY; REVERSE-TRANSCRIPTASE INHIBITORS; MULTICENTER AIDS COHORT; HEALTH-CARE SETTINGS; D-A-D; MYOCARDIAL-INFARCTION; MEDICINE ASSOCIATION; LIFE EXPECTANCY; PATIENTS OLDER AB The proportion of human immunodeficiency virus (HIV)-infected patients aged 50 and older has greatly increased since the beginning of the epidemic, particularly since 1996, when combination antiretroviral therapy became available. By 2015, 50% of HIV-infected individuals in the United States are likely to be aged 50 and older. The rate of progression of untreated HIV disease, response to therapy, and complicating effects of comorbidities differ in older and younger patients. Older untreated patients with HIV demonstrate faster rates of CD4+ cell loss and more rapid progression to acquired immunodeficiency syndrome (AIDS) and death than younger individuals. Synergistic deleterious effects of chronic immune activation on the course of HIV infection with the immune senescence of aging may promote this accelerated course. Despite the increasing prevalence in older patients and cost-effectiveness analyses that favor HIV testing, older patients are less likely to be routinely evaluated for HIV infection. Consequently, when diagnosed, older patients have more-advanced disease than do younger patients and, upon presentation with AIDS-defining conditions, are less likely to receive timely appropriate therapy. The treatment of older HIV-infected patients is complicated by preexisting comorbid conditions, including cardiovascular, hepatic, and metabolic complications, which in turn may be exacerbated by the effects of HIV infection per se, modest immunodeficiency (i.e., at CD4+ counts > 350 cells/mu L), and the metabolic and other adverse effects of combination antiretroviral therapy. Nevertheless, older patients derive substantial benefit from combination antiretroviral therapy despite having less of an immunological response than expected given their adherence to therapy and excellent virological responses. C1 VA Greater Los Angeles Healthcare Syst, Infect Dis Sect, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Goetz, MB (reprint author), VA Greater Los Angeles Healthcare Syst, Infect Dis Sect 111 F, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM matthew.goetz@va.gov OI Goetz, Matthew/0000-0003-4542-992X NR 69 TC 85 Z9 86 U1 1 U2 1 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD NOV PY 2009 VL 57 IS 11 BP 2129 EP 2138 DI 10.1111/j.1532-5415.2009.02494.x PG 10 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 512KU UT WOS:000271248500022 PM 19793157 ER PT J AU High, KP Yoshikawa, TT AF High, Kevin P. Yoshikawa, Thomas T. TI Reply to Dr. Snustad SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Letter ID LATERAL SLUMP SIGN; ASYMPTOMATIC BACTERIURIA; INFECTION; RESIDENTS; FACILITIES C1 [High, Kevin P.] Wake Forest Univ Hlth Sci, Infect Dis Sect, Winston Salem, NC 27106 USA. [Yoshikawa, Thomas T.] Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP High, KP (reprint author), Wake Forest Univ Hlth Sci, Infect Dis Sect, Winston Salem, NC 27106 USA. NR 9 TC 1 Z9 1 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD NOV PY 2009 VL 57 IS 11 BP 2158 EP 2159 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 512KU UT WOS:000271248500032 ER PT J AU Lee, SJ Covinsky, KE AF Lee, Sei J. Covinsky, Kenneth E. TI Response Letter to Drs. Giesbrecht and Rehm SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Letter ID ALL-CAUSE MORTALITY; ALCOHOL-CONSUMPTION; DRINKING C1 [Lee, Sei J.] San Francisco VA Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94143 USA. RP Lee, SJ (reprint author), San Francisco VA Med Ctr, San Francisco, CA USA. NR 9 TC 0 Z9 0 U1 1 U2 1 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD NOV PY 2009 VL 57 IS 11 BP 2175 EP 2176 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 512KU UT WOS:000271248500046 ER PT J AU Braddy, KK Imam, SN Palla, KR Lee, TA AF Braddy, Kathryn K. Imam, Syed N. Palla, Kavita R. Lee, Todd A. TI Vitamin D Deficiency/Insufficiency Practice Patterns in a Veterans Health Administration Long-Term Care Population: A Retrospective Analysis SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Article DE Vitamin D; long-term care; vitamin D insufficiency; vitamin D deficiency ID D DEFICIENCY; SECONDARY HYPERPARATHYROIDISM; D INADEQUACY; PREVALENCE; METAANALYSIS; FRACTURES AB Objectives: To evaluate the prevalence of vitamin D deficiency/insufficiency in long-term care patients at a Veterans Health Administration (VHA) hospital and to assess treatment and follow-up of low vitamin D levels. Design: Observational cohort study. Setting: VA hospital extended care center (ECC). Participants: 2218 ECC patients between January 2001 and December 2006 were screened. Measurement: Serum 25-hydroxyvitamin D (25[OH]D) level, vitamin D therapy regimen, time to follow-up, documented adverse event to vitamin D therapy. Results: Of 2218 patients admitted to the ECC during the study period, 229 (10%) had a vitamin D level measured. Among these 229 patients, 49% were vitamin D sufficient (25[OH]D >= 30 ng/mL), 14% were insufficient (25[OH]D = 21-29 ng/mL), and 37% were deficient (25[OH]D <= 20 ng/mL). Sixty-nine percent of patients with low vitamin D levels received some form of vitamin D therapy, whereas 43% received treatment as well as follow-up evaluation of vitamin D status within 3 months. Only 13% received a formulation of vitamin D appropriate for the severity of their deficiency/insufficiency with concurrent calcium supplementation and had a repeat vitamin D level within 3 months. Conclusion: Vitamin D levels were measured infrequently in long-term care patients. Among those monitored, the rate of vitamin D deficiency/insufficiency is high. Few patients with low vitamin D status received proper treatment and follow-up. These data support the need to educate physicians regarding the high prevalence of vitamin D insufficiency/deficiency among long-term care patients to ensure that patients with low vitamin D levels are identified and treated appropriately. (J Am Med Dir Assoc 2009; 10: 653-657) C1 [Braddy, Kathryn K.] VA Maryland Hlth Care Syst, Baltimore, MD 21201 USA. [Braddy, Kathryn K.; Imam, Syed N.; Palla, Kavita R.; Lee, Todd A.] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. RP Braddy, KK (reprint author), VA Maryland Hlth Care Syst, 10 N Greene St,119, Baltimore, MD 21201 USA. EM kathryn.kuhn@va.gov NR 13 TC 44 Z9 44 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1525-8610 J9 J AM MED DIR ASSOC JI J. Am. Med. Dir. Assoc. PD NOV PY 2009 VL 10 IS 9 BP 653 EP 657 DI 10.1016/j.jamda.2009.08.010 PG 5 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 524NQ UT WOS:000272150400012 PM 19883889 ER PT J AU Smith, RG Rubin, SA Ellestad, MH AF Smith, Ryan G. Rubin, Stanley A. Ellestad, Myrvin H. TI Exercise hypertension: an adverse prognosis? SO JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION LA English DT Review DE Exercise hypertension; prognosis; hypertension; cardiovascular events ID BLOOD-PRESSURE RESPONSE; CORONARY-ARTERY-DISEASE; MIDDLE-AGED MEN; LEFT-VENTRICULAR MASS; MYOCARDIAL-INFARCTION; CARDIOVASCULAR MORTALITY; RISK; INCREASE AB We sought to clarify the prognostic importance of an "exaggerated" or "hypertensive" systolic blood pressure response to exercise during an exercise test. Studies evaluating the prognosis for cardiovascular events and cardiovascular mortality in those with hypertension during exercise testing were systematically reviewed. Fourteen studies were identified. Six studies were of healthy volunteers or hypertensives. Eight studies were in subjects with known or suspected heart disease. Without established heart disease, exercise hypertension predicted cardiovascular events and cardiovascular death. However, two of the six studies included a multivariate analysis; both demonstrated no independent association. Studies in subjects with known or suspected heart disease demonstrated that exercise hypertension predicted fewer cardiac events and lesser mortality or, after multivariate adjustment, no associated risk. In a healthy population, a higher exercise blood pressure may indicate hypertension or prehypertension, instead of normal vascular function, and an associated long-term adverse prognosis. In a population with a high burden of heart disease, the highest risk subjects with the most extensive cardiac disease may not be capable of generating pressure or workload to allow the manifestation of exercise systolic hypertension. By comparison, therefore, those with exercise hypertension have a better prognosis. J Am Soc Hypertens 2009;3(6):366-373. (C) 2009 American Society of Hypertension. All rights reserved. C1 [Smith, Ryan G.; Rubin, Stanley A.] Univ Calif Los Angeles, Sch Med Los Angeles, Los Angeles, CA 90024 USA. [Smith, Ryan G.; Rubin, Stanley A.] Greater Los Angeles, Vet Adm, Los Angeles, CA USA. [Ellestad, Myrvin H.] UCI Sch Med, Irvine, CA USA. [Ellestad, Myrvin H.] Long Beach Mem Hosp Med Ctr, Long Beach, CA USA. RP Smith, RG (reprint author), VA Greater Los Angeles Healthcare Syst, Div Cardiol 111E, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM smithryang@ucla.edu NR 28 TC 14 Z9 15 U1 1 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1933-1711 J9 J AM SOC HYPERTENS JI J. Am. Soc. Hypertens. PD NOV-DEC PY 2009 VL 3 IS 6 BP 366 EP 373 DI 10.1016/j.jash.2009.10.003 PG 8 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 589ZV UT WOS:000277193700003 PM 20409979 ER PT J AU Palevsky, PM Weisbord, SD AF Palevsky, Paul M. Weisbord, Steven D. TI Critical Care Nephrology: It's Not Just Acute Kidney Injury SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Editorial Material ID STAGE RENAL-DISEASE; CLINICAL-FEATURES; UNIT; DIALYSIS; FAILURE C1 [Palevsky, Paul M.; Weisbord, Steven D.] VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA 15240 USA. [Weisbord, Steven D.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. [Palevsky, Paul M.; Weisbord, Steven D.] Univ Pittsburgh, Sch Med, Dept Med, Renal Electrolyte Div, Pittsburgh, PA USA. RP Palevsky, PM (reprint author), VA Pittsburgh Healthcare Syst, Renal Sect, Room 7E123 111F-U,Univ Dr, Pittsburgh, PA 15240 USA. EM palevsky@pitt.edu OI Palevsky, Paul/0000-0002-7334-5400 NR 11 TC 0 Z9 0 U1 0 U2 1 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD NOV PY 2009 VL 20 IS 11 BP 2281 EP 2282 DI 10.1681/ASN.2009080875 PG 2 WC Urology & Nephrology SC Urology & Nephrology GA 526BD UT WOS:000272261600003 PM 19797471 ER PT J AU Samuelson, KW Neylan, TC Lenoci, M Metzler, TJ Cardenas, V Weiner, MW Marmar, CR AF Samuelson, Kristin W. Neylan, Thomas C. Lenoci, Maryanne Metzler, Thomas J. Cardenas, Valerie Weiner, Michael W. Marmar, Charles R. TI Longitudinal effects of PTSD on memory functioning SO JOURNAL OF THE INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY LA English DT Article DE Veterans; Neuropsychology; Verbal learning; Delayed memory; Immediate recall; Aging ID POSTTRAUMATIC-STRESS-DISORDER; CHILDHOOD SEXUAL-ABUSE; SHORT-TERM-MEMORY; HOLOCAUST SURVIVORS; DECLARATIVE MEMORY; COMBAT VETERANS; PERFORMANCE; ATTENTION; WOMEN; DEFICITS AB Numerous Studies have demonstrated explicit and working memory deficits related to posttraumatic stress disorder (PTSD), but few have addressed longitudinal changes in memory functioning. There is some evidence to Suggest in interactive effect of PTSD and aging on verbal memory decline in Holocaust Survivors (Yehuda et al., 2006). However. the longitudinal trajectory of neuropsychologgical functioning has not been investigated in Vietnam veterans, a younger but substantial population of aging trauma Survivors. We administered tests 017 Visual and verbal memory, and working memory to derive different dependent measures in veterans between the ages of 41 and 63, the majority of whom served in the Vietnam War. Twenty-five veterans with PTSD and 22 veterans without PTSD were assessed over two time points (mean age at follow-up = 54.0; mean inter-test interval = 34 months). The PTSD+group, consisting of veterans with chronic, primarily combat-related PTSD, did not show a significant change in PTSD symptoms over time. Compared to veterans without PTSD. veterans with PTSD showed it greater decline in delayed facial recognition only, and this decline was extremely Subtle. (JINS, 2009, 15, 853-861.) C1 [Samuelson, Kristin W.] Alliant Int Univ, Calif Sch Profess Psychol, San Francisco, CA 94133 USA. [Samuelson, Kristin W.; Neylan, Thomas C.; Lenoci, Maryanne; Metzler, Thomas J.; Cardenas, Valerie; Weiner, Michael W.; Marmar, Charles R.] San Francisco VA Med Ctr, Mental Hlth Serv, San Francisco, CA USA. [Neylan, Thomas C.; Metzler, Thomas J.; Weiner, Michael W.; Marmar, Charles R.] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. [Cardenas, Valerie; Weiner, Michael W.] Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. RP Samuelson, KW (reprint author), Alliant Int Univ, Calif Sch Profess Psychol, 1 Beach St,Suite 100, San Francisco, CA 94133 USA. EM ksamuelson@alliant.edu FU Sierra Pacific (VISN 21) Mental Illness Research, Education, and Clinical Center (MIRECC); Department of Defense FX This study was supported by the Sierra Pacific (VISN 21) Mental Illness Research, Education, and Clinical Center (MIRECC) and the Department of Defense. The authors do not have any conflicts of interest that might be interpreted as influencing the research. NR 48 TC 13 Z9 14 U1 1 U2 11 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA SN 1355-6177 J9 J INT NEUROPSYCH SOC JI J. Int. Neuropsychol. Soc. PD NOV PY 2009 VL 15 IS 6 BP 853 EP 861 DI 10.1017/S1355617709990282 PG 9 WC Clinical Neurology; Neurosciences; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 523ZV UT WOS:000272114500005 PM 19703319 ER PT J AU Benge, JF Perrier, ND Massman, PJ Meyers, CA Kayl, AE Wefel, JS AF Benge, Jared F. Perrier, Nancy D. Massman, Paul J. Meyers, Christina A. Kayl, Anne E. Wefel, Jeffrey S. TI Cognitive and affective sequelae of primary hyperparathyroidism and early response to parathyroidectomy SO JOURNAL OF THE INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY LA English DT Article DE Hyperparathyroidism; Parathyroidectomy; Cognition; Depression; Neuropsychology; Surgery ID ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM; TEST-RETEST RELIABILITY; NORMATIVE DATA; HYPER-PARATHYROIDISM; HORMONE; BRAIN; DYSFUNCTION; EDUCATION; BEHAVIOR; DEFICITS AB Cognitive and affective complaints are common in patients with primary hyperparathyroidism (PHPT), but few studies have used psychometric testing to document these symptoms and their response to parathyroidectomy. The current Study sought to clarify the nature of cognitive and affective impairments in PHPT and changes postparathyroidectomy. One hundred eleven patients with PHPT underwent neuropsychological evaluation prior to parathyroidectomy with 68 returning for an early postsurgical evaluation. Changes in cognition were assessed using practice effect corrected reliable change indices. Biochemical and anesthesia variables were compared between groups who improved and declined. In a subset of patients, assessment revealed a significant pattern of cognitive slowing, reductions in psychomotor speed, memory impairment, and depression prior to parathyroidectomy. Postsurgical evaluations revealed a trend for improvements on timed tests and depression but a decline in memory. Older patients responded less well to surgical intervention, as did patients who experienced more dramatic changes in biochemical status following surgery. Cognitive changes early postparathyroidectomy are characterized by improved information processing speed and decline in verbal memory, with younger patients more likely to recover during this acute phase. The need for longer-term follow-up studies and increasing utilization of neuropsychological assessments in this population are discussed. (JINS, 2009, 15, 1002-1011.) C1 [Wefel, Jeffrey S.] Univ Texas MD Anderson Canc Ctr, Dept Neurooncol, Unit 431, Sect Neuropsychol, Houston, TX 77230 USA. [Benge, Jared F.] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. [Benge, Jared F.] Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. [Perrier, Nancy D.] Univ Texas MD Anderson Canc Ctr, Dept Surg Oncol, Houston, TX 77230 USA. [Massman, Paul J.] Univ Houston, Dept Psychol, Houston, TX USA. RP Wefel, JS (reprint author), Univ Texas MD Anderson Canc Ctr, Dept Neurooncol, Unit 431, Sect Neuropsychol, POB 301402, Houston, TX 77230 USA. EM jwefel@mdanderson.org FU American Geriatric Society, Jahnigan FX No pharmaceutical or corporate funding was used in the preparation of this manuscript or collection of data. Support was in part funded by the American Geriatric Society, Jahnigan Scholars grant. Portions of this work were presented previously as a poster at the 36th Annual Meeting of the International Neuropsychological Society, Waikoloa, HI. NR 51 TC 16 Z9 17 U1 1 U2 3 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA SN 1355-6177 J9 J INT NEUROPSYCH SOC JI J. Int. Neuropsychol. Soc. PD NOV PY 2009 VL 15 IS 6 BP 1002 EP 1011 DI 10.1017/S1355617709990695 PG 10 WC Clinical Neurology; Neurosciences; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 523ZV UT WOS:000272114500022 PM 19807940 ER PT J AU Dwyer, HA Matthews, PB Azadani, A Ge, L Guy, TS Tseng, EE AF Dwyer, Harry A. Matthews, Peter B. Azadani, Ali Ge, Liang Guy, T. Sloane Tseng, Elaine E. TI Migration forces of transcatheter aortic valves in patients with noncalcific aortic insufficiency SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article ID PERCUTANEOUS HEART-VALVE; HIGH-RISK PATIENTS; BLOOD-FLOW; IMPLANTATION; PROSTHESIS; STENOSIS; MODEL; EXPERIENCE; FEASIBILITY; REPLACEMENT AB Objective: Transcatheter aortic valves have been successfully implanted into the calcified leaflets of patients with severe aortic stenosis. However, their stability in patients with noncalcified aortic insufficiency is unknown. Similar to thoracic and abdominal aortic stent grafts, transcatheter aortic valves are subjected to antegrade ejection forces during systole. However, retrograde migration forces into the left ventricle are also generated by the diastolic pressure gradient across the closed valve. It has been suggested that leaflet calcification anchors the prosthesis, and measurements of migration forces should be considered before clinical trials in noncalcified aortic insufficiency. The objective of this study was to use computational fluid dynamics simulations to quantify forces that could potentially dislodge the prosthesis. Methods: A computational fluid dynamics model was developed to simulate systolic flow through a geometric mesh of the aortic root and transcatheter aortic valves. Hemodynamic measurements were made at discrete moments during ejection. Unsteady control volume analysis was used for calculations of force on the mesh. Results: Results of the simulation indicate that a total force of 0.602 N acts on the transcatheter aortic valves during systole, 99% of which is in the direction of axial flow. The largest contributor to force was the dynamic pressure gradient through the transcatheter aortic valves. This antegrade force is approximately 10 times smaller than the retrograde force (6.01 N) on the closed valve during diastole. Conclusion: Our model simulated systolic flow through a transcatheter aortic valve and demonstrated migration into the left ventricle to be of greater concern than antegrade ejection. C1 [Tseng, Elaine E.] UCSF Med Ctr, Div Cardiothorac Surg, Dept Surg, San Francisco, CA 94143 USA. [Dwyer, Harry A.] Univ Calif Davis, Dept Mech & Aeronaut Engn, Davis, CA 95616 USA. [Matthews, Peter B.; Azadani, Ali; Ge, Liang; Guy, T. Sloane; Tseng, Elaine E.] San Francisco VA Med Ctr, San Francisco, CA USA. RP Tseng, EE (reprint author), UCSF Med Ctr, Div Cardiothorac Surg, Dept Surg, 500 Parnassus Ave,Suite W405,Box 0118, San Francisco, CA 94143 USA. EM elaine.tseng@ucsfmedctr.org FU American Heart Association Beginning [0565148Y]; Northern California Institute for Research and Education FX This work was supported by the American Heart Association Beginning Grant-in-Aid 0565148Y (Burlingame, Calif) and the Northern California Institute for Research and Education (San Francisco, Calif). The authors have no financial conflicts of interest to disclose. NR 25 TC 22 Z9 22 U1 0 U2 4 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5223 J9 J THORAC CARDIOV SUR JI J. Thorac. Cardiovasc. Surg. PD NOV PY 2009 VL 138 IS 5 BP 1227 EP 1233 DI 10.1016/j.jtcvs.2009.02.057 PG 7 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 507RG UT WOS:000270871700026 PM 19748632 ER PT J AU Moreira, DM Presti, JC Aronson, WJ Terris, MK Kane, CJ Amling, CL Freedland, SJ AF Moreira, Daniel M. Presti, Joseph C., Jr. Aronson, William J. Terris, Martha K. Kane, Christopher J. Amling, Christopher L. Freedland, Stephen J. TI Natural History of Persistently Elevated Prostate Specific Antigen After Radical Prostatectomy: Results From the SEARCH Database SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; mortality; prostate-specific antigen; prostatectomy ID BIOCHEMICAL RECURRENCE; DOUBLING TIME; FREE SURVIVAL; CANCER; PSA; RISK; PROGRESSION; MORTALITY; PREDICTS; RELAPSE AB Purpose: We examined natural history, predictors of biochemical recurrence and all cause mortality in patients with persistently elevated prostate specific antigen after radical prostatectomy in the Shared Equal Access Regional Cancer Hospital cohort. Materials and Methods: We reviewed data on 1,156 men treated with radical prostatectomy after 1997. Prostate specific antigen persistence was defined as failure to achieve prostate specific antigen less than 0.03 ng/ml within 6 months postoperatively. Disease-free and overall survival was compared between men with and without persistence using the log rank test. Predictors of biochemical recurrence and all cause death were analyzed using the Cox model. Results: A total of 291 men (25%) had persistence, which was associated with increased biochemical recurrence and all cause death (p <0.001 and 0.041, respectively). In patients with persistence 1 and 5-year biochemical recurrence-free survival was 68% and 36%, significantly lower than 95% and 72%, respectively, in men without persistence. Ten-year overall survival in patients with vs without persistence was 63% vs 80%. In men with persistence independent predictors of prostate specific antigen recurrence were higher prostate specific antigen nadir (HR 2.19, p <0.001), positive surgical margins (HR 1.75, p = 0.022) and high pathological Gleason score (8-10 vs 2-6 HR 2.40, p = 0.026). Independent predictors of overall mortality were a higher prostate specific antigen nadir (HR 1.46, p = 0.013) and seminal vesicle invasion (HR 3.15, p = 0.047). Conclusions: Prostate specific antigen persistence is associated with increased biochemical recurrence and overall mortality. In men with persistence the prostate specific antigen nadir is an independent predictor of recurrence and mortality. Thus, prostate specific antigen persistence and nadir are important tools for early postoperative risk stratification. C1 [Freedland, Stephen J.] Duke Univ, Sch Med, Div Urol, Dept Pathol, Durham, NC 27710 USA. [Moreira, Daniel M.; Freedland, Stephen J.] Duke Univ, Sch Med, Div Urol Surg, Dept Surg, Durham, NC 27710 USA. [Moreira, Daniel M.; Freedland, Stephen J.] Duke Univ, Sch Med, Duke Prostate Ctr, Durham, NC 27710 USA. [Moreira, Daniel M.; Freedland, Stephen J.] Vet Affairs Med Ctr Durham, Urol Sect, Durham, NC USA. [Presti, Joseph C., Jr.; Aronson, William J.] Stanford Univ, Med Ctr, Dept Urol, Palo Alto, CA 94304 USA. [Presti, Joseph C., Jr.] Vet Affairs Med Ctr, Urol Sect, Dept Surg, Palo Alto, CA 94304 USA. [Aronson, William J.] Univ Calif Los Angeles, Med Ctr, Dept Surg, Urol Sect,W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90024 USA. [Aronson, William J.] Univ Calif Los Angeles, Med Ctr, Dept Urol, Los Angeles, CA 90024 USA. [Kane, Christopher J.] Univ Calif San Diego, Med Ctr, Dept Surg, Div Urol, San Diego, CA 92103 USA. [Terris, Martha K.] Vet Affairs Med Ctr, Urol Sect, Div Surg, Augusta, GA USA. [Terris, Martha K.] Med Coll Georgia, Dept Surg, Div Urol Surg, Augusta, GA 30912 USA. [Amling, Christopher L.] Univ Alabama, Dept Surg, Div Urol, Birmingham, AL 35294 USA. RP Freedland, SJ (reprint author), Duke Univ, Sch Med, Div Urol, Dept Pathol, Box 2626 DUMC, Durham, NC 27710 USA. EM steve.freedland@duke.edu OI Terris, Martha/0000-0002-3843-7270 FU Department of Veterans Affairs; National Institute of Health [R01CA100938]; National Institutes of Health Specialized Programs of Research Excellence [P50 CA92131-01A1]; Georgia Cancer Coalition (MKT); Department of Defense; Prostate Cancer Research Program (SJF); American Urological Association Foundation; Astellas Rising Star in Urology Award (SJF) FX Supported by Department of Veterans Affairs, National Institute of Health R01CA100938 WIN, National Institutes of Health Specialized Programs of Research Excellence Grant P50 CA92131-01A1 (WJA), Georgia Cancer Coalition (MKT), Department of Defense, Prostate Cancer Research Program (SJF) and American Urological Association Foundation/Astellas Rising Star in Urology Award (SJF). NR 18 TC 18 Z9 18 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD NOV PY 2009 VL 182 IS 5 BP 2250 EP 2255 DI 10.1016/j.juro.2009.07.022 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 506EO UT WOS:000270756900049 PM 19758614 ER PT J AU Bhoopalam, N Campbell, SC Moritz, T Broderick, WR Iyer, P Arcenas, AG Van Veldhuizen, PJ Friedman, N Reda, D Warren, S Garewal, H AF Bhoopalam, Nirmala Campbell, Steven C. Moritz, Thomas Broderick, William R. Iyer, Padmini Arcenas, Anthony G. Van Veldhuizen, Peter J. Friedman, Nicholas Reda, Domenic Warren, Stuart Garewal, Harinder TI Intravenous Zoledronic Acid to Prevent Osteoporosis in a Veteran Population With Multiple Risk Factors for Bone Loss on Androgen Deprivation Therapy SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; androgen antagonists; zoledronic acid; osteoporosis ID RANDOMIZED CONTROLLED-TRIAL; PROSTATE-CANCER; MINERAL DENSITY; CLINICAL FRACTURES; MEN; HEALTH AB Purpose: Androgen deprivation therapy for prostate cancer is associated with osteoporosis and increased fracture risk. Previous studies of zoledronic acid demonstrated bone loss prevention in patients initiating androgen deprivation therapy. There are limited data on patients on prolonged androgen deprivation therapy or in Veterans Affairs patients with multiple risk factors for osteoporosis. Methods: We randomized 93 patients with MO prostate cancer in this placebo controlled trial in the Veterans Affairs health care system. Preplanned strata included 50 patients on androgen deprivation therapy for less than 1 year (stratum 1) and 43 on androgen deprivation therapy for greater than 1 year (stratum 2). In each stratum patients were randomized to 4 mg zoledronic acid intravenously every 3 months for 4 treatments or intravenous placebo. The primary end point was the percent change in bone mineral density at the lumbar spine at 12 months. Results: Age, race, body mass index and osteoporosis risk factors were similar for the 2 treatments. Most patients were former smokers, had moderate alcohol intake, were not on calcium/vitamin D supplements and were relatively sedentary at baseline. In stratum 1 spine bone mineral density increased 5.95% in the zoledronic acid arm and decreased 3.23% in the placebo arm (p = 0.0044). In stratum 2 spine bone mineral density increased 6.08% in the zoledronic acid arm and only increased 1.57% in the placebo arm (p = 0.0005). Treatment was well tolerated with minimal impact on renal function. Conclusions: Zoledronic acid improved bone mineral density in patients with MO prostate cancer on androgen deprivation therapy for 1 year or less, or greater than 1 year. This finding indicates that bisphosphonate therapy remains effective when initiated later in the course of androgen deprivation therapy and is efficacious in Veterans Affairs patients with multiple risk factors for osteoporosis. C1 [Bhoopalam, Nirmala; Campbell, Steven C.; Moritz, Thomas; Broderick, William R.; Friedman, Nicholas; Reda, Domenic] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. [Iyer, Padmini] Vet Affairs Long Beach Healthcare Syst, Washington, DC USA. [Arcenas, Anthony G.] Vet Affairs Med Ctr, Washington, DC 20422 USA. [Van Veldhuizen, Peter J.] Kansas City Vet Affairs, Kansas City, MO USA. [Warren, Stuart] Cooperat Studies Clin Res Pharm Coordinating Ctr, Albuquerque, NM USA. [Garewal, Harinder] So Arizona Vet Affairs Healthcare Syst, Tucson, AZ USA. RP Bhoopalam, N (reprint author), Loyola Univ Chicago, Edward Hines Vet Affairs Hosp, Stritch Sch Med, Bldg 200,Room 910,5000 S 5th Ave, Hines, IL 60141 USA. EM nirmala.bhoopalam@va.gov FU Novartis Pharmaceutical Corp., East Hanover, New Jersey FX Supported by a grant from Novartis Pharmaceutical Corp., East Hanover, New Jersey. NR 24 TC 29 Z9 29 U1 0 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD NOV PY 2009 VL 182 IS 5 BP 2257 EP 2264 DI 10.1016/j.juro.2009.07.046 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 506EO UT WOS:000270756900052 PM 19758618 ER PT J AU Hirata, H Kawamoto, K Kikuno, N Kawakami, T Kawakami, K Saini, S Yamamura, S Dahiya, R AF Hirata, Hiroshi Kawamoto, Ken Kikuno, Nobuyuki Kawakami, Toshifumi Kawakami, Kazumori Saini, Sharanjot Yamamura, Soichiro Dahiya, Rajvir TI Restoring Erectile Function by Antioxidant Therapy in Diabetic Rats SO JOURNAL OF UROLOGY LA English DT Article DE penis; diabetes mellitus; gene expression; tempol; insulin ID OXIDATIVE STRESS; DYSFUNCTION; APOPTOSIS; IMPACT; PENIS; EXPRESSION; PROTEIN; MUSCLE; INJURY AB Purpose: Diabetes mediates an increase in reactive oxygen species that can lead to impaired endothelial function, decreased smooth muscle in the diabetic corpus cavernosum and increased apoptosis. We hypothesized that antioxidant therapy may restore erectile function by inhibiting apoptosis in diabetic rat crura. Materials and Methods: A total of 40 male Sprague-Dawley rats were randomized to 5 groups of 8 each, including healthy controls, rats with diabetes, and rats with diabetes with the antioxidant tempol. (4-hydroxytetramethyl-piperidine-1-oxyl) (Sigma-Aldrich (R)), with insulin, and with tempol and insulin. Intracavernous pressure was measured for functional analysis. Smooth muscle and collagen fiber levels in the rat penile corpus cavernosum were assessed by hematoxylin and eosin, and Masson's trichrome staining. Endothelial cells were assessed by CD31 staining. Reactive oxygen species related genes were analyzed by cDNA microarray. We confirmed mRNA and protein expression profiles for these genes in diabetic and treated rats using real-time reverse transcriptase-polymerase chain reaction and immunohistochemistry. TUNEL assay was done to analyze apoptosis status. Results: Intracavernous pressure in diabetic rats was significantly decreased vs controls. After treatment with tempol or insulin alone intracavernous pressure was significantly increased compared to that in untreated diabetic rats. In the diabetic group mean smooth muscle area significantly decreased but was restored after combined tempol and insulin. Endothelial cell area in diabetic rats significantly decreased and was not restored by any treatments. However, apoptosis was restored to normal by combined insulin and tempol. Of 84 reactive oxidative stress and antioxidant genes 32 were identified specific to diabetic rats compared to healthy controls. UCP3 expression was significantly increased in diabetic rats and normal levels were restored by all treatments. Conclusions: To our knowledge this is the first report that tempol and insulin can restore erectile function in diabetic rats by inhibiting apoptosis. C1 San Francisco VA Med Ctr, Dept Urol, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94121 USA. RP Dahiya, R (reprint author), Vet Affairs Med Ctr, Urol Res Ctr, 112F,4150 Clement St, San Francisco, CA 94121 USA. EM rdahiya@urology.ucsf.edu FU NIDDK NIH HHS [R01DK075524] NR 21 TC 15 Z9 20 U1 0 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD NOV PY 2009 VL 182 IS 5 BP 2518 EP 2525 DI 10.1016/j.juro.2009.07.009 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 506EO UT WOS:000270756900142 PM 19765757 ER PT J AU Groeneveld, PW Yang, L Greenhut, A Yang, FF AF Groeneveld, Peter W. Yang, Lin Greenhut, Alexis Yang, Feifei TI Comparative effectiveness of carotid arterial stenting versus endarterectomy SO JOURNAL OF VASCULAR SURGERY LA English DT Article ID HIGH-RISK PATIENTS; RANDOMIZED-TRIAL; CLINICAL-TRIAL; STENOSIS AB Background Carotid arterial stent (CAS) systems are an alterative to carotid endarterectomy for the treatment of moderate to severe carotid stenosis, but the effectiveness of CAS compared to endarterectomy in preventing stroke and death is uncertain. This study's objective was to compare the clinical outcomes among Medicare beneficiaries undergoing carotid revascularization before and after CAS became widely available. Objectives. This observational, retrospective cohort study compared 46,784 patients undergoing carotid revascularization from August 2005-March 2006 (the coverage era) to propensity-score-matched patients undergoing carotid revascularization between October 2002-September 2004 (the pre-coverage era), before widespread Medicare coverage of CAS. Methods. Mortality was compared at 90 and 270 days after revascularization, as were the combined outcomes of periprocedural acute myocardial infarction and any stroke or death within 90 and 270 days after revascularization, between the two eras. Comparisons were also made between localities with high (23% of carotid procedures being CAS) and lower (9% of carotid procedures being CAS) adoption rates of carotid stents during the coverage era. Results: There were no significant differences in 90-day mortality (2.2% vs; 2.2%; P = .79), 90-day combined outcomes (4.5% vs 4.3%; P = .13), or 270-day mortality (4.8% vs 4.6%; P = .17) between the coverage and pre-coverage eras, but there were more 270-day combined outcomes in the coverage era (7.7% vs 7.3%; P = .03). In localities with higher adoption of carotid stents, there was higher 90-day mortality (adjusted odds ratio [OR] 1.15; P = .16), 90-day combined outcomes (OR = 1.17; P = .03), 270-day mortality (OR = 1.13; P = .07), and 270-day combined outcomes (OR = 1.10; P = .09) in the coverage era. There were no differences in event rates between eras in areas with lower carotid stent adoption. Conclusion: The adoption of carotid stents for treatment of carotid stenosis was associated with increased rates of adverse clinical outcomes after carotid revascularization. (J Vasc Surg 2009;50:1040-8.) C1 [Groeneveld, Peter W.] Philadelphia Vet Affairs Med Ctr, Dept Med, Philadelphia, PA USA. [Groeneveld, Peter W.; Yang, Lin; Greenhut, Alexis; Yang, Feifei] Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. [Groeneveld, Peter W.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Groeneveld, PW (reprint author), 1229 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM peter.groeneveld@va.gov FU NHLBI NIH HHS [1-R01-HL086919, R01 HL086919, R01 HL086919-02] NR 22 TC 10 Z9 10 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD NOV PY 2009 VL 50 IS 5 BP 1040 EP 1048 DI 10.1016/j.jvs.2009.05.054 PG 9 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 514JL UT WOS:000271390300011 PM 19628358 ER PT J AU Galofre, JC Davies, TF AF Galofre, Juan C. Davies, Terry F. TI Autoimmune Thyroid Disease in Pregnancy: A Review SO JOURNAL OF WOMENS HEALTH LA English DT Review ID SUBCLINICAL HYPOTHYROIDISM; ENDOCRINE-SOCIETY; LEVOTHYROXINE REQUIREMENTS; CLINICAL ENDOCRINOLOGISTS; AMERICAN ASSOCIATION; FETAL MICROCHIMERISM; JOINT STATEMENT; DYSFUNCTION; MANAGEMENT; WOMEN AB The maternal physiological changes that occur in normal pregnancy induce complex endocrine and immune responses. During a normal pregnancy, thyroid gland volume may enlarge, and thyroid hormone production increases. Hence, the interpretation of thyroid function during gestation needs to be adjusted according to pregnancy-specific ranges. The elevated prevalence of gestation-related thyroid disorders (10%-15%) and the important repercussions for both mother and fetus reported in multiple studies throughout the world denote, in our opinion, the necessity for routine thyroid function screening both before and during pregnancy. Once thyroid dysfunction is suspected or confirmed, management of the thyroid disorder necessitates regular monitoring in order to ensure a successful outcome. The aim of treating hyperthyroidism in pregnancy with antithyroid drugs is to maintain serum thyroxine (T-4) in the upper normal range of the assay used with the lowest possible dose of drug, whereas in hypothyroidism, the goal is to return serum thyroid-stimulating hormone (TSH) to the range between 0.5 and 2.5mU/L. C1 [Galofre, Juan C.; Davies, Terry F.] Mt Sinai Hosp, Mt Sinai Sch Med, Thyroid Res Unit, New York, NY 10029 USA. [Galofre, Juan C.; Davies, Terry F.] James J Peters VA Med Ctr, New York, NY 10029 USA. [Galofre, Juan C.] Univ Navarra, Dept Endocrinol & Nutr, Clin Univ, E-31080 Pamplona, Spain. RP Davies, TF (reprint author), Mt Sinai Med Ctr, Box 1055,1 Gustave L Levy Pl, New York, NY 10029 USA. EM terry.davies@mssm.edu NR 74 TC 15 Z9 15 U1 0 U2 2 PU MARY ANN LIEBERT, INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1540-9996 EI 1931-843X J9 J WOMENS HEALTH JI J. Womens Health PD NOV PY 2009 VL 18 IS 11 BP 1847 EP 1856 DI 10.1089/jwh.2008.1234 PG 10 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 525XH UT WOS:000272250500017 PM 19951221 ER PT J AU VanSwearingen, JM Perera, S Brach, JS Cham, R Rosano, C Studenski, SA AF VanSwearingen, Jessie M. Perera, Subashan Brach, Jennifer S. Cham, Rakie Rosano, Caterina Studenski, Stephanie A. TI A Randomized Trial of Two Forms of Therapeutic Activity to Improve Walking: Effect on the Energy Cost of Walking SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article DE Exercise; Gait; Energy cost ID DWELLING OLDER-ADULTS; HEMIPARETIC STROKE PATIENTS; LOWER-EXTREMITY FUNCTION; STEP WIDTH VARIABILITY; PHYSICAL PERFORMANCE; GAIT VARIABILITY; AEROBIC EXERCISE; FALL RISK; METABOLIC COST; HEART-RATE AB Background. Therapeutic activities to improve mobility often include walking practice and exercises to improve deficits in endurance, strength. and balance. Because walking may also be energy inefficient in people with decreased mobility, another approach is to reduce energy cost by improving timing and coordination (TC) of movement. Methods. This pilot randomized trial of older adults with slow and variable gait offered two types of therapeutic activity over 12 weeks. One addressed Walking, Endurance, Balance, and Strength (WEBS) and the other focused on TC. Outcomes were energy cost of walking and measures of mobility. Results. Of 50 participants (mean age. 77.2 +/- 5.5 years, 65% women). 47 completed the study. Baseline gait speed was 0.85 +/- 0.13 m/s and energy cost of walking was 0.30 +/- 0.10 mL/kg/m, nearly twice normal. Both interventions increased gait speed (TC by 0.21 m/s and WEBS by 0.14 m/s, p < .001). TC reduced the energy cost of walking 0.10 +/- 0.03 mL/kg/m more than WEBS (p < .001) and reduced the modified Gait Abnormalities Rating Scale 1.5 +/- 0.6 more points than WEBS (p < .05). TC had a 9.8 +/- 3.5 points greater gain than WEBS in self-reported confidence in walking (p < .01). Conclusions. In older adults with slow and variable gait, activity focused on TC reduced the energy cost of walking and improved confidence in walking more than WEBS while generating at least equivalent gains in mobility. To optimize mobility, future larger studies should assess various combinations of TC and WEBS over longer periods of time. C1 [VanSwearingen, Jessie M.; Brach, Jennifer S.] Univ Pittsburgh, Dept Phys Therapy, Sch Hlth & Rehabil Sci, Pittsburgh, PA 15260 USA. [Perera, Subashan; Studenski, Stephanie A.] Univ Pittsburgh, Sch Med, Dept Med, Div Geriatr Med, Pittsburgh, PA 15260 USA. [Cham, Rakie] Univ Pittsburgh, Sch Engn, Dept Bioengn, Pittsburgh, PA 15260 USA. [Rosano, Caterina] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15260 USA. [Studenski, Stephanie A.] VA Pittsburgh Healthcare Syst, GRECC, Pittsburgh, PA USA. RP VanSwearingen, JM (reprint author), Univ Pittsburgh, Dept Phys Therapy, Sch Hlth & Rehabil Sci, 6035 Forbes Tower, Pittsburgh, PA 15260 USA. EM jessievs@pitt.edu RI Perera, Subashan/D-7603-2014 FU NIA NIH HHS [1 K23 AG026766-01, 1 P30 AG024827, AG023641, P30 AG024827] NR 84 TC 37 Z9 37 U1 7 U2 12 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD NOV PY 2009 VL 64 IS 11 BP 1190 EP 1198 DI 10.1093/gerona/glp098 PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 509UU UT WOS:000271044900015 PM 19643842 ER PT J AU Johansen, KL Zhang, R Huang, YJ Chen, SC Blagg, CR Goldfarb-Rumyantzev, AS Hoy, CD Lockridge, RS Miller, BW Eggers, PW Kutner, NG AF Johansen, Kirsten L. Zhang, Rebecca Huang, Yijian Chen, Shu-Cheng Blagg, Christopher R. Goldfarb-Rumyantzev, Alexander S. Hoy, Chistopher D. Lockridge, Robert S., Jr. Miller, Brent W. Eggers, Paul W. Kutner, Nancy G. TI Survival and hospitalization among patients using nocturnal and short daily compared to conventional hemodialysis: a USRDS study SO KIDNEY INTERNATIONAL LA English DT Article DE daily hemodialysis; hospitalization; survival; USRDS ID LEFT-VENTRICULAR HYPERTROPHY; QUALITY-OF-LIFE; IN-CENTER HEMODIALYSIS; VASCULAR ACCESS; HOME HEMODIALYSIS; DAILY DIALYSIS; LONG-TERM; COST; MORTALITY; TRIAL AB We estimated the survival and hospitalization among frequent hemodialysis users in comparison to those patients undergoing thrice-weekly conventional hemodialysis. All patients had similar characteristics and medical histories. In this cohort study of frequent hemodialysis users and propensity score-matched controls, the collaborating clinicians identified 94 patients who used nocturnal hermodialysis (NHD) and 43 patients who used short-duration daily hemodialysis (SDHD) for a minimum of 60 days. Ten propensity score-matched control patients for each NHD and SDHD patient were identified from the United States Renal Data System database. Primary outcomes were risk for all-cause mortality and risk for the composite outcome of mortality or major morbid event (acute myocardial infarction or stroke) estimated using Cox proportional hazards models. Risks for all-cause, cardiovascular-related, infection-related, and vascular access-related hospital admissions were also studied. Nocturnal hemodialysis was associated with significant reductions in mortality risk and risk for mortality or major morbid event when compared to conventional hemodialysis. There was a reduced but non-significant risk of death for patients using SDHD compared to controls. All-cause and specific hospitalizations did not differ significantly between NHD and SDHD patients and their matched control cohorts. Our study suggests that NHD may improve patient survival. Kidney International (2009) 76, 984-990; doi:10.1038/ki.2009.291; published online 19 August 2009 C1 [Kutner, Nancy G.] Emory Univ, Dept Rehabil Med, USRDS Rehabil QoL Special Studies Ctr, Atlanta, GA 30322 USA. [Johansen, Kirsten L.] Univ Calif San Francisco, Nephrol Sect, San Francisco VA Med Ctr, San Francisco, CA 94143 USA. [Johansen, Kirsten L.] Univ Calif San Francisco, Div Nephrol, San Francisco, CA 94143 USA. [Chen, Shu-Cheng] USRDS Coordinating Ctr, Minneapolis, MN USA. [Blagg, Christopher R.] NW Kidney Ctr, Seattle, WA USA. [Goldfarb-Rumyantzev, Alexander S.] Harvard Univ, Sch Med, Boston, MA USA. [Hoy, Chistopher D.] Rubin Dialysis Ctr, Saratoga Springs, NY USA. [Lockridge, Robert S., Jr.] Lynchburg Nephrol Dialysis, Lynchburg, VA USA. [Miller, Brent W.] Washington Univ, Sch Med, St Louis, MO USA. [Eggers, Paul W.] NIDDK, NIH, Bethesda, MD USA. RP Kutner, NG (reprint author), Emory Univ, Dept Rehabil Med, USRDS Rehabil QoL Special Studies Ctr, 1441 Clifton Rd NE, Atlanta, GA 30322 USA. EM nkutner@emory.edu FU National Institutes of Health [N01-DK-1-2471, HHSN267200715004C] FX This study was supported by the National Institutes of Health contracts N01-DK-1-2471 and HHSN267200715004C, ADB No. N01-DK-7-5004. The interpretation and reporting of the data presented here are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the United States government. An abstract was presented in poster form at the annual meeting of the American Society of Nephrology; 3 November 2007, San Francisco, CA, USA. NR 37 TC 101 Z9 101 U1 0 U2 2 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD NOV PY 2009 VL 76 IS 9 BP 984 EP 990 DI 10.1038/ki.2009.291 PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 507LC UT WOS:000270853800011 PM 19692997 ER PT J AU Gariti, KO Sadeghi, L Joisa, SD Holmes, WC AF Gariti, Katherine O. Sadeghi, Leila Joisa, Sowmya D. Holmes, William C. TI Veterans' Distress Related to Participation in a Study About Detainee Abuse SO MILITARY MEDICINE LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER; TRAUMA-FOCUSED RESEARCH; RISK-FACTORS; LOCUS; BENEFITS AB Unintended consequences of participating in research studies are not well characterized, particularly in veterans who are frequent study participants. Our objective, then, was to assess the rate of and variables associated with distress resulting from veterans' participation in a study on a sensitive subject. Veterans Administration (VA) hospital outpatients were administered questionnaires with three increasingly severe scenarios of a U.S. soldier abusing a detainee. Distress-upset requiring clinical intervention-was assessed, as were sociodemographic characteristics, post-traumatic stress disorder (PTSD), depression, and locus of control (LOC). Three hundred fifty-one veterans participated. Forty-three (12%) became distressed. Modeling indicated distress was associated with minority status (odds ratio [OR] = 5.72, 95% confidence interval [CI] = 1.59, 20.58), PTSD (OR = 2.66, 95% CI = 1.12, 6.29), and external LOC (OR = 6.27, 95% CI = 2.82, 13.90). Distress related to study participation was high in this veteran sample. Higher rates in some subgroups suggested that some individuals may not be able to accurately anticipate risk for harm in sensitive studies. C1 [Gariti, Katherine O.] Philadelphia Vet Affairs Med Ctr, Mental Hlth Clin, Philadelphia, PA 19104 USA. [Sadeghi, Leila] NYU Langone Med Ctr, Dept Pediat, New York, NY 10016 USA. [Joisa, Sowmya D.] Good Samaritan Hosp, Lebanon, PA 17042 USA. [Holmes, William C.] Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. RP Gariti, KO (reprint author), Philadelphia Vet Affairs Med Ctr, Mental Hlth Clin, Univ & Woodland Ave, Philadelphia, PA 19104 USA. NR 17 TC 1 Z9 1 U1 1 U2 1 PU ASSOC MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 EI 1930-613X J9 MIL MED JI Milit. Med. PD NOV PY 2009 VL 174 IS 11 BP 1149 EP 1154 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 601LL UT WOS:000278060900005 PM 19960821 ER PT J AU Nath, SD He, X Voruganti, VS Blangero, J MacCluer, JW Comuzzie, AG Arar, NH Abboud, HE Thameem, F AF Nath, Subrata D. He, Xin Voruganti, V. Saroja Blangero, John MacCluer, Jean W. Comuzzie, Anthony G. Arar, Nedal H. Abboud, Hanna E. Thameem, Farook TI The 27-bp repeat polymorphism in intron 4 (27 bp-VNTR) of endothelial nitric oxide synthase (eNOS) gene is associated with albumin to creatinine ratio in Mexican Americans SO MOLECULAR AND CELLULAR BIOCHEMISTRY LA English DT Article DE eNOS; Genetic polymorphisms; Association analyses; ACR; Triglycerides; Mexican Americans ID GLOMERULAR-FILTRATION-RATE; WIDE LINKAGE SCANS; TRANSMISSION DISEQUILIBRIUM; DIABETIC-NEPHROPATHY; RISK-FACTORS; DISEASE; KIDNEY; ECNOS; GENOTYPE; REGION AB The T-786C, Glu298Asp, and 27 bp variable number of tandem repeats (27 bp-VNTR-a/b) polymorphsims of the endothelial nitric oxide synthase (eNOS) gene are thought to alter nitric oxide production and contribute to the development of vascular and renal disease risk. The objective of this study is to investigate whether these three polymorphisms examined previously by others are associated with cardiovascular and renal disease risk in Mexican Americans. Study participants (N = 848; 21 families) were genotyped for T-786C, Glu298Asp, and 27 bp-VNTR-a/b polymorphisms by PCR followed by restriction digestion. Association analyses were performed by a measured genotype approach implemented in the program SOLAR. Of the phenotypes (type 2 diabetes, hypertension, body mass index, waist circumference, total cholesterol, high density lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure, albumin to creatinine ratio (ACR), and estimated glomerular filtration rate) examined for association, the 27 bp-VNTR-a/b variant exhibited statistically significant association with ACR (P = 0.047) after accounting for the trait specific covariate effects. In addition, the promoter variant (T-786C) showed a significant association with triglycerides (P = 0.034) after accounting for covariate influences. In conclusion, the present study adds evidence to the role of eNOS candidate gene polymorphisms in modulating the risk factors related to cardiovascular-renal disease in Mexican Americans although the magnitude of the genetic effect is small. C1 [Nath, Subrata D.; He, Xin; Arar, Nedal H.; Abboud, Hanna E.; Thameem, Farook] Univ Texas Hlth Sci Ctr San Antonio, Div Nephrol, Dept Med, San Antonio, TX 78229 USA. [Arar, Nedal H.; Abboud, Hanna E.] S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. [Voruganti, V. Saroja; Blangero, John; MacCluer, Jean W.; Comuzzie, Anthony G.] SW Fdn Biomed Res, Dept Genet, San Antonio, TX 78227 USA. RP Thameem, F (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Div Nephrol, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM thameem@uthscsa.edu FU American Heart Association; Carl W. Gottschalk Research Scholars of the American Society of Nephrology; George O'Brien Kidney Research Center [P50 DK061597]; Satellite Healthcare; San Antonio Area Foundation; NIH [P01 HL45522]; National Center for Research Resources [UL1 RR025767, KL2 RR025766]; [R01 MH59490] FX We thank the members of SAFHS for their participation and cooperation. This study was supported by the Grant-in-Aid from the American Heart Association (FT), Carl W. Gottschalk Research Scholars of the American Society of Nephrology (FT), George O'Brien Kidney Research Center (P50 DK061597; HEA, FT), Norman S. Coplan grant from the Satellite Healthcare (FT), San Antonio Area Foundation (FT), VA-MERIT Review (HEA, NHA). The SAFHS is supported by NIH grant P01 HL45522. The development of SOLAR was supported by R01 MH59490. This work was supported by the National Center for Research Resources contracts UL1 RR025767 and KL2 RR025766 for the Institute for Integration of Medicine and Science. NR 29 TC 9 Z9 10 U1 0 U2 1 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0300-8177 J9 MOL CELL BIOCHEM JI Mol. Cell. Biochem. PD NOV PY 2009 VL 331 IS 1-2 BP 201 EP 205 DI 10.1007/s11010-009-0159-5 PG 5 WC Cell Biology SC Cell Biology GA 513FN UT WOS:000271308000023 PM 19468830 ER PT J AU Jha, AR Pillai, SK York, VA Sharp, ER Storm, EC Wachter, DJ Martin, JN Deeks, SG Rosenberg, MG Nixon, DF Garrison, KE AF Jha, Aashish R. Pillai, Satish K. York, Vanessa A. Sharp, Elizabeth R. Storm, Emily C. Wachter, Douglas J. Martin, Jeffrey N. Deeks, Steven G. Rosenberg, Michael G. Nixon, Douglas F. Garrison, Keith E. TI Cross-Sectional Dating of Novel Haplotypes of HERV-K 113 and HERV-K 115 Indicate These Proviruses Originated in Africa before Homo sapiens SO MOLECULAR BIOLOGY AND EVOLUTION LA English DT Article DE insertion frequencies; haplotype; HERV-K113 and HERV-K115; hervotype; human evolution; Homo erectus ID ENDOGENOUS RETROVIRUS FAMILY; BREAST-CANCER PATIENTS; INSERTIONAL POLYMORPHISMS; REVERSE-TRANSCRIPTASE; EVOLUTIONARY DYNAMICS; RHEUMATOID-ARTHRITIS; SUBSTITUTION RATES; HUMAN-POPULATIONS; MOLECULAR CLOCK; MIDDLE-AWASH AB The human genome, human endogenous retroviruses (HERV), of which HERV-K 113 and HERV-K 115 are the only known full-length proviruses that are insertionally polymorphic. Although a handful of previously published papers have documented their prevalence in the global population; to date, there has been no report on their prevalence in the United States population. Here, we studied the geographic distribution of K113 and K115 among 156 HIV-1+ subjects from the United States, including African Americans, Hispanics, and Caucasians. In the individuals studied, we found higher insertion frequencies of K113 (21%) and K115 (35%) in African Americans compared with Caucasians (K113 9% and K115 6%) within the United States. We also report the presence of three single nucleotide polymorphism sites in the K113 5' long terminal repeats (LTRs) and four in the K115 5' LTR that together constituted four haplotypes for K113 Lind five haplotypes for K115. HERV insertion times can be estimated from the sequence differences between the 5' and 3' LTR of each insertion, but this dating method cannot be used with HERV-K115. We developed a method to estimate insertion times by applying coalescent inference to 5' LTR sequences within our study population and validated this approach using an independent estimate derived from the genetic distance between K113 5' and 3' LTR sequences. Using our method, we estimated the insertion dates of K113 and K115 to be it minimum of 800,000 and 1.1 million years ago, respectively. Both these insertion dates predate the emergence of anatomically modern Homo sapiens. C1 [Jha, Aashish R.; York, Vanessa A.; Sharp, Elizabeth R.; Storm, Emily C.; Wachter, Douglas J.; Nixon, Douglas F.; Garrison, Keith E.] Univ Calif San Francisco, Div Expt Med, San Francisco, CA 94143 USA. [Jha, Aashish R.] Univ Chicago, Dept Human Genet, Chicago, IL 60637 USA. [Pillai, Satish K.] Univ Calif San Francisco, Dept Med, San Francisco Vet Affairs Med Ctr, Div Infect Dis, San Francisco, CA USA. [Martin, Jeffrey N.; Deeks, Steven G.] Univ Calif San Francisco, Dept Med, Div HIV AIDS, San Francisco Gen Hosp, San Francisco, CA USA. [Rosenberg, Michael G.] Albert Einstein Coll Med, Jacobi Med Ctr, Bronx, NY 10467 USA. [Garrison, Keith E.] St Marys Coll, Moraga, CA 94575 USA. RP Jha, AR (reprint author), Univ Calif San Francisco, Div Expt Med, San Francisco, CA 94143 USA. EM nepaliaashish@gmail.com OI Nixon, Douglas/0000-0002-2801-1786 FU UCSF AIDS Research Institute; Pfizer, Inc.,; National Institutes of Health [1KO1DA024654, A176059]; University of California San Francisco AIDS Research Institute FX This study was conducted in part from funds from the UCSF AIDS Research Institute, a sponsored research agreement from Pfizer, Inc., and National Institutes of Health grants 1KO1DA024654 (S.K.P.) and A176059 (D.F.N.). This study was conducted in part from funds from the University of California San Francisco AIDS Research Institute, a sponsored research agreement from Pfizer, Inc., and National Institutes of Health grants 1KO1DA024654 (S.K.P.) and A176059 (D.F.N.). NR 48 TC 19 Z9 19 U1 0 U2 6 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0737-4038 J9 MOL BIOL EVOL JI Mol. Biol. Evol. PD NOV PY 2009 VL 26 IS 11 BP 2617 EP 2626 DI 10.1093/molbev/msp180 PG 10 WC Biochemistry & Molecular Biology; Evolutionary Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Evolutionary Biology; Genetics & Heredity GA 514UX UT WOS:000271422300020 PM 19666991 ER PT J AU Heinlen, LD McClain, MT Gross, T Anderson, J Pachner, A Harley, JB James, JA AF Heinlen, Latisha D. McClain, Micah T. Gross, Tim Anderson, Jourdan Pachner, Andrew Harley, John B. James, Judith A. TI Multiple sclerosis patients make antibodies against a unique sequence of EBNA-1 that cross reacts with myelin basic protein SO MULTIPLE SCLEROSIS LA English DT Meeting Abstract CT 14th Annual Meeting of the Americas-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis/Cons ortium-for-Multiple-Sclerosis-Centers CY MAY 27-30, 2009 CL Atlanta, GA SP Amer Comm Treatment & Res Multiple Sclerosis, Consortium Multiple Sclerosis Ctr C1 [Heinlen, Latisha D.; McClain, Micah T.; Gross, Tim; Anderson, Jourdan; James, Judith A.] Univ Oklahoma, Hlth Sci Ctr, Oklahoma Med Res Fdn, Dept Clin Immunol, Oklahoma City, OK USA. [Pachner, Andrew] Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Neurol & Neurosci, Newark, NJ 07103 USA. [Harley, John B.] Univ Oklahoma, Hlth Sci Ctr, Oklahoma Med Res Fdn, Dept Arthrit & Immunol,US Dept Vet Affairs, Oklahoma City, OK USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 1352-4585 J9 MULT SCLER JI Mult. Scler. PD NOV PY 2009 VL 15 IS 11 BP 1389 EP 1389 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 516IU UT WOS:000271536400027 ER PT J AU Ott, KM Haddock, KS Fox, SE Shinn, JK Walters, SE Hardin, JW Durand, K Harris, JL AF Ott, Karen M. Haddock, K. Sue Fox, Sandra E. Shinn, Julie K. Walters, Sandra E. Hardin, James W. Durand, Kerri Harris, James L. TI The Clinical Nurse Leader(SM): Impact On Practice Outcomes in the Veterans Health Administration SO NURSING ECONOMICS LA English DT Article ID HEART-FAILURE AB The Clinical Nurse Leader (CNL) role was designed to meet an identified need for expert clinical leadership at the point of care. The Veterans Health Administration (VHA) became early adopters of the CNL role, foreseeing the value of this pivotal clinical leader at the point of care to meet the complex health care needs of America's veterans and shape health care delivery. Impact data were collected and assimilated from seven Veterans Administration Medical Centers to support how CNLs impact the delivery of quality and safe patient care and how practice changes could be sustained. Data collection and analyses resulted in many lessons learned. The new CNL role was implemented in a variety of settings in the VHA system. Integration of the CNL role in all areas of practice in every care setting has the promise of streamlining coordination of care for veterans across all spectrums in the provision of care. C1 [Ott, Karen M.] Vet Hlth Adm, Natl CNL, Off Nursing Serv, Washington, DC USA. [Haddock, K. Sue] Vet Hlth Adm, CNL Evaluat Program, Off Nursing Serv, Washington, DC USA. [Haddock, K. Sue; Durand, Kerri] William Jennings Bryan Dorn VA Med Ctr, Columbia, SC USA. [Fox, Sandra E.] VA Tennessee Valley Healthcare Syst, Surg Serv, Nashville, TN USA. [Shinn, Julie K.] William S Middleton Mem Vet Adm Med Ctr, Inpatient Nursing Serv, Madison, WI USA. [Walters, Sandra E.] VA Tennessee Valley Healthcare Syst, Educ Affiliat & Res, Nashville, TN USA. [Hardin, James W.] Univ S Carolina, Biostat Collaborat Unit, Columbia, SC 29208 USA. [Hardin, James W.] Univ S Carolina, Dept Epidemiol & Biostat, Columbia, SC 29208 USA. RP Ott, KM (reprint author), Vet Hlth Adm, Natl CNL, Off Nursing Serv, Washington, DC USA. RI Hardin, James/Q-7617-2016 OI Hardin, James/0000-0003-0506-5500 NR 19 TC 13 Z9 13 U1 0 U2 5 PU JANNETTI PUBLICATIONS, INC PI PITMAN PA EAST HOLLY AVENUE, BOX 56, PITMAN, NJ 08071-0056 USA SN 0746-1739 J9 NURS ECON JI Nurs. Econ. PD NOV-DEC PY 2009 VL 27 IS 6 BP 363 EP + PG 9 WC Nursing SC Nursing GA 531KJ UT WOS:000272664600002 PM 20050486 ER PT J AU Kong, A Neuthouser, ML Xiao, LR Ulrich, CM McTiernan, A Foster-Schubert, KE AF Kong, Angela Neuthouser, Marian L. Xiao, Liren Ulrich, Cornelia M. McTiernan, Anne Foster-Schubert, Karen E. TI Higher habitual intake of dietary fat and carbohydrates are associated with lower leptin and higher ghrelin concentrations in overweight and obese postmenopausal women with elevated insulin levels SO NUTRITION RESEARCH LA English DT Article DE Ghrelin; Leptin; Insulin; Dietary carbohydrates; Dietary fats; Dietary habits; Obesity; Women ID INCREASES FOOD-INTAKE; PLASMA LEPTIN; CIRCULATING GHRELIN; BODY-WEIGHT; HEALTHY-MEN; GLUCOSE; SENSITIVITY; HUMANS; ENERGY; SECRETION AB A highly regulated homeostatic system governs body weight; however, it is possible that this system might be impaired by the sustained intake of highly palatable foods. Short-term feeding studies suggest that the appetite-stimulating hormone ghrelin is suppressed less effectively by dietary fat intake, and diets high in sucrose decrease levels of the adipose hormone leptin. We hypothesized that higher habitual intake of dietary fat and carbohydrate (CHO) would be associated with elevated concentrations of circulating plasma ghrelin and lower circulating leptin in humans, a hormonal profile that could promote weight gain. To test our hypothesis, we examined the cross-sectional associations of ghrelin and leptin with the habitual macronutrient intake of 165 healthy overweight and obese sedentary women and tested the modifying role of insulin in these associations. We observed a significant inverse association between leptin concentrations and percentage energy from CHO independent of body mass index, percentage body fat, age, and intraabdominal fat (beta = -0.11 P = .04). No significant associations were observed between ghrelin and macronutrients or their subtypes among the total cohort. Among women with insulin concentrations at or greater than the median, we found a statistically significant positive association between intake of saturated fat and ghrelin concentrations, as well as additional statistically significant associations between leptin concentrations and macronutrients not observed among the total cohort. Our results provide some evidence that diets higher in fat and CHO are associated with a hormonal profile (ie, lower leptin and higher ghrelin concentrations), which could enhance weight gain, particularly among individuals with higher circulating insulin concentrations. (C) 2009 Elsevier Inc. All rights reserved. C1 [Foster-Schubert, Karen E.] Univ Washington, Dept Med, Seattle, WA 98109 USA. [Foster-Schubert, Karen E.] VA Puget Sound Hlth Care Syst, Seattle, WA 98109 USA. [Kong, Angela; Foster-Schubert, Karen E.] Univ Washington, Nutr Sci Program, Seattle, WA 98109 USA. [Kong, Angela; Neuthouser, Marian L.; Xiao, Liren; Ulrich, Cornelia M.; McTiernan, Anne; Foster-Schubert, Karen E.] Fred Hutchinson Canc Res Ctr, Canc Prevent Program, Seattle, WA 98109 USA. RP Foster-Schubert, KE (reprint author), Univ Washington, Nutr Sci Program, Seattle, WA 98109 USA. EM kfoster@u.washington.edu FU Transdisciplinary Research in Energetics and Cancer [U54 CA116847]; National Cancer Institute [R25 CA94880, R01 CA69334]; National Center for Research Resources [5 KL2 RR025015-03] FX This study was supported by the Transdisciplinary Research in Energetics and Cancer (U54 CA116847), National Cancer Institute (Grant R25 CA94880), National Cancer Institute (R01 CA69334), and National Center for Research Resources (Grant 5 KL2 RR025015-03). NR 50 TC 13 Z9 13 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0271-5317 J9 NUTR RES JI Nutr. Res. PD NOV PY 2009 VL 29 IS 11 BP 768 EP 776 DI 10.1016/j.nutres.2009.10.013 PG 9 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 531KG UT WOS:000272664300003 PM 19932865 ER PT J AU Broughton, DE Beigi, RH Switzer, GE Raker, CA Anderson, BL AF Broughton, D. E. Beigi, R. H. Switzer, G. E. Raker, C. A. Anderson, B. L. TI Obstetric Health Care Workers' Attitudes and Beliefs Regarding Influenza Vaccination in Pregnancy SO OBSTETRICS AND GYNECOLOGY LA English DT Article ID WOMEN; IMMUNIZATION; KNOWLEDGE AB OBJECTIVE: To explore obstetric health care workers' attitudes and beliefs regarding influenza vaccination in pregnancy. METHODS: A survey consisting of 16 multiple-choice questions was administered to nurses, medical and nursing assistants, receptionists, and clinical administrators in obstetric settings. Survey questions addressed general knowledge of influenza and recommendations for vaccination during pregnancy, as well as personal beliefs about the acceptability of the vaccine in the pregnant population. The study was conducted at two sites, Women & Infants Hospital in Providence, III, and Magee-Women's Hospital in Pittsburgh, PA. Variables were compared by Fisher exact test. RESULTS: Two hundred sixty-seven completed surveys were available for analysis, with a completion rate of 85%. Almost one third of health care workers surveyed do not believe that vaccines are a safe and effective way to decrease infections (31%) and a minority believe that vaccines are safe in pregnancy (36%). just over half of health care workers know that pregnant women are at increased risk of complications from the flu (56.6%). Only 46% were able to correctly identify influenza symptoms, and only 65% would recommend influenza vaccination to a pregnant woman if indicated. A small percentage would be willing to give an avian influenza vaccine to pregnant women during a pandemic if it had not been tested in pregnancy (12.3%). CONCLUSION: Many obstetric health care workers lack knowledge regarding the safety and importance of influenza vaccination during pregnancy. Misinformed or inadequately informed health care workers may represent a barrier to influenza vaccine coverage of pregnant women. This lack of knowledge among the health care workforce takes on added importance in the setting of the H1N1 2009 swine-origin influenza pandemic. (Obstet Gynecol 2009,114:981-7) C1 [Broughton, D. E.] Brown Univ, Women & Infants Hosp, Alpert Med Sch, Dept Obstet & Gynecol, Providence, RI 02912 USA. Univ Pittsburgh, Dept Obstet Gynecol & Reprod Sci, Pittsburgh, PA USA. Magee Womens Hosp, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Ctr Hlth Equ & Promot, VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Broughton, DE (reprint author), Brown Univ, Alpert Med Sch, MS3,Box 8191,75 Waterman St, Providence, RI 02912 USA. EM darcy.e.broughton@gmail.com FU Alpert Medical School Scholarly Concentration in Women's Reproductive Health, Freedom Rights; Brown University Women's Reproductive Health Research scholar program [5K12-HD050108-04]; Department of Obstetrics, Gynecolog and Reproductive Sciences; Magee-Women's Hospital of the University of Pittsburgh Medical Center FX 1) Alpert Medical School Scholarly Concentration in Women's Reproductive Health, Freedom & Rights; 2) Brown University Women's Reproductive Health Research scholar program, 5K12-HD050108-04; and 3) Departmental funding. Department of Obstetrics, Gynecolog and Reproductive Sciences, Magee-Women's Hospital of the University of Pittsburgh Medical Center NR 16 TC 39 Z9 41 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD NOV PY 2009 VL 114 IS 5 BP 981 EP 987 PG 7 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 513AH UT WOS:000271293500004 PM 20168097 ER PT J AU Gangaputra, S Newcomb, CW Liesegang, TL Kacmaz, RO Jabs, DA Levy-Clarke, GA Nussenblatt, RB Rosenbaum, JT Suhler, EB Thorne, JE Foster, CS Kempen, JH AF Gangaputra, Sapna Newcomb, Craig W. Liesegang, Teresa L. Kacmaz, R. Oktay Jabs, Douglas A. Levy-Clarke, Grace A. Nussenblatt, Robert B. Rosenbaum, James T. Suhler, Eric B. Thorne, Jennifer E. Foster, C. Stephen Kempen, John H. CA Systemic Immunosuppressive Therapy TI Methotrexate for Ocular Inflammatory Diseases SO OPHTHALMOLOGY LA English DT Article ID LOW-DOSE METHOTREXATE; JUVENILE RHEUMATOID-ARTHRITIS; CORTICOSTEROID-SPARING THERAPY; IDIOPATHIC ARTHRITIS; IMMUNOSUPPRESSIVE THERAPY; INDUCED PNEUMONITIS; INTRAOCULAR LEVELS; OPTIC NEUROPATHY; CHRONIC UVEITIS; TOXICITY AB Purpose: To evaluate the outcome of treatment with methotrexate for noninfectious ocular inflammation. Design: Retrospective cohort study. Participants: Patients with noninfectious ocular inflammation managed at 4 tertiary ocular inflammation clinics in the United States observed to add methotrexate as a single, noncorticosteroid immunosuppressive agent to their treatment regimen, between 1979 and 2007, inclusive. Methods: Participants were identified from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study. Demographic and clinical characteristics, including dosage, route of administration of methotrexate, and main outcome measures, were obtained for every eye of every patient at every visit via medical record review by trained expert reviewers. Main Outcome Measures: Control of inflammation, corticosteroid-sparing effects, and incidence of and reason for discontinuation of therapy. Results: Among 384 patients (639 eyes) observed from the point of addition of methotrexate to an anti-inflammatory regimen, 32.8%, 9.9%, 21.4%, 14.6%, 15.1%, and 6.3%, respectively, had anterior uveitis, intermediate uveitis, posterior or panuveitis, scleritis, ocular mucous membrane pemphigoid, and other forms of ocular inflammation. In these groups, complete suppression of inflammation sustained for 28 days was achieved within 6 months in 55.6%, 47.4%, 38.6%, 56.4%, 39.5%, and 76.7%, respectively. Corticosteroid-sparing success (sustained suppression of inflammation with prednisone <= 10 mg/d) was achieved within 6 months among 46.1%, 41.3%, 20.7%, 37.3%, 36.5%, and 50.9%, respectively. Overall, success within 12 months was 66% and 58.4% for sustained control and corticosteroid sparing (<= 10 mg), respectively. Methotrexate was discontinued within 1 year by 42% of patients. It was discontinued owing to ineffectiveness in 50 patients (13%); 60 patients (16%) discontinued because of side effects, which typically were reversible with dose reduction or discontinuation. Remission was seen in 43 patients, with 7.7% remitting within 1 year of treatment. Conclusions: Our data suggest that adding methotrexate to an anti-inflammatory regimen not involving other noncorticosteroid immunosuppressive drugs is moderately effective for management of inflammatory activity and for achieving corticosteroid-sparing objectives, although many months may be required for therapeutic success. Methotrexate was well tolerated by most patients, and seems to convey little risk of serious side effects during treatment. Financial Disclosure(s): The authors have no proprietary or commercial interests in any of the materials discussed in this article. Ophthalmology 2009,116:2188-2198 (C) 2009 by the American Academy of Ophthalmology. C1 [Kempen, John H.] Univ Penn, Dept Ophthalmol, Ctr Prevent Ophthalmol & Biostat, Philadelphia, PA 19104 USA. [Gangaputra, Sapna] Univ Wisconsin, Dept Ophthalmol, Fundus Photograph Reading Ctr, Madison, WI USA. [Gangaputra, Sapna; Jabs, Douglas A.; Thorne, Jennifer E.] Johns Hopkins Univ, Dept Ophthalmol, Baltimore, MD USA. [Jabs, Douglas A.; Thorne, Jennifer E.] Johns Hopkins Univ, Dept Epidemiol, Baltimore, MD USA. [Newcomb, Craig W.; Kempen, John H.] Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. [Newcomb, Craig W.; Kempen, John H.] Univ Penn, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. [Liesegang, Teresa L.; Rosenbaum, James T.; Suhler, Eric B.] Oregon Hlth & Sci Univ, Dept Ophthalmol, Portland, OR 97201 USA. [Rosenbaum, James T.] Oregon Hlth & Sci Univ, Dept Med, Portland, OR 97201 USA. [Kacmaz, R. Oktay; Foster, C. Stephen] Massachusetts Eye Res & Surg Inst, Cambridge, MA USA. [Kacmaz, R. Oktay; Jabs, Douglas A.] Mt Sinai Sch Med, Dept Ophthalmol, New York, NY USA. [Levy-Clarke, Grace A.] St Lukes Cataract & Laser Inst, Tarpon Springs, FL USA. [Levy-Clarke, Grace A.; Nussenblatt, Robert B.] NEI, Immunol Lab, Bethesda, MD 20892 USA. [Suhler, Eric B.] Portland VA Med Ctr, Portland, OR USA. [Foster, C. Stephen] Harvard Univ, Sch Med, Dept Ophthalmol, Boston, MA USA. RP Kempen, JH (reprint author), Univ Penn, Dept Ophthalmol, Ctr Prevent Ophthalmol & Biostat, 3535 Market St,Suite 700, Philadelphia, PA 19104 USA. EM john.kempen@uphs.upenn.edu FU National Eye Institute [EY014943]; Paul and Evanina Mackall Foundation; Research to Prevent Blindness James S. Adams Special Scholar Award; Senior Scientific Investigator Award; Prevent Blindness Harrington Special Scholar Award FX Supported primarily by National Eye Institute Grant EY014943 (JHK). Additional support was provided by Research to Prevent Blindness and the Paul and Evanina Mackall Foundation. Dr Kempen is a Research to Prevent Blindness James S. Adams Special Scholar Award recipient. Drs Jabs and Rosenbaum are Research to Prevent Blindness Senior Scientific Investigator Award recipients. Dr Thorne is a Research to Prevent Blindness Harrington Special Scholar Award recipient. Dr Levy-Clarke was previously supported by and Dr Nussenblatt continues to be supported by intramural funds of the National Eye Institute. NR 49 TC 81 Z9 83 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0161-6420 J9 OPHTHALMOLOGY JI Ophthalmology PD NOV PY 2009 VL 116 IS 11 BP 2188 EP 2198 DI 10.1016/j.ophtha.2009.04.020 PG 11 WC Ophthalmology SC Ophthalmology GA 512ZQ UT WOS:000271291600022 PM 19748676 ER PT J AU Morone, NE Rollman, BL Moore, CG Qin, L Weiner, DK AF Morone, Natalia E. Rollman, Bruce L. Moore, Charity G. Qin, Li Weiner, Debra K. TI A Mind-Body Program for Older Adults with Chronic Low Back Pain: Results of a Pilot Study SO PAIN MEDICINE LA English DT Article DE Low Back Pain; Mindfulness; Meditation; Mind-Body; Aged AB Objectives. Determine the impact of an 8-week mindfulness meditation program on disability, psychological function, and pain severity in community-dwelling older adults with chronic low back pain, and to test the education control program for feasibility. Design. Randomized controlled trial. Participants. Forty community-dwelling older adults with moderate low back pain or greater for at least the previous 3 months. Intervention. Participants were randomized to an 8-week meditation program or an 8-week education control program. Outcome Measures. Disability, psychological function, and pain severity were assessed. The same measures were obtained for both groups at baseline, at the end of the program, and 4 months after program completion. Results. Sixteen participants (80%) completed the meditation program and 19 (95%) completed the education program. Both the meditation and control group improved on measures of disability, pain, and psychological function, both at program completion and 4-month follow-up. The differences between the two groups did not reach statistical significance. The meditation group practiced mindfulness meditation a mean of 5 days/week (range 1-7) and mean of 31 minutes/session (range 22-48). At 4 months follow-up 14/16 (88%) participants continued to meditate. Conclusion. Both the intervention group and the education control group improved on outcome measures suggesting both programs had a beneficial effect. Participants continued to meditate on 4-month follow-up. The control program was feasible but not inert. Piloting the control program in mind-body research can inform the design of larger clinical trials. C1 [Morone, Natalia E.; Rollman, Bruce L.; Moore, Charity G.; Qin, Li] Univ Pittsburgh, Div Gen Internal Med, Pittsburgh, PA USA. [Weiner, Debra K.] Univ Pittsburgh, Dept Med, Div Geriatr Med, Pittsburgh, PA USA. [Weiner, Debra K.] Univ Pittsburgh, Dept Anesthesiol, Pittsburgh, PA USA. [Weiner, Debra K.] Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA USA. [Weiner, Debra K.] VA Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA. RP Morone, NE (reprint author), 230 McKee Pl,Suite 600, Pittsburgh, PA 15213 USA. EM moronene@upmc.edu OI Moore, Charity/0000-0002-0060-0124 FU NIH [1KL2RR024154-04]; National Center for Research Resources (NCRR), a component of the NIH [UL1RR024153]; NIH Roadmap for Medical Research FX During the time of this work Dr. Morone was funded by the NIH Roadmap Multidisciplinary Clinical Research Career Development Award Grant (1KL2RR024154-04) from the National Institutes of Health (NIH). This publication was also made possible by Grant Number UL1RR024153 from the National Center for Research Resources (NCRR), a component of the NIH and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Special thanks to Daniel Schenck, DC for co-teaching the mindfulness meditation program and to Vinny Losasso for assistance in data collection and preparation of the manuscript. NR 37 TC 48 Z9 48 U1 3 U2 12 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1526-2375 J9 PAIN MED JI Pain Med. PD NOV-DEC PY 2009 VL 10 IS 8 BP 1395 EP 1407 DI 10.1111/j.1526-4637.2009.00746.x PG 13 WC Medicine, General & Internal SC General & Internal Medicine GA V20FE UT WOS:000208125100008 PM 20021599 ER PT J AU Thrower, EC Wang, J Cheriyan, S Lugea, A Kolodecik, TR Yuan, JZ Reeve, JR Gorelick, FS Pandol, SJ AF Thrower, Edwin C. Wang, Jeffrey Cheriyan, Salim Lugea, Aurelia Kolodecik, Thomas R. Yuan, Jingzhen Reeve, Joseph R., Jr. Gorelick, Fred S. Pandol, Stephen J. TI Protein Kinase C delta-Mediated Processes in Cholecystokinin-8-Stimulated Pancreatic Acini SO PANCREAS LA English DT Article DE amylase secretion; genetic deletion; trypsinogen ID DAMAGE-INDUCED APOPTOSIS; KAPPA-B ACTIVATION; PKC-DELTA; TYROSINE PHOSPHORYLATION; AMYLASE RELEASE; CELLS; ROTTLERIN; EPSILON; MECHANISM; ISOFORMS AB Objectives: To define the role of protein kinase C delta (PKC delta) in acinar cell responses to the hormone cholecystokinin-8 (CCK) using isoform-specific inhibitors and a previously unreported genetic deletion model. Methods: Pancreatic acinar cells were isolated from (1) rat, and pretreated with a PKC delta-specific inhibitor or (2) PKC delta-deficient and wild type mice. Isolated cells were stimulated with CCK (0.001-100 nmol/L) and cell responses were measured. Results: The PKC delta inhibitor did not affect stimulated amylase secretion from rat pancreatic acinar cells. Cholecystokinin-8 stimulation induced a typical biphasic dose-response curve for amylase secretion in acinar cells isolated from both PKC delta(-/-) and wild type mice, with maximal stimulation at 10-pmol/L CCK. Cholecystokinin-8 (100 nmol/L) induced zymogen and nuclear factor kappa B activation in both PKC delta(-/-) and wild type mice, although it was up to 50% less in PKC delta(-/-). Conclusions: In contrast to previous studies, this study has used specific and complementary approaches to examine PKC delta-mediated acinar cell responses. We could not confirm that it mediates amylase release but corroborated its role in the early stages of acute pancreatitis. C1 [Thrower, Edwin C.; Cheriyan, Salim; Kolodecik, Thomas R.; Gorelick, Fred S.] Vet Adm Connecticut Healthcare, Sect Digest Dis, Dept Internal Med, West Haven, CT USA. [Thrower, Edwin C.; Cheriyan, Salim; Kolodecik, Thomas R.; Gorelick, Fred S.] Yale Univ, Sch Med, New Haven, CT USA. [Wang, Jeffrey; Lugea, Aurelia; Yuan, Jingzhen; Reeve, Joseph R., Jr.; Pandol, Stephen J.] Vet Affairs Greater Los Angeles Hlth Care Syst, Res Ctr Alcohol Liver & Pancreat Dis, Los Angeles, CA USA. [Wang, Jeffrey; Lugea, Aurelia; Yuan, Jingzhen; Reeve, Joseph R., Jr.; Pandol, Stephen J.] Univ Calif Los Angeles, Los Angeles, CA USA. RP Thrower, EC (reprint author), Vet Adm Med Ctr, 950 Campbell Ave,Bldg 4, West Haven, CT 06516 USA. EM edwin.thrower@yale.edu FU National Institutes of Health [R21 DK69702, RO1 DK33850, DK54021]; USC-UCLA Research Center for Alcoholic Liver and Pancreatic Injury [5 P60 AA11999]; Veterans Administration Merit and Senior Career Development Award FX This work was supported by a National Institutes of Health grant R21 (DK69702 to E. C. T.), National Institutes of Health Grants RO1 (DK33850 to J. R. R., Jr; DK54021 to F. S. G.), USC-UCLA Research Center for Alcoholic Liver and Pancreatic Injury grant (5 P60 AA11999 from NIAAA; Tsukamoto; to S. J. P.), and a Veterans Administration Merit and Senior Career Development Award (to F. S. G.). NR 34 TC 20 Z9 20 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0885-3177 J9 PANCREAS JI Pancreas PD NOV PY 2009 VL 38 IS 8 BP 930 EP 935 DI 10.1097/MPA.0b013e3181b8476a PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 512DZ UT WOS:000271225300014 PM 19752773 ER PT J AU Hui, H Tang, YG Zhu, L Khoury, N Wang, KY Perfetti, R Pandol, SJ Go, VLW AF Hui, H. Tang, Y. G. Zhu, L. Khoury, N. Wang, K. Y. Perfetti, R. Pandol, S. J. Go, V. L. W. TI GLP-1 Directed Human Embryonic Stem Cells Differentiation Into Insulin Producing Cells Via Hedgehog, CAMP, PI3K Pathways SO PANCREAS LA English DT Meeting Abstract C1 [Hui, H.; Wang, K. Y.; Pandol, S. J.; Go, V. L. W.] Univ Calif Los Angeles, David Geffen Sch Med, UCLA Ctr Excellence Pancreat Dis, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. [Hui, H.; Tang, Y. G.; Zhu, L.; Khoury, N.; Perfetti, R.] Cedars Sinai Med Ctr, Los Angeles, CA 90048 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 0885-3177 J9 PANCREAS JI Pancreas PD NOV PY 2009 VL 38 IS 8 BP 1005 EP 1005 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 512DZ UT WOS:000271225300139 ER PT J AU Hui, H Tang, YG Wang, KY Pandol, SJ Go, VLW AF Hui, H. Tang, Y. G. Wang, K. Y. Pandol, S. J. Go, V. L. W. TI Inhibitory Effects of GLP-1 on Proliferation and Tumiorgenicisty of Pancreatic Cancer Stem Cells In Vitro SO PANCREAS LA English DT Meeting Abstract C1 [Hui, H.; Wang, K. Y.; Pandol, S. J.; Go, V. L. W.] Univ Calif Los Angeles, David Geffen Sch Med, UCLA Ctr Excellence Pancreat Dis, Los Angeles, CA 90095 USA. [Hui, H.; Pandol, S. J.] Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. [Tang, Y. G.] Cedars Sinai Med Ctr, Div Med Genet, Los Angeles, CA 90048 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 0885-3177 J9 PANCREAS JI Pancreas PD NOV PY 2009 VL 38 IS 8 BP 1005 EP 1005 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 512DZ UT WOS:000271225300138 ER PT J AU Thrower, E Yuan, J Usmani, A Jones, C Ireson, C Pandol, S Guha, S AF Thrower, E. Yuan, J. Usmani, A. Jones, C. Ireson, C. Pandol, S. Guha, S. TI Protein Kinase D Regulates Secretagogue-Induced Amylase Secretion and Zymogen Activation SO PANCREAS LA English DT Meeting Abstract C1 [Thrower, E.; Usmani, A.; Jones, C.] VA Connecticut Healthcare, Sect Digest Dis, West Haven, CT USA. [Thrower, E.; Usmani, A.; Jones, C.] Yale Univ, Sch Med, New Haven, CT 06520 USA. [Yuan, J.; Pandol, S.] VA Greater LA Hlth Care Syst, Los Angeles, CA USA. [Yuan, J.; Pandol, S.] Univ Calif Los Angeles, Los Angeles, CA 90024 USA. [Ireson, C.] Canc Res Technol, London, England. [Guha, S.] Univ Texas MD Anderson Canc Ctr, Dept Gastroenterol Hepatol & Nutr, Houston, TX 77030 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 0885-3177 J9 PANCREAS JI Pancreas PD NOV PY 2009 VL 38 IS 8 BP 1056 EP 1056 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 512DZ UT WOS:000271225300376 ER PT J AU Yuan, J Liu, Y Shalbueva, N Tan, T Gukovskaya, AS Pandol, SJ AF Yuan, J. Liu, Y. Shalbueva, N. Tan, T. Gukovskaya, A. S. Pandol, S. J. TI Protein Kinase C Epsilon Mediates Ethanol and Carbachol-Induced Depolarization in Pancreatic Acinar Cells SO PANCREAS LA English DT Meeting Abstract C1 VA Greater LA Hlth Care Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA 90024 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 0885-3177 J9 PANCREAS JI Pancreas PD NOV PY 2009 VL 38 IS 8 BP 1066 EP 1066 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 512DZ UT WOS:000271225300424 ER PT J AU Yuan, J Liu, Y Pandol, SJ Gukovskaya, AS Tan, T Thrower, E Guha, S AF Yuan, J. Liu, Y. Pandol, S. J. Gukovskaya, A. S. Tan, T. Thrower, E. Guha, S. TI Protein Kinase D Regulates Cell Death Pathways in Acute Pancreatitis SO PANCREAS LA English DT Meeting Abstract C1 [Yuan, J.; Pandol, S. J.; Gukovskaya, A. S.] VA Greater LA Hlth Care Syst, Los Angeles, CA USA. [Yuan, J.; Pandol, S. J.; Gukovskaya, A. S.] Univ Calif Los Angeles, Los Angeles, CA 90024 USA. [Liu, Y.] Beijing Hosp, Beijing, Peoples R China. [Thrower, E.] VA Connecticut Healthcare, West Haven, CT USA. [Thrower, E.] Yale Univ, Sch Med, New Haven, CT 06520 USA. [Guha, S.] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 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 0885-3177 J9 PANCREAS JI Pancreas PD NOV PY 2009 VL 38 IS 8 BP 1066 EP 1066 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 512DZ UT WOS:000271225300423 ER PT J AU Wooten, K AF Wooten, Karen TI Clinical Features and Electrodiagnosis of Diabetic Peripheral Neuropathy in the Dysvascular Patient SO PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA LA English DT Article DE Neuropathy; Electrodiagnosis; Diabetes; Dysvascular; Amputee; Diabetic peripheral neuropathy; Polyneuropathy ID DISTAL SYMMETRIC POLYNEUROPATHY; ACADEMY-OF-NEUROLOGY; AUTONOMIC NEUROPATHY; NERVE-CONDUCTION; CLASSIFICATION; ASSOCIATION; MELLITUS; CACHEXIA AB Diabetic peripheral neuropathy (DPN) is a common disorder that can lead to limb loss and death. Up to 50% of DPN patients can be asymptomatic. This fact contributes to making DPN the leading cause of lower limb amputation. The degree of heterogeneity in the clinical manifestations of DPN makes diagnosing this condition difficult. This article reviews the characteristics, diagnosis, electrodiagnosis, classification, pathogenesis, and treatment of DPN. C1 [Wooten, Karen] Vet Affairs Puget Sound Hlth Care Syst, Rehabilitat Care Serv S117, Seattle, WA 98108 USA. [Wooten, Karen] Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Wooten, K (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Rehabilitat Care Serv S117, 1660 S Columbian Way, Seattle, WA 98108 USA. EM Karen.wooten@va.gov NR 35 TC 7 Z9 10 U1 0 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1047-9651 J9 PHYS MED REHABIL CLI JI Phys. Med. Rehabil. Clin. N. Am. PD NOV PY 2009 VL 20 IS 4 BP 657 EP + DI 10.1016/j.pmr.2009.06.011 PG 21 WC Rehabilitation SC Rehabilitation GA 509NI UT WOS:000271024300006 PM 19781504 ER PT J AU Hakimi, KN AF Hakimi, Kevin N. TI Pre-Operative Rehabilitation Evaluation of the Dysvascular Patient Prior to Amputation SO PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA LA English DT Article DE Amputation; Rehabilitation; Diabetes mellitus; Diabetes complications; Peripheral vascular diseases ID LOWER-LIMB AMPUTATION; LOWER-EXTREMITY AMPUTATIONS; OUTCOMES; AMPUTEE; 10-YEAR AB Lower-extremity amputation secondary to dysvascular disease, including diabetes and peripheral vascular disease, is a major health problem in the United States. Due to the increased comorbidities in this patient population, pre-operative rehabilitation evaluation by a multidisciplinary team is crucial to ensure optimal patient outcomes. This article discusses the key factors that may affect functional outcomes in this patient population and outlines important history and physical examination components that should be evaluated pre-operatively. C1 [Hakimi, Kevin N.] VA Puget Sound Hlth Care Syst, Rehabil Care Serv, Seattle, WA 98108 USA. [Hakimi, Kevin N.] Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98159 USA. RP Hakimi, KN (reprint author), VA Puget Sound Hlth Care Syst, Rehabil Care Serv, RCS 117,1660 S Columbian Way, Seattle, WA 98108 USA. EM khakimi@u.washington.edu NR 20 TC 5 Z9 5 U1 0 U2 4 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1047-9651 J9 PHYS MED REHABIL CLI JI Phys. Med. Rehabil. Clin. N. Am. PD NOV PY 2009 VL 20 IS 4 BP 677 EP + DI 10.1016/j.pmr.2009.06.015 PG 13 WC Rehabilitation SC Rehabilitation GA 509NI UT WOS:000271024300007 PM 19781505 ER PT J AU Hammond, MC AF Hammond, Margaret C. TI Honoring Those Who Have Served SO PM&R LA English DT Editorial Material C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Hammond, MC (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,128N, Seattle, WA 98108 USA. EM margaret.hammond@va.gov NR 7 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 1934-1482 J9 PM&R JI PM&R PD NOV PY 2009 VL 1 IS 11 BP 991 EP 992 DI 10.1016/j.pmrj.2009.10.009 PG 2 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA V24LO UT WOS:000208412100001 PM 19942183 ER PT J AU Ong, MK Rubenstein, LV AF Ong, Michael K. Rubenstein, Lisa V. TI Wishing Upon a STAR*D: The Promise of Ideal Depression Care by Primary Care Providers SO PSYCHIATRIC SERVICES LA English DT Editorial Material ID DISSEMINATING QUALITY IMPROVEMENT; RANDOMIZED CONTROLLED-TRIAL; COLLABORATIVE CARE; OUTCOMES; PREFERENCES; INCENTIVES; MANAGEMENT; VISITS; IMPACT; TIME AB The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial found that after initial treatment, depressed patients treated in primary care settings had the same or slightly better outcomes than those treated in specialty care settings. The authors describe challenges to using the STAR*D approach and protocols in usual primary care settings. These include inadequate availability of appointments, insufficient resources for care management and treatment monitoring, and lack of payment to primary care providers for providing mental health care. Substantial reengineering of payment and delivery systems is needed in order for the STAR*D approach to be viable in primary care clinics. (Psychiatric Services 60: 1460-1462, 2009) C1 [Ong, Michael K.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90024 USA. [Rubenstein, Lisa V.] Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. RP Ong, MK (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, 911 Broxton Ave,1st Floor, Los Angeles, CA 90024 USA. EM michael.ong@ucla.edu RI Ong, Michael/F-7397-2013 FU NIMH NIH HHS [P30 MH082760, P30-MH082760, P30 MH068639] NR 24 TC 3 Z9 3 U1 0 U2 0 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD NOV PY 2009 VL 60 IS 11 BP 1460 EP 1462 PG 3 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 514KM UT WOS:000271393200009 PM 19880461 ER PT J AU Cully, JA Johnson, M Moffett, ML Khan, M Deswal, A AF Cully, Jeffrey A. Johnson, Michael Moffett, Maurice L. Khan, Myrna Deswal, Anita TI Depression and Anxiety in Ambulatory Patients With Heart Failure SO PSYCHOSOMATICS LA English DT Article ID PRIMARY-CARE PATIENTS; QUALITY-OF-CARE; PULMONARY-DISEASE; COMPETING DEMANDS; RISK; SYMPTOMS; PREVALENCE; PREDICTORS; OUTCOMES; IDENTIFICATION AB Background: Depression and anxiety are common in heart failure, but the prevalence, incidence, and relationship of these conditions to health service use and mortality remains uncertain. Objective: The authors sought to delineate these parameters and identify patient factors predicting hospitalizations for heart failure and mortality 12 months after their initial diagnosis of heart failure. Method: The authors utilized a retrospective database cohort of 12,028 ambulatory patients with newly diagnosed heart failure to examine diagnosed depression and anxiety and the relationship of these conditions to health service use and all-cause mortality. Results: Patients with diagnosed depression and/or anxiety (18% of the cohort) were frequently identified by providers within the first 30 days after a heart failure diagnosis. They subsequently utilized twice as many health services, but they did not show increased mortality risk. Discussion: Although mental health intervention data for heart failure patients are limited, the prevalence and impact of depression and anxiety in these patients suggest that assessment and intervention efforts appear warranted early in the heart failure process. (Psychosomatics 2009; 50: 592-598) C1 Michael E DeBakey Vet Affairs Med Ctr, Hlth Serv Res & Dev Serv, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Vet Affairs S Cent Mental Illness Res Educ & Clin, Houston, TX USA. Baylor Coll Med, Winters Ctr Heart Failure Res, Cardiol Sect, Houston, TX 77030 USA. RP Cully, JA (reprint author), 2002 Holcombe 152, Houston, TX 77030 USA. EM jcully@bcm.edu NR 33 TC 12 Z9 12 U1 1 U2 3 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0033-3182 J9 PSYCHOSOMATICS JI Psychosomatics PD NOV-DEC PY 2009 VL 50 IS 6 BP 592 EP 598 PG 7 WC Psychiatry; Psychology SC Psychiatry; Psychology GA 529AU UT WOS:000272488900007 PM 19996230 ER PT J AU Brown, CA Cheng, EM Hays, RD Vassar, SD Vickrey, BG AF Brown, Carlos A. Cheng, Eric M. Hays, Ron D. Vassar, Stefanie D. Vickrey, Barbara G. TI SF-36 includes less Parkinson Disease (PD)-targeted content but is more responsive to change than two PD-targeted health-related quality of life measures SO QUALITY OF LIFE RESEARCH LA English DT Article DE Health-related quality of life; Parkinson Disease; PDQUALIF; PDQ-39; Responsiveness; SF-36 ID PATIENT-REPORTED OUTCOMES; MULTIPLE-SCLEROSIS; INSTRUMENTS; SCALE; DISABILITY AB To compare validity including responsiveness, and internal consistency reliability and scaling assumptions of a generic (SF-36) and Parkinson Disease (PD)-targeted (PDQ-39; PDQUALIF) health-related quality of life (HRQOL) measures. Ninety-six PD patients were administered for all HRQOL measures by telephonic interview at baseline and 18 months. Relative efficiency and responsiveness were compared relative to four external criteria (self-ratings of PD's daily effects, global Quality of Life, PD symptom severity, and a depression screener). We examined whether PD-targeted measures explained unique variance beyond the SF-36 by regressing criterion variables on HRQOL scales/items. Adequacy of PD-targeted measures' original scaling was explored by item-scale correlations. Relative efficiency estimates were similar for generic and PD-targeted measures across all criteria. Responsiveness analyses showed that the SF-36 yielded large (> 0.8) effect sizes (ES) for three of eight scales for each of two criterion variables, compared to only one large ES for any scale in either PD-targeted measure. Adjusted R (2) increased from 14 to 27% in regression models that included PD-targeted items compared to models with only SF-36 scales. Item-scale correlations showed significant cross-loading of items across scales of the PD-targeted measures. SF-36 responsiveness was better than that of two PD-targeted measures, yet those measures had content that significantly explains PD patients' HRQOL. C1 [Brown, Carlos A.; Cheng, Eric M.; Vassar, Stefanie D.; Vickrey, Barbara G.] Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. RP Cheng, EM (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. EM eric.cheng@va.gov RI Hays, Ronald/D-5629-2013 FU Department of Veterans Affairs, Veterans Health Administration; VA Health Services Research & Development Service [PDI 01-158]; NIH/NINDS [NS038367]; NINDS [K23NS058571] FX We acknowledge with thanks Michele Maines, MSG, Sunberri Murphy, and Amelia Mittleman for bibliographic support, and Harvey Lopez and Jessika Herrera for their administrative assistance. Erin Jacob assisted in the data collection. We thank Drs. Jeff Bronstein, Yvette Bordelon, and Indu Subramanian for recruitment of patients. The research presented here was supported by the Department of Veterans Affairs, Veterans Health Administration, VA Health Services Research & Development Service project number PDI 01-158, and by NIH/NINDS NS038367 for the UCLA UDALL Parkinson Disease Center of Excellence. Eric Cheng was supported by an NINDS career development award (K23NS058571). NR 34 TC 22 Z9 24 U1 1 U2 9 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0962-9343 J9 QUAL LIFE RES JI Qual. Life Res. PD NOV PY 2009 VL 18 IS 9 BP 1219 EP 1237 DI 10.1007/s11136-009-9530-y PG 19 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 504XH UT WOS:000270650900010 PM 19714487 ER PT J AU Hausmann, LRM Ye, FF Schofield, JW Woods, RL AF Hausmann, Leslie R. M. Ye, Feifei Schofield, Janet Ward Woods, Rochelle L. TI Sense of Belonging and Persistence in White and African American First-Year Students SO RESEARCH IN HIGHER EDUCATION LA English DT Article DE Sense of belonging; Persistence; Intentions; Intervention ID CAMPUS RACIAL CLIMATE; REDUCING INTERGROUP BIAS; COLLEGE-STUDENTS; PREDOMINANTLY WHITE; MINORITY-STUDENTS; HIGHER-EDUCATION; SOCIAL INTEGRATION; THEORETICAL-MODEL; ETHNIC-MINORITY; CAUSAL MODEL AB The authors argue for the inclusion of students' subjective sense of belonging in an integrated model of student persistence (Cabrera et al., J Higher Educ 64:123-139, 1993). The effects of sense of belonging and a simple intervention designed to increase sense of belonging are tested in the context of this model. The intervention increased sense of belonging for white students, but not for African American students. However, sense of belonging had direct effects on institutional commitment and indirect effects on intentions to persist and actual persistence behavior for both white and African American students. C1 [Hausmann, Leslie R. M.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15206 USA. [Ye, Feifei] Univ Pittsburgh, Dept Educ Psychol, Pittsburgh, PA USA. [Schofield, Janet Ward] Univ Pittsburgh, Dept Psychol, Pittsburgh, PA 15260 USA. [Schofield, Janet Ward] Univ Pittsburgh, Ctr Learning Res & Dev, Pittsburgh, PA 15260 USA. [Woods, Rochelle L.] Univ Michigan, Off Acad Multicultural Initiat, Ann Arbor, MI 48109 USA. RP Hausmann, LRM (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, 7180 Highland Dr 151C H, Pittsburgh, PA 15206 USA. EM leslie.hausmann@gmail.com NR 56 TC 24 Z9 26 U1 7 U2 19 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0361-0365 J9 RES HIGH EDUC JI Res. High. Educ. PD NOV PY 2009 VL 50 IS 7 BP 649 EP 669 DI 10.1007/s11162-009-9137-8 PG 21 WC Education & Educational Research SC Education & Educational Research GA 480YQ UT WOS:000268773600002 ER PT J AU Choudhury, D Tuncel, M Levi, M AF Choudhury, Devasmita Tuncel, Meryem Levi, Moshe TI Disorders of Lipid Metabolism and Chronic Kidney Disease in the Elderly SO SEMINARS IN NEPHROLOGY LA English DT Review DE Lipid disorder; elderly; chronic kidney disease; end-stage renal disease; dyslipidemia ID CHRONIC-RENAL-FAILURE; CORONARY-HEART-DISEASE; HMG-COA REDUCTASE; AGE-RELATED HYPERCHOLESTEROLEMIA; NUTRITION EXAMINATION SURVEY; ELEMENT-BINDING PROTEINS; WHITE ADIPOSE-TISSUE; 3RD NATIONAL-HEALTH; CARDIOVASCULAR EVENTS; MYOCARDIAL-INFARCTION C1 [Choudhury, Devasmita] Univ Texas SW Med Ctr Dallas, Inctr & Home Dialysis, Dallas VA Med Ctr, Dallas, TX 75390 USA. [Tuncel, Meryem] Texas Tech Univ, Hlth Sci Ctr, Dept Hypertens & Nephrol, Lubbock, TX 79430 USA. [Levi, Moshe] Univ Colorado, Dept Med, Denver VA Med Ctr, Denver, CO USA. RP Levi, M (reprint author), 12700 E 19th Ave,Res 2,Room 7002, Aurora, CO 80045 USA. EM moshe.levi@UCHSC.edu OI Levi, Moshe/0000-0002-6225-946X FU NIA NIH HHS [R01 AG026529, R01 AG026529-01A2] NR 90 TC 5 Z9 7 U1 0 U2 3 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0270-9295 J9 SEMIN NEPHROL JI Semin. Nephrol. PD NOV PY 2009 VL 29 IS 6 BP 610 EP 620 DI 10.1016/j.semnephrol.2009.07.006 PG 11 WC Urology & Nephrology SC Urology & Nephrology GA 617CD UT WOS:000279257500009 PM 20006793 ER PT J AU Kim, JH Deasy, BM Seo, HY Studer, RK Vo, NV Georgescu, HI Sowa, GA Kang, JD AF Kim, Joo Han Deasy, Bridget M. Seo, Hyoung Yeon Studer, Rebecca K. Vo, Nam V. Georgescu, Helga I. Sowa, Gwendolyn A. Kang, James D. TI Differentiation of Intervertebral Notochordal Cells Through Live Automated Cell Imaging System In Vitro SO SPINE LA English DT Article DE notochordal cells; chondrocyte-like cells; live automated cell imager; (35)S sulfate incorporation; RT-PCR ID NUCLEUS PULPOSUS; EXTRACELLULAR-MATRIX; CULTURE SYSTEM; DISC; EXPRESSION; PROLIFERATION; CHONDROCYTES; SOX9 AB Study Design. We demonstrated the differentiation of notochordal cells by direct observation using a live automated cell imaging system. We also hypothesized that notochordal cells have characteristics of chondrocyte-like cells. Objective. To determine characteristics of notochordal cells by matrix protein expression and their differentiation using a live automated cell imager. Summary of Background Data. Although notochordal cells are critical to homeostasis of intervertebral disc, their fate has not been extensively studied and there is little evidence of notochordal cells as progenitors. Methods. Notochordal cells purified from rabbit nucleus pulposus were isolated after serial filtration. Notochordal cells in 3-dimensional culture were compared to chondrocyte-like cells by (35)S sulfate incorporation into proteoglycan and reverse transcription polymerase chain reaction for gene expression(collagen II and aggrecan). Notochordal cells in 2-D culture were used for immunocytochemical staining (collagen II, aggrecan, and SOX9) and time-lapsed cell tracking study. Results. Notochordal cells were capable of proteoglycan production at a rate comparable to chondrocyte-like cells (108% +/- 22.6% to chondrocyte-like cells) and expressed collagen II, aggrecan, and SOX9. In time- lapsed cell tracking analysis, notochordal cells were slower in population doubling time than chondrocyte-like cells and differentiated into 3 morphologically distinct cell types: vacuolated cells (area: 2392 +/- 507.1 mu m(2), velocity: 0.09 +/- 0.01 mu m/min); giant cells (area: 12678 +/- 1637.0 mu m(2), velocity: 0.08 +/- 0.01 mu m/min) which grew rapidly without cell division; polygonal cells (area: 3053 +/- 751.2 mu m(2), 0.14 +/- 0.01 mu m/min) morphologically similar to typical differentiation type of chondrocyte-like cells ( area: 2671 +/- 235.6 mu m(2), 0.19 +/- 0.01 mu m/min). Rarely, notochordal cells formed clusters analogous to that observed in vivo. Conclusion. These studies demonstrate a chondrocyte phenotype of notochordal cells and are the first direct evidence of notochordal cell differentiation, suggesting that they may act as progenitor cells, which has the potential to lead to their use in novel approaches to regeneration of degenerative intervertebral disc. C1 [Sowa, Gwendolyn A.] Univ Pittsburgh, Sch Med, Dept Phys Med & Rehabil, Pittsburgh, PA 15261 USA. [Kim, Joo Han; Deasy, Bridget M.; Vo, Nam V.; Georgescu, Helga I.; Kang, James D.] Univ Pittsburgh, Sch Med, Dept Orthopaed Surg, Pittsburgh, PA 15261 USA. [Kim, Joo Han] Korea Univ, Coll Med, Dept Neurosurg, Seoul 136705, South Korea. [Seo, Hyoung Yeon] Chonnam Natl Univ, Dept Orthopaed Surg, Coll Med, Kwangju, South Korea. [Studer, Rebecca K.] Univ Pittsburgh, Sch Med, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15261 USA. RP Sowa, GA (reprint author), Univ Pittsburgh, Sch Med, Dept Phys Med & Rehabil, 200 Lothrop St,E1658,Biomed Sci Tower, Pittsburgh, PA 15261 USA. EM sowaga@upmc.edu RI Kim, Joo Han/B-8129-2014 OI Kim, Joo Han/0000-0002-4747-9763 FU Pittsburgh Foundation at Department of Orthopedic Surgery; University of Pittsburgh FX Supported by the Pittsburgh Foundation at Department of Orthopedic Surgery, University of Pittsburgh. NR 26 TC 35 Z9 40 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0362-2436 J9 SPINE JI SPINE PD NOV 1 PY 2009 VL 34 IS 23 BP 2486 EP 2493 DI 10.1097/BRS.0b013e3181b26ed1 PG 8 WC Clinical Neurology; Orthopedics SC Neurosciences & Neurology; Orthopedics GA 515CT UT WOS:000271444900002 PM 19841610 ER PT J AU Livhits, M Mercado, C Yermilov, I Parikh, JA Dutson, E Mehran, A Ko, CY Gibbons, MM AF Livhits, Masha Mercado, Cheryl Yermilov, Irina Parikh, Janak A. Dutson, Erik Mehran, Amir Ko, Clifford Y. Gibbons, Melinda Maggard TI Does weight loss immediately before bariatric surgery improve outcomes: a systematic review SO SURGERY FOR OBESITY AND RELATED DISEASES LA English DT Review DE Bariatric surgery; Predictors; Weight loss; Preoperative weight loss; Outcomes AB Background: Preoperative weight loss before bariatric surgery has been proposed as a predictive factor for improved patient compliance and the degree of excess weight loss achieved after surgery. In the present study, we sought to determine the effect of preoperative weight loss on postoperative outcomes. Methods: A search of MEDLINE was completed to identify the patient factors associated with weight loss after bariatric surgery. Of the 909 screened reports, 15 had reported on preoperative weight loss and the degree of postoperative weight loss achieved. A meta-analysis was performed that compared the postoperative weight loss and perioperative outcomes in patients who had lost weight preoperatively compared to those who had not. Results: Of the 15 articles (n = 3404 patients) identified, 5 found a positive effect of preoperative weight loss on postoperative weight loss, 2 found a positive short-term effect that was not sustained long term, 5 did not find an effect difference, and 1 found a negative effect. A meta-analysis revealed a significant increase in the 1-year postoperative weight loss (mean difference of 5% EWL, 95% confidence interval 2.68-7.32) for patients who had lost weight preoperatively. A meta-analysis of other outcomes revealed a decreased operative time for patients who had lost weight preoperatively (mean difference 23.3 minutes, 95% confidence interval 13.8-32.8). Conclusion: Preoperative weight loss before bariatric surgery appears to be associated with greater weight loss postoperatively and might help to identify patients who would have better compliance after surgery. (C) 2009 American Society for Metabolic and Bariatric Surgery. All rights reserved. C1 [Livhits, Masha; Mercado, Cheryl; Yermilov, Irina; Parikh, Janak A.; Dutson, Erik; Mehran, Amir; Ko, Clifford Y.; Gibbons, Melinda Maggard] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. [Livhits, Masha; Yermilov, Irina; Parikh, Janak A.; Ko, Clifford Y.; Gibbons, Melinda Maggard] Vet Affairs Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. [Gibbons, Melinda Maggard] Olive View Univ Calif, Dept Surg, Sylmar, CA USA. RP Livhits, M (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, 10833 LeComte Ave,72-215 CHS, Los Angeles, CA 90095 USA. EM mlivhits@mednet.ucla.edu NR 35 TC 46 Z9 48 U1 0 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1550-7289 EI 1878-7533 J9 SURG OBES RELAT DIS JI Surg. Obes. Relat. Dis. PD NOV-DEC PY 2009 VL 5 IS 6 BP 713 EP 721 DI 10.1016/j.soard.2009.08.014 PG 9 WC Surgery SC Surgery GA V30LE UT WOS:000208816700017 PM 19879814 ER PT J AU Izci, Y Seckin, H Ates, O Baskaya, MK AF Izci, Yusuf Seckin, Hakan Ates, Oezkan Baskaya, Mustafa K. TI Supracerebellar transtentorial transcollateral sulcus approach to the atrium of the lateral ventricle: microsurgical anatomy and surgical technique in cadaveric dissections SO SURGICAL NEUROLOGY LA English DT Article DE Atrium; Collateral sulcus; Lateral ventricle; Supracerebellar approach ID ARTERIOVENOUS-MALFORMATIONS; TEMPORAL-LOBE; FIBER DISSECTION; TUMORS AB Background: Access to lesions located in the atrium of the lateral ventricle without causing neurologic deficit can be challenging. Here, we demonstrate the supracerebellar transtentorial transcollateral sulcus (STTS) approach as an alternative route to the atrium of the lateral ventricle using anatomical dissections in cadavers. Methods: Suboccipital craniotomy with extension above the transverse sinus was performed in 5 arterial and venous latex-injected cadaveric heads (10 hemispheres). After the dural opening, arachnoidal dissection of the supracerebellar space was performed, and the tentorium cerebelli was cut from lateral to medial. This revealed the parahippocampal and fusiform gyri and collateral sulcus (CS). The distance from the CS to the atrium was measured. Results: The atrium of the lateral ventricle was entered through the CS in each specimen. The cerebral hemispheres were removed from each cadaveric specimen, and dissections were performed. The distance from the CS to the atrium was 1.30 cm on the right side and 1.31 cm on the left. The CS was bifurcated in 62% of the hemispheres, whereas it was single in 38%. Through this approach, only the "u" fibers of the CS were damaged, and the fibers of the optic radiation in the inferolateral wall of the atrium were preserved. Conclusion: The STTS approach may be an effective alternative approach to lesions located in the medioposterior aspect of the atrium of the lateral ventricle in selected cases. Further clinical studies to evaluate the safety and efficacy of this approach are needed. (C) 2009 Elsevier Inc. All rights reserved. C1 [Baskaya, Mustafa K.] Univ Wisconsin, Dept Neurol Surg, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53792 USA. RP Baskaya, MK (reprint author), Univ Wisconsin, Dept Neurol Surg, Madison, WI 53792 USA. EM m.baskaya@neurosurg.wisc.edu NR 16 TC 14 Z9 16 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0090-3019 J9 SURG NEUROL JI Surg. Neurol. PD NOV PY 2009 VL 72 IS 5 BP 509 EP 514 DI 10.1016/j.surneu.2009.01.025 PG 6 WC Clinical Neurology; Surgery SC Neurosciences & Neurology; Surgery GA 616TX UT WOS:000279233800014 PM 19328525 ER PT J AU Ross, JS Detsky, AS AF Ross, Joseph S. Detsky, Allan S. TI Health Care Choices and Decisions in the United States and Canada SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material C1 [Detsky, Allan S.] Mt Sinai Hosp, Dept Med, Toronto, ON M5G 1X5, Canada. [Detsky, Allan S.] Univ Toronto, Dept Hlth Policy, Toronto, ON, Canada. [Detsky, Allan S.] Univ Toronto, Dept Management, Toronto, ON, Canada. [Detsky, Allan S.] Univ Toronto, Dept Evaluat & Med, Toronto, ON, Canada. [Detsky, Allan S.] Univ Hlth Network, Toronto, ON, Canada. [Ross, Joseph S.] Mt Sinai Sch Med, Dept Geriatr, New York, NY USA. [Ross, Joseph S.] Mt Sinai Sch Med, Dept Palliat Care & Med, New York, NY USA. [Ross, Joseph S.] James J Peters Vet Adm Med Ctr, Hlth Serv Res & Dev Res Enhancement Award Program, Bronx, NY USA. [Ross, Joseph S.] James J Peters Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. RP Detsky, AS (reprint author), Mt Sinai Hosp, Dept Med, 429-600 Univ Ave, Toronto, ON M5G 1X5, Canada. EM adetsky@mtsinai.on.ca FU NIA NIH HHS [K08 AG032886, K08 AG032886-01] NR 8 TC 3 Z9 3 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD OCT 28 PY 2009 VL 302 IS 16 BP 1803 EP 1804 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 511FW UT WOS:000271150300024 PM 19861673 ER PT J AU Saam, T Raya, JG Cyran, CC Bochmann, K Meimarakis, G Dietrich, O Clevert, DA Frey, U Yuan, C Hatsukami, TS Werf, A Reiser, MF Nikolaou, K AF Saam, Tobias Raya, Jose G. Cyran, Clemens C. Bochmann, Katja Meimarakis, Georgios Dietrich, Olaf Clevert, Dirk A. Frey, Ute Yuan, Chun Hatsukami, Thomas S. Werf, Abe Reiser, Maximilian F. Nikolaou, Konstantin TI High resolution carotid black-blood 3T MR with parallel imaging and dedicated 4-channel surface coils SO JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE LA English DT Article ID RISK-ASSESSMENT STRATEGIES; MAGNETIC-FIELD STRENGTHS; RICH NECROTIC CORE; IN-VIVO; ATHEROSCLEROTIC PLAQUE; QUANTITATIVE ASSESSMENT; VULNERABLE PATIENT; LESIONS; REPRODUCIBILITY; ULTRASOUND AB Background: Most of the carotid plaque MR studies have been performed using black-blood protocols at 1.5 T without parallel imaging techniques. The purpose of this study was to evaluate a multi-sequence, black-blood MR protocol using parallel imaging and a dedicated 4-channel surface coil for vessel wall imaging of the carotid arteries at 3 T. Materials and methods: 14 healthy volunteers and 14 patients with intimal thickening as proven by duplex ultrasound had their carotid arteries imaged at 3 T using a multi-sequence protocol (time-of-flight MR angiography, pre-contrast T1w-, PDw- and T2w sequences in the volunteers, additional post-contrast T1w- and dynamic contrast enhanced sequences in patients). To assess intrascan reproducibility, 10 volunteers were scanned twice within 2 weeks. Results: Intrascan reproducibility for quantitative measurements of lumen, wall and outer wall areas was excellent with Intraclass Correlation Coefficients >0.98 and measurement errors of 1.5%, 4.5% and 1.9%, respectively. Patients had larger wall areas than volunteers in both common carotid and internal carotid arteries and smaller lumen areas in internal carotid arteries (p < 0.001). Positive correlations were found between wall area and cardiovascular risk factors such as age, hypertension, coronary heart disease and hypercholesterolemia (Spearman's r = 0.45-0.76, p < 0.05). No significant correlations were found between wall area and body mass index, gender, diabetes or a family history of cardiovascular disease. Conclusion: The findings of this study indicate that high resolution carotid black-blood 3 T MR with parallel imaging is a fast, reproducible and robust method to assess carotid atherosclerotic plaque in vivo and this method is ready to be used in clinical practice. C1 [Saam, Tobias; Raya, Jose G.; Dietrich, Olaf] Univ Munich, Dept Clin Radiol, Josef Lissner Lab Biomed Imaging, Munich, Germany. [Meimarakis, Georgios; Frey, Ute] Univ Munich, Dept Surg, Munich, Germany. [Yuan, Chun] Univ Washington, Dept Radiol, Seattle, WA 98195 USA. [Hatsukami, Thomas S.] VA Puget Sound Hlth Care Syst, Seattle Div, Seattle, WA 98108 USA. [Hatsukami, Thomas S.] Univ Washington, Dept Surg, Seattle, WA 98195 USA. [Werf, Abe] Machnet BV, Td Eelde, Netherlands. RP Saam, T (reprint author), Univ Munich, Dept Clin Radiol, Josef Lissner Lab Biomed Imaging, Grosshadern Campus, Munich, Germany. EM Tobias.Saam@med.uni-muenchen.de; Jose.Raya@med.uni-muenchen.de; Clemens.Cyran@med.uni-muenchen.de; katja.bochmann@med.uni-muenchen.de; Georgios.Meimarakis@med.uni-muenchen.de; Olaf.Dietrich@med.uni-muenchen.de; Dirk.Clevert@med.uni-muenchen.de; Ute.Frey@med.uni-muenchen.de; cyuan@u.washington.edu; tomhat@u.washington.edu; avanderwerf@machnet.nl; Maximilian.Reiser@med.uni-muenchen.de; Nikolaou@med.uni-muenchen.de RI Dietrich, Olaf/C-4696-2014 OI Dietrich, Olaf/0000-0001-6182-5039; Nikolaou, Konstantin/0000-0003-2668-7325; Clevert, Dirk Andre/0000-0003-3889-5447 NR 30 TC 26 Z9 27 U1 0 U2 2 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1097-6647 J9 J CARDIOVASC MAGN R JI J. Cardiov. Magn. Reson. PD OCT 27 PY 2009 VL 11 AR 41 DI 10.1186/1532-429X-11-41 PG 12 WC Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging SC Cardiovascular System & Cardiology; Radiology, Nuclear Medicine & Medical Imaging GA 516FY UT WOS:000271528700001 PM 19860875 ER PT J AU Bastani, S Sherman, W Schnickel, GT Hsieh, GR Bhatia, R Fishbein, MC Ardehali, A AF Bastani, Sam Sherman, William Schnickel, Gabriel T. Hsieh, George R. Bhatia, Rubina Fishbein, Michael C. Ardehali, Abbas TI Chemokine Receptor Blockade With a Synthetic Nonpeptide Compound Attenuates Cardiac Allograft Vasculopathy SO TRANSPLANTATION LA English DT Article DE Chemokines; Transplantation; T-lymphocytes ID CHRONIC REJECTION; SMALL-MOLECULE; IFN-GAMMA; INDUCIBLE PROTEIN-10; CYTOKINE PRODUCTION; CCR5 ANTAGONIST; CARBON-MONOXIDE; TARGETING CCR5; CXCR3; PATHOGENESIS AB Background. Recruitment of recipient mononuclear cells to the donor heart is a central event in the development of cardiac allograft vasculopathy (CAV). The role of individual chemokine receptors in this process is incompletely defined. TAK-779 (N,N-dimethyl-N-[4-[[[2-(4-methylphen)-6,7-dihydro-5H-benzocyclohepten-8-yl]carbonyl]amino]benzyl]tetra-hydro-2H-pyran-4-aminium chloride) is a synthetic nonpeptide antagonist of CCR5 and CXCR3. The purpose of this study is to determine if combined CCR5 and CXCR3 blockade by TAK-779 would attenuate CAV in an experimental model. Methods. We used a previously characterized murine model of CAV. Recipient mice were treated with TAK-779 or vehicle control. Donor hearts were harvested on day 24 posttransplantation and analyzed for intimal thickening and cellular infiltration. Recipient splenocytes were analyzed for proliferative response and interferon (IFN)-gamma production by enzyme-linked immunosorbent spot assay. The donor hearts were also examined for heme oxygenase-1 (HO-1) gene induction. Results. CCR5 and CXCR3 blockade by TAK-779 reduced the severity of intimal lesions (53 +/- 10% vs. 16 +/- 2%; P<0.05) and decreased the number of graft infiltrating CCR5(+) and CXCR3(+) CD4 and CD8 lymphocytes. Moreover, treatment with TAK-779 (a) decreased alloantigen-specific T-lymphocyte proliferation and number of IFN-gamma producing cells and (b) increased HO-1 gene transcript level in the allografts. Conclusions. Antagonism of CCR5 and CXCR3 by TAK-779 is effective in controlling CAV. The beneficial effects of TAK-779 maybe because of (a) reduction in CCR5(+) and CXCR3(+) T-lymphocyte subset infiltration into the graft, (b) attenuation of alloantigen-specific T-lymphocyte proliferative response and IFN-gamma production, and (c) induction of HO-1 gene. This compound may offer a novel approach in clinical management of CAV. C1 [Ardehali, Abbas] Univ Calif Los Angeles, Med Ctr, Dept Surg, David Geffen Sch Med,Div Cardiothorac Surg, Los Angeles, CA 90024 USA. [Bastani, Sam; Schnickel, Gabriel T.; Hsieh, George R.; Ardehali, Abbas] W Los Angeles VA Med Ctr, Los Angeles, CA USA. [Fishbein, Michael C.] Univ Calif Los Angeles, Dept Pathol & Lab Med, David Geffen Sch Med, Los Angeles, CA 90024 USA. RP Ardehali, A (reprint author), Univ Calif Los Angeles, Med Ctr, Dept Surg, David Geffen Sch Med,Div Cardiothorac Surg, 62-186 CHS,10833 Le Conte Ave, Los Angeles, CA 90024 USA. EM aardehali@mednet.ucla.edu OI Schnickel, Gabriel/0000-0003-4392-2200 FU American Heart Association; Veterans Administration Research FX This work was supported by the American Heart Association and Veterans Administration Research services grants. NR 35 TC 13 Z9 15 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0041-1337 J9 TRANSPLANTATION JI Transplantation PD OCT 27 PY 2009 VL 88 IS 8 BP 995 EP 1001 DI 10.1097/TP.0b013e3181b9ccd5 PG 7 WC Immunology; Surgery; Transplantation SC Immunology; Surgery; Transplantation GA 511MP UT WOS:000271169700009 PM 19855245 ER PT J AU Franciosi, S Sosa, MAG English, DF Oler, E Oung, T Janssen, WGM De Gasperi, R Schmeidler, J Dickstein, DL Schmitz, C Gandy, S Hof, PR Buxbaum, JD Elder, GA AF Franciosi, Sonia Sosa, Miguel A. Gama English, Daniel F. Oler, Elizabeth Oung, Twethida Janssen, William G. M. De Gasperi, Rita Schmeidler, James Dickstein, Dara L. Schmitz, Christoph Gandy, Sam Hof, Patrick R. Buxbaum, Joseph D. Elder, Gregory A. TI Novel cerebrovascular pathology in mice fed a high cholesterol diet SO MOLECULAR NEURODEGENERATION LA English DT Article ID DENSITY-LIPOPROTEIN RECEPTOR; ALZHEIMERS-DISEASE; MICROVASCULAR RESPONSES; METABOLIC SYNDROME; APOLIPOPROTEIN-E; KNOCKOUT MICE; RISK-FACTOR; LOW-FAT; HYPERCHOLESTEROLEMIA; ATHEROSCLEROSIS AB Background: Hypercholesterolemia causes atherosclerosis in medium to large sized arteries. Cholesterol is less known for affecting the microvasculature and has not been previously reported to induce microvascular pathology in the central nervous system (CNS). Results: Mice with a null mutation in the low-density lipoprotein receptor (LDLR) gene as well as C57BL/6J mice fed a high cholesterol diet developed a distinct microvascular pathology in the CNS that differs from cholesterol-induced atherosclerotic disease. Microvessel diameter was increased but microvascular density and length were not consistently affected. Degenerative changes and thickened vascular basement membranes were present ultrastructurally. The observed pathology shares features with the microvascular pathology of Alzheimer's disease (AD), including the presence of string-like vessels. Brain apolipoprotein E levels which have been previously found to be elevated in LDLR-/- mice were also increased in C57BL/6J mice fed a high cholesterol diet. Conclusion: In addition to its effects as an inducer of atherosclerosis in medium to large sized arteries, hypercholesterolemia also induces a microvascular pathology in the CNS that shares features of the vascular pathology found in AD. These observations suggest that high cholesterol may induce microvascular disease in a range of CNS disorders including AD. C1 [Franciosi, Sonia; Sosa, Miguel A. Gama; English, Daniel F.; De Gasperi, Rita; Schmeidler, James; Gandy, Sam; Buxbaum, Joseph D.; Elder, Gregory A.] Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. [Franciosi, Sonia; English, Daniel F.; Buxbaum, Joseph D.] Mt Sinai Sch Med, Lab Mol Neuropsychiat, New York, NY 10029 USA. [Franciosi, Sonia; Sosa, Miguel A. Gama; De Gasperi, Rita] Vet Affairs Med Ctr, James J Peters Dept, Res & Dev Serv, Bronx, NY 10468 USA. [Oler, Elizabeth; Oung, Twethida; Janssen, William G. M.; Dickstein, Dara L.; Schmitz, Christoph; Hof, Patrick R.; Buxbaum, Joseph D.] Mt Sinai Sch Med, Dept Neurosci, New York, NY 10029 USA. [Dickstein, Dara L.; Hof, Patrick R.] Mt Sinai Sch Med, Computat Neurobiol & Imaging Ctr, New York, NY 10029 USA. [Gandy, Sam; Elder, Gregory A.] Mt Sinai Sch Med, Dept Neurol, New York, NY 10029 USA. [Gandy, Sam; Elder, Gregory A.] Vet Affairs Med Ctr, James J Peters Dept, Neurol Serv, Bronx, NY 10468 USA. [Hof, Patrick R.] Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY 10029 USA. [Buxbaum, Joseph D.] Mt Sinai Sch Med, Dept Genet & Genom Sci, New York, NY 10029 USA. RP Elder, GA (reprint author), Mt Sinai Sch Med, Dept Psychiat, 1 Gustave L Levy Pl, New York, NY 10029 USA. EM sfranciosi@cmmt.ubc.ca; miguel.gama-sosa@mssm.edu; englishdaniel@gmail.com; lizoler@gmail.com; twethida.oung@mssm.edu; bill.janssen@mssm.edu; rita.de-gasperi@mssm.edu; james.schmeidler@mssm.edu; dara.dickstein@mssm.edu; cs.999@gmx.net; samuel.gandy@mssm.edu; patrick.hof@mssm.edu; joseph.buxbaum@mssm.edu; gregory.elder@mssm.edu RI Dickstein, Dara/F-3036-2013 OI Buxbaum, Joseph/0000-0001-8898-8313 FU NIH [AG02219, AG05138] FX We thank Bridget Wicinski for expert technical assistance. This work was supported by NIH grants AG02219 and AG05138. NR 53 TC 11 Z9 11 U1 0 U2 2 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1750-1326 J9 MOL NEURODEGENER JI Mol. Neurodegener. PD OCT 24 PY 2009 VL 4 AR 42 DI 10.1186/1750-1326-4-42 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 517JG UT WOS:000271608800001 PM 19852847 ER PT J AU Choi, AI Shlipak, MG Hunt, PW Martin, JN Deeks, SG AF Choi, Andy I. Shlipak, Michael G. Hunt, Peter W. Martin, Jeffrey N. Deeks, Steven G. TI HIV-infected persons continue to lose kidney function despite successful antiretroviral therapy SO AIDS LA English DT Article DE antiretroviral therapy; glomerular filtration rate; HIV; kidney diseases; viral load ID IMPROVES RENAL-FUNCTION; RISK-FACTORS; SERUM CREATININE; DISEASE; NEPHROPATHY; WOMEN; ASSOCIATION; FAILURE; RECOMMENDATIONS; PROTEINURIA AB Objective: To identify risk factors associated with kidney function decline in a contemporary cohort of treated and untreated HIV-infected patients. Methods: We followed individuals enrolled in the Study of the Consequences Of the Protease inhibitor Era cohort for longitudinal changes in kidney function, defined as glomerular filtration rate estimated from serum creatinine (eGFR). eGFR slope was calculated using linear mixed effects models adjusted for age, sex, race, and time-updated CD4 cell count, viral load, antiretroviral therapy (ART), and comorbid conditions. Results: We followed 615 patients for a mean of 3.4 (+/- 2.5) years. In multivariable adjusted analyses, predictors of eGFR decline included female sex, diabetes, and hyperlipidemia; CD4 cell count and viral load were not associated with eGFR loss. Among patients who initiated treatment, antiretroviral exposure was associated with a +2.8 (95% confidence interval 0.8-4.7) ml/min per 1.73 m(2) per year effect on eGFR slope. Although these patients appeared to benefit from ART based on the slowing of their eGFR decline, they continued to lose kidney function at a rate of -1.9 (95% confidence interval -3.7 to -0.1) ml/min per 1.73 m(2) per year. In the subgroup of individuals receiving suppressive ART with viral loads maintained below 500 copies/ml, intermittent viremic episodes (blips) were strongly associated with more rapid rates of eGFR loss [-6.7 (95% confidence interval -11.1 to -2.4) ml/min per 1.73 m2 per year]. Conclusion: Although ART appears to help curb kidney function decline, patients who achieved durable viral suppression continue to manifest substantial loss of eGFR. Loss of kidney function may be attributable to treatment-related factors, intermittent viremia, and traditional risk factors for kidney disease. (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins C1 [Choi, Andy I.; Shlipak, Michael G.] San Francisco VA Med Ctr, Dept Med, San Francisco, CA 94121 USA. [Choi, Andy I.; Shlipak, Michael G.; Martin, Jeffrey N.] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. [Hunt, Peter W.; Deeks, Steven G.] San Francisco Gen Hosp, Posit Hlth Program, San Francisco, CA 94110 USA. [Martin, Jeffrey N.] Univ Calif San Francisco, Ctr AIDS Prevent Studies, San Francisco, CA 94143 USA. RP Choi, AI (reprint author), San Francisco VA Med Ctr, Dept Med, Box 111J,4150 Clement St, San Francisco, CA 94121 USA. EM andy.choi@ucsf.edu FU National Institutes of Health [K23DK080645-01A1, K23AI65244, K24AI069994, R01 DK066488-01]; Centers for AIDS Research at UCSF [A127763, MH59037]; UCSF Clinical and Translational Science Institute [UL1 RR024131-01]; National Center for Research Resources [KL2 RR024130]; American Heart Association Early Investigator Award; American Foundation for AIDS Research [106710-40-RGRL] FX This study was supported by grants from the National Institutes of Health (K23DK080645-01A1, K23AI65244, K24AI069994, and R01 DK066488-01), the Centers for AIDS Research at UCSF (A127763 and MH59037), the UCSF Clinical and Translational Science Institute (UL1 RR024131-01), the National Center for Research Resources (KL2 RR024130), the American Heart Association Early Investigator Award, and the American Foundation for AIDS Research (106710-40-RGRL). These funding sources had no involvement in the design or execution of this study. NR 38 TC 54 Z9 55 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 J9 AIDS JI Aids PD OCT 23 PY 2009 VL 23 IS 16 BP 2143 EP 2149 DI 10.1097/QAD.0b013e3283313c91 PG 7 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 517FS UT WOS:000271599200009 PM 19684507 ER PT J AU Sidransky, E Nalls, MA Aasly, JO Aharon-Peretz, J Annesi, G Barbosa, ER Bar-Shira, A Berg, D Bras, J Brice, A Chen, CM Clark, LN Condroyer, C De Marco, EV Durr, A Eblan, MJ Fahn, S Farrer, MJ Fung, HC Gan-Or, Z Gasser, T Gershoni-Baruch, R Giladi, N Griffith, A Gurevich, T Januario, C Kropp, P Lang, AE Lee-Chen, GJ Lesage, S Marder, K Mata, IF Mirelman, A Mitsui, J Mizuta, I Nicoletti, G Oliveira, C Ottman, R Orr-Urtreger, A Pereira, LV Quattrone, A Rogaeva, E Rolfs, A Rosenbaum, H Rozenberg, R Samii, A Samaddar, T Schulte, C Sharma, M Singleton, A Spitz, M Tan, EK Tayebi, N Toda, T Troiano, AR Tsuji, S Wittstock, M Wolfsberg, TG Wu, YR Zabetian, CP Zhao, Y Ziegler, SG AF Sidransky, E. Nalls, M. A. Aasly, J. O. Aharon-Peretz, J. Annesi, G. Barbosa, E. R. Bar-Shira, A. Berg, D. Bras, J. Brice, A. Chen, C. -M. Clark, L. N. Condroyer, C. De Marco, E. V. Duerr, A. Eblan, M. J. Fahn, S. Farrer, M. J. Fung, H. -C. Gan-Or, Z. Gasser, T. Gershoni-Baruch, R. Giladi, N. Griffith, A. Gurevich, T. Januario, C. Kropp, P. Lang, A. E. Lee-Chen, G. -J. Lesage, S. Marder, K. Mata, I. F. Mirelman, A. Mitsui, J. Mizuta, I. Nicoletti, G. Oliveira, C. Ottman, R. Orr-Urtreger, A. Pereira, L. V. Quattrone, A. Rogaeva, E. Rolfs, A. Rosenbaum, H. Rozenberg, R. Samii, A. Samaddar, T. Schulte, C. Sharma, M. Singleton, A. Spitz, M. Tan, E. -K. Tayebi, N. Toda, T. Troiano, A. R. Tsuji, S. Wittstock, M. Wolfsberg, T. G. Wu, Y. -R. Zabetian, C. P. Zhao, Y. Ziegler, S. G. TI Multicenter Analysis of Glucocerebrosidase Mutations in Parkinson's Disease SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID LEWY BODY DISORDERS; GAUCHER-DISEASE; GENE-MUTATIONS; EARLY-ONSET; RISK-FACTOR; GBA; SUSCEPTIBILITY; MANIFESTATIONS; POLYMORPHISM; ASSOCIATION AB Background Recent studies indicate an increased frequency of mutations in the gene encoding glucocerebrosidase (GBA), a deficiency of which causes Gaucher's disease, among patients with Parkinson's disease. We aimed to ascertain the frequency of GBA mutations in an ethnically diverse group of patients with Parkinson's disease. Methods Sixteen centers participated in our international, collaborative study: five from the Americas, six from Europe, two from Israel, and three from Asia. Each center genotyped a standard DNA panel to permit comparison of the genotyping results across centers. Genotypes and phenotypic data from a total of 5691 patients with Parkinson's disease (780 Ashkenazi Jews) and 4898 controls (387 Ashkenazi Jews) were analyzed, with multivariate logistic-regression models and the Mantel-Haenszel procedure used to estimate odds ratios across centers. Results All 16 centers could detect two GBA mutations, L444P and N370S. Among Ashkenazi Jewish subjects, either mutation was found in 15% of patients and 3% of controls, and among non-Ashkenazi Jewish subjects, either mutation was found in 3% of patients and less than 1% of controls. GBA was fully sequenced for 1883 non-Ashkenazi Jewish patients, and mutations were identified in 7%, showing that limited mutation screening can miss half the mutant alleles. The odds ratio for any GBA mutation in patients versus controls was 5.43 across centers. As compared with patients who did not carry a GBA mutation, those with a GBA mutation presented earlier with the disease, were more likely to have affected relatives, and were more likely to have atypical clinical manifestations. Conclusions Data collected from 16 centers demonstrate that there is a strong association between GBA mutations and Parkinson's disease. C1 [Sidransky, E.; Eblan, M. J.; Samaddar, T.; Tayebi, N.; Ziegler, S. G.] NHGRI, Sect Mol Neurogenet, Med Genet Branch, Bethesda, MD 20892 USA. [Nalls, M. A.; Bras, J.; Samii, A.] NIA, Neurogenet Lab, NIH, Bethesda, MD 20892 USA. [Wolfsberg, T. G.] NHGRI, Genome Technol Branch, NIH, Bethesda, MD 20892 USA. [Aasly, J. O.] St Olavs Hosp, Dept Neurol, Trondheim, Norway. [Aasly, J. O.] Norwegian Univ Sci & Technol, Dept Neurosci, N-7034 Trondheim, Norway. [Aharon-Peretz, J.] Technion Israel Inst Technol, Cognit Neurol & Movement Disorder Unit, Haifa, Israel. [Gershoni-Baruch, R.] Technion Israel Inst Technol, Human Genet Rambam Med Ctr, Haifa, Israel. [Gershoni-Baruch, R.] Technion Israel Inst Technol, Bruce Rappaport Fac Med, IL-31096 Haifa, Israel. [Rosenbaum, H.] Technion Israel Inst Technol, Dept Hematol, IL-31096 Haifa, Israel. [Rosenbaum, H.] Technion Israel Inst Technol, Dept Bone Marrow Transplant, IL-31096 Haifa, Israel. [Nicoletti, G.; Quattrone, A.] Magna Graecia Univ Catanzaro, Dept Med Sci, Inst Neurol, Catanzaro, Italy. [Annesi, G.; De Marco, E. V.; Nicoletti, G.; Quattrone, A.] CNR, Inst Neurol Sci, Cosenza, Italy. [Barbosa, E. R.; Spitz, M.] Univ Sao Paulo, Sch Med, Dept Neurol, Movement Disorders Unit, Sao Paulo, Brazil. [Pereira, L. V.; Rozenberg, R.] Univ Sao Paulo, Biosci Inst, Dept Genet & Evolutionary Biol, Mol Genet Lab, Sao Paulo, Brazil. [Bar-Shira, A.; Gan-Or, Z.; Orr-Urtreger, A.] Tel Aviv Univ, Genet Inst, IL-69978 Tel Aviv, Israel. [Giladi, N.; Gurevich, T.; Mirelman, A.] Tel Aviv Univ, Tel Aviv Sourasky Med Ctr, Dept Neurol, Movement Disorders Unit,Parkinson Ctr, IL-69978 Tel Aviv, Israel. [Gan-Or, Z.; Giladi, N.; Gurevich, T.; Orr-Urtreger, A.] Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel. [Berg, D.; Gasser, T.; Schulte, C.; Sharma, M.] Univ Tubingen, Dept Neurodegenerat Dis, Hertie Inst Clin Brain Res, Tubingen, Germany. [Bras, J.; Oliveira, C.] Univ Coimbra, Ctr Neurosci & Cell Biol, Coimbra, Portugal. [Januario, C.; Oliveira, C.] Univ Coimbra Hosp, Neurol Serv, Coimbra, Portugal. [Brice, A.; Condroyer, C.; Duerr, A.; Lesage, S.] Univ Paris 06, INSERM, Ctr Rech,Inst Cerveau & Moelle Epiniere, Unite Mixte Rech S679, Paris, France. [Brice, A.; Duerr, A.] Grp Hosp Pitie Salpetriere, AP HP, F-75634 Paris, France. [Brice, A.; Duerr, A.] Grp Hosp Pitie Salpetriere, Dept Genet & Cytogenet, F-75634 Paris, France. [Chen, C. -M.; Fung, H. -C.; Wu, Y. -R.] Chang Gung Univ, Coll Med, Chang Gung Mem Hosp, Dept Neurol, Taipei, Taiwan. [Clark, L. N.; Marder, K.] Columbia Univ Coll Phys & Surg, Taub Inst Res Alzheimers Dis & Aging Brain, New York, NY 10032 USA. [Clark, L. N.] Columbia Univ Coll Phys & Surg, Ctr Human Genet, New York, NY 10032 USA. [Clark, L. N.] Columbia Univ Coll Phys & Surg, Dept Pathol, New York, NY 10032 USA. [Fahn, S.; Marder, K.; Ottman, R.] Columbia Univ Coll Phys & Surg, Dept Neurol, New York, NY 10032 USA. [Marder, K.] Columbia Univ Coll Phys & Surg, Dept Psychiat, New York, NY 10032 USA. [Marder, K.; Ottman, R.] Columbia Univ Coll Phys & Surg, Gertrude H Sergievsky Ctr, New York, NY 10032 USA. [Ottman, R.] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY USA. [Ottman, R.] New York State Psychiat Inst & Hosp, New York, NY 10032 USA. [Farrer, M. J.] Mayo Clin, Coll Med, Dept Neurosci, Neurogenet Lab, Jacksonville, FL 32224 USA. [Griffith, A.] Evergreen Hosp Med Ctr, Booth Gardner Parkinsons Care Ctr, Kirkland, WA USA. [Kropp, P.] Univ Rostock, Inst Med Psychol, Rostock, Germany. [Rolfs, A.] Univ Rostock, Albrecht Kossel Inst Neuroregenerat, Rostock, Germany. [Wittstock, M.] Univ Rostock, Dept Neurol, Rostock, Germany. [Lang, A. E.] Toronto Western Hosp, Movement Disorders Ctr, Div Neurol, Dept Med, Toronto, ON M5T 2S8, Canada. [Rogaeva, E.] Univ Toronto, Ctr Res Neurodegenerat Dis, Toronto, ON, Canada. [Lee-Chen, G. -J.] Natl Taiwan Normal Univ, Dept Life Sci, Taipei, Taiwan. [Mata, I. F.; Samii, A.; Zabetian, C. P.] VA Puget Sound Hlth Care Syst, Parkinsons Dis & Geriatr Res Educ & Clin Ctr, Seattle, WA USA. [Mata, I. F.; Samii, A.; Zabetian, C. P.] Univ Washington, Dept Neurol, Seattle, WA 98195 USA. [Mitsui, J.; Tsuji, S.] Univ Tokyo, Grad Sch Med, Dept Neurol, Tokyo, Japan. [Mizuta, I.; Toda, T.] Kobe Univ, Grad Sch Med, Div Neurol & Mol Brain Sci, Kobe, Hyogo 657, Japan. [Tan, E. -K.] Singapore Gen Hosp, Natl Inst Neurosci, Singapore 0316, Singapore. [Tan, E. -K.] Duke NUS Grada Med Sch, Singapore, Singapore. RP Sidransky, E (reprint author), NHGRI, Sect Mol Neurogenet, Med Genet Branch, Rm 1A213,35 Convent Dr, Bethesda, MD 20892 USA. EM sidranse@mail.nih.gov RI ; Bras, Jose/D-3366-2009; Bras, Jose/A-1428-2011; Singleton, Andrew/C-3010-2009; Mitsui, Jun/B-5455-2012; Pereira, Lygia/C-1049-2012; Kropp, Peter/B-8132-2012; Barbosa, Egberto/G-7763-2012; Ottman, Ruth/O-2371-2013; QUATTRONE, Aldo/A-6734-2016; IB/USP, Genetica e Biologia /G-1755-2017 OI Schulte, Claudia/0000-0003-4006-1265; Oliveira, Catarina/0000-0001-6942-4328; DEMARCO, ELVIRAVALERIA/0000-0002-4947-8481; Mitsui, Jun/0000-0001-7425-4765; Pereira, Lygia/0000-0002-0002-725X; Ottman, Ruth/0000-0001-7074-242X; QUATTRONE, Aldo/0000-0003-2001-957X; Zabetian, Cyrus/0000-0002-7739-4306; Gan-Or, Ziv/0000-0003-0332-234X FU National Institutes of Health [Z01AG000957-05]; National Institute of Neurological Disorders and Stroke and the National Center for Research Resources [NS050487, NS060113, NS40256]; Parkinson's Disease Foundation; Department of Veterans Affairs, Seattle; German National Genome Network, German Ministry for Education and Research [01GS08134]; French Parkinson's Disease Genetics Study Group; Duke-National University of Singapore (NUS) Graduate Medical School, National Medical Research Council, Biomedical Research Council, Singapore Millennium Foundation; SingHealth, Singapore General Hospital, National Neuroscience Institute; Tel Aviv Sourasky Medical Center Grant of Excellence; Wolfson and Kahn Foundations; Portuguese Fundacao para a Ciencia e a Tecnologia; National Science Council, Executive Yuan, Taiwan [NSC-95-2314-B-182A-061]; Ministry of Education, Culture, Sports, Science and Technology of Japan FX Supported in part by the Intramural Research Programs of NHGRI and the National Institute on Aging (project Z01AG000957-05), National Institutes of Health; grants from the National Institute of Neurological Disorders and Stroke and the National Center for Research Resources (NS050487, NS060113, and NS40256); grants from the Parkinson's Disease Foundation; a Merit Review Award from the Department of Veterans Affairs, Seattle; a grant from the German National Genome Network, German Ministry for Education and Research (01GS08134); a grant from the French Parkinson's Disease Genetics Study Group; a grant from the Duke-National University of Singapore (NUS) Graduate Medical School, National Medical Research Council, Biomedical Research Council, Singapore Millennium Foundation; a grant from SingHealth, Singapore General Hospital, National Neuroscience Institute; the Tel Aviv Sourasky Medical Center Grant of Excellence; grants from the Wolfson and Kahn Foundations; a grant from the Portuguese Fundacao para a Ciencia e a Tecnologia; a grant from the National Science Council, Executive Yuan, Taiwan (NSC-95-2314-B-182A-061); and a Grant-in-Aid for Scientific Research on Priority Areas, Applied Genomics, and Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan. NR 44 TC 558 Z9 566 U1 5 U2 29 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 OCT 22 PY 2009 VL 361 IS 17 BP 1651 EP 1661 DI 10.1056/NEJMoa0901281 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 508YW UT WOS:000270977400007 PM 19846850 ER PT J AU Palevsky, PM AF Palevsky, Paul M. TI Renal Support in Acute Kidney Injury - How Much Is Enough? SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material ID CRITICALLY-ILL PATIENTS; CONTINUOUS VENOVENOUS HEMOFILTRATION; RANDOMIZED-TRIAL; FAILURE; SURVIVAL; DIALYSIS; THERAPY C1 [Palevsky, Paul M.] VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA USA. [Palevsky, Paul M.] Univ Pittsburgh, Sch Med, Dept Med, Renal Electrolyte Div, Pittsburgh, PA USA. RP Palevsky, PM (reprint author), VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA USA. OI Palevsky, Paul/0000-0002-7334-5400 NR 11 TC 8 Z9 16 U1 0 U2 1 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 OCT 22 PY 2009 VL 361 IS 17 BP 1699 EP 1701 DI 10.1056/NEJMe0907831 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 508YW UT WOS:000270977400014 PM 19846856 ER PT J AU Pedrini, S Thomas, C Brautigam, H Schmeidler, J Ho, L Fraser, P Westaway, D Hyslop, PSG Martins, RN Buxbaum, JD Pasinetti, GM Dickstein, DL Hof, PR Ehrlich, ME Gandy, S AF Pedrini, Steve Thomas, Carlos Brautigam, Hannah Schmeidler, James Ho, Lap Fraser, Paul Westaway, David Hyslop, Peter St George Martins, Ralph N. Buxbaum, Joseph D. Pasinetti, Giulio M. Dickstein, Dara L. Hof, Patrick R. Ehrlich, Michelle E. Gandy, Sam TI Dietary composition modulates brain mass and solubilizable A levels in a mouse model of aggressive Alzheimer's amyloid pathology SO MOLECULAR NEURODEGENERATION LA English DT Article ID INSULIN-RESISTANCE; TRANSGENIC MICE; DISEASE; DEMENTIA; NEUROPATHOLOGY; CHOLESTEROL; ACID; ACCUMULATION; DEFICITS AB Objective: Alzheimer's disease (AD) is a progressive neurodegenerative disease of the central nervous system (CNS). Recently, an increased interest in the role diet plays in the pathology of AD has resulted in a focus on the detrimental effects of diets high in cholesterol and fat and the beneficial effects of caloric restriction. The current study examines how dietary composition modulates cerebral amyloidosis and neuronal integrity in the TgCRND8 mouse model of AD. Methods: From 4 wks until 18 wks of age, male and female TgCRND8 mice were maintained on one of four diets: (1) reference (regular) commercial chow; (2) high fat/low carbohydrate custom chow (60 kcal% fat/30 kcal% protein/10 kcal% carbohydrate); (3) high protein/low carbohydrate custom chow (60 kcal% protein/30 kcal% fat/10 kcal% carbohydrate); or (4) high carbohydrate/low fat custom chow (60 kcal% carbohydrate/30 kcal% protein/10 kcal% fat). At age 18 wks, mice were sacrificed, and brains studied for (a) wet weight; (b) solubilizable A beta content by ELISA; (c) amyloid plaque burden; (d) stereologic analysis of selected hippocampal subregions. Results: Animals receiving a high fat diet showed increased brain levels of solubilizable A beta, although we detected no effect on plaque burden. Unexpectedly, brains of mice fed a high protein/low carbohydrate diet were 5% lower in weight than brains from all other mice. In an effort to identify regions that might link loss of brain mass to cognitive function, we studied neuronal density and volume in hippocampal subregions. Neuronal density and volume in the hippocampal CA3 region of TgCRND8 mice tended to be lower in TgCRND8 mice receiving the high protein/low carbohydrate diet than in those receiving the regular chow. Neuronal density and volume were preserved in CA1 and in the dentate gyrus. Interpretation: Dissociation of A beta changes from brain mass changes raises the possibility that diet plays a role not only in modulating amyloidosis but also in modulating neuronal vulnerability. However, in the absence of a study of the effects of a high protein/low carbohydrate diet on nontransgenic mice, one cannot be certain how much, if any, of the loss of brain mass exhibited by high protein/low carbohydrate diet-fed TgCRND8 mice was due to an interaction between cerebral amyloidosis and diet. Given the recent evidence that certain factors favor the maintenance of cognitive function in the face of substantial structural neuropathology, we propose that there might also exist factors that sensitize brain neurons to some forms of neurotoxicity, including, perhaps, amyloid neurotoxicity. Identification of these factors could help reconcile the poor clinicopathological correlation between cognitive status and structural neuropathology, including amyloid pathology. C1 [Pedrini, Steve; Gandy, Sam] Thomas Jefferson Univ, Jefferson Med Coll, Farber Inst Neurosci, Philadelphia, PA 19107 USA. [Thomas, Carlos; Brautigam, Hannah; Schmeidler, James; Ho, Lap; Buxbaum, Joseph D.; Pasinetti, Giulio M.; Dickstein, Dara L.; Hof, Patrick R.; Ehrlich, Michelle E.; Gandy, Sam] Mt Sinai Sch Med, Alzheimers Dis Res Ctr, New York, NY USA. [Thomas, Carlos; Brautigam, Hannah; Schmeidler, James; Ho, Lap; Buxbaum, Joseph D.; Pasinetti, Giulio M.; Gandy, Sam] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. [Thomas, Carlos; Brautigam, Hannah; Ho, Lap; Pasinetti, Giulio M.; Ehrlich, Michelle E.; Gandy, Sam] Mt Sinai Sch Med, Dept Neurol, New York, NY USA. [Thomas, Carlos; Brautigam, Hannah; Ho, Lap; Pasinetti, Giulio M.; Gandy, Sam] James J Peters Vet Affairs Med Ctr, Bronx, NY USA. [Fraser, Paul; Hyslop, Peter St George] Univ Toronto, Ctr Res Neurodegenerat Dis, Toronto, ON, Canada. [Westaway, David] Univ Alberta, Ctr Prions & Prot Folding Dis, Edmonton, AB, Canada. [Hyslop, Peter St George] Univ Cambridge, Cambridge, England. [Martins, Ralph N.] Edith Cowan Univ, Joondalup, WA, Australia. [Brautigam, Hannah; Dickstein, Dara L.; Hof, Patrick R.] Mt Sinai Sch Med, Dept Neurosci, New York, NY USA. [Ehrlich, Michelle E.] Mt Sinai Sch Med, Dept Pediat, New York, NY USA. RP Gandy, S (reprint author), Thomas Jefferson Univ, Jefferson Med Coll, Farber Inst Neurosci, Philadelphia, PA 19107 USA. EM steve.pedrini@jefferson.edu; carlos.thomas@mssm.edu; hannah.brautigam@mssm.edu; james.schmeidler@mssm.edu; lap.ho@mssm.edu; paul.fraser@utoronto.ca; david.westaway@ualberta.ca; p.hyslop@utoronto.ca; r.martins@ecu.edu.au; joseph.buxbaum@mssm.edu; giulio.pasinetti@mssm.edu; dara.dickstein@mssm.edu; patrick.hof@mssm.edu; michelle.ehrlich@mssm.edu; samuel.gandy@mssm.edu RI Dickstein, Dara/F-3036-2013 OI Buxbaum, Joseph/0000-0001-8898-8313 FU Dr. Robert C. and Veronica Atkins Foundation; NIH [P01 AG10491, P01 AG02219, P50 AG05138] FX This work was supported by the Dr. Robert C. and Veronica Atkins Foundation (S.G., S.P., C.T., G.M.P., L.H.) and NIH grants P01 AG10491 (S.G., S.P., C.T., H.B., J.D.B., R.N.M., M.E.E.; S. Gandy, Program Director), P01 AG02219 (P.R.H., J.D.B., J.S., G.M.P., D.L.D.; H. Haroutunian, Program Director), and P50 AG05138 (P.R.H., J.D.B., J.S., G.M.P., D.L.D.; M. Sano, Program Director). NR 25 TC 16 Z9 18 U1 0 U2 3 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1750-1326 J9 MOL NEURODEGENER JI Mol. Neurodegener. PD OCT 21 PY 2009 VL 4 AR 40 DI 10.1186/1750-1326-4-40 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 517JD UT WOS:000271608500001 PM 19845940 ER PT J AU Bergman, J Gore, JL Saigal, CS Kwan, L Litwin, MS AF Bergman, Jonathan Gore, John L. Saigal, Christopher S. Kwan, Lorna Litwin, Mark S. TI Partnership and Outcomes in Men With Prostate Cancer SO CANCER LA English DT Article DE prostatic neoplasms; quality of life; marital relationship; outcome assessment; neoplasms ID QUALITY-OF-LIFE; BREAST-CANCER; PSYCHOLOGICAL DISTRESS; ERECTILE DYSFUNCTION; COUPLES; HEALTH; SUPPORT; CARCINOMA; VALIDITY; WOMEN AB BACKGROUND: Being in a supportive relationship may have improved the health-related quality of life (HRQOL) of men with prostate cancer, if the support was strong and positive. In the current study, the authors sought to examine the impact of partnership status on the mental health of men treated for localized prostate cancer. METHODS: Participants had clinically localized prostate cancer and chose treatment with radical prostatectomy (n=307), external-beam radiotherapy (n=78), or brachytherapy (n=91). The authors prospectively assessed subject characteristics and HRQOL outcomes and evaluated associations between partnership outcomes and HRQOL measures. Two multivariate linear regression models were then created, I for baseline HRQOL outcomes and 1 for change in HRQOL from baseline to 12 months, with partnership status as the main predictor and subject characteristics as covariates. RESULTS: Partnership status was not found to be associated with either baseline physical or mental health, but partnered participants had less bowel bother (P=.02) and a lower fear of recurrence (P=.03) at baseline than did unpartnered subjects. Men with fewer comorbid conditions scored better across almost all baseline HRQOL domains. Primary treatment type was significantly associated with changes in physical HRQOL, with men undergoing radical prostatectomy describing better changes in physical health than those treated with brachytherapy (P=.04) or those receiving external-beam radiotherapy (P <=.01). CONCLUSIONS: Physical and mental health was found to be comparable in the study cohort of partnered and unpartnered men treated for prostate cancer. The universally high socioeconomic status of the current study cohort may mitigate differences in HRQOL by partnership status. Cancer 2009;115:4688-94. (C) 2009 American Cancer Society. C1 [Bergman, Jonathan; Gore, John L.] Univ Calif Los Angeles, Dept Urol, Robert Wood Johnson Clin Scholars Program, Los Angeles, CA 90095 USA. [Gore, John L.; Saigal, Christopher S.] Vet Adm Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. [Saigal, Christopher S.; Litwin, Mark S.] Univ Calif Los Angeles, Dept Hlth Serv, Los Angeles, CA 90095 USA. [Saigal, Christopher S.; Kwan, Lorna; Litwin, Mark S.] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Los Angeles, CA 90095 USA. RP Bergman, J (reprint author), Univ Calif Los Angeles, Dept Urol, Robert Wood Johnson Clin Scholars Program, Box 951738, Los Angeles, CA 90095 USA. EM jbergman@mednet.ucla.edu OI Gore, John/0000-0002-2847-5062 NR 27 TC 11 Z9 12 U1 2 U2 8 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER-AM CANCER SOC JI Cancer PD OCT 15 PY 2009 VL 115 IS 20 BP 4688 EP 4694 DI 10.1002/cncr.24544 PG 7 WC Oncology SC Oncology GA 505ZJ UT WOS:000270740900008 PM 19626653 ER PT J AU Trautner, BW Musher, DM AF Trautner, Barbara W. Musher, Daniel M. TI Surveillance Definitions for Urinary Tract Infections Reply SO CLINICAL INFECTIOUS DISEASES LA English DT Letter C1 [Trautner, Barbara W.; Musher, Daniel M.] Baylor Coll Med, Dept Med, Div Infect Dis, Houston, TX 77005 USA. [Trautner, Barbara W.] Baylor Coll Med, Dept Phys Med & Rehabil, Houston, TX 77005 USA. [Trautner, Barbara W.; Musher, Daniel M.] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Trautner, BW (reprint author), Baylor Coll Med, Dept Med, Div Infect Dis, Spinal Cord Injury 128,MCDVAMC 2002,Holcombe Blvd, Houston, TX 77005 USA. EM trautner@bcm.edu NR 2 TC 0 Z9 0 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 OCT 15 PY 2009 VL 49 IS 8 BP 1289 EP 1289 DI 10.1086/605693 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 499NY UT WOS:000270230100028 ER PT J AU Hinrichs, C Singh, V Mukherjee, L Xu, GF Chung, MK Johnson, SC AF Hinrichs, Chris Singh, Vikas Mukherjee, Lopamudra Xu, Guofan Chung, Moo K. Johnson, Sterling C. CA Alzheimer's Dis Neuroimaging Initi TI Spatially augmented LPboosting for AD classification with evaluations on the ADNI dataset SO NEUROIMAGE LA English DT Article ID DIMENSIONAL PATTERN-CLASSIFICATION; PRODROMAL ALZHEIMERS-DISEASE; COGNITIVE DECLINE; FEATURE-SELECTION; BRAIN ATROPHY; MR-IMAGES; DIAGNOSIS; ALGORITHM; DEMENTIA; PET AB Structural and functional brain images are playing an important role in helping us understand the changes associated with neurological disorders such as Alzheimer's disease (AD). Recent efforts have now started investigating their utility for diagnosis purposes. This line of research has shown promising results where methods from machine learning (such as Support Vector Machines) have been used to identify AD-related patterns from images, for use in diagnosing new individual subjects. In this paper, we propose a new framework for AD classification which makes use of the Linear Program (LP) boosting with novel additional regularization based on spatial "smoothness" in 3D image coordinate spaces. The algorithm formalizes the expectation that since the examples for training the classifier are images, the voxels eventually selected for specifying the decision boundary must constitute spatially contiguous chunks, i.e., "regions" must be preferred over isolated voxels. This prior belief turns out to be useful for significantly reducing the space of possible classifiers and leads to substantial benefits in generalization. In our method, the requirement of spatial contiguity (of selected discriminating voxels) is incorporated within the optimization framework directly. Other methods have made use of similar biases as a pre- or post-processing step, however, our model incorporates this emphasis on spatial smoothness directly into the learning step. We report on extensive evaluations of our algorithm on MR and FDG-PET images from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset, and discuss the relationship of the classification output with the clinical and cognitive biomarker data available within ADNI. (C) 2009 Elsevier Inc. All rights reserved. C1 [Hinrichs, Chris; Singh, Vikas] Univ Wisconsin, Dept Comp Sci, Madison, WI 53706 USA. [Hinrichs, Chris; Singh, Vikas; Chung, Moo K.] Univ Wisconsin, Dept Biostat & Med Informat, Madison, WI 53705 USA. [Mukherjee, Lopamudra] Univ Wisconsin, Dept Math & Comp Sci, Whitewater, WI 53190 USA. [Xu, Guofan; Johnson, Sterling C.] Univ Wisconsin, Dept Med, Madison, WI 53792 USA. [Xu, Guofan; Johnson, Sterling C.] William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53792 USA. RP Hinrichs, C (reprint author), 7645 Med Sci Ctr, Madison, WI 53706 USA. EM hinrichs@cs.wisc.edu RI Scharre, Douglas/E-4030-2011 OI Johnson, Sterling/0000-0002-8501-545X FU Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, UW ICTR through an NIH Clinical and Translational Science Award (CTSA) [1UL1RR025011]; Department of Veterans Affairs; Wisconsin Comprehensive Memory Program; NIH [AG021155, U01 AG024904]; Alzheimer's Disease Neuroimaging Initiative; National Institute on Aging; National Institute of Biomedical Imaging and Bioengineering (NIBIB); Pfizer Inc.; Wyeth Research; Bristol-Myers Squibb; Eli Lilly and Company; GlaxoSmithKline; Merck Co. Inc.; AstraZeneca AB; Novartis Pharmaceuticals Corporation; Alzheimer's Association; Eisai Global Clinical Development; Elan Corporation plc; Forest Laboratories; Institute for the Study of Aging FX This research was supported in part by the Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, UW ICTR through an NIH Clinical and Translational Science Award (CTSA) 1UL1RR025011, a Merit Review Grant from the Department of Veterans Affairs, the Wisconsin Comprehensive Memory Program, and an NIH grant AG021155. The authors also acknowledge the facilities and resources at the William S. Middleton Memorial Veterans Hospital.; Data collection and sharing for this project was funded by the Alzheimer's Disease Neuroimaging Initiative (ADNI; Principal Investigator: Michael Weiner; NIH grant U01 AG024904). ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering (NIBIB), and through generous contributions from the following: Pfizer Inc., Wyeth Research, Bristol-Myers Squibb, Eli Lilly and Company, GlaxoSmithKline, Merck & Co. Inc., AstraZeneca AB, Novartis Pharmaceuticals Corporation, Alzheimer's Association, Eisai Global Clinical Development, Elan Corporation plc, Forest Laboratories, and the Institute for the Study of Aging, with participation from the U.S. Food and Drug Administration. Industry partnerships are coordinated through the Foundation for the National Institutes of Health. The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer's Disease Cooperative Study at the University of California, San Diego. ADNI data are disseminated by the Laboratory of Neuro Imaging at the University of California, Los Angeles. NR 46 TC 72 Z9 72 U1 0 U2 10 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1053-8119 EI 1095-9572 J9 NEUROIMAGE JI Neuroimage PD OCT 15 PY 2009 VL 48 IS 1 BP 138 EP 149 DI 10.1016/j.neuroimage.2009.05.056 PG 12 WC Neurosciences; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging GA 488AO UT WOS:000269321100017 PM 19481161 ER PT J AU Tamura, MK Covinsky, KE Chertow, GM Yaffe, K Landefeld, CS McCulloch, CE AF Tamura, Manjula Kurella Covinsky, Kenneth E. Chertow, Glenn M. Yaffe, Kristine Landefeld, C. Seth McCulloch, Charles E. TI Functional Status of Elderly Adults before and after Initiation of Dialysis SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID MINIMUM DATA SET; COMPREHENSIVE GERIATRIC ASSESSMENT; CHRONIC KIDNEY-DISEASE; STAGE RENAL-DISEASE; CARDIAC REHABILITATION; CORONARY-BYPASS; HEMODIALYSIS; SURVIVAL; OUTCOMES; HOSPITALIZATION AB BACKGROUND It is unclear whether functional status before dialysis is maintained after the initiation of this therapy in elderly patients with end-stage renal disease (ESRD). METHODS Using a national registry of patients undergoing dialysis, which was linked to a national registry of nursing home residents, we identified all 3702 nursing home residents in the United States who were starting treatment with dialysis between June 1998 and October 2000 and for whom at least one measurement of functional status was available before the initiation of dialysis. Functional status was measured by assessing the degree of dependence in seven activities of daily living (on the Minimum Data Set-Activities of Daily Living [MDS-ADL] scale of 0 to 28 points, with higher scores indication greater functional difficulty). RESULTS The median MDS-ADL score increased from 12 during the 3 months before the initiation of dialysis to 16 during the 3 months after the initiation of dialysis. Three months after the initiation of dialysis, functional status had been maintained in 39% of nursing home residents, but by 12 months after the initiation of dialysis, 58% had died and predialysis functional status had been maintained in only 13%. In a random-effects model, the initiation of dialysis was associated with a sharp declin in functional status, indicated by an increase of 2.8 points in the MDS-ADL score (95% confidence interval [CI], 2.5 to 3.0); this decline was independent of age, sex, race, and functional-status trajectory before the initiation of dialysis. The decline in functional status associated with the initiation of dialysis remained substantial (1.7 points; 95% CI, 1.4 to 2.1), even after adjustment for the presence or absence of an accelerated functional decline during the 3-month period before the initiation of dialysis. CONCLUSIONS Among nursing home residents with ESRD, the initiation of dialysis is associated with a substantial and sustained decline in functional status. C1 [Tamura, Manjula Kurella; Chertow, Glenn M.] Stanford Univ, Sch Med, Div Nephrol, Dept Med, Palo Alto, CA 94304 USA. [Covinsky, Kenneth E.; Landefeld, C. Seth] Univ Calif San Francisco, Dept Med, Div Geriatr, San Francisco, CA USA. [Yaffe, Kristine] Univ Calif San Francisco, Dept Psychiat & Neurol, San Francisco, CA 94143 USA. [Yaffe, Kristine; McCulloch, Charles E.] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. [Covinsky, Kenneth E.; Yaffe, Kristine; Landefeld, C. Seth] San Francisco VA Med Ctr, San Francisco, CA USA. RP Tamura, MK (reprint author), Stanford Univ, Sch Med, Div Nephrol, Dept Med, 780 Welch Rd,Suite 106, Palo Alto, CA 94304 USA. EM mktamura@stanford.edu RI Kurella Tamura, Manjula/C-8284-2014 OI Kurella Tamura, Manjula/0000-0001-5227-2479 FU National Institute of Aging [K23AG028952]; National Center for Research Resources [KL2RR024130]; National Institute of Diabetes and Digestive and Kidney Diseases [N01DK12450] FX Supported by a Paul B. Beeson Career Development Award in Aging (K23AG028952, to Dr. Kurella Tamura) from the National Institute of Aging and grants from the National Center for Research Resources (KL2RR024130) and the National Institute of Diabetes and Digestive and Kidney Diseases (N01DK12450). NR 26 TC 214 Z9 225 U1 2 U2 11 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 OCT 15 PY 2009 VL 361 IS 16 BP 1539 EP 1547 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 506LT UT WOS:000270777000007 ER PT J AU Baldys, A Raymond, JR AF Baldys, Aleksander Raymond, John R., Sr. TI Critical Role of ESCRT Machinery in EGFR Recycling SO BIOCHEMISTRY LA English DT Article ID ENDOCYTIC MEMBRANE TRAFFICKING AB The molecular mechanisms of EGFR vesicular trafficking to lysosomes have recently received considerable attention. It is now clear that endosomal sorting complexes required for transport (ESCRTs) are critical for EGFR degradation. Although an increasing number of membrane receptors also undergo recycling via specific pathways, little information is available regarding regulated recycling of EGFR. In this study, we investigated the roles of ESCRTs in EGFR recycling after stimulation with amphiregulin (AR). We used ESCRT small interfering RNA (siRNA) duplexes to demonstrate that AR-induced EGFR intracellular processing involves active sorting to the recycling pathway through specific members of the ESCRT family. C1 Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Med Serv, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Res Serv, Charleston, SC 29425 USA. RP Raymond, JR (reprint author), Room 213,Colcock Hall,179 Ashley Ave, Charleston, SC 29425 USA. EM raymondj@musc.edu FU Department of Veterans Affairs Merit; Research Enhancement Award Program; National Institutes of Health [DK052448, GM063909]; American Heart Association; Medical University of South Carolina Division of Nephrology and Dialysis Clinics, Inc. FX This work was supported by Department of Veterans Affairs Merit and Research Enhancement Award Program grants (to J.R.R.), by National Institutes of Health Grants DK052448 and GM063909 (J.R.R.), by an American Heart Association (Mid-Atlantic) fellowship (to A.B.), and by a laboratory endowment jointly supported by the Medical University of South Carolina Division of Nephrology and Dialysis Clinics, Inc. (to J.R.R.). NR 10 TC 21 Z9 21 U1 0 U2 4 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0006-2960 J9 BIOCHEMISTRY-US JI Biochemistry PD OCT 13 PY 2009 VL 48 IS 40 BP 9321 EP 9323 DI 10.1021/bi900865u PG 3 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 502KU UT WOS:000270459100001 PM 19673488 ER PT J AU Mahimainathan, L Ghosh-Choudhury, N Venkatesan, B Das, F Mandal, CC Dey, N Habib, SL Kasinath, BS Abboud, HE Choudhury, GG AF Mahimainathan, Lenin Ghosh-Choudhury, Nandini Venkatesan, Balachandar Das, Falguni Mandal, Chandi C. Dey, Nirmalya Habib, Samy L. Kasinath, Balakuntalam S. Abboud, Hanna E. Choudhury, Goutam Ghosh TI TSC2 Deficiency Increases PTEN via H1F1 alpha SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID TUBEROUS SCLEROSIS COMPLEX; TUMOR-SUPPRESSOR GENE; INDUCIBLE FACTOR-I; CELL-SURVIVAL; RENAL ANGIOMYOLIPOMAS; 3-KINASE/AKT PATHWAY; SIGNALING PATHWAY; MESANGIAL CELLS; DOWN-REGULATION; S6 KINASE AB Substantial evidence suggests roles of TSC2 and PTEN in the development of cancer predisposition syndromes. Loss of TSC2 results in benign tumors, neurological disorders, and angiomyolipomas. We found that PTEN mRNA and protein levels are elevated in Tsc2(-/-) mouse embryo fibroblasts with concomitant reduction in Akt phosphorylation. Reconstitution of TSC2 in Tsc2(-/-) mouse embryo fibroblasts decreases PTEN levels. Interestingly, increased HIF1 alpha activity present in Tsc2 null cells is required for PTEN transcription and protein expression. We identified a canonical hypoxia-responsive element in the PTEN promoter, which regulates the transcription of this tumor suppressor protein in a TSC2-dependent manner. Finally, we demonstrate a positive correlation between expression of HIF1 alpha and PTEN in renal angiomyolipomas from TSC patients. Our results reveal a unique function of HIF1 alpha in up-regulation of PTEN and provide a new mechanism of reduced Akt phosphorylation in Tsc2 null cells. These data suggest that PTEN may safeguard against developing malignant tumors in patients with TSC deficiency. C1 [Mahimainathan, Lenin; Venkatesan, Balachandar; Das, Falguni; Dey, Nirmalya; Kasinath, Balakuntalam S.; Abboud, Hanna E.; Choudhury, Goutam Ghosh] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. [Ghosh-Choudhury, Nandini; Mandal, Chandi C.] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. [Ghosh-Choudhury, Nandini; Habib, Samy L.; Kasinath, Balakuntalam S.; Abboud, Hanna E.; Choudhury, Goutam Ghosh] S Texas Vet Hlth Care Syst, Vet Affairs Res, San Antonio, TX 78229 USA. [Habib, Samy L.; Choudhury, Goutam Ghosh] S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Choudhury, GG (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Mail Code 7882,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM choudhuryg@uthscsa.edu FU National Institutes of Health [RC1 DIK50190]; Juvenile Diabetes Research Foundation; Veterans Affairs Research Service Merit Review Grants FX This work was supported, in whole or in part, by National Institutes of Health Grant RC1 DIK50190. This work was also supported by the Juvenile Diabetes Research Foundation and Veterans Affairs Research Service Merit Review Grants (to G. G. C.). NR 60 TC 15 Z9 15 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD OCT 9 PY 2009 VL 284 IS 41 BP 27790 EP 27798 DI 10.1074/jbc.M109.028860 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 505FP UT WOS:000270676300005 PM 19648120 ER PT J AU Gesty-Palmer, D Flannery, P Yuan, L Corsino, L Spurney, R Lefkowitz, RJ Luttrell, LM AF Gesty-Palmer, Diane Flannery, Pat Yuan, Ling Corsino, Leonor Spurney, Robert Lefkowitz, Robert J. Luttrell, Louis M. TI A beta-Arrestin-Biased Agonist of the Parathyroid Hormone Receptor (PTH1R) Promotes Bone Formation Independent of G Protein Activation SO SCIENCE TRANSLATIONAL MEDICINE LA English DT Article ID OSTEOBLASTIC CELLS; KIDNEY-CELLS; KINASE; MICE; BETA-ARRESTIN2; ENDOCYTOSIS; SELECTIVITY; COMPLEXES; PATHWAYS; SIGNALS AB About 40% of the therapeutic agents in use today exert their effects through seven-transmembrane receptors (7TMRs). When activated by ligands, these receptors trigger two pathways that independently transduce signals to the cell: one through heterotrimeric GTP-binding proteins (G proteins) and one through beta-arrestins; so-called biased agonists can selectively activate these distinct pathways. Here, we investigate selective activation of these pathways through the use of a biased agonist for the type 1 parathyroid hormone (PTH)-PTH-related protein receptor (PTH1R), (D-Trp(12), Tyr(34))-PTH(7-34) (PTH-beta arr), which activates beta-arrestin but not classic G protein signaling. In mice, PTH-beta arr induces anabolic bone formation, as does the nonselective agonist PTH (1-34), which activates both mechanisms. In beta-arrestin2-null mice, the increase in bone mineral density evoked by PTH(1-34) is attenuated and that stimulated by PTH-beta arr is ablated. The beta-arrestin2-dependent pathway contributes primarily to trabecular bone formation and does not stimulate bone resorption. These results show that a biased agonist selective for the beta-arrestin pathway can elicit a response in vivo distinct from that elicited by nonselective agonists. Ligands with these properties may form the basis for improved 7TMR-directed pharmacologic agents with enhanced therapeutic specificity. C1 [Gesty-Palmer, Diane; Flannery, Pat; Yuan, Ling; Corsino, Leonor; Spurney, Robert; Lefkowitz, Robert J.] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. [Gesty-Palmer, Diane] Durham Vet Affairs Med Ctr, Durham, NC 27705 USA. [Lefkowitz, Robert J.] Duke Univ, Med Ctr, Dept Biochem, Durham, NC 27710 USA. [Lefkowitz, Robert J.] Duke Univ, Med Ctr, Howard Hughes Med Inst, Durham, NC 27710 USA. [Luttrell, Louis M.] Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. [Luttrell, Louis M.] Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. [Luttrell, Louis M.] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29401 USA. RP Lefkowitz, RJ (reprint author), Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. EM lefko001@receptor-biol.duke.edu FU Howard Hughes Medical Institute; NHLBI NIH HHS [R01 HL016037-37, HL16037, HL70631, R01 HL016037, R01 HL070631]; NICHD NIH HHS [HD043446, K12 HD043446]; NIDDK NIH HHS [DK55524, DK64353, R01 DK055524, R01 DK064353, R56 DK055524, T32 DK007012] NR 42 TC 71 Z9 71 U1 0 U2 5 PU AMER ASSOC ADVANCEMENT SCIENCE PI WASHINGTON PA 1200 NEW YORK AVE, NW, WASHINGTON, DC 20005 USA SN 1946-6234 J9 SCI TRANSL MED JI Sci. Transl. Med. PD OCT 7 PY 2009 VL 1 IS 1 AR 1ra1 DI 10.1126/scitranslmed.3000071 PG 9 WC Cell Biology; Medicine, Research & Experimental SC Cell Biology; Research & Experimental Medicine GA 589KY UT WOS:000277147500004 PM 20368153 ER PT J AU Morley, JF Duda, JE AF Morley, James F. Duda, John E. TI Autopsy investigation of neurodegenerative disease transplant patients Hindsight is 20/20 SO NEUROLOGY LA English DT Editorial Material ID PARKINSONS-DISEASE; PATHOLOGY; NEURONS C1 [Duda, John E.] Philadelphia VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA 19104 USA. [Morley, James F.] Penn Hosp, Parkinsons Dis & Movement Disorders Ctr, Philadelphia, PA 19107 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Duda, JE (reprint author), Philadelphia VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, MS 127,3900 Woodland Ave, Philadelphia, PA 19104 USA. EM john.duda@va.gov NR 10 TC 0 Z9 0 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 OCT 6 PY 2009 VL 73 IS 14 BP 1086 EP 1087 DI 10.1212/WNL.0b013e3181bc6758 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 502QG UT WOS:000270474500002 PM 19726748 ER PT J AU Isaac, C Lee, B Carnes, M AF Isaac, Carol Lee, Barbara Carnes, Molly TI Interventions That Affect Gender Bias in Hiring: A Systematic Review SO ACADEMIC MEDICINE LA English DT Article AB Purpose To systematically review experimental evidence for interventions mitigating gender bias in employment. Unconscious endorsement of gender stereotypes can undermine academic medicine's commitment to gender equity. Method The authors performed electronic and hand searches for randomized controlled studies since 1973 of interventions that affect gender differences in evaluation of job applicants. Twenty-seven studies met all inclusion criteria. Interventions fell into three categories: application information, applicant features, and rating conditions. Results The studies identified gender bias as the difference in ratings or perceptions of men and women with identical qualifications. Studies reaffirmed negative bias against women being evaluated for positions traditionally or predominantly held by men (male sex-typed jobs). The assessments of male and female raters rarely differed. Interventions that provided raters with clear evidence of job-relevant competencies were effective. However, clearly competent women were rated lower than equivalent men for male sex-typed jobs unless evidence of communal qualities was also provided. A commitment to the value of credentials before review of applicants and women's presence at above 25% of the applicant pool eliminated bias against women. Two studies found unconscious resistance to "antibias" training, which could be overcome with distraction or an intervening task. Explicit employment equity policies and an attractive appearance benefited men more than women, whereas repeated employment gaps were more detrimental to men. Masculine-scented perfume favored the hiring of both sexes. Negative bias occurred against women who expressed anger or who were perceived as self-promoting. Conclusions High-level evidence exists for strategies to mitigate gender bias in hiring. Acad Med. 2009; 84: 1440-1446. C1 [Isaac, Carol; Carnes, Molly] Univ Wisconsin, Ctr Womens Hlth Res, Madison, WI 53715 USA. [Carnes, Molly] Meriter Hosp, Madison, WI USA. [Carnes, Molly] Univ Wisconsin, Dept Med, Sch Med & Publ Hlth, Madison, WI 53715 USA. [Carnes, Molly] Univ Wisconsin, Dept Psychiat, Sch Med & Publ Hlth, Madison, WI 53715 USA. [Carnes, Molly] Univ Wisconsin, Dept Ind & Syst Engn, Madison, WI 53715 USA. [Carnes, Molly] Univ Wisconsin, WISELI, Coll Engn, Madison, WI 53715 USA. [Carnes, Molly] William S Middleton Mem Vet Adm Med Ctr, Women Vet Hlth Program, Madison, WI USA. [Isaac, Carol] Univ Wisconsin, Dept Orthoped & Rehabil, Madison, WI 53715 USA. RP Carnes, M (reprint author), Univ Wisconsin, Ctr Womens Hlth Res, 700 Regent St,Suite 301, Madison, WI 53715 USA. EM mlcarnes@wisc.edu FU University of Wisconsin School of Medicine and Public Health; Meriter Hospital; National Institute on Aging [T32 AG00265] FX This research was funded by the University of Wisconsin School of Medicine and Public Health and Meriter Hospital. Dr. Isaac was supported by grant no. T32 AG00265 from the National Institute on Aging. Dr. Carnes is employed part time by the William S. Middleton Veterans Hospital. This report is GRECC manuscript no. 2000-30. NR 62 TC 44 Z9 44 U1 4 U2 39 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 OCT PY 2009 VL 84 IS 10 BP 1440 EP 1446 DI 10.1097/ACM.0b013e3181b6ba00 PG 7 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA V15EU UT WOS:000207786100032 PM 19881440 ER PT J AU Bradford, A Kunik, ME Schulz, P Williams, SP Singh, H AF Bradford, Andrea Kunik, Mark E. Schulz, Paul Williams, Susan P. Singh, Hardeep TI Missed and Delayed Diagnosis of Dementia in Primary Care Prevalence and Contributing Factors SO ALZHEIMER DISEASE & ASSOCIATED DISORDERS LA English DT Review DE dementia; diagnostic errors; primary care ID GENERAL-PRACTITIONERS; ALZHEIMERS-DISEASE; COGNITIVE IMPAIRMENT; HEALTH-CARE; ELDERLY PATIENTS; UNITED-STATES; MENTAL-STATE; PHYSICIANS; ATTITUDES; PERSPECTIVES AB Dementia is a growing public health problem for which early detection may be beneficial. Currently, the diagnosis of dementia in primary care is dependent mostly on clinical suspicion on the basis of patient symptoms or caregivers' concerns and is prone to be missed or delayed. We conducted a systematic review of the literature to ascertain the prevalence and contributing factors for missed and delayed dementia diagnoses in primary care. Prevalence of missed and delayed diagnosis was estimated by abstracting quantitative data from studies of diagnostic sensitivity among primary care providers. Possible predictors and contribution factory factors were determined from the text of quantitative and qualitative Studies of patient, caregiver, provider, and system-related barriers. Overall estimates of diagnostic sensitivity varied among studies and seemed to be in part a function of dementia severity, degree of patient impairment, dementia subtype, and frequency of patient-provider contact. Major contributory factors included problems with attitudes and patient-provider communication, educational deficits. and system resource constraints. The true prevalence of missed and delayed diagnoses of dementia is unknown but seems to be high. Until the case for dementia screening becomes more compelling, efforts to promote timely detection should focus on removing barriers to diagnosis. C1 [Bradford, Andrea] Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. [Kunik, Mark E.] Baylor Coll Med, Houston VA HSR&D Ctr Excellence, Hlth Serv Delivery & Org Program, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Kunik, Mark E.; Singh, Hardeep] Baylor Coll Med, Sect Hlth Serv Res, Dept Med, Houston, TX 77030 USA. [Schulz, Paul] Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. [Williams, Susan P.] Baylor Coll Med, Dept Med, Sect Geriatr, Houston, TX 77030 USA. [Singh, Hardeep] Baylor Coll Med, Hlth Policy & Qual Program, Houston VA HSR&D Ctr Excellence, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Singh, Hardeep] Baylor Coll Med, Ctr Inquiry Improve Outpatient Safety Effect Elec, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Bradford, A (reprint author), Baylor Coll Med, Dept Psychiat & Behav Sci, VA Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM abradfor@bcm.tmc.edu OI Bradford, Andrea/0000-0002-8390-8844 FU NIH K23 career development award [K23CA125585]; Houston VA HSR&D Center of Excellence [HFP90-020] FX The study was supported by an NIH K23 career development award (K23CA125585) to Dr Singh, and in part by the Houston VA HSR&D Center of Excellence (HFP90-020). NR 76 TC 123 Z9 127 U1 4 U2 21 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 OCT-DEC PY 2009 VL 23 IS 4 BP 306 EP 314 PG 9 WC Clinical Neurology; Pathology SC Neurosciences & Neurology; Pathology GA 527XE UT WOS:000272403700002 PM 19568149 ER PT J AU Krueger, KR Wilson, RS Bennett, DA Aggarwal, NT AF Krueger, Kristin R. Wilson, Robert S. Bennett, David A. Aggarwal, Neelum T. TI A Battery of Tests for Assessing Cognitive Function in Older Latino Persons SO ALZHEIMER DISEASE & ASSOCIATED DISORDERS LA English DT Article DE Spanish language tests; cognitive domains; cognitive function; longitudinal studies ID ALZHEIMERS-DISEASE; NEUROPSYCHOLOGICAL BATTERY; INDIVIDUAL-DIFFERENCES; SPANISH-SPEAKING; COMMUNITY; ENGLISH; PERFORMANCE; IMPAIRMENT; SYSTEMS; AGE AB With the proportion of older Latinos in the United States rapidly growing, dementia is expected to be an increasing public health problem in this segment of the population. Yet relatively few cognitive test batteries have been developed for evaluating older Spanish-speaking- persons. We selected a batter), of cognitive tests used in cognitive aging studies of English speakers, adapted it for Spanish speakers, and administered it to 66 older Latinos (mean age = 71.1, SD = 8.1). The results of a factor analysis supported grouping the tests into the same 5 functional domains identified for English speakers. Composite measures of performance in each domain were positively related to education and. with some exceptions, inversely related to age. The results suggest that this battery may be useful in epidemiologic research on cognition in older Latinos. C1 [Krueger, Kristin R.; Wilson, Robert S.; Bennett, David A.; Aggarwal, Neelum T.] Rush Univ, Med Ctr, Rush Alzheimers Dis Ctr, Chicago, IL 60612 USA. [Krueger, Kristin R.; Wilson, Robert S.] Rush Univ, Med Ctr, Dept Behav Sci, Chicago, IL 60612 USA. [Wilson, Robert S.; Bennett, David A.; Aggarwal, Neelum T.] Rush Univ, Med Ctr, Dept Neurol Sci, Chicago, IL 60612 USA. RP Krueger, KR (reprint author), S Texas Vet Hlth Care Syst, Audie L Murphy Div, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM Kristin.Krueger@va.gov FU National Institute on Aging [P30 AG10161] FX Supported by grant P30 AG10161 from the National Institute on Aging. NR 30 TC 11 Z9 11 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0893-0341 J9 ALZ DIS ASSOC DIS JI Alzheimer Dis. Assoc. Dis. PD OCT-DEC PY 2009 VL 23 IS 4 BP 384 EP 388 PG 5 WC Clinical Neurology; Pathology SC Neurosciences & Neurology; Pathology GA 527XE UT WOS:000272403700014 PM 19561439 ER PT J AU Spies, C Farzaneh-Far, R Na, B Kanaya, A Schiller, NB Whooley, MA AF Spies, Christian Farzaneh-Far, Ramin Na, Beeya Kanaya, Alka Schiller, Nelson B. Whooley, Mary A. TI Relation of Obesity to Heart Failure Hospitalization and Cardiovascular Events in Persons With Stable Coronary Heart Disease (from the Heart and Soul Study) SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID BODY-MASS INDEX; DEPRESSIVE SYMPTOMS; ABDOMINAL OBESITY; RISK; MORTALITY; WEIGHT; DYSFUNCTION; DISORDERS; ADIPOSITY; INSULIN AB Obesity is an independent risk factor for recurrent events among patients with established coronary heart disease (CHD). The goal of the present study was to identify potential mechanisms underlying this association. We measured the waist-to-hip ratio and body mass index in 979 outpatients with stable CHD and followed them for a mean of 4.9 years. We used proportional hazards models to evaluate the extent to which the association of obesity with subsequent heart failure (HF) hospitalization or cardiovascular (CV) events (myocardial infarction, stroke, or CHD death) was explained by baseline co-morbidities, cardiac disease severity, inflammation, insulin resistance, neurohormones and adipokines. Of the 979 participants, 128 (13%) were hospitalized for HF and 152 (16%) developed a CV event. Each standard deviation (SD) increase in the waist-to-hip ratio was associated with a 30% increased risk of HF hospitalization (unadjusted hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.1 to 1.6). This association was not attenuated after adjustment for potential mediators (HR 1.6, 95% CI 1.2 to 2.1.). Likewise, each SD increase in the waist-to-hip ratio was associated with a 20% greater risk of CV events (unadjusted HR 1.2, 95% CI 1.0 to 1.4), and this remained unchanged after adjustment for potential mediators (adjusted HR 1.3, 95% CI 1.0 to 1.5). The body mass index was not associated with the risk of HF or CV events. In conclusion, abdominal obesity is an independent predictor of HF hospitalization and recurrent CV events in patients with stable CHD. This association does not appear to be mediated by co-morbid conditions, cardiac disease severity, insulin resistance, inflammation, neurohormones, or adipokines. (C) 2009 Elsevier Inc. All rights reserved. (Am J Cardiol 2009;104:883-889) C1 [Farzaneh-Far, Ramin; Na, Beeya; Whooley, Mary A.] Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. [Spies, Christian] Queens Med Ctr, Honolulu, HI USA. [Farzaneh-Far, Ramin; Kanaya, Alka; Schiller, Nelson B.; Whooley, Mary A.] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. [Whooley, Mary A.] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. RP Farzaneh-Far, R (reprint author), Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. EM rfarzanehfar@medicine.ucsf.edu FU Department of Veterans Affairs, Washington, DC; National Heart Lung and Blood Institute [RO 1 HL079235] FX The Heart and Soul Study was funded by the Department of Veterans Affairs, Washington, DC; the National Heart Lung and Blood Institute, Grant RO 1 HL079235, Bethesda, Maryland; the American Federation for Aging Research (Paul Beeson Scholars Program), New York, New York; the Robert Wood Johnson Foundation (Faculty Scholars Program), Princeton, New Jersey; and the Nancy Kirwan Heart Research Fund, San Francisco, California. Dr. Farzaneh-Far was supported by an American Heart Association Fellow-to-Faculty Transition Award (Dallas, Texas). NR 30 TC 11 Z9 12 U1 1 U2 4 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD OCT 1 PY 2009 VL 104 IS 7 BP 883 EP 889 DI 10.1016/j.amjcard.2009.05.027 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 503MG UT WOS:000270537800003 PM 19766751 ER PT J AU Singh, H Daci, K Petersen, LA Collins, C Petersen, NJ Shethia, A El-Serag, HB AF Singh, Hardeep Daci, Kuang Petersen, Laura A. Collins, Clyde Petersen, Nancy J. Shethia, Anila El-Serag, Hashem B. TI Missed Opportunities to Initiate Endoscopic Evaluation for Colorectal Cancer Diagnosis SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID IRON-DEFICIENCY ANEMIA; PRIMARY-CARE; GASTROINTESTINAL-TRACT; MALPRACTICE CLAIMS; DELAY; COLON; POPULATION; CARCINOMA; SYMPTOMS; ERRORS AB OBJECTIVES: Delayed diagnosis of colorectal cancer (CRC) is among the most common reasons for ambulatory diagnostic malpractice claims in the United States. Our objective was to describe missed opportunities to diagnose CRC before endoscopic referral, in terms of patient characteristics, nature of clinical clues, and types of diagnostic-process breakdowns involved. METHODS: We conducted a retrospective cohort study of consecutive, newly diagnosed cases of CRC between February 1999 and June 2007 at a tertiary health-care system in Texas. Two reviewers independently evaluated the electronic record of each patient using a standardized pretested data collection instrument. Missed opportunities were defined as care episodes in which endoscopic evaluation was not initiated despite the presence of one or more clues that warrant a diagnostic workup for CRC. Predictors of missed opportunities were evaluated in logistic regression. The types of breakdowns involved in the diagnostic process were also determined and described. RESULTS: Of the 513 patients with CRC who met the inclusion criteria, both reviewers agreed on the presence of at least one missed opportunity in 161 patients. Among these patients there was a mean of 4.2 missed opportunities and 5.3 clues. The most common clues were suspected or confirmed iron deficiency anemia, positive fecal occult blood test, and hematochezia. The odds of a missed opportunity were increased in patients older than 75 years (odds ratio (OR) = 2.3; 95% confidence interval (CI) 1.3-4.1) or with iron deficiency anemia (OR = 2.2; 95 % CI 1.3-3.6), whereas the odds of a missed opportunity were lower in patients with abnormal flexible sigmoidoscopy (OR = 0.06; 95 % CI 0.01-0.51), or imaging suspicious for CRC (OR = 0.3; 95 % CI 0.1-0.9). Anemia was the clue associated with the longest time to endoscopic referral (median = 393 days). Most process breakdowns occurred in the provider-patient clinical encounter and in the follow-up of patients or abnormal diagnostic test results. CONCLUSIONS: Missed opportunities to initiate workup for CRC are common despite the presence of many clues suggestive of CRC diagnosis. Future interventions are needed to reduce the process breakdowns identified. C1 [El-Serag, Hashem B.] Baylor Coll Med, Dept Med, Michael E DeBakey Vet Affairs Med Ctr, Houston VA HSR&D Ctr Excellence, Houston, TX 77030 USA. [Singh, Hardeep; Petersen, Laura A.; Petersen, Nancy J.; Shethia, Anila] Michael E DeBakey Vet Affairs Med Ctr, Ctr Inquiry Improve Outpatient Safety Effect Elec, Houston, TX USA. [Singh, Hardeep; Petersen, Laura A.; Petersen, Nancy J.; Shethia, Anila] Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. [El-Serag, Hashem B.] Baylor Coll Med, Dept Med, Michael E DeBakey Vet Affairs Med Ctr, Sect Gastroenterol & Hepatol, Houston, TX 77030 USA. RP Singh, H (reprint author), VA Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM hardeeps@bcm.edu FU NIH K23 [K23CA125585]; Houston VA HSR&D Center of Excellence [HFP90-020] FX This work was supported by an NIH K23 career development award (K23CA125585) to Dr Singh, and in part by the Houston VA HSR&D Center of Excellence (HFP90-020). These sources had no role in study design or execution, collection of data, the writing of the paper, or the decision to submit the paper for publication. NR 44 TC 46 Z9 49 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD OCT PY 2009 VL 104 IS 10 BP 2543 EP 2554 DI 10.1038/ajg.2009.324 PG 12 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 507KY UT WOS:000270853300022 PM 19550418 ER PT J AU Chavalitdhamrong, D Kijsirichareanchai, K Sul, J Jutabha, R AF Chavalitdhamrong, Disaya Kijsirichareanchai, Kunut Sul, James Jutabha, Rome TI The Self-administered Capsule Endoscopy is Useful for the Obscure Gastrointestinal Bleeding Cases SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Meeting Abstract CT 74th Annual Scientific Meeting and Postgraduate Course of the American-College-of-Gastroenterology CY OCT 23-28, 2009 CL San Diego, CA SP Amer Coll Gastroenterol C1 [Kijsirichareanchai, Kunut; Sul, James; Jutabha, Rome] Univ Calif Los Angeles, Med Ctr, Capsule Endoscopy Serv, Los Angeles, CA 90024 USA. [Chavalitdhamrong, Disaya] Mt Sinai Sch Med Program, James J Peters Vet Affairs Med Ctr, Bronx, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD OCT PY 2009 VL 104 SU 3 MA 1435 BP S539 EP S540 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 507LA UT WOS:000270853601423 ER PT J AU Chavalitdhamrong, D Kijsirichareanchai, K Sul, J Jutabha, R AF Chavalitdhamrong, Disaya Kijsirichareanchai, Kunut Sul, James Jutabha, Rome TI Endoscopic Placement of a Capsule Endoscope by Using Mini-snare SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Meeting Abstract CT 74th Annual Scientific Meeting and Postgraduate Course of the American-College-of-Gastroenterology CY OCT 23-28, 2009 CL San Diego, CA SP Amer Coll Gastroenterol C1 [Kijsirichareanchai, Kunut; Sul, James; Jutabha, Rome] Univ Calif Los Angeles, Capsule Endoscopy Serv, Los Angeles, CA USA. [Chavalitdhamrong, Disaya] Mt Sinai Sch Med Program, James J Peters Vet Affairs Med Ctr, Bronx, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD OCT PY 2009 VL 104 SU 3 MA 1066 BP S392 EP S392 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 507LA UT WOS:000270853601055 ER PT J AU Halley, L Lahr, C Subramony, C Kothari, T Schmieg, R Spree, D Eriator, I Kasser, C Kedar, A Abell, T AF Halley, Lindsey Lahr, Christopher Subramony, Charu Kothari, Truptesh Schmieg, Robert Spree, Danielle Eriator, Ike Kasser, Christine Kedar, Archana Abell, Thomas TI Pain and Gastroparesis: Not a Contraindication for a Trial of Gastric Electrical Stimulation SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Meeting Abstract CT 74th Annual Scientific Meeting and Postgraduate Course of the American-College-of-Gastroenterology CY OCT 23-28, 2009 CL San Diego, CA SP Amer Coll Gastroenterol C1 [Halley, Lindsey; Lahr, Christopher; Subramony, Charu; Schmieg, Robert; Spree, Danielle; Eriator, Ike; Kedar, Archana; Abell, Thomas] Univ Mississippi, Med Ctr, Jackson, MS 39216 USA. [Kasser, Christine] Univ Tennessee, Memphis, TN USA. [Kothari, Truptesh] James J Peters VA Med Ctr, Bronx, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD OCT PY 2009 VL 104 SU 3 MA 112 BP S45 EP S45 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 507LA UT WOS:000270853600112 ER PT J AU Hughes, J Lahr, C Subramony, C Kothari, T Schmieg, R Spree, D Cutts, T Kedar, A Abell, T AF Hughes, Joy Lahr, Christopher Subramony, Charu Kothari, Truptesh Schmieg, Robert Spree, Danielle Cutts, Teresa Kedar, Archana Abell, Thomas TI Depression and Gastroparesis: A Histological, Physiological and Clinical Outcome Analysis in Response to Gastric Stimulation SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Meeting Abstract CT 74th Annual Scientific Meeting and Postgraduate Course of the American-College-of-Gastroenterology CY OCT 23-28, 2009 CL San Diego, CA SP Amer Coll Gastroenterol C1 [Hughes, Joy; Lahr, Christopher; Subramony, Charu; Schmieg, Robert; Spree, Danielle; Kedar, Archana; Abell, Thomas] Univ Mississippi, Med Ctr, Jackson, MS 39216 USA. [Kothari, Truptesh] James J Peters VA Med Ctr, Bronx, NY USA. [Cutts, Teresa] Univ Tennessee, Memphis, TN USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD OCT PY 2009 VL 104 SU 3 MA 113 BP S45 EP S45 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 507LA UT WOS:000270853600113 ER PT J AU Isani, M Lahr, C Subramony, C Kothari, T Schmieg, R Spree, D Vedanarayanan, V Kedar, A Abell, T AF Isani, Mubina Lahr, Christopher Subramony, Charu Kothari, Truptesh Schmieg, Robert Spree, Danielle Vedanarayanan, Vetta Kedar, Archana Abell, Thomas TI Migraines and Gastroparesis: A Histologic, Physiologic, and Clinical Analysis with Temporary Gastric Stimulation SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Meeting Abstract CT 74th Annual Scientific Meeting and Postgraduate Course of the American-College-of-Gastroenterology CY OCT 23-28, 2009 CL San Diego, CA SP Amer Coll Gastroenterol C1 [Isani, Mubina; Lahr, Christopher; Subramony, Charu; Schmieg, Robert; Spree, Danielle; Vedanarayanan, Vetta; Kedar, Archana; Abell, Thomas] Univ Mississippi, Med Ctr, Jackson, MS 39216 USA. [Kothari, Truptesh] James J Peters VA Med Ctr, Bronx, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD OCT PY 2009 VL 104 SU 3 MA 111 BP S44 EP S44 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 507LA UT WOS:000270853600111 ER PT J AU Kothari, T Hughes, J Lahr, C Subramony, C Schmieg, R Spree, D Uwaifo, G Kedar, A Abell, T AF Kothari, Truptesh Hughes, Joy Lahr, Christopher Subramony, Charu Schmieg, Robert Spree, Danielle Uwaifo, Gabriel Kedar, Archana Abell, Thomas TI Diabetes and Gastroparesis: A Histologic, Physiologic and Clinical Analysis in Response to Temporary and Subsequent Permanent Gastric Stimulation SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Meeting Abstract CT 74th Annual Scientific Meeting and Postgraduate Course of the American-College-of-Gastroenterology CY OCT 23-28, 2009 CL San Diego, CA SP Amer Coll Gastroenterol C1 [Hughes, Joy; Lahr, Christopher; Subramony, Charu; Schmieg, Robert; Spree, Danielle; Uwaifo, Gabriel; Kedar, Archana; Abell, Thomas] Univ Mississippi, Med Ctr, Jackson, MS 39216 USA. [Kothari, Truptesh] James J Peters VA Med Ctr, Bronx, NY USA. RI Uwaifo, Gabriel/M-2361-2016 OI Uwaifo, Gabriel/0000-0002-6962-9304 NR 0 TC 0 Z9 0 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD OCT PY 2009 VL 104 SU 3 MA 114 BP S46 EP S46 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 507LA UT WOS:000270853600114 ER PT J AU Ramirez, F Leung, F AF Ramirez, Francisco Leung, Felix TI Water Method for Colonoscopy in Sedated Patients is Easy to Learn for an Experienced Colonoscopist and May Minimize the Need for Technical Assistance SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Meeting Abstract CT 74th Annual Scientific Meeting and Postgraduate Course of the American-College-of-Gastroenterology CY OCT 23-28, 2009 CL San Diego, CA SP Amer Coll Gastroenterol C1 [Ramirez, Francisco] Carl T Hayden VA Med Ctr, Phoenix, AZ USA. [Leung, Felix] Univ Calif Los Angeles, David Geffen Sch Med, Sepulveda Ambulatory Care Ctr, VA Greater Healthcare Syst, Los Angeles, CA 90095 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD OCT PY 2009 VL 104 SU 3 MA 1399 BP S525 EP S525 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 507LA UT WOS:000270853601387 ER PT J AU Shah, K Qureshi, SU Johnson, M Parikh, N Schulz, PE Kunik, ME AF Shah, Kairav Qureshi, Salah U. Johnson, Michael Parikh, Niraj Schulz, Paul E. Kunik, Mark E. TI Does Use of Antihypertensive Drugs Affect the Incidence or Progression of Dementia? A Systematic Review SO AMERICAN JOURNAL OF GERIATRIC PHARMACOTHERAPY LA English DT Review DE incidence or progression of dementia; antihypertensive drugs ID PLACEBO-CONTROLLED TRIAL; COGNITIVE FUNCTION; BLOOD-PRESSURE; ALZHEIMERS-DISEASE; VASCULAR DEMENTIA; MEDICATION-USE; HYPERTENSION; RISK; PREVALENCE; PREVENTION AB Background: Hypertension appears to contribute to the development of dementia. Antihypertensive drugs may play an important role in altering the incidence or progression of dementia, particularly dementia of the vascular type; however, the neuroprotective effects of these agents in other types of dementia are not well characterized. Objectives: The main aims of this review were to examine the relationship between use of antihypertensive agents and the incidence and progression of Alzheimer's dementia (AD), vascular dementia (VaD), and unspecified dementia, and to consider whether these agents may be neuroprotective. Methods: A search of the English-language literature (January 1996-August 2009) was conducted using PubMed, Ovid MEDLINE, EBSCO MEDLINE, and the Cochrane Database of Systematic Reviews for publications mentioning both antihypertensive drugs and dementia. A combination of searches was performed using the following terms: antihypertensive drugs, dementia, cognitive impairment, Alzheimer's dementia, vascular dementia, progression of cognitive impairment, severity of cognitive impairment, severity of dementia, prevalence, and incidence. Searches were also performed using the names of antihypertensive drug classes. The bibliographies of all retrieved articles were reviewed for additional relevant publications. The focus was on randomized controlled trials, cohort studies, and case-control studies, excluding studies in animals, patients aged <45 years, drugs other than antihypertensive agents, and the role in cognition of hormones, receptors, and enzymes. Results: Sixty-five potentially relevant articles were identified from the 536 publications retrieved by the literature search. After application of the exclusion criteria, 12 original studies were included in the review, all published between 1999 and 2008 and most involving patients with AD or VaD. The most frequently studied antihypertensive agents were calcium channel blockers (7 studies), diuretics (6 studies), and angiotensin-converting enzyme (ACE) inhibitors (6 studies). Overall, these medications appeared to be beneficial in dementia, but only ACE inhibitors and diuretics significantly reduced the risk for and progression of dementia in the majority of studies. Conclusions: Antihypertensive medications-particularly ACE inhibitors and diuretics-may be helpful in reducing the risk for and progression of dementia. Large randomized clinical trials are warranted to further explore the relationship between antihypertensive drugs and dementia. (Am J Geriatr Pharmacother. 2009;7:250-261) (C) 2009 Excerpta Medica Inc. C1 [Shah, Kairav; Qureshi, Salah U.; Schulz, Paul E.; Kunik, Mark E.] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. [Shah, Kairav] Univ Texas Houston, Sch Publ Hlth, Houston, TX USA. [Qureshi, Salah U.; Kunik, Mark E.] Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. [Qureshi, Salah U.; Schulz, Paul E.; Kunik, Mark E.] Baylor Coll Med, Houston, TX 77030 USA. [Qureshi, Salah U.; Kunik, Mark E.] Vet Affairs S Cent Mental Illness Res Educ & Clin, Houston, TX USA. [Johnson, Michael] Univ Houston, Coll Pharm, Dept Clin Sci & Adm, Houston, TX 77030 USA. [Parikh, Niraj] Anal Grp Inc, Boston, MA USA. RP Kunik, ME (reprint author), Michael E DeBakey VAMC 151, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM mkunik@bcm.tmc.edu FU Houston Veterans Affairs Health Services Research and Development Center of Excellence [HFP90-020] FX This work was supported in part by the Houston Veterans Affairs Health Services Research and Development Center of Excellence (HFP90-020). The views expressed are those of the authors and do not necessarily reflect those of the Department of Veterans Affairs (Baylor College of Medicine), with which 3 of the authors are affiliated. NR 34 TC 62 Z9 62 U1 2 U2 11 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 1543-5946 J9 AM J GERIATR PHARMAC JI Am. J. Geriatr. Pharmacother. PD OCT PY 2009 VL 7 IS 5 BP 250 EP 261 DI 10.1016/j.amjopharm.2009.11.001 PG 12 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 525XU UT WOS:000272251900002 PM 19948301 ER PT J AU Wright, RM Sloane, R Pieper, CF Ruby-Scelsi, C Twersky, J Schmader, KE Hanlon, JT AF Wright, Rollin M. Sloane, Richard Pieper, Carl F. Ruby-Scelsi, Christine Twersky, Jack Schmader, Kenneth E. Hanlon, Joseph T. TI Underuse of Indicated Medications Among Physically Frail Older US Veterans at the Time of Hospital Discharge: Results of a Cross-Sectional Analysis of Data From the Geriatric Evaluation and Management Drug Study SO AMERICAN JOURNAL OF GERIATRIC PHARMACOTHERAPY LA English DT Article DE medication use; underutilization; comorbidity; transition of care; frail elderly ID QUALITY-OF-CARE; PHARMACOLOGICAL CARE; CONTROLLED-TRIAL; POLYPHARMACY; INPATIENTS; DISEASES; PEOPLE; COMORBIDITY; OUTPATIENTS; VALIDATION AB Background: Medication underutilization, or the omission of a potentially beneficial medication indicated for disease management, is common among older adults but poorly understood. Objectives: The aims of this work were to assess the prevalence of medication underuse and to determine whether polypharmacy or comorbidity was associated with medication underuse among physically frail older veterans transitioning from the hospital to the community. Methods: This was a cross-sectional analysis of patients who were discharged from 11 US veterans' hospitals to outpatient care, based on data from the Geriatric Evaluation and Management Drug Study, a substudy of the Veterans Affairs Cooperative Study of geriatric evaluation and management. Patients were enrolled between August 31, 1995, and January 31, 1999. To qualify for the study, patients had to be aged >= 65 years, hospitalized in a medical or surgical ward for >48 hours, and meet >= 2 of the following criteria: moderate functional disability; recent cerebrovascular accident with residual neurological deficit; history of >= 1 fall in the previous 3 months; documented difficulty with walking (ie, requiring personal assistance or equipment), not including preadmission use of a wheelchair with ability to transfer to and from chair independently; malnutrition (admission serum albumin of 3.5 g/dL, <80% of ideal body weight, or recent >= 15-lb weight loss reported in admission history); dementia; depression; documented diagnosis of new fracture or revision needed of older fracture; unplanned admission within 3 months of previous admission; and prolonged bed rest. Clinical pharmacist/physician pairs reviewed medical records and medication lists and independently applied the Assessment of Underutilization (AOU) index to determine omissions of indicated medications. Discordances in index ratings were resolved during clinical consensus conferences. The primary outcome measure was the percentage of patients with >= 1 medication omission detected by the AOU. Multivariable logistic regression analyses identified factors associated with underuse. Results: A total of 384 patients were included in the study. The majority (53.6%) were between the ages of 65 and 74 years, and the mean (SD) Charlson comorbidity index was 2.44 (1.93). Overall, 374 patients (97.4%) were men and 274 (71.4%) were white. Medication undertreatment occurred in 238 participants (62.0%). Diseases of the circulatory, endocrine/nutritional, musculoskeletal, and respiratory systems were the most commonly undertreated conditions. The indicated medications most likely to be omitted were nitrates for those with a history of myocardial infarction, multivitamins in those with malnutrition, and inhaled anticholinergics for chronic obstructive airways disease. Statistically significant factors associated with medication underuse included limitations in activities of daily living (adjusted odds ratio [AOR], 2.17 [95% CI, 1.27-3.71]; P = 0.01), being white (AOR, 1.70 [95% CI, 1.06-2.71]; P = 0.03), and Charlson comorbidity index (AOR, 1.13 for each 1-point increase [95% CI, 1.00-1.27]; P = 0.04). Discharge from a general medicine service as opposed to a surgical service was associated with lower risk of medication underuse (AOR, 0.61 [95% CI, 0.38-0.98]; P = 0.04). Conclusions: Medication underuse was relatively common in this study. Patients with greater comorbidity, but not polypharmacy, had increased odds of undertreatment. (Am J Geriatr Pharmacother 2009;7:271280) (C) 2009 Excerpta Medica Inc. C1 [Wright, Rollin M.; Ruby-Scelsi, Christine; Hanlon, Joseph T.] Univ Pittsburgh, Div Geriatr Med, Dept Med, Sch Med, Pittsburgh, PA 15213 USA. [Sloane, Richard; Pieper, Carl F.; Twersky, Jack; Schmader, Kenneth E.] Duke Univ, Med Ctr, Ctr Study Aging & Human Dev, Durham, NC 27710 USA. [Pieper, Carl F.] Duke Univ, Med Ctr, Dept Biostat & Bioinformat, Durham, NC 27710 USA. [Ruby-Scelsi, Christine; Hanlon, Joseph T.] Univ Pittsburgh, Sch Pharm, Dept Pharm & Therapeut, Pittsburgh, PA 15261 USA. [Twersky, Jack; Schmader, Kenneth E.] Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Durham, NC USA. [Twersky, Jack; Schmader, Kenneth E.] Duke Univ, Med Ctr, Dept Med, Div Geriatr Med, Durham, NC 27710 USA. [Hanlon, Joseph T.] Vet Affairs Pittsburgh Hlth Care Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Hanlon, Joseph T.] Vet Affairs Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Hanlon, JT (reprint author), Univ Pittsburgh, Div Geriatr Med, Dept Med, Sch Med, Kaufmann Med Bldg,Suite 500,3471 5th Ave, Pittsburgh, PA 15213 USA. EM jth14@pitt.edu FU Veterans Affairs Cooperative Study Program 006; National Institute on Aging [R01-AG-027017, P30 AG024827]; National Institute of Allergy and Infectious Diseases [K24-AI-51324-01]; John A. Hartford Foundation Center of Excellence in Geriatrics; [R01-AG-15432] FX Financial support was provided by the grant R01-AG-15432 and the Veterans Affairs Cooperative Study Program 006. Additional support was provided by R01-AG-027017 and P30 AG024827 from the National Institute on Aging, K24-AI-51324-01 from the National Institute of Allergy and Infectious Diseases, and from the John A. Hartford Foundation Center of Excellence in Geriatrics. NR 37 TC 21 Z9 22 U1 0 U2 8 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 1543-5946 J9 AM J GERIATR PHARMAC JI Am. J. Geriatr. Pharmacother. PD OCT PY 2009 VL 7 IS 5 BP 271 EP 280 DI 10.1016/j.amjopharm.2009.11.002 PG 10 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 525XU UT WOS:000272251900004 PM 19948303 ER PT J AU Snow, AL Chandler, JF Kunik, ME Davila, JA Balasubramanyam, V Steele, AB Morgan, RO AF Snow, A. Lynn Chandler, Joseph F. Kunik, Mark E. Davila, Jessica A. Balasubramanyam, Valli Steele, Avila B. Morgan, Robert O. TI Self-Reported Pain in Persons With Dementia Predicts Subsequent Decreased Psychosocial Functioning SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE Pain; dementia; psychosocial functioning ID LOW-BACK-PAIN; QUALITY-OF-LIFE; NURSING-HOME RESIDENTS; LONG-TERM-CARE; ALZHEIMERS-DISEASE; MARITAL SATISFACTION; BEHAVIORAL TREATMENT; DEPRESSION; ASSOCIATION; AGITATION AB Objectives: Pain self-report is the assessment gold standard in cognitively intact populations but has been discouraged in persons with dementia because of significant evidence that pain intensity is often underreported by persons with dementia. However, most community-dwelling persons with dementia are cared for in primary care settings where a more in depth pain assessment is unlikely. Therefore, it is vital to know the clinical predictive value of self-report pain assessment in this population. Psychosocial functioning is a meaningful focus for clinical prediction, because psychosocial constructs are integrally related to quality of life, physical functioning, and one's ability to function in the presence of pain. The purpose of this study was to investigate the degree to which answers to simple self-report pain questions can predict changes in psychosocial functioning 4 months later in community-dwelling older adults with dementia. Design: Longitudinal. Patients and caregivers were assessed every 4 months for 24 months. Setting: Veterans Affairs Medical Center, Houston, TX. Participants: One hundred seventy-one patients over age 60 years diagnosed with dementia in the previous year and with no previous aggression were recruited from Veterans Administration clinics. Measurements: Pain, agitation, depression, involvement in pleasant events, caregiver burden, psychosis, and patient/caregiver relationship quality (mutuality). Results: Pain scores at each time period were predictive of increased agitation and depression and decreased pleasant event frequency 4 months later. Conclusions: Our results suggest that persons with dementia who affirmatively respond to pain questions are at higher risk for developing negative psychosocial states. (Am J Geriatr Psychiatry 2009; 17:873-880) C1 [Snow, A. Lynn; Chandler, Joseph F.] Univ Alabama, Ctr Mental Hlth & Aging, Dept Psychol, Tuscaloosa, AL 35487 USA. [Snow, A. Lynn] Tuscaloosa Vet Affairs Med Ctr, Res & Dev Serv, Tuscaloosa, AL USA. [Kunik, Mark E.; Davila, Jessica A.; Balasubramanyam, Valli; Steele, Avila B.] Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. [Kunik, Mark E.; Davila, Jessica A.; Balasubramanyam, Valli; Steele, Avila B.] Baylor Coll Med, Hlth Serv Res & Dev Serv, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Kunik, Mark E.] Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. [Kunik, Mark E.; Davila, Jessica A.] Baylor Coll Med, Dept Med, Houston, TX 77030 USA. [Snow, A. Lynn; Kunik, Mark E.] Vet Affairs S Cent Mental Illness Res Educ & Clin, N Little Rock, AR USA. [Morgan, Robert O.] Univ Texas Sch Publ Hlth, Div Management Policy & Community Hlth, Houston, TX USA. RP Snow, AL (reprint author), Univ Alabama, Ctr Mental Hlth & Aging, Dept Psychol, 207 Osband Hall,Box 870315, Tuscaloosa, AL 35487 USA. EM LSNOW@bama.ua.edu FU Department of Veterans Affairs; Veterans Health Administration; Health Services Research and Development Service, Washington, DC [IIR 01-159-2, HFP 90-020] FX The study sponsors had no role in the design, conduct, analysis, interpretation, writing, or decision to publish this study. NR 47 TC 15 Z9 15 U1 5 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD OCT PY 2009 VL 17 IS 10 BP 873 EP 880 DI 10.1097/JGP.0b013e3181ad4f73 PG 8 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 501LG UT WOS:000270382800007 PM 19910876 ER PT J AU Schillerstrom, JE Salazar, R Regwan, H Bonugli, RJ Royall, DR AF Schillerstrom, Jason E. Salazar, Ricardo Regwan, Heather Bonugli, Rebecca J. Royall, Donald R. TI Executive Function in Self-Neglecting Adult Protective Services Referrals Compared With Elder Psychiatric Outpatients SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE Adult protective services; executive function; depression ID CONSENT AB Objective: Psychometric performance, with an emphasis on executive function, was compared between adult protective services (APS) clients referred for a decision-making capacity consultation and elders seen in an outpatient geriatric psychiatry clinic. Methods: The authors performed a retrospective medical records review extracting general, executive, and visuospatial cognitive performance and depression symptom burden in APS referrals (N = 63) and geriatric psychiatry outpatients (N = 58). Results: After adjusting for age and education, APS clients had worse mean executive performance as measured by the Executive Interview (24.3 [SD 6.4] versus 17.3 [SD 7.6], F([1, 87]) 15.7, p < 0.001) and CLOX1 (7.4 [SD 4.0] versus 9.3 [SD 4.2], F([1, 92]) 4.79, p = 0.03). There were no differences in visuospatial or general cognitive abilities. The self-neglect subgroup had worse cognitive performance on each measure than other APS referrals. Conclusions: Compared with routine geriatric psychiatry patients, APS referrals are more likely to be executively impaired but less depressed. General cognitive screens do not distinguish these two groups. (Am J Geriatr Psychiatry 2009; 17:907-910) C1 [Schillerstrom, Jason E.] Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat, San Antonio, TX 78229 USA. [Royall, Donald R.] S Texas Vet Healthcare Syst, Audie L Murphy Div, San Antonio, TX USA. RP Schillerstrom, JE (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM schillerstr@uthscsa.edu; royall@uthscsa.edu NR 10 TC 8 Z9 8 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD OCT PY 2009 VL 17 IS 10 BP 907 EP 910 DI 10.1097/JGP.0b013e3181b4bf64 PG 4 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 501LG UT WOS:000270382800011 PM 19910879 ER PT J AU Beeri, MS Schmeidler, J Haroutunian, V West, R Ostad, D Grossman, HT Rosendorff, C Silverman, JM AF Beeri, Michal Schnaider Schmeidler, James Haroutunian, Vahram West, Rebecca Ostad, Doris Grossman, Hillel T. Rosendorff, Clive Silverman, Jeremy M. TI Better Cognitive Performance Associated With Worse Cardiac Functioning Suggests Antagonistic Pleiotropy in Very Elderly Subjects SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Letter C1 [Beeri, Michal Schnaider; Schmeidler, James; Haroutunian, Vahram; West, Rebecca; Ostad, Doris; Grossman, Hillel T.; Rosendorff, Clive; Silverman, Jeremy M.] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. [Haroutunian, Vahram; Rosendorff, Clive] James J Peters Vet Affair Med Ctr, Bronx, NY USA. RP Beeri, MS (reprint author), Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. FU NIA NIH HHS [K01 AG023515-01A2, P01-AG02219, R01 AG034087, P50 AG005138, K01 AG023515, AG05138, P01 AG002219] NR 5 TC 4 Z9 4 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD OCT PY 2009 VL 17 IS 10 BP 911 EP 912 DI 10.1097/JGP.0b013e3181ad4d2f PG 2 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 501LG UT WOS:000270382800012 PM 19910880 ER PT J AU Aspinall, SL Banthin, JS Good, CB Miller, GE Cunningham, FE AF Aspinall, Sherrie L. Banthin, Jessica S. Good, Chester B. Miller, G. Edward Cunningham, Francesca E. TI VA Pharmacy Users: How They Differ From Other Veterans SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID MENTAL-HEALTH PROBLEMS; CARE; EXPENDITURES; MEDICARE; ACCESS; IRAQ AB Objective: To compare users and nonusers of Veterans Affairs (VA) pharmacy services by age group. Study Design: Cross-sectional. Methods: We used data on sociodemographics, health status, and medical conditions from the Medical Expenditure Panel Survey (MEPS) to compare users and nonusers of VA pharmacies for medications. Data were pooled for 2003-2005 to ensure adequate sample sizes. Student t tests were used to compare the means for each variable, and all analyses were adjusted for the complex sample design of the MEPS. Results: Among both nonelderly (18-64 years) and elderly (> 65 years) veterans, a higher proportion who used VA pharmacy services versus those who did not use VA pharmacy services (1) were black (nonelderly: 17.7% vs 7.4%, P < .001; elderly: 9.4% vs 4.7%, P < .001); (2) had no alternative insurance (nonelderly: 27.2% vs 4.8%, P < .001; elderly: 36.3% vs 19.9%, P < .001); (3) had lower incomes (nonelderly: 32.4% vs 11.5%, P < .001; elderly: 32.4% vs 25.4%, P = .01); (4) had less than a high school education (nonelderly: 13.0% vs 6.5%, P < .001; elderly: 27.5% vs 17.6%, P < .001); (5) were disabled; and (6) reported poorer health. A higher percentage of nonelderly users reported a mental health condition (31.6% vs 19.4%, P < .001). Conclusions: Veterans who use VA pharmacy services appear to be more ill than those who do not use VA pharmacy services. In addition, the VA appears to be a safety net for uninsured veterans who have mental health problems. (Am J Manag Care. 2009; 15(10): 701-708) C1 [Aspinall, Sherrie L.; Good, Chester B.] VA Pittsburgh Healthcare Syst, VA Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15206 USA. [Aspinall, Sherrie L.; Good, Chester B.; Cunningham, Francesca E.] VA Ctr Medicat Safety, Hines, IL USA. [Aspinall, Sherrie L.; Good, Chester B.] Univ Pittsburgh, Sch Pharm, Pittsburgh, PA 15260 USA. [Good, Chester B.] Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. [Banthin, Jessica S.; Miller, G. Edward] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Washington, DC USA. RP Aspinall, SL (reprint author), VA Pittsburgh Healthcare Syst, VA Ctr Hlth Equ Res & Promot, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM sherrie.aspinall@va.gov NR 13 TC 3 Z9 3 U1 1 U2 1 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD OCT PY 2009 VL 15 IS 10 BP 701 EP 708 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 508YN UT WOS:000270975300004 PM 19845422 ER PT J AU Ross, JS Keyhani, S Korenstein, D AF Ross, Joseph S. Keyhani, Salomeh Korenstein, Deborah TI Appropriateness of Collaborations between Industry and the Medical Profession: Physicians' Perceptions SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE Attitude of health personnel; Biomedical research; Drug industry ID EDUCATIONAL INTERVENTION; GIFTS AB BACKGROUND: Physicians' ratings of the appropriateness of collaboration and of receiving payment for collaboration with the pharmaceutical and medical device industries may differ. METHODS: We administered an anonymous, cross-sectional survey to a convenience sample of faculty and postgraduate physicians from all departments within the 11 hospitals affiliated with the Mount Sinai School of Medicine in New York City and New Jersey. We examined 12 collaborations with the pharmaceutical and medical device industries using 4-point Likert scales, ranging from very appropriate to very inappropriate. RESULTS: Surveys were distributed to physicians within 35 departments at 11 hospitals; 590 surveys were completed by physicians at 9 hospitals, yielding a 67% response rate. Physicians' assessment of appropriateness varied among the different collaborations, ranging from nearly all rating developing a drug or device (92%) and designing a drug/device trial (91%) as appropriate to fewer rating preparing a manuscript of a drug/device trial (60%) and recruiting patients for a drug/device trial (65%) as appropriate for physicians not involved in trial design. Physicians consistently rated receiving payment for collaboration as appropriate less often than they rated the collaboration itself as appropriate and ratings varied among the collaborations. For example, 81% rated receiving payment to develop a drug or device as appropriate, whereas 38% rated receiving payment to recruit patients for a drug/device trial when the physician was not involved in trial design as appropriate. CONCLUSIONS: Physicians' broadly perceived most collaboration with the pharmaceutical and medical device industries, and of receiving payment for collaboration, as appropriate. Published by Elsevier Inc. . The American Journal of Medicine (2009) 122, 955-960 C1 [Ross, Joseph S.] Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY 10029 USA. [Ross, Joseph S.; Keyhani, Salomeh] James J Peters VA Med Ctr, HSR&D Res Enhancement Award Program, Bronx, NY USA. James J Peters VA Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. [Keyhani, Salomeh] Mt Sinai Sch Med, Dept Hlth Policy, New York, NY USA. [Korenstein, Deborah] Mt Sinai Sch Med, Dept Med, New York, NY USA. RP Ross, JS (reprint author), Mt Sinai Sch Med, Dept Geriatr & Adult Dev, 1 Gustave L Levy Pl,Box 1070, New York, NY 10029 USA. EM joseph.ross@mssm.edu FU Attorney General Consumer and Prescriber FX Data collection for this work was partially supported by the Attorney General Consumer and Prescriber Grant Program administered by the State of Oregon. Dr. Ross was compensated for his work as a consultant at the request of plaintiffs in litigation against Merck and Co., Inc. related to rofecoxib from 2006-2007. NR 14 TC 8 Z9 8 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD OCT PY 2009 VL 122 IS 10 BP 955 EP 960 DI 10.1016/j.amjmed.2009.04.013 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 501UV UT WOS:000270409200015 PM 19786162 ER PT J AU Pasadhika, S Kempen, JH Newcomb, CW Liesegang, TL Pujari, SS Rosenbaum, JT Thorne, JE Foster, CS Jabs, DA Levy-Clarke, GA Nussenblatt, RB Suhler, EB AF Pasadhika, Sirichai Kempen, John H. Newcomb, Craig W. Liesegang, Teresa L. Pujari, Siddharth S. Rosenbaum, James T. Thorne, Jennifer E. Foster, C. Stephen Jabs, Douglas A. Levy-Clarke, Grace A. Nussenblatt, Robert B. Suhler, Eric B. TI Azathioprine for Ocular Inflammatory Diseases SO AMERICAN JOURNAL OF OPHTHALMOLOGY LA English DT Article ID LONG-TERM; IMMUNOSUPPRESSIVE THERAPY; BEHCETS-SYNDROME; CONTROLLED TRIAL; DRUGS; MANAGEMENT; PREGNANCY; ARTHRITIS; UVEITIS; AGENTS AB PURPOSE: To evaluate treatment outcomes of azathioprine for noninfectious ocular inflammatory diseases. DESIGN: Retrospective cohort study. METHODS: Medical records of 145 patients starting azathioprine as a sole noncorticosteroid immunosuppressant at 4 tertiary uveitis services were reviewed. Main outcome measures included control of ocular inflammation, sustained control after tapering prednisone to <= 10 mg/day, and discontinuation of treatment because of side effects. RESULTS: Among 145 patients (255 eyes) treated with azathioprine, 63% had uveitis, 23% had mucous membrane pemphigoid, 11% bad scleritis, and 3% had other inflammatory diseases. By Kaplan-Meier analysis, 62% (95% confidence interval [CI], 50% to 74%) of patients with active disease initially gained complete inactivity of inflammation sustained over at least 28 days within 1 year of therapy, and 47% (95% CI, 37% to 58%) tapered systemic corticosteroids to <= 10 mg daily while maintaining control of inflammation within 1 year of therapy. Treatment success was most common for intermediate uveitis (90% with sustained inactivity within 1 year; 95% CI, 64% to 99%). Over the median follow-up of 230 days (interquartile range, 62 to 679 days), azathioprine was discontinued at a rate of 0.45 per person,years (/PY): 0.16/PY because of side effects, 0.10/PY because of ineffectiveness, 0.09/PY because of disease remission, and 0.10/PY because of unspecified causes. CONCLUSIONS: Azathioprine was moderately effective as a single corticosteroid-sparing immunosuppressive agent in terms of control of inflammation and corticosteroid-sparing benefits, but required several months to achieve treatment goals; it seems especially useful for patients with intermediate uveitis. Treatment-limiting side effects occurred in approximately one-fourth of patients within 1 year, but typically were reversible. (Am J Ophthalmol 2009;148:500-509. (C) 2009 by Elsevier Inc. All rights reserved.) C1 [Kempen, John H.] Univ Penn, Dept Ophthalmol, Ctr Prevent Ophthalmol & Biostat, Philadelphia, PA 19104 USA. [Pasadhika, Sirichai; Liesegang, Teresa L.; Rosenbaum, James T.; Suhler, Eric B.] Oregon Hlth & Sci Univ, Dept Ophthalmol, Portland, OR 97201 USA. [Rosenbaum, James T.] Oregon Hlth & Sci Univ, Dept Internal Med, Portland, OR 97201 USA. [Kempen, John H.] Univ Penn, Scheie Eye Inst, Ocular Inflammat Serv, Philadelphia, PA 19104 USA. [Kempen, John H.; Newcomb, Craig W.] Univ Penn, Ctr Clin Epidemiol & Biostat, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. [Pujari, Siddharth S.; Foster, C. Stephen] Massachusetts Eye Res & Surg Inst, Cambridge, MA USA. [Thorne, Jennifer E.; Jabs, Douglas A.] Johns Hopkins Univ, Dept Ophthalmol, Baltimore, MD USA. [Thorne, Jennifer E.; Jabs, Douglas A.] Johns Hopkins Univ, Dept Epidemiol, Baltimore, MD USA. [Foster, C. Stephen] Harvard Univ, Sch Med, Dept Ophthalmol, Boston, MA USA. [Jabs, Douglas A.] Mt Sinai Sch Med, Dept Ophthalmol, New York, NY USA. [Jabs, Douglas A.] Mt Sinai Sch Med, Dept Med, New York, NY USA. [Levy-Clarke, Grace A.; Nussenblatt, Robert B.] NEI, Immunol Lab, Bethesda, MD 20892 USA. [Levy-Clarke, Grace A.] St Lukes Cataract & Laser Inst, Tarpon Springs, FL USA. [Suhler, Eric B.] Portland VA Med Ctr, Portland, OR USA. RP Kempen, JH (reprint author), Univ Penn, Dept Ophthalmol, Ctr Prevent Ophthalmol & Biostat, 3535 Market St,Suite 700, Philadelphia, PA 19104 USA. EM john.kempen@uphs.upenn.edu FU NATIONAL EYE INSTITUTE, BETHESDA, MARYLAND [EY-014943]; Research to Prevent Blindness; Veterans' Administration; Genentech; Eyegate; Lux Biosciences; Abbott FX THIS STUDY WAS SUPPORTED BY THE NATIONAL EYE INSTITUTE, BETHESDA, MARYLAND, GRANT NO. EY-014943 (DR KEMPEN); the Paul and Evanina Mackall Foundation, New York, New York; and Research to Prevent Blindness Inc, New York, New York. Dr Kempen is a Research to Prevent Blindness James S. Adams Special Scholar Award recipient. Drs Jabs and Rosenbaum are recipients of Research to Prevent Blindness Senior Scientific Investigator Awards. Dr Levy-Clarke previously was supported by and Dr Nussenblatt is supported by intramural funds of the National Eye Institute, Bethesda, Maryland. Dr Sublet also received support from the Veterans' Administration. Dr Foster has served as a consultant to Allergan, Bausch & Lomb, and Sirion; owns equity or stock options in Eyegate; and h is received speaking fees from Alcon, Allergan, Inspire, Ista, Bausch & Lomb, and Centocor. Dr Jabs has served as a consultant to Abbott, Genzyme Corporation, Novartis, Allergan, the Emmes Corporation (DSMC member), and the Johns Hopkins University Dana Center for Preventive Ophthalmology. Dr Kempen has served as a Consultant to Lux Biosciences and has participated in clinical trials funded by Allergan and Eyegate. Dr Rosenbaum has served as a Consultant to Abbott, Amgen, Allergan, Lux Biosciences, and Novartis; holds equity ownership/stock options in Amgen; and has received research Support from Genentech, Lux Biosciences, and Abbott. Dr Suhler has received research support from Eyegate, Genentech, Lux Biosciences, and Abbott. Involved in design of study (S.P., J.H.K., C.W.N.); conduct of study (S.P., J.H.K., E.B.S.); collection of data (S.P., J.H.K., CW.N., T.L.L., S.S.P., J.T.R., J.E.T., C.S.F., D.A.J., G.A.L.-C., R.B.N., E.B.S.); management (S.P., J.H.K., JT.R., J.E.T., C.S.F., D.A.]., G.A.L.-C., R.B.N., E.B.S.), analysis, and interpretation of data (S.P., J.H.K., CW.N., E.B.S.); and preparation (S.P., J.H.K., E.B.S.), review, and approval of the manuscript (S.P., J.H.K., C.W.N., T.L.L., S.S.P., J.T.R., J.E.T., C.S.F., D.A.J., G.A.L.-C., R.B.N., E.B.S.). The protocol was approved by Institutional Review Boards of all participating institutions and was conducted in accordance with the principles of the Declaration of Helsinki and the Health Insurance Portability and Accountability Act. NR 26 TC 69 Z9 72 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9394 J9 AM J OPHTHALMOL JI Am. J. Ophthalmol. PD OCT PY 2009 VL 148 IS 4 BP 500 EP 509 DI 10.1016/j.ajo.2009.05.008 PG 10 WC Ophthalmology SC Ophthalmology GA 503MI UT WOS:000270538000006 PM 19570522 ER PT J AU Jones, JA Beck, C Barbour, JR Zavadzkas, JA Mukherjee, R Spinale, FG Ikonomidis, JS AF Jones, Jeffrey A. Beck, Christy Barbour, John R. Zavadzkas, Jouzas A. Mukherjee, Rupak Spinale, Francis G. Ikonomidis, John S. TI Alterations in Aortic Cellular Constituents during Thoracic Aortic Aneurysm Development Myofibroblast-Mediated Vascular Remodeling SO AMERICAN JOURNAL OF PATHOLOGY LA English DT Article ID MATRIX PROTEIN EXPRESSION; EXTRACELLULAR-MATRIX; ASCENDING AORTA; MURINE MODEL; MONOCLONAL-ANTIBODY; METALLOPROTEINASES; VALVE; MACROPHAGE; APOPTOSIS; PATTERNS AB The present study tested the hypothesis that changes in the resident endogenous cellular population accompany alterations in aortic collagen and elastin content during thoracic aortic aneurysm (TAA) development in a murine model. Descending thoracic aortas were analyzed at various time points (2, 4, 8, and 16 weeks) post-TAA induction (0-5 M CaCl(2), 15 minutes). Aortic tissue sections were subjected to histological staining and morphometric analysis for collagen and elastin, as well as immunostaining for cell-type-specific markers to quantify fibroblasts, myofibroblasts, and smooth-muscle cells. Results were compared with reference control mice processed in die same fashion. Aortic dilatation was accompanied by changes in the elastic architecture that included: a decreased number of elastic lamellae (from 6 to 4); altered area fraction of elastin (elevated at 4 weeks and decreased at 16 weeks); and a decreased area between elastic lamellae (minimum reached at 4 weeks). Total collagen content did not change over time. increased immunoreactivity for fibroblast and myofibroblast markers was observed at 8- and 16-week post-TAA-induction, whereas immunoreactivity for smooth-muscle cell markers peaked at 4 weeks and returned to baseline by 16 weeks. Therefore, this study demonstrated that changes in aortic elastin content were accompanied by the emergence of a subset of fibroblast-derived myofibroblasts whose altered phenotype may play a significant role in TAA development through the enhancement of extracellular matrix proteolysis. (Am J Pathol 2009, 175:1746-1756; DOI: 10.2353/ajpath.2009.081141) C1 [Jones, Jeffrey A.; Beck, Christy; Barbour, John R.; Zavadzkas, Jouzas A.; Mukherjee, Rupak; Spinale, Francis G.; Ikonomidis, John S.] Med Univ S Carolina, Dept Surg, Div Cardiothorac Surg Res, Charleston, SC 29425 USA. [Jones, Jeffrey A.; Spinale, Francis G.] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Jones, JA (reprint author), Med Univ S Carolina, Dept Surg, Div Cardiothorac Surg Res, Strom Thurmond Res Bldg,114 Doughty St,Suite 625, Charleston, SC 29425 USA. EM jonesja@musc.edu FU National Institutes of Health/National Heart, Lung, and Blood Institute [R01 HL075488-05]; Department of Veterans Affairs [BLRD-CDA-2] FX Supported by National Institutes of Health/National Heart, Lung, and Blood Institute grant R01 HL075488-05 and a Career Development Award (BLRD-CDA-2) from the Department of Veterans Affairs. NR 50 TC 27 Z9 28 U1 1 U2 5 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 OCT PY 2009 VL 175 IS 4 BP 1746 EP 1756 DI 10.2353/ajpath.2009.081141 PG 11 WC Pathology SC Pathology GA 503AM UT WOS:000270503100039 PM 19729479 ER PT J AU Akiba, Y Watanabe, C Mizumori, M Kaunitz, JD AF Akiba, Yasutada Watanabe, Chikako Mizumori, Misa Kaunitz, Jonathan D. TI Luminal L-glutamate enhances duodenal mucosal defense mechanisms via multiple glutamate receptors in rats SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE intracellular alkalinization; mucus secretion; bicarbonate secretion; monosodium glutamate; taste receptor ID CALCIUM-SENSING RECEPTOR; MUCUS GEL THICKNESS; BITTER TASTE RECEPTORS; INTRACELLULAR PH; GASTROINTESTINAL-TRACT; CA2+-SENSING RECEPTOR; CARBONIC-ANHYDRASES; CHORDA TYMPANI; BLOOD-FLOW; ACID AB Akiba Y, Watanabe C, Mizumori M, Kaunitz JD. Luminal L-glutamate enhances duodenal mucosal defense mechanisms via multiple glutamate receptors in rats. Am J Physiol Gastrointest Liver Physiol 297: G781-G791, 2009. First published July 30, 2009; doi: 10.1152/ajpgi.90605.2008.-Presence of taste receptor families in the gastrointestinal mucosa suggests a physiological basis for local and early detection of a meal. We hypothesized that luminal L-glutamate, which is the primary nutrient conferring fundamental umami or proteinaceous taste, influences mucosal defense mechanisms in rat duodenum. We perfused the duodenal mucosa of anesthetized rats with L-glutamate (0.1-10 mM). Intracellular pH (pH(i)) of the epithelial cells, blood flow, and mucus gel thickness (MGT) were simultaneously and continuously measured in vivo. Some rats were pretreated with indomethacin or capsaicin. Duodenal bicarbonate secretion (DBS) was measured with flow-through pH and CO(2) electrodes. We tested the effects of agonists or antagonists for metabotropic glutamate receptor (mGluR) 1 or 4 or calcium-sensing receptor (CaSR) on defense factors. Luminal L-glutamate dose dependently increased pHi and MGT but had no effect on blood flow in the duodenum. L-glutamate (10 mM)-induced cellular alkalinization and mucus secretion were inhibited by pretreatment with indomethacin or capsaicin. L-glutamate effects on pH(i) and MGT were mimicked by mGluR4 agonists and inhibited by an mGluR4 antagonist. CaSR agonists acidified cells with increased MGT and DBS, unlike L-glutamate. Perfusion of L-glutamate with inosinate (inosine 5'-monophosphate, 0.1 mM) enhanced DBS only in combination, suggesting synergistic activation of the L-glutamate receptor, typical of taste receptor type 1. L-leucine or L-aspartate had similar effects on DBS without any effect on pHi and MGT. Preperfusion of L-glutamate prevented acid-induced cellular injury, suggesting that L-glutamate protects the mucosa by enhancing mucosal defenses. Luminal L-glutamate may activate multiple receptors and afferent nerves and locally enhance mucosal defenses to prevent subsequent injury attributable to acid exposure in the duodenum. C1 [Akiba, Yasutada; Kaunitz, Jonathan D.] Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. [Akiba, Yasutada; Watanabe, Chikako; Mizumori, Misa; Kaunitz, Jonathan D.] Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. [Akiba, Yasutada; Watanabe, Chikako; Mizumori, Misa; Kaunitz, Jonathan D.] Brentwood Biomed Res Inst, Los Angeles, CA USA. RP Akiba, Y (reprint author), W Los Angeles Vet Affairs Med Ctr, Bldg 114,Suite 217,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM yasuakiba@hotmail.com FU Ajinomoto, Japan; Department of Veterans Affairs Merit Review Award, NIH-NIDDK [R01 DK54221, P30 DK0413] FX This work was supported by a research grant from Ajinomoto, Japan (Y. Akiba), Department of Veterans Affairs Merit Review Award, NIH-NIDDK R01 DK54221 (J. Kaunitz), and the animal core of NIH-NIDDK P30 DK0413 (J. E. Rozengurt). NR 48 TC 58 Z9 62 U1 0 U2 2 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 OCT PY 2009 VL 297 IS 4 BP G781 EP G791 DI 10.1152/ajpgi.90605.2008 PG 11 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 498LI UT WOS:000270141400017 PM 19643955 ER PT J AU Jasuja, D Mor, MK Hartwig, KC Palevsky, PM Fine, MJ Weisbord, SD AF Jasuja, Deepak Mor, Maria K. Hartwig, Kathryn C. Palevsky, Paul M. Fine, Michael J. Weisbord, Steven D. TI Provider Knowledge of Contrast-Induced Acute Kidney Injury SO AMERICAN JOURNAL OF THE MEDICAL SCIENCES LA English DT Article DE Contrast; Acute kidney injury; Providers; Knowledge ID RADIOCONTRAST-INDUCED NEPHROPATHY; RANDOMIZED CONTROLLED-TRIAL; ACUTE-RENAL-FAILURE; CORONARY INTERVENTION; CARDIAC ANGIOGRAPHY; RISK-FACTORS; MEDIA; PREVENTION; NEPHROTOXICITY; INSUFFICIENCY AB Background Although past research has elucidated the principal risk factors and efficacy of preventive interventions for contrast-induced acute kidney injury (CIAKI), provider awareness of this empiric evidence base is largely unknown. We sought to assess provider knowledge of the risk factors and preventive interventions for CIAKI. Methods: We asked medical providers caring for patients undergoing procedures with intravascular iodinated contrast to complete a survey designed to assess their knowledge of the risk factors and preventive interventions,for CIAKI. Results: Of the 87 participating providers, nearly all (n = 85; 98%) recognized chronic kidney disease and intravascular volume depletion as risk factors. However, 35 (41%) incorrectly identified allergy to contrast media as a risk factor and 8 (10%) incorrectly identified intravenous (IV) water as an effective preventive intervention. Compared with those with little or no prior training on CIAKI, those with substantial prior training correctly reported that peripheral vascular disease and atrial fibrillation are not risk factors and that fenoldopam and IV water are ineffective preventive interventions (P < 0.05). Trainees were more likely than those who had completed their postgraduate medical training to correctly report that IV saline and sodium bicarbonate are effective preventive interventions and that fenoldopam, dopamine, mannitol, and IV water are ineffective measures (P < 0.05). Conclusions: There is wide variability in providers' knowledge of CIAKI. Providers with more training on CIAKI and trainees had greater knowledge of the risk factors and preventive interventions for CIAKI. These findings underscore the need to standardize and intensify provider education of this costly and preventable iatrogenic condition. C1 [Mor, Maria K.; Hartwig, Kathryn C.; Fine, Michael J.; Weisbord, Steven D.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. [Jasuja, Deepak] Univ Pittsburgh, Dept Gen Internal Med, Med Ctr McKeesport, Pittsburgh, PA USA. [Palevsky, Paul M.; Weisbord, Steven D.] VA Pittsburgh Healthcare Syst, Renal Sect, Med Specialty Serv Line, Pittsburgh, PA 15240 USA. [Palevsky, Paul M.; Weisbord, Steven D.] Univ Pittsburgh, Sch Med, Dept Med, Renal Electrolyte Div, Pittsburgh, PA USA. [Mor, Maria K.] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Pittsburgh, PA 15261 USA. [Fine, Michael J.] Univ Pittsburgh, Sch Med, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. RP Weisbord, SD (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Mailstop 111F-U,7E Room 120, Pittsburgh, PA 15240 USA. EM weisbordsd@upmc.edu OI Palevsky, Paul/0000-0002-7334-5400 FU NIAID NIH HHS [K24 AI001769] NR 27 TC 4 Z9 4 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-9629 J9 AM J MED SCI JI Am. J. Med. Sci. PD OCT PY 2009 VL 338 IS 4 BP 280 EP 286 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 511OE UT WOS:000271174300006 PM 19641454 ER PT J AU Reese, PP Feldman, HI Asch, DA Halpern, SD Blumberg, EA Thomasson, A Shults, J Bloom, RD AF Reese, P. P. Feldman, H. I. Asch, D. A. Halpern, S. D. Blumberg, E. A. Thomasson, A. Shults, J. Bloom, R. D. TI Transplantation of Kidneys from Donors at Increased Risk for Blood-Borne Viral Infection: Recipient Outcomes and Patterns of Organ Use SO AMERICAN JOURNAL OF TRANSPLANTATION LA English DT Article DE Centers for Disease Control (CDC); kidney transplantation; viral infection ID EXPANDED CRITERIA DONORS; CARDIAC DEATH; INFORMING CANDIDATES; SURVIVAL; DIALYSIS; DONATION; INMATES AB Kidney transplantation from deceased donors classified as increased risk for viral infection by the Centers for Disease Control (CDC) is controversial. Analyses of Organ Procurement and Transplantation Network (OPTN) data from 7/1/2004 to 7/1/2006 were performed. The primary cohort included 48 054 adults added to the kidney transplant wait list. Compared to receiving a standard criteria donor (SCD) kidney or remaining wait-listed, CDC recipients (HR 0.80, p = 0.18) had no significant difference in mortality. In a secondary cohort of 19 872 kidney recipients at 180 centers, SCD (reference) and CDC (HR 0.91, p = 0.16) recipients had no difference in the combined endpoint of allograft failure or death. Among centers performing > 10 kidney transplants during the study period, the median proportion of CDC transplants/total transplants was 7.2% (range 1.1-35.6%). Higher volume transplant centers were more likely to use CDC kidneys compared to low and intermediate volume centers (p < 0.01). An analysis of procured kidneys revealed that 6.8% of SCD versus 7.8% of CDC (p = 0.13) kidneys were discarded. In summary, center use of CDC kidneys varied widely, and recipients had good short-term outcomes. OPTN should collect detailed data about long-term outcomes and recipient viral testing so the potential risks of CDC kidneys can be fully evaluated. C1 [Reese, P. P.; Feldman, H. I.; Halpern, S. D.; Bloom, R. D.] Univ Penn, Dept Med, Div Renal, Philadelphia, PA 19104 USA. [Reese, P. P.; Feldman, H. I.; Halpern, S. D.; Thomasson, A.; Shults, J.] Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. [Reese, P. P.; Asch, D. A.; Halpern, S. D.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Asch, D. A.] Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. [Blumberg, E. A.] Univ Penn, Dept Med, Div Infect Dis, Philadelphia, PA 19104 USA. RP Reese, PP (reprint author), Univ Penn, Dept Med, Div Renal, Philadelphia, PA 19104 USA. EM peter.reese@uphs.upenn.edu OI Asch, David/0000-0002-7970-286X FU NIH [K23 - DK078688-01, K24 - DK002651]; Greenwall Foundation FX The authors acknowledge Stacey Doll for her helpful suggestions for the study. Dr. Reese is supported by NIH grant K23 - DK078688-01. Dr. Feldman is supported by NIH grant K24 - DK002651. Dr. Halpern is supported by a Greenwall Foundation Faculty Scholar Award in Bioethics. NR 23 TC 19 Z9 20 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1600-6135 J9 AM J TRANSPLANT JI Am. J. Transplant. PD OCT PY 2009 VL 9 IS 10 BP 2338 EP 2345 DI 10.1111/j.1600-6143.2009.02782.x PG 8 WC Surgery; Transplantation SC Surgery; Transplantation GA 494GY UT WOS:000269801000018 PM 19702645 ER PT J AU Rozet, I Tontisirin, N Vavilala, MS Treggiari, MM Lee, LA Lam, AM AF Rozet, Irene Tontisirin, Nuj Vavilala, Monica S. Treggiari, Miriam M. Lee, Lorri A. Lam, Arthur M. TI Prolonged Propofol Anesthesia Is Not Associated with an Increase in Blood Lactate SO ANESTHESIA AND ANALGESIA LA English DT Article ID HEPATIC GLUCOSE-PRODUCTION; FREE FATTY-ACIDS; INFUSION SYNDROME; METABOLIC-ACIDOSIS; LACTIC-ACIDOSIS; ISOFLURANE ANESTHESIA; HALOTHANE ANESTHESIA; CONSCIOUS DOGS; SEVOFLURANE; CHILDREN AB BACKGROUND: Lactic acidosis is considered an early sign of propofol infusion syndrome. In this study, we investigated the changes in lactate and pH with propofol versus volatile anesthesia (VA) of long duration. METHODS: Demographic and intraoperative data were recorded retrospectively from the anesthesia records of patients who underwent elective spine surgery longer than 8 h. Propofol patients were matched 1:2 to VA patients, based on anesthesia time (AT) (+/- 30 min) and blood loss (BL) (+/- 500 mL). RESULTS: Of 246 patients identified, 50 received propofol (AT 10 +/- 2 h, BL = 1955 +/- 1409 mL) and were matched to 100 VA cases (AT = 10 +/- 1 h, BL = 1801 +/- 1543 mL), and of those, 40 and 72 patients, respectively, had complete lactate data at baseline and at 8 h after anesthesia and were included in the main analysis. The propofol group received 8.8 +/- 2 mg.kg(-1).h(-1) of propofol. The VA group age was older than the propofol group (58 +/- 12 vs 51 +/- 15 yr, respectively, P = 0.002), but there was no difference between the groups in gender, ASA grade, intraoperative hemodynamic variables, and use of vasopressors. After 8 h, the VA group had a larger increase in arterial lactate from baseline compared with the propofol group (change from baseline: propofol, 0.48 +/- 0.72 mmol/L; VA, 1.2 +/- 1.2 mmol/L, P = 0.001). CONCLUSIONS: During prolonged spine surgery > 8 h, VA was associated with higher serum lactate, when compared with propofol infusion. Prospective studies are needed to elucidate the exact mechanisms and clinical implications of this finding. (Anesth Analg 2009;109:1105-10) C1 [Rozet, Irene] Univ Washington, Dept Anesthesiol, VA Puget Sound Hlth Care Syst, Harborview Med Ctr, Seattle, WA 98108 USA. [Vavilala, Monica S.] Univ Washington, Dept Pediat, Harborview Med Ctr, Seattle, WA 98108 USA. [Vavilala, Monica S.; Treggiari, Miriam M.; Lee, Lorri A.; Lam, Arthur M.] Univ Washington, Dept Neurol Surg, Harborview Med Ctr, Seattle, WA 98108 USA. RP Rozet, I (reprint author), Univ Washington, Dept Anesthesiol, VA Puget Sound Hlth Care Syst, Harborview Med Ctr, 1660 S Columbian Way, Seattle, WA 98108 USA. EM irozet@u.washington.edu NR 38 TC 7 Z9 7 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-2999 J9 ANESTH ANALG JI Anesth. Analg. PD OCT PY 2009 VL 109 IS 4 BP 1105 EP 1110 DI 10.1213/ANE.0b013e3181b5a220 PG 6 WC Anesthesiology SC Anesthesiology GA 499HL UT WOS:000270209100020 PM 19641048 ER PT J AU Simons, CW Benouni, S Gibbon, G Klaustermeyer, W AF Simons, Caroline Watson Benouni, Saraleen Gibbon, Gary Klaustermeyer, William TI SEVERE ANAPHYLACTOID SHOCK SECONDARY TO GADOLINIUM CONTRAST MEDIA SO ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY LA English DT Letter ID ADVERSE-REACTIONS C1 [Simons, Caroline Watson; Benouni, Saraleen; Gibbon, Gary; Klaustermeyer, William] Univ Calif Los Angeles, Div Allergy & Immunol, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90095 USA. RP Simons, CW (reprint author), Univ Calif Los Angeles, Div Allergy & Immunol, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90095 USA. EM crwatson98@yahoo.com NR 8 TC 2 Z9 2 U1 0 U2 1 PU AMER COLL ALLERGY ASTHMA IMMUNOLOGY PI ARLINGTON HTS PA 85 WEST ALGONQUIN RD SUITE 550, ARLINGTON HTS, IL 60005 USA SN 1081-1206 J9 ANN ALLERG ASTHMA IM JI Ann. Allergy Asthma Immunol. PD OCT PY 2009 VL 103 IS 4 BP 359 EP 360 PG 2 WC Allergy; Immunology SC Allergy; Immunology GA 509YP UT WOS:000271055500018 PM 19852205 ER PT J AU Kang, HK Bullman, TA AF Kang, Han K. Bullman, Tim A. TI Is There an Epidemic of Suicides among Current and Former US Military Personnel? SO ANNALS OF EPIDEMIOLOGY LA English DT Article ID PERSIAN-GULF-WAR; VIETNAM VETERANS; MORTALITY; RISK; ARMY C1 [Kang, Han K.; Bullman, Tim A.] Environm Epidemiol Serv, US Dept Vet Affairs, Washington, DC 20420 USA. [Kang, Han K.] DC VA Med Ctr, War Related Illness & Injury Study Ctr, Washington, DC USA. [Kang, Han K.] George Washington Univ, Washington, DC 20052 USA. RP Kang, HK (reprint author), Environm Epidemiol Serv, US Dept Vet Affairs, 810 Vermont Ave NW, Washington, DC 20420 USA. EM han.kang@va.gov NR 20 TC 35 Z9 35 U1 1 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1047-2797 J9 ANN EPIDEMIOL JI Ann. Epidemiol. PD OCT PY 2009 VL 19 IS 10 BP 757 EP 760 DI 10.1016/j.annepidem.2009.05.004 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 499BR UT WOS:000270192000011 PM 19628411 ER PT J AU Zivkovic, SA Delios, A Lacomis, D Lentzsch, S AF Zivkovic, Sasa A. Delios, Ana Lacomis, David Lentzsch, Suzanne TI Small fiber neuropathy associated with multiple myeloma and IgA monoclonal gammopathy SO ANNALS OF HEMATOLOGY LA English DT Letter ID PERIPHERAL NEUROPATHY; SENSORY NEUROPATHY; SKIN BIOPSY C1 [Zivkovic, Sasa A.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Zivkovic, Sasa A.; Delios, Ana; Lacomis, David] Univ Pittsburgh, Dept Neurol, Med Ctr, Pittsburgh, PA 15260 USA. [Lacomis, David] Univ Pittsburgh, Dept Pathol Neuropathol, Med Ctr, Pittsburgh, PA 15260 USA. [Lentzsch, Suzanne] Univ Pittsburgh, Div Hematol Oncol, Dept Med, Med Ctr, Pittsburgh, PA 15260 USA. RP Zivkovic, SA (reprint author), VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. EM zivkovics@upmc.edu NR 9 TC 4 Z9 4 U1 0 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0939-5555 J9 ANN HEMATOL JI Ann. Hematol. PD OCT PY 2009 VL 88 IS 10 BP 1043 EP 1044 DI 10.1007/s00277-009-0724-8 PG 2 WC Hematology SC Hematology GA 485GT UT WOS:000269109900021 PM 19277656 ER PT J AU Hawker, K O'Connor, P Freedman, MS Calabresi, PA Antel, J Simon, J Hauser, S Waubant, E Vollmer, T Panitch, H Zhang, JM Chin, P Smith, CH AF Hawker, Kathleen O'Connor, Paul Freedman, Mark S. Calabresi, Peter A. Antel, Jack Simon, Jack Hauser, Stephen Waubant, Emmanuelle Vollmer, Timothy Panitch, Hillel Zhang, Jiameng Chin, Peter Smith, Craig H. CA OLYMPUS Trial Grp TI Rituximab in Patients with Primary Progressive Multiple Sclerosis Results of a Randomized Double-Blind Placebo-Controlled Multicenter Trial SO ANNALS OF NEUROLOGY LA English DT Article ID INNATE IMMUNE-SYSTEM; INTERFERON BETA-1A; AGED MICE; B-CELLS; INFLAMMATION; DAMAGE; EVENT; MRI; NEUROINFLAMMATION; AUTOANTIBODIES AB Objective: Rituximab, a monoclonal antibody selectively depleting CD20+ B cells, has demonstrated efficacy in reducing disease activity in relapsing-remitting multiple sclerosis (MS). We evaluated rituximab in adults with primary progressive MS (PPMS) through 96 weeks and safety through 122 weeks. Methods: Using 2:1 randomization, 439 PPMS patients received two 1,000mg intravenous rituximab or placebo infusions every 24 weeks, through 96 weeks (4 courses). The primary endpoint was time to confirmed disease progression (CDP), a prespecified increase in Expanded Disability Status Scale sustained for 12 weeks. Secondary endpoints were change from baseline to week 96 in T2 lesion volume and total brain volume on magnetic resonance imaging scans. Results: Differences in time to CDP between rituximab and placebo did not reach significance (96-week rates: 38.5% placebo, 30.2% rituximab; p = 0.14). From baseline to week 96, rituximab patients had less (p < 0.001) increase in T2 lesion volume; brain volume change was similar (p = 0.62) to placebo. Subgroup analysis showed time to CDP was delayed in rituximab-treated patients aged <51 years (hazard ratio [HR] = 0.52; p = 0.010), those with gadolinium-enhancing lesions (HR = 0.41; P = 0.007), and those aged <51 years with gadolinium-enhancing lesions (HR = 0.33; p = 0.009) compared with placebo. Adverse events were comparable between groups; 16.1% of rituximab and 13.6% of placebo patients reported serious events. Serious infections occurred in 4.5% of rituximab and <1.0% of placebo patients. Infusion-related events, predominantly mild to moderate, were more common with rituximab during the first course, and decreased to rates comparable to placebo on successive courses. Interpretation: Although time to CDP between groups was not significant, overall subgroup analyses suggest selective B-cell depletion may affect disease progression in younger patients, particularly those with inflammatory lesions. C1 [Hawker, Kathleen] Ohio State Univ, Dept Neurol, Med Ctr, Columbus, OH 43210 USA. [O'Connor, Paul] Univ Toronto, Dept Med, Toronto, ON, Canada. [Freedman, Mark S.] Ottawa Hosp, Dept Med, Ottawa, ON, Canada. [Calabresi, Peter A.] Johns Hopkins Univ, Dept Neurol, Baltimore, MD USA. [Antel, Jack] McGill Univ, Dept Neurol & Neurosurg, Montreal, PQ, Canada. [Simon, Jack] Portland VA Med Ctr, Dept Neurol, Portland, OR USA. [Hauser, Stephen; Waubant, Emmanuelle] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. [Vollmer, Timothy] Univ Colorado, Dept Neurol, Denver, CO 80202 USA. [Panitch, Hillel] Univ Vermont, Dept Neurol, Burlington, VT USA. [Zhang, Jiameng; Chin, Peter; Smith, Craig H.] Genentech Inc, San Francisco, CA 94080 USA. RP Hawker, K (reprint author), Eli Lilly & Co, 450 S Meridian St, Indianapolis, IN 46225 USA. EM hawkerks@lilly.com FU Clinicaltrials.gov [NCT00087529]; Genentech, Inc.; Biogen Idec, Inc. FX This study was supported by Clinicaltrials.gov under "A Study to Evaluate the Safety and Efficacy of Rituximab in Adults With Primary Progressive Multiple Sclerosis" (grant NCT00087529), by Genentech, Inc., and by Biogen Idec, Inc. NR 38 TC 247 Z9 250 U1 2 U2 9 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0364-5134 J9 ANN NEUROL JI Ann. Neurol. PD OCT PY 2009 VL 66 IS 4 BP 460 EP 471 DI 10.1002/ana.21867 PG 12 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 507SJ UT WOS:000270874700006 PM 19847908 ER PT J AU Nannini, M Astolfi, A Pantaleo, MA Di Battista, M Santini, D Catena, F Heinrich, MC Saponara, M Lolli, C Maleddu, A Formica, S Biasco, G AF Nannini, Margherita Astolfi, Annalisa Pantaleo, Maria A. Di Battista, Monica Santini, Donatella Catena, Fausto Heinrich, Mike C. Saponara, Maristella Lolli, Cristian Maleddu, Alessandra Formica, Serena Biasco, Guido TI HIGH RESOLUTION COPY NUMBER ANALYSIS OF GASTROINTESTINAL STROMAL TUMORS (GISTs) WITH AFFYMETRIX TECHNOLOGY SO ANNALS OF ONCOLOGY LA English DT Meeting Abstract C1 [Nannini, Margherita; Pantaleo, Maria A.; Di Battista, Monica; Saponara, Maristella; Lolli, Cristian; Maleddu, Alessandra; Biasco, Guido] Univ Bologna, Dept Hematol & Oncol Sci LA Seragnoli, I-40126 Bologna, Italy. [Astolfi, Annalisa; Formica, Serena; Biasco, Guido] Univ Bologna, Interdept Ctr Canc Res G Prodi, I-40126 Bologna, Italy. [Santini, Donatella] Univ Bologna, Pathol Unit, St Orsola Malpighi Hosp, I-40126 Bologna, Italy. [Catena, Fausto] Univ Bologna, Emergency Surg & Transplant Dept, St Orsola Malpighi Hosp, I-40126 Bologna, Italy. [Heinrich, Mike C.] Oregon Hlth & Sci Univ, Dept Med, Portland VA Med Ctr, Portland, OR 97201 USA. [Heinrich, Mike C.] Oregon Hlth & Sci Univ, Oregon Hlth & Sci Univ Knight Canc Inst, Portland, OR 97201 USA. RI Saponara, Maristella/J-9904-2016; nannini, margherita/J-9866-2016 OI Saponara, Maristella/0000-0003-0715-171X; NR 0 TC 0 Z9 0 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0923-7534 J9 ANN ONCOL JI Ann. Oncol. PD OCT PY 2009 VL 20 SU 8 PG 2 WC Oncology SC Oncology GA V15CV UT WOS:000207781000221 ER PT J AU Pantaleo, MA Astolfi, A Di Battista, M Paterini, P Santini, D Catena, F Heinrich, MC Nannini, M Saponara, M Lolli, C Maleddu, A Formica, S Biasco, G AF Pantaleo, Maria A. Astolfi, Annalisa Di Battista, Monica Paterini, Paola Santini, Donatella Catena, Fausto Heinrich, Mike C. Nannini, Margherita Saponara, Maristella Lolli, Cristian Maleddu, Alessandra Formica, Serena Biasco, Guido TI IGF1R OVEREXPRESSION IN WILD TYPE GASTROINETSTINAL STROMAL TUMOR (GISTS) STUDIED WITH GENOME ARRAY ANALYSES AND WESTERN BLOTTING SO ANNALS OF ONCOLOGY LA English DT Meeting Abstract C1 [Pantaleo, Maria A.; Di Battista, Monica; Nannini, Margherita; Saponara, Maristella; Lolli, Cristian; Maleddu, Alessandra; Biasco, Guido] Univ Bologna, Dept Hematol & Oncol Sci LA Seragnoli, I-40126 Bologna, Italy. [Astolfi, Annalisa; Paterini, Paola; Formica, Serena] Univ Bologna, Interdept Ctr Canc Res G Prodi, I-40126 Bologna, Italy. [Santini, Donatella] Univ Bologna, Pathol Unit, St Orsola Malpighi Hosp, I-40126 Bologna, Italy. [Catena, Fausto] Univ Bologna, Emergency Surg & Transplant Dept, St Orsola Malpighi Hosp, I-40126 Bologna, Italy. [Heinrich, Mike C.] Oregon Hlth & Sci Univ, Dept Med, Portland VA Med Ctr, Portland, OR 97201 USA. [Heinrich, Mike C.] Oregon Hlth & Sci Univ, Oregon Hlth & Sci Univ Knight Canc Inst, Portland, OR 97201 USA. RI Saponara, Maristella/J-9904-2016; nannini, margherita/J-9866-2016 OI Saponara, Maristella/0000-0003-0715-171X; NR 0 TC 0 Z9 0 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0923-7534 J9 ANN ONCOL JI Ann. Oncol. PD OCT PY 2009 VL 20 SU 8 PG 1 WC Oncology SC Oncology GA V15CV UT WOS:000207781000219 ER PT J AU Johnson, ML Petersen, LA Sundaravaradan, R Byrne, MM Hasche, JC Osemene, NI Wei, II Morgan, RO AF Johnson, Michael L. Petersen, Laura A. Sundaravaradan, Raji Byrne, Margaret M. Hasche, Jennifer C. Osemene, Nora I. Wei, Iris I. Morgan, Robert O. TI The Association of Medicare Drug Coverage with Use of Evidence-Based Medications in the Veterans Health Administration SO ANNALS OF PHARMACOTHERAPY LA English DT Article DE managed care; Medicare; pharmacy; veterans ID ACUTE MYOCARDIAL-INFARCTION; ACCESS; VA; IDENTIFICATION; POPULATIONS; PREVALENCE; OUTCOMES; HMOS; CARE AB BACKGROUND: Veterans with Medicare managed-care plans have access to pharmacy benefits outside the Veterans Health Administration (VA), but how this coverage affects use of medications for specific disease conditions within the VA is unclear. OBJECTIVE: To examine patterns of pharmacotherapy among patients with diabetes mellitus, ischemic heart disease, and chronic heart failure enrolled in fee-for-service (FFS) or managed-care (HMO) plans and to test whether pharmacy benefit coverage within Medicare is associated with the receipt of evidence-based medications in the VA. METHODS: A retrospective analysis of veterans dually enrolled in the VA and Medicare healthcare systems was conducted. We used VA and Medicare administrative data from 2002 in multivariable logistic regression analysis to determine the unique association of enrollment in Medicare FFS or managed-care plans on the use of medications, after adjusting for sociodemographic, geographic, and patient clinical factors. RESULTS: A total of 369,697 enrollees met inclusion criteria for diabetes, ischemic heart disease, or chronic heart failure. Among patients with diabetes, adjusted odds ratios (ORs) of receiving angiotensin-converting enzyme (ACE) inhibitors and oral hypoglycemics in the FFS group were, respectively, 0.86 and 0.80 (p < 0.001). Among patients with ischemic heart disease, FFS patients were generally less likely to receive beta-blockers, antianginals, and statins. Among patients with chronic heart failure, adjusted ORs of receiving ACE inhibitors, angiotensin-receptor blockers, and statins in the FFS group were, respectively, 0.90, 0.78, and 0.79 (all p < 0.05). There were few systematic differences within HMO coverage levels. CONCLUSIONS: FFS-enrolled veterans were generally less likely to be receiving condition-related medications from the VA, compared with HMO-enrolled veterans with lower levels of prescription drug coverage. Pharmacy prescription coverage within Medicare affects the use of evidence-based medications for specific disease conditions in the VA. C1 [Johnson, Michael L.] Univ Houston, Coll Pharm, Dept Clin Sci & Adm, Houston, TX 77030 USA. [Johnson, Michael L.; Petersen, Laura A.; Sundaravaradan, Raji; Hasche, Jennifer C.; Morgan, Robert O.] Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. [Petersen, Laura A.] Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. [Byrne, Margaret M.] Univ Miami, Sch Med, Dept Epidemiol & Publ Hlth, Miami, FL USA. [Osemene, Nora I.] Texas So Univ, Coll Pharm & Hlth Sci, Houston, TX 77004 USA. [Wei, Iris I.] Ctr Medicare Serv, Off Res Dev & Informat, Res & Evaluat Grp, Div Res Hlth Plans & Drugs, Baltimore, MD USA. [Wei, Iris I.] Ctr Medicaid Serv, Off Res Dev & Informat, Res & Evaluat Grp, Div Res Hlth Plans & Drugs, Baltimore, MD USA. RP Johnson, ML (reprint author), 1441 Moursund St, Houston, TX 77030 USA. EM mikejohnson@uh.edu NR 30 TC 2 Z9 2 U1 0 U2 0 PU HARVEY WHITNEY BOOKS CO PI CINCINNATI PA PO BOX 42696, CINCINNATI, OH 45242 USA SN 1060-0280 J9 ANN PHARMACOTHER JI Ann. Pharmacother. PD OCT PY 2009 VL 43 IS 10 BP 1565 EP 1575 DI 10.1345/aph.1L606 PG 11 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 503YR UT WOS:000270579100001 PM 19706740 ER PT J AU Gee, JR Burmeister, CB Havighurst, TC Kim, K AF Gee, Jason R. Burmeister, Corrie B. Havighurst, Thomas C. Kim, Kyungmann TI Cyclin-mediated G1 Arrest by Celecoxib Differs in Low-versus High-grade Bladder Cancer SO ANTICANCER RESEARCH LA English DT Article DE Cyclooxygenase (COX)-2; celecoxib; bladder cancer; chemoprevention ID COLON-CARCINOMA CELLS; CYCLOOXYGENASE-2 INHIBITORS; INDUCED APOPTOSIS; COX-2 EXPRESSION; INDUCE APOPTOSIS; URINARY-BLADDER; AKT ACTIVATION; LUNG-CANCER; IN-VITRO; GROWTH AB Background: Celecoxib and other non-steroidal anti-inflammatory drugs (NSAIDs) are being evaluated in the prevention of bladder and other cancers. Here we investigate molecular effects of celecoxib independent of cyclooxygenase (COX)-2 expression levels in urothelial carcinoma of the bladder. Materials and Methods: Low-grade RT-4 and high-grade UM-UC-3 bladder cancer cells were treated with 0-50,mu M celecoxib. Growth, cell cycle and apoptosis were measured by crystal violet elution and flow cytometry. Western analysis was performed for COX-2, Rb, cyclin B1/D1, and phosphocyclin B1/D1 COX-2 induction was achieved with phorbol ester. Results: Celecoxib inhibited growth of RT-4 and UM-UC-3, with G(1) cell cycle arrest and altered cyclin B1/D1 expression in RT-4, whereas Rb up-regulation occurred in UM-UC-3. Apoptosis occurred in both cell lines. Conclusion: Celecoxib induces G(1) cell cycle arrest in low- and high-grade bladder cancer by different pathways. This heterogeneous molecular response supports combination approaches to prevention and treatment. C1 [Gee, Jason R.] Univ Wisconsin, Dept Urol, Sch Med & Publ Hlth, Clin Sci Ctr G5 342, Madison, WI 53792 USA. [Havighurst, Thomas C.; Kim, Kyungmann] Univ Wisconsin, Dept Biostat & Informat, Madison, WI 53792 USA. [Gee, Jason R.] William S Middleton Mem Vet Adm Med Ctr, Dept Urol, Madison, WI USA. RP Gee, JR (reprint author), Univ Wisconsin, Dept Urol, Sch Med & Publ Hlth, Clin Sci Ctr G5 342, 600 Highland Ave, Madison, WI 53792 USA. EM Gee@urology.wisc.edu FU Office of Research and Development, Biomedical Laboratory R&D Service, Department of Veterans Affairs [P30 CA 14520] FX This work is supported by the Office of Research and Development, Biomedical Laboratory R&D Service, Department of Veterans Affairs (J.R. Gee) and by P30 CA 14520 (T. Havighurst & K. Kim). NR 40 TC 7 Z9 7 U1 0 U2 1 PU INT INST ANTICANCER RESEARCH PI ATHENS PA EDITORIAL OFFICE 1ST KM KAPANDRITIOU-KALAMOU RD KAPANDRITI, PO BOX 22, ATHENS 19014, GREECE SN 0250-7005 J9 ANTICANCER RES JI Anticancer Res. PD OCT PY 2009 VL 29 IS 10 BP 3769 EP 3775 PG 7 WC Oncology SC Oncology GA 515QL UT WOS:000271487400005 PM 19846907 ER PT J AU Huebschmann, AG Reis, EN Emsermann, C Dickinson, LM Reusch, JEB Bauer, TA Regensteiner, JG AF Huebschmann, Amy G. Reis, Erin N. Emsermann, Caroline Dickinson, L. Miriam Reusch, Jane E. B. Bauer, Timothy A. Regensteiner, Judith G. TI Women with type 2 diabetes perceive harder effort during exercise than nondiabetic women SO APPLIED PHYSIOLOGY NUTRITION AND METABOLISM-PHYSIOLOGIE APPLIQUEE NUTRITION ET METABOLISME LA English DT Article DE ratings of perceived exertion scale of Borg; type 2 diabetes mellitus; overweight; obesity; physical activity; exercise ID HABITUAL PHYSICAL-ACTIVITY; CAUSE-SPECIFIC MORTALITY; CARDIORESPIRATORY FITNESS; GLUCOSE-TOLERANCE; SKELETAL-MUSCLE; OXYGEN-UPTAKE; US ADULTS; MEN; SCALE; PREVALENCE AB Regular exercise is a cornerstone of diabetes treatment; however, people with type 2 diabetes (T2D) are commonly sedentary. It is possible that a harder rate of perceived exertion (RPE) during exercise for those with T2D as compared with nondiabetics may be a barrier to physical activity. This study examined RPE (Borg scale, ordinal range 6-20) during submaximal exercise at identical absolute work rates to test the hypothesis that women with T2D demonstrate harder RPE during exercise than nondiabetic controls. In a prespecified analysis of existing data from equivalently sedentary women, RPE during submaximal exercise was compared among women with uncomplicated T2D (n = 13, mean body mass index (BMI) 34.2, mean hemoglobin A1c 9%), overweight controls (OC, n = 13, mean BMI 30.7), and normal-weight controls (NWC, n = 13, mean BMI 23.1). Subjects performed three 7 min, constant-load exercise tests at 20 W and 30 W. Mixed-effects general linear modeling was used to test for differences in mean RPE estimates among groups with and without adjustment for relative work intensity, age, habitual physical activity, or BMI. Subjects with T2D perceived harder effort during bicycling exercise than controls, as measured by RPE at 20 W and 30 W (p < 0.05 for T2D vs. OC and for T2D vs. NWC). Adjusting for relative work intensity eliminated significant group RPE differences at 30 W, but group RPE differences at 20 W remained significant. Harder perceived effort during exercise may be a barrier to physical activity for those with T2D. C1 [Huebschmann, Amy G.; Reis, Erin N.; Bauer, Timothy A.; Regensteiner, Judith G.] Univ Colorado, Denver Sch Med, Div Gen Internal Med, Aurora, CO 80045 USA. [Huebschmann, Amy G.; Reusch, Jane E. B.; Regensteiner, Judith G.] Univ Colorado, Denver Sch Med, Ctr Womens Hlth Res, Dept Med, Aurora, CO 80045 USA. [Emsermann, Caroline; Dickinson, L. Miriam] Univ Colorado, Denver Sch Med, Div Family Med, Aurora, CO 80045 USA. [Reusch, Jane E. B.] Univ Colorado, Denver Sch Med, Div Endocrinol, Aurora, CO 80045 USA. [Reusch, Jane E. B.] Univ Colorado, Denver Sch Med, Denver VAMC, Denver, CO 80220 USA. [Regensteiner, Judith G.] Univ Colorado, Denver Sch Med, Div Cardiol, Aurora, CO 80045 USA. RP Huebschmann, AG (reprint author), Univ Colorado, Denver Sch Med, Div Gen Internal Med, POB 6511,Mailstop B180, Aurora, CO 80045 USA. EM Amy.Huebschmann@ucdenver.edu FU General Internal Medicine Division of the University of Colorado Denver (UCD) School of Medicine; American Diabetes Association; Health Resources and Services Administration faculty development grant; UCD Center for Women's Health Research Junior Faculty Research Development Award; Armstrong Family Foundation grant; National Research Service Award [F32 DK088413-01]; American Diabetes Association award; Veteran Affairs Merit award; National Institutes of Health [DK064741] FX As noted in the manuscript, the demographic and (V) over dotO2 peak data have been published previously by Regensteiner et al. (1998). RPE data were presented in abstract form only at the 2007 American Diabetes Association 67th Scientific Sessions and the 2007 National Diabetes Health Disparities Conference. The analysis of RPE data was supported by a small grant from the General Internal Medicine Division of the University of Colorado Denver (UCD) School of Medicine, and the primary data acquisition for this study was funded by the American Diabetes Association. A. G. H. is supported by a Health Resources and Services Administration faculty development grant, by the UCD Center for Women's Health Research Junior Faculty Research Development Award, and by an Armstrong Family Foundation grant; T. A. B. is supported by National Research Service Award F32 DK088413-01; J. G. R. is supported by an American Diabetes Association award; J. E. B. R. is supported by a Veteran Affairs Merit award and National Institutes of Health grant DK064741. We are also grateful to Vermed, Inc., for their generous donation of ECG electrodes for all of our exercise studies. NR 45 TC 20 Z9 20 U1 0 U2 0 PU NATL RESEARCH COUNCIL CANADA-N R C RESEARCH PRESS PI OTTAWA PA BUILDING M 55, OTTAWA, ON K1A 0R6, CANADA SN 1715-5312 J9 APPL PHYSIOL NUTR ME JI Appl. Physiol. Nutr. Metab. PD OCT PY 2009 VL 34 IS 5 BP 851 EP 857 DI 10.1139/H09-074 PG 7 WC Nutrition & Dietetics; Physiology; Sport Sciences SC Nutrition & Dietetics; Physiology; Sport Sciences GA 541LW UT WOS:000273418200005 PM 19935846 ER PT J AU Martell, BA Orson, FM Poling, J Mitchell, E Rossen, RD Gardner, T Kosten, TR AF Martell, Bridget A. Orson, Frank M. Poling, James Mitchell, Ellen Rossen, Roger D. Gardner, Tracie Kosten, Thomas R. TI Cocaine Vaccine for the Treatment of Cocaine Dependence in Methadone-Maintained Patients A Randomized, Double-blind, Placebo-Controlled Efficacy Trial SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article ID CHOLERA B-SUBUNIT; WHOLE-CELL VACCINE; CONTINGENCY MANAGEMENT; IMMUNOLOGICAL MEMORY; ACTIVE IMMUNIZATION; MONOCLONAL-ANTIBODY; SWEDISH VOLUNTEERS; SMOKING-CESSATION; IMMUNE FUNCTION; IMMUNOGENICITY AB Context: Cocaine dependence, which affects 2.5 million Americans annually, has no US Food and Drug Administration-approved pharmacotherapy. Objectives: To evaluate the immunogenicity, safety, and efficacy of a novel cocaine vaccine to treat cocaine dependence. Design: A 24-week, phase 2b, randomized, double-blind, placebo-controlled trial with efficacy assessed during weeks 8 to 20 and follow-up to week 24. Setting: Cocaine- and opioid-dependent persons recruited from October 2003 to April 2005 from greater New Haven, Connecticut. Participants: One hundred fifteen methadone-maintained subjects (67% male, 87% white, aged 18-46 years) were randomized to vaccine or placebo, and 94 subjects (82%) completed the trial. Most smoked crack cocaine along with using marijuana (18%), alcohol (10%), and nonprescription opioids (44%). Intervention: Over 12 weeks, 109 of 115 subjects received 5 vaccinations of placebo or succinylnorcocaine linked to recombinant cholera toxin B-subunit protein. Main Outcome Measure: Semiquantitative urinary cocaine metabolite levels measured thrice weekly with a positive cutoff of 300 ng/mL. Results: The 21 vaccinated subjects (38%) who attained serum IgG anticocaine antibody levels of 43 mu g/mL or higher (ie, high IgG level) had significantly more cocaine-free urine samples than those with levels less than 43 mu g/mL (ie, low IgG level) and the placebo-receiving subjects during weeks 9 to 16 (45% vs 35% cocaine-free urine samples, respectively). The proportion of subjects having a 50% reduction in cocaine use was significantly greater in the subjects with a high IgG level than in subjects with a low IgG level (53% of subjects vs 23% of subjects, respectively) (P = .048). The most common adverse effects were injection site induration and tenderness. There were no treatment-related serious adverse events, withdrawals, or deaths. Conclusions: Attaining high (>= 43 mu g/mL) IgG anticocaine antibody levels was associated with significantly reduced cocaine use, but only 38% of the vaccinated subjects attained these IgG levels and they had only 2 months of adequate cocaine blockade. Thus, we need improved vaccines and boosters. C1 [Orson, Frank M.; Rossen, Roger D.; Gardner, Tracie; Kosten, Thomas R.] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Martell, Bridget A.] Yale Univ, Sch Med, Dept Med, New Haven, CT 06510 USA. [Poling, James; Mitchell, Ellen] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA. [Martell, Bridget A.; Poling, James; Mitchell, Ellen] Vet Affairs Connecticut Healthcare Syst, West Haven, CT USA. [Gardner, Tracie; Kosten, Thomas R.] Baylor Coll Med, Dept Med, Houston, TX 77030 USA. [Gardner, Tracie; Kosten, Thomas R.] Baylor Coll Med, Dept Immunol, Houston, TX 77030 USA. [Gardner, Tracie; Kosten, Thomas R.] Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. RP Kosten, TR (reprint author), Michael E DeBakey Vet Affairs Med Ctr, 2002 Holcombe,Bldg 110,Room 229, Houston, TX 77030 USA. EM kosten@bcm.edu OI Poling, James/0000-0002-0133-3136 FU National Institute on Drug Abuse [1 R01 DA15477, K05-DA 0454, P50-DA12762]; Veterans Affairs Mental Illness Research, Education, and Clinical Center (New England MIRECC); Veteran's Affairs Office of Research and Development/Cooperative Studies Program Career Development Award [733A] FX This work was supported by grants 1 R01 DA15477, K05-DA 0454 (Dr Kosten), and P50-DA12762 from the National Institute on Drug Abuse and by the Veterans Affairs Mental Illness Research, Education, and Clinical Center (New England MIRECC). Dr Martell was provided salary support by the Veteran's Affairs Office of Research and Development/Cooperative Studies Program Career Development Award CRCD # 733A at the time the research was conducted. Celtic Pharmaceuticals supplied the succinylnorcocaine recombinant cholera toxin B-subunit vaccine and gave Dr Kosten travel fees for consultative services. NR 53 TC 109 Z9 111 U1 0 U2 15 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD OCT PY 2009 VL 66 IS 10 BP 1116 EP 1123 PG 8 WC Psychiatry SC Psychiatry GA 502YE UT WOS:000270496100009 PM 19805702 ER PT J AU Middleton, LE Yaffe, K AF Middleton, Laura E. Yaffe, Kristine TI Promising Strategies for the Prevention of Dementia SO ARCHIVES OF NEUROLOGY LA English DT Review ID COGNITIVE FUNCTION; ALZHEIMER-DISEASE; OLDER-ADULTS; PHYSICAL-ACTIVITY; RANDOMIZED-TRIAL; BLOOD-PRESSURE; RISK; IMPAIRMENT; DECLINE; MEMORY AB The incidence and prevalence of dementia are expected to increase several-fold in the coming decades. Given that the current pharmaceutical treatment of dementia can only modestly improve symptoms, risk factor modification remains the cornerstone for dementia prevention. Some of the most promising strategies for the prevention of dementia include vascular risk factor control, cognitive activity, physical activity, social engagement, diet, and recognition of depression. In observational studies, vascular risk factors including diabetes, hypertension, dyslipidemia, and obesity-are fairly consistently associated with increased risk of dementia. In addition, people with depression are at high risk for cognitive impairment. Population studies have reported that intake of antioxidants or polyunsaturated fatty acids may be associated with a reduced incidence of dementia, and it has been reported that people who are cognitively, socially, and physically active have a reduced risk of cognitive impairment. However, results from randomized trials of risk factor modification have been mixed. Most promising, interventions of cognitive and physical activity improve cognitive performance and slow cognitive decline. Future studies should continue to examine the implication of risk factor modification in controlled trials, with particular focus on whether several simultaneous interventions may have additive or multiplicative effects. Arch Neurol. 2009;66(10):1210-1215 C1 [Middleton, Laura E.; Yaffe, Kristine] Univ Calif San Francisco, Dept Psychiat, Sch Med, San Francisco, CA 94121 USA. [Yaffe, Kristine] Univ Calif San Francisco, Dept Neurol, Sch Med, San Francisco, CA 94121 USA. [Yaffe, Kristine] Univ Calif San Francisco, Dept Epidemiol & Biostat, Sch Med, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Yaffe, K (reprint author), Univ Calif San Francisco, Dept Psychiat, Sch Med, 4150 Clement St,Box 181, San Francisco, CA 94121 USA. EM kristine.yaffe@ucsf.edu RI Middleton, Laura/C-6024-2009 OI Middleton, Laura/0000-0001-8624-3123 FU National Institute on Aging [AG 031155] FX This work was supported in part by grant AG 031155 from the National Institute on Aging (Dr Yaffe). NR 37 TC 170 Z9 174 U1 4 U2 36 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0003-9942 EI 1538-3687 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD OCT PY 2009 VL 66 IS 10 BP 1210 EP 1215 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 504LA UT WOS:000270617000004 PM 19822776 ER PT J AU Arterburn, D Livingston, EH Schifftner, T Kahwati, LC Henderson, WG Maciejewski, ML AF Arterburn, David Livingston, Edward H. Schifftner, Tracy Kahwati, Leila C. Henderson, William G. Maciejewski, Matthew L. TI Predictors of Long-term Mortality After Bariatric Surgery Performed in Veterans Affairs Medical Centers SO ARCHIVES OF SURGERY LA English DT Article ID GASTRIC BYPASS-SURGERY; RISK-FACTORS; SURGICAL CARE; UNITED-STATES; DEATH RATES; OBESITY; METAANALYSIS; OVERWEIGHT; QUALITY; EXPENDITURES AB Hypothesis: The purpose of this study was to examine patient factors associated with mortality among veterans who undergo bariatric surgery. Design: Prospective study that uses data from the Veterans Affairs (VA) National Surgical Quality Improvement Program. Setting: Group Health Center for Health Studies, the VA North Texas Health Care System, the Denver VA Medical Center, and the Durham VA Medical Center. Patients: We identified 856 veterans who had undergone bariatric surgery in 1 of 12 VA bariatric centers from January 1, 2000, through December 31, 2006. Main Outcome Measures: The risk of death was estimated via Cox proportional hazards. Results: The 856 veterans had a mean body mass index (BMI) of 48.7, a mean age of 54 years, and a mean DCG score of 0.76; 73.0% were men, 83.9% were white, and 7.0% had an ASA class equal to 4. Fifty-four veterans (6.3%) had died by the end of 2006. In our Cox models, patients with a BMI greater than 50 (superobesity; hazard ratio [HR], 1.8; P=.04) or aDCGscore greater than or equal to 2 (HR, 3.4; P<.001) had an increased risk of death. Conclusion: Superobese veterans and those with a greater burden of chronic disease had a greater risk of death after bariatric surgery from 2000 through 2006. C1 [Maciejewski, Matthew L.] Durham VA Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC 27705 USA. [Maciejewski, Matthew L.] Univ N Carolina, Sch Pharm, Div Pharmaceut Outcomes & Policy, Chapel Hill, NC USA. [Arterburn, David] Univ Washington, Ctr Hlth Studies, Grp Hlth, Seattle, WA 98195 USA. [Arterburn, David] Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA 98195 USA. [Livingston, Edward H.] Univ Texas SW Med Ctr Dallas, Div Gastrointestinal & Endocrine Surg, Dallas, TX 75390 USA. [Livingston, Edward H.] Vet Adm N Texas Hlth Care Syst, Dallas, TX USA. [Livingston, Edward H.] Univ Texas Arlington, Arlington, TX USA. [Schifftner, Tracy; Henderson, William G.] Univ Colorado, Denver Vet Affairs Med Ctr, Denver, CO 80202 USA. [Henderson, William G.] Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA. [Henderson, William G.] Univ Colorado, Hlth Sci Ctr, Colorado Hlth Outcomes Program, Denver, CO 80262 USA. [Kahwati, Leila C.] Off Patient Care Serv, Natl Ctr Hlth Promot & Dis Prevent, Vet Hlth Adm, Dept Vet Affairs, Durham, NC USA. RP Maciejewski, ML (reprint author), Durham VA Med Ctr, Ctr Hlth Serv Res Primary Care, Stop Code 152,508 Fulton St, Durham, NC 27705 USA. EM matthew.maciejewski@va.gov FU Office of Research and Development, Health Services Research and Development Service, Department of Veterans Affairs [IIR 05-201] FX This work was supported by the Office of Research and Development, Health Services Research and Development Service, Department of Veterans Affairs, project number IIR 05-201. NR 33 TC 26 Z9 26 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD OCT PY 2009 VL 144 IS 10 BP 914 EP 920 PG 7 WC Surgery SC Surgery GA 508JJ UT WOS:000270926400009 PM 19841358 ER PT J AU Large, CH Di Daniel, E Li, XB George, MS AF Large, Charles H. Di Daniel, Elena Li, Xingbao George, Mark S. TI Neural network dysfunction in bipolar depression: clues from the efficacy of lamotrigine SO BIOCHEMICAL SOCIETY TRANSACTIONS LA English DT Article DE bipolar depression; functional magnetic resonance imaging (fMRI); gamma oscillation; lamotrigine; transcranial magnetic stimulation (TMS) ID TRANSCRANIAL MAGNETIC STIMULATION; PROTEIN-KINASE-C; CORTICAL EXCITABILITY; MOOD STABILIZERS; CELLULAR PLASTICITY; DOUBLE-BLIND; LITHIUM; DISORDER; MECHANISMS; RECEPTORS AB One strategy to understand bipolar disorder is to study the mechanism of action of mood-stabilizing drugs, such as valproic acid and lithium. This approach has implicated a number of intracellular signalling elements, such as GSK beta (glycogen synthase kinase 3 beta), ERK (extracellular-signal-regulated kinase)/MAPK (mitogen-activated protein kinase) or protein kinase C. However, lamotrigine does not seem to modulate any of these targets, which is intriguing given that its profile in the clinic differs from that of valproic acid or lithium, with greater efficacy to prevent episodes of depression than mania. The primary target of lamotrigine is the voltage-gated sodium channel, but it is unclear why inhibition of these channels might confer antidepressant efficacy. in healthy volunteers, we found that lamotrigine had a facilitatory effect on the BOLD (blood-oxygen-level-dependent) response to TMS (transcranial magnetic stimulation) of the prefrontal cortex. This effect was in contrast with an inhibitory effect of lamotrigine when TMS was applied over the motor cortex. in a follow-up study, a similar prefrontal specific facilitatory effect was observed in a larger cohort of healthy subjects, whereas valproic acid inhibited motor and prefrontal cortical TMS-induced BOLD response. In vitro, we found that lamotrigine (3-10 mu M) enhanced the power of gamma frequency network oscillations induced by kainic acid in the rat hippocampus, an effect that was not observed with valproic acid (100 mu M). These data suggest that lamotrigine has a positive effect on corticolimbic network function that may differentiate it from other mood stabilizers. The results are also consistent with the notion of corticolimbic network dysfunction in bipolar disorder. C1 [Large, Charles H.] GlaxoSmithKline SpA, Med Res Ctr, Neurosci Ctr Excellence Drug Discovery, I-37135 Verona, Italy. [Di Daniel, Elena] GlaxoSmithKline Inc, Neurosci Ctr Excellence Drug Discovery, Harlow CM19 5AW, Essex, England. [Li, Xingbao; George, Mark S.] Med Univ S Carolina, Brain Stimulat Lab, Charleston, SC 29425 USA. [George, Mark S.] Ralph H Johnson Vet Adm Hosp, Charleston, SC 29401 USA. RP Large, CH (reprint author), GlaxoSmithKline SpA, Med Res Ctr, Neurosci Ctr Excellence Drug Discovery, Via Fleming 4, I-37135 Verona, Italy. EM charles.h.large@gsk.com NR 52 TC 8 Z9 9 U1 1 U2 10 PU PORTLAND PRESS LTD PI LONDON PA THIRD FLOOR, EAGLE HOUSE, 16 PROCTER STREET, LONDON WC1V 6 NX, ENGLAND SN 0300-5127 J9 BIOCHEM SOC T JI Biochem. Soc. Trans. PD OCT PY 2009 VL 37 BP 1080 EP 1084 DI 10.1042/BST0371080 PG 5 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 510DG UT WOS:000271067600028 PM 19754456 ER PT J AU Nakano, T Inoue, I Shinozaki, R Matsui, M Akatsuka, T Takahashi, S Tanaka, K Akita, M Seo, M Hokari, S Katayama, S Komoda, T AF Nakano, Takanari Inoue, Ikuo Shinozaki, Rina Matsui, Masanori Akatsuka, Toshitaka Takahashi, Seiichiro Tanaka, Kayoko Akita, Masumi Seo, Makoto Hokari, Shigeru Katayama, Shigehiro Komoda, Tsugikazu TI A possible role of lysophospholipids produced by calcium-independent phospholipase A(2) in membrane-raft budding and fission SO BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES LA English DT Article DE Alkaline phosphatase; Brush border; Caco-2; Influenza virus; MDCK; Lysophosphatidylcholine ID INTESTINAL ALKALINE-PHOSPHATASE; BRUSH-BORDER PROTEINS; INFLUENZA-VIRUS; LIPID RAFTS; LYSOPHOSPHATIDYLCHOLINE; MICRODOMAINS; ABSORPTION; SECRETION; VESICLES; RELEASE AB Phospholipase A(2) (PLA(2)) not only plays a role in the membrane vesiculation system but also mediates membrane-raft budding and fission in artificial giant liposomes. This study aimed to demonstrate the same effects in living cells. Differentiated Caco-2 cells were cultured on filter membranes. MDCK cells were challenged with Influenza virus. The MDCK cultures were harvested for virus titration with a plaque assay. Alkaline phosphatase (ALP), a membrane-raft associated glycosylphosphatidylinositol (GPI)-anchored protein, was 70% released by adding 0.2 mmol/l lysophosphatidylcholine, which was abolished by treatment with a membrane-raft disrupter, methyl-beta-cyclodextrin. Activation of calcium-independent PLA(2) (iPLA(2)) by brefeldin A increased the apical release of ALP by approximately 1.5-fold (p<0.01), which was blocked by PLA(2) inhibitor bromoenol lactone (BEL). BEL also reduced Influenza virus production into the media (<10%) in the MDCK culture. These results suggest that cells utilize inverted corn-shaped lysophospholipids generated by PLA(2) to modulate plasma membrane structure and assist the budding of raft-associated plasma membrane particles, which virus utilizes for its budding. Brush borders are enriched with membrane-rafts and undergo rapid turnover; thus, PLA(2) may be involved in the regulatory mechanism in membrane dynamism. Further, iPLA(2) may provide a therapeutic target for viral infections. (C) 2009 Elsevier B.V. All rights reserved. C1 [Nakano, Takanari; Shinozaki, Rina; Takahashi, Seiichiro; Seo, Makoto; Hokari, Shigeru; Komoda, Tsugikazu] Saitama Med Univ, Fac Med, Dept Biochem, Saitama 3500455, Japan. [Inoue, Ikuo; Katayama, Shigehiro] Saitama Med Univ, Fac Med, Dept Endocrinol & Diabet, Saitama 3500455, Japan. [Matsui, Masanori; Akatsuka, Toshitaka] Saitama Med Univ, Fac Med, Dept Microbiol, Saitama 3500455, Japan. [Tanaka, Kayoko; Akita, Masumi] Saitama Med Univ, Fac Med, Dept Morphol, Saitama 3500455, Japan. RP Nakano, T (reprint author), W Los Angeles Vet Affairs Med Ctr, Bldg 114,Suite 217,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM nk.takanari@gmail.com NR 31 TC 11 Z9 11 U1 0 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0005-2736 J9 BBA-BIOMEMBRANES JI Biochim. Biophys. Acta-Biomembr. PD OCT PY 2009 VL 1788 IS 10 BP 2222 EP 2228 DI 10.1016/j.bbamem.2009.07.015 PG 7 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 511FT UT WOS:000271150000026 PM 19643079 ER PT J AU Perez, VI Bokov, A Van Remmen, H Mele, J Ran, QT Ikeno, Y Richardson, A AF Perez, Viviana I. Bokov, Alex Van Remmen, Holly Mele, James Ran, Qitao Ikeno, Yuji Richardson, Arlan TI Is the oxidative stress theory of aging dead? SO BIOCHIMICA ET BIOPHYSICA ACTA-GENERAL SUBJECTS LA English DT Review DE Antioxidant defense; Oxidative stress; oxidative damage; Knockout mice; Transgenic mice; Longevity ID CUZN SUPEROXIDE-DISMUTASE; METHIONINE SULFOXIDE REDUCTASE; ADULT DROSOPHILA-MELANOGASTER; REPLICATIVE LIFE-SPAN; CAENORHABDITIS-ELEGANS; TRANSGENIC MICE; COPPER-ZINC; GLUTATHIONE-PEROXIDASE; GENE-EXPRESSION; MOTOR-NEURONS AB Currently, the oxidative stress (or free radical) theory of aging is the most popular explanation of how aging occurs at the molecular level. While data from studies in invertebrates (e.g., C. elegans and Drosophila) and rodents show a correlation between increased lifespan and resistance to oxidative stress (and in some cases reduced oxidative damage to macromolecules). direct evidence showing that alterations in oxidative damage/stress play a role in aging are limited to a few studies with transgenic Drosophila that overexpress antioxidant enzymes. Over the past eight years, our laboratory has conducted an exhaustive study on the effect of under- or overexpressing a large number and wide variety of genes coding for antioxidant enzymes. In this review, we present the survival data from these studies together. Because only one (the deletion of the Sod I gene) of the 18 genetic manipulations we studied had an effect on lifespan, our data calls into serious question the hypothesis that alterations in oxidative damage/stress play a role in the longevity of mice. (C) 2009 Elsevier B.V. All rights reserved. C1 [Perez, Viviana I.; Bokov, Alex; Van Remmen, Holly; Ran, Qitao; Ikeno, Yuji; Richardson, Arlan] Univ Texas Hlth Sci Ctr San Antonio, Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. [Perez, Viviana I.; Van Remmen, Holly; Ran, Qitao; Richardson, Arlan] Univ Texas Hlth Sci Ctr San Antonio, Dept Cellular & Struct Biol, San Antonio, TX 78245 USA. [Bokov, Alex] Univ Texas Hlth Sci Ctr San Antonio, Dept Epidemiol & Biostat, San Antonio, TX 78245 USA. [Van Remmen, Holly; Mele, James] Univ Texas Hlth Sci Ctr San Antonio, Dept Physiol, San Antonio, TX 78245 USA. [Ikeno, Yuji] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78245 USA. [Van Remmen, Holly; Ikeno, Yuji; Richardson, Arlan] S Texas Vet Hlth Care Syst, GRECC, San Antonio, TX 78229 USA. RP Richardson, A (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Barshop Inst Longev & Aging Studies, Texas Res Pk Campus,15355 Lambda Dr, San Antonio, TX 78245 USA. EM RICHARDSONA@uthscsa.edu FU National Institutes of Health [R01-AG-015908, R01-AG-023843, P01-AG19316, P01AG020591, R37-AG026557]; Department of Veterans Affairs; San Antonio Nathan Shock Center for Excellence in the Basic Biology of Aging [P30-AG-13319] FX Financial support for the lifespan data generated over the past eight years was provided by the National Institutes of Health (grants R01-AG-015908, R01-AG-023843, P01-AG19316, P01AG020591, and R37-AG026557) and the Department of Veterans Affairs (Merit Grants and a Research Enhancement Award Program [AP, HVR, QR, YI]). Special acknowledgement is given to the Animal Core of the San Antonio Nathan Shock Center for Excellence in the Basic Biology of Aging (P30-AG-13319) directed by Dr. James Nelson, Dr. Randy Strong, and Vivian Diaz. NR 104 TC 285 Z9 295 U1 2 U2 49 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 OCT PY 2009 VL 1790 IS 10 BP 1005 EP 1014 DI 10.1016/j.bbagen.2009.06.003 PG 10 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 503EO UT WOS:000270516100007 PM 19524016 ER PT J AU New, AS Fan, J Murrough, JW Liu, X Liebman, RE Guise, KG Tang, CY Charney, DS AF New, Antonia S. Fan, Jin Murrough, James W. Liu, Xun Liebman, Rachel E. Guise, Kevin G. Tang, Cheuk Y. Charney, Dennis S. TI A Functional Magnetic Resonance Imaging Study of Deliberate Emotion Regulation in Resilience and Posttraumatic Stress Disorder SO BIOLOGICAL PSYCHIATRY LA English DT Article DE Alexithymia; PTSD; resilience; sexual assault; trauma ID CORTICOLIMBIC BLOOD-FLOW; CHILDHOOD SEXUAL-ABUSE; SCRIPT-DRIVEN IMAGERY; NEGATIVE AFFECT; TRAUMA; PTSD; RESPONSES; SUPPRESSION; ALEXITHYMIA; PREVALENCE AB Background: Sexual violence is an important public health problem in the United States, with 13% to 26% of women reporting a history of sexual assault. While unfortunately common, there is substantial individual variability in response to sexual assault. Approximately half of rape victims develop posttraumatic stress disorder (PTSD), while others develop no psychopathology (e.g., trauma-exposed non-PTSD). In this project, we examined the neural mechanisms underlying differences in response to sexual violence, focusing specifically on the deliberate modification of emotional responses to negative stimuli. Methods: Using functional magnetic resonance imaging (fMRI) blood oxygenation level-dependent (BOLD) response, we examined the neural circuitry underlying effortful modification of emotional responses to negative pictures in 42 women: 14 with PTSD after sexual trauma, 14 with no psychiatric diagnosis after sexual trauma, and 14 nontraumatized control subjects. Results: In response to deliberate attempts to downregulate emotional responses, nontraumatized healthy control subjects were more successful than either trauma-exposed group (PTSD or non-PTSD) in downregulating responses to the negative pictures as measured by subjective rating and BOLD response in regions of prefrontal cortex (PFC). In contrast, after deliberate attempts to upregulate emotional responses, regions of PFC were activated by trauma-exposed non-PTSD subjects more than by healthy control subjects or PTSD subjects. Conclusions: Successful downregulation of emotional responses to negative stimuli appears to be impaired by trauma exposure. In contrast, the ability to upregulate emotional responses to negative stimuli may be a protective factor in the face of trauma exposure and associated with resilience. C1 [New, Antonia S.] James J Peters Vet Affairs Med Ctr, Mental Hlth Care Ctr, Bronx, NY USA. [New, Antonia S.; Fan, Jin; Murrough, James W.; Liu, Xun; Liebman, Rachel E.; Guise, Kevin G.; Tang, Cheuk Y.; Charney, Dennis S.] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. RP New, AS (reprint author), Mt Sinai Sch Med, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM antonia.new@mssm.edu RI Fan, Jin/A-6716-2009; Murrough, James/J-7129-2013; Liu, Xun/C-2400-2009 OI Fan, Jin/0000-0001-9630-8330; Murrough, James/0000-0001-6286-1242; Liu, Xun/0000-0003-1366-8926 FU National Center for Research Resources at the National Institutes of Health [5-M01 RR00071] FX This material is the result of work, supported with resources and the use of facilities at the Peters Veterans Affairs Medical Center and by a Grant (5-M01 RR00071) for the Mount Sinai General Clinical Research Center from the National Center for Research Resources at the National Institutes of Health NR 60 TC 79 Z9 82 U1 10 U2 33 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 OCT 1 PY 2009 VL 66 IS 7 BP 656 EP 664 DI 10.1016/j.biopsych.2009.05.020 PG 9 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 496NQ UT WOS:000269981700006 PM 19589502 ER PT J AU Yehuda, R Cai, GQ Golier, JA Sarapas, C Galea, S Ising, M Rein, T Schmeidler, J Muller-Myhsok, B Holsboer, F Buxbaum, JD AF Yehuda, Rachel Cai, Guiqing Golier, Julia A. Sarapas, Casey Galea, Sandro Ising, Marcus Rein, Theo Schmeidler, James Mueller-Myhsok, Bertram Holsboer, Florian Buxbaum, Joseph D. TI Gene Expression Patterns Associated with Posttraumatic Stress Disorder Following Exposure to the World Trade Center Attacks SO BIOLOGICAL PSYCHIATRY LA English DT Article DE Childhood trauma; cortisol; gene expression; human FKBP5 protein; posttraumatic stress disorders; September 11 terrorist attacks ID FKBP5; POLYMORPHISMS; COHORT; SCALE; PTSD AB Background: Although genetic risk factors for posttraumatic stress disorder (PTSD) in similarly traumatized cohorts can be confounded with risk for type of exposure, the primary risk for exposure to the 9/11 attack on New York City was proximity, allowing study of PTSD risk in a sample that is not confounded by exposure-related risk. Methods: Thirty-five Caucasians (15 with PTSD, stratified for exposure, age, and gender) were selected from a population-representative sample of persons exposed to the attack from which longitudinal data had been collected in four previous waves. Whole blood gene expression and cortisol levels were obtained. Results: Seventeen probe sets were differentially expressed in PTSD. Identified genes were generally involved in hypothalamic-pituitary-adrenal (HPA) axis, signal transduction, or brain and immune cell function. FKBP5, a modulator of glucocorticoid receptor (GR) sensitivity, showed reduced expression in PTSD, consistent with enhanced GR responsiveness. FKBP5 expression was predicted by cortisol when entered with PTSD severity in regression analysis. Quantitative polymerase chain reaction confirmed significant reductions in FKBP5. Also less expressed in PTSD were STAT5B, a direct inhibitor of GR, and major histocompatibility complex (MHC) Class II. Conclusions: Consistent with observations of HPA axis dysfunction in PTSD, several genes involved in glucocorticoid signaling are differentially expressed among those with current PTSD. C1 [Yehuda, Rachel; Golier, Julia A.; Sarapas, Casey; Schmeidler, James] James J Peters Vet Affairs Med Ctr, Bronx, NY 10458 USA. [Yehuda, Rachel; Golier, Julia A.; Sarapas, Casey; Schmeidler, James] Mt Sinai Sch Med, Bronx, NY USA. [Cai, Guiqing; Buxbaum, Joseph D.] Mt Sinai Sch Med, New York, NY USA. [Galea, Sandro] Univ Michigan, Ctr Social Epidemiol & Populat Hlth, Ann Arbor, MI 48109 USA. [Ising, Marcus; Rein, Theo; Mueller-Myhsok, Bertram; Holsboer, Florian] Max Planck Inst Psychiat, D-80804 Munich, Germany. RP Yehuda, R (reprint author), James J Peters Vet Affairs Med Ctr, 526 OOMH PTSD 116-A,130 W Kingsbridge Rd, Bronx, NY 10458 USA. EM rachel.yehuda@va.gov RI Muller-Myhsok, Bertram/A-3289-2013 OI Buxbaum, Joseph/0000-0001-8898-8313; Rein, Theo/0000-0003-2850-4289 FU NCRR NIH HHS [5MO1 RR00071]; NIMH NIH HHS [1R56MH077321-01] NR 20 TC 120 Z9 122 U1 3 U2 15 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 OCT 1 PY 2009 VL 66 IS 7 BP 708 EP 711 DI 10.1016/j.biopsych.2009.02.034 PG 4 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 496NQ UT WOS:000269981700015 PM 19393990 ER PT J AU Deardorff, R Spinale, FG AF Deardorff, Rachael Spinale, Francis G. TI Cytokines and matrix metalloproteinases as potential biomarkers in chronic heart failure SO BIOMARKERS IN MEDICINE LA English DT Review DE chronic heart failure; cytokines; matrix metalloproteinases; tissue inhibitors of matrix metalloproteinases ID TUMOR-NECROSIS-FACTOR; IDIOPATHIC DILATED CARDIOMYOPATHY; ACUTE MYOCARDIAL-INFARCTION; FACTOR-ALPHA; CIRCULATING LEVELS; TISSUE INHIBITORS; PROINFLAMMATORY CYTOKINES; SYSTOLIC DYSFUNCTION; EJECTION FRACTION; SOLUBLE RECEPTORS AB Heart failure (HF) is accompanied by the upregulation of bioactive signaling molecules, known as cytokines, and a family of downstream proteases, matrix metalloproteinases (MMPs). It is now apparent that these molecules contribute to adverse myocardial remodeling during HF. Elevated levels of cytokines and MMPs exist in the myocardium and can subsequently spill over into the systemic circulation. The purpose of this article is to examine clinical studies of HF that have quantified levels of different types of cytokines, MMPs and endogenous tissue inhibitors of MMPs in relation to this disease process. HF is a complex syndrome that can develop from various etiologies and can be characterized into two distinct phenotypes: systolic and diastolic. This article will present recent clinical studies that have identified significant differences between the cytokine and MMP circulating profile of systolic and diastolic HF patients. In general, elevated levels of cytokines and MMPs exist in systolic HF patients when compared with diastolic HF patients, whereas diastolic HF patients have elevated levels of cytokines and MMPs when compared with controls. Therefore, future studies distinguishing between HF phenotypes may provide more consistent results in determining possible analytes to be used as biomarkers. Furthermore, this article will emphasize why standardization of analytical techniques and establishment of referent cytokine and MMP levels are necessary if these analytes are to be used as biomarkers for the diagnosis, prognosis and evaluation of treatment in the context of HF. C1 [Deardorff, Rachael] Med Univ S Carolina, Div Cardiothorac Surg, Charleston, SC 29403 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Deardorff, R (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, Charleston, SC 29403 USA. FU NIH [HL-59165]; Ralph H Johnson Veterans' Association Medical Center FX This article was made possible through research funding from the NIH Grant HL-59165 and Merit Review Funding from the Ralph H Johnson Veterans' Association Medical Center. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed NR 74 TC 14 Z9 15 U1 0 U2 4 PU FUTURE MEDICINE LTD PI LONDON PA UNITEC HOUSE, 3RD FLOOR, 2 ALBERT PLACE, FINCHLEY CENTRAL, LONDON, N3 1QB, ENGLAND SN 1752-0363 J9 BIOMARK MED JI Biomark. Med. PD OCT PY 2009 VL 3 IS 5 BP 513 EP 523 DI 10.2217/BMM.09.60 PG 11 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 511CA UT WOS:000271140300008 PM 20161487 ER PT J AU Lin, HZ Zhou, XH AF Lin, Huazhen Zhou, Xiao-Hua TI A semiparametric 2-part mixed-effects heteroscedastic transformation model for correlated right-skewed semicontinuous data SO BIOSTATISTICS LA English DT Article DE Laplace approximation; Mixed effects; Right skewed; Semicontinuous; Semiparametric; Transformation model ID GENERALIZED LINEAR-MODELS; REGRESSION-MODEL; RETRANSFORMATION; SAMPLES; TRIAL; ZERO AB In longitudinal or hierarchical structure studies, we often encounter a semicontinuous variable that has a certain proportion of a single value and a continuous and skewed distribution among the rest of values. In this paper, we propose a new semiparametric 2-part mixed-effects transformation model to fit correlated skewed semicontinuous data. In our model, we allow the transformation to be nonparametric. Fitting the proposed model faces computational challenges due to intractable numerical integrations. We derive the estimates for the parameter and the transformation function based on an approximate likelihood, which has high-order accuracy but less computational burden. We also propose an estimator for the expected value of the semicontinuous outcome on the original scale. Finally, we apply the proposed methods to a clinical study on effectiveness of a collaborative care treatment on late-life depression on health care costs. C1 [Zhou, Xiao-Hua] VA Puget Sound Hlth Care Syst, HSR&D Ctr Excellence, Seattle, WA 98108 USA. [Zhou, Xiao-Hua] Univ Washington, Dept Stat, Seattle, WA 98195 USA. [Lin, Huazhen] Sichuan Univ, Dept Math, Chengdu 610064, Sichuan, Peoples R China. RP Zhou, XH (reprint author), VA Puget Sound Hlth Care Syst, HSR&D Ctr Excellence, Seattle, WA 98108 USA. EM azhou@u.washington.edu NR 29 TC 5 Z9 5 U1 0 U2 3 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1465-4644 EI 1468-4357 J9 BIOSTATISTICS JI Biostatistics PD OCT PY 2009 VL 10 IS 4 BP 640 EP 658 DI 10.1093/biostatistics/kxp019 PG 19 WC Mathematical & Computational Biology; Statistics & Probability SC Mathematical & Computational Biology; Mathematics GA 493KI UT WOS:000269735000004 PM 19546166 ER PT J AU Bitting, RL Bent, S Li, YM Kohlwes, J AF Bitting, Rhonda L. Bent, Stephen Li, Yongmei Kohlwes, Jeffrey TI The prognosis and treatment of acquired hemophilia: a systematic review and meta-analysis SO BLOOD COAGULATION & FIBRINOLYSIS LA English DT Article DE acquired coagulation disorders; hemophilia and other bleeding disorders; immunotherapy; other coagulation inhibitors ID FACTOR-VIII INHIBITORS; PORCINE FACTOR-VIII; IMMUNOSUPPRESSIVE THERAPY; EXPERIENCE; MANAGEMENT; PREDNISONE; RITUXIMAB; INFUSION; REGIMEN; COHORT AB The inhibition of factor VIII by autoantibody development, or acquired hemophilia, occurs in approximately one person per million each year and can cause life-threatening bleeding. Due to the disease rarity, there are no randomized studies addressing prognostic features and treatment. The goal of this study is to identify prognostic indictors in acquired hemophilia to guide treatment choices. MEDLINE and EMBASE search from 1985-2008 retrieved 32 studies with detailed clinical information on five or more patients with acquired hemophilia. Univariate and multivariate analysis of the effects of age, sex, underlying condition, inhibitor titer, and treatment regimen were evaluated with regards to complete remission and death. A total of 32 studies containing 359 patients with acquired hemophilia were included in the analysis. The all-cause mortality rate in this cohort was 21%. Multivariate analyses revealed that patients more likely to die are the elderly [odds ratio (OR) 2.4, 95% confidence interval (CI) 1.32-4.36] and those with underlying malignancy (OR 2.76, CI 1.38-5.50). Early achievement of complete remission resulted in improved survival. Complete remission occurred in 94% of patients receiving combination chemotherapy, 82% receiving dual therapy, and 68% receiving steroids alone. Patients receiving immunosuppression had reduced odds of persistent hemophilia, with combination chemotherapy being the most efficacious (OR 0.04, CI 0.01-0.23) and steroid therapy alone being the least (OR 0.38, CI 0.140.94). In acquired hemophilia, increased age, underlying malignancy, and lack of complete remission are risk factors for death. Although the included studies were not randomized, patients treated with combination chemotherapy had the greatest odds of remission and the lowest odds of death. Blood Coagul Fibrinolysis 20:517-523 (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. C1 [Bitting, Rhonda L.; Bent, Stephen; Kohlwes, Jeffrey] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Li, Yongmei] San Francisco VA Med Ctr, Dept Med, San Francisco, CA USA. RP Bitting, RL (reprint author), 521 Pamassus Ave,Suite C-430, San Francisco, CA 94143 USA. EM rhonda.bitting@ucsf.edu NR 42 TC 28 Z9 29 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0957-5235 J9 BLOOD COAGUL FIBRIN JI Blood Coagul. Fibrinolysis PD OCT PY 2009 VL 20 IS 7 BP 517 EP 523 DI 10.1097/MBC.0b013e32832ca388 PG 7 WC Hematology SC Hematology GA 506HC UT WOS:000270764800006 PM 19644360 ER PT J AU O'Connor, MF Bower, JE Cho, HJ Creswell, JD Dimitrov, S Hamby, ME Hoyt, MA Martin, JL Robles, TF Sloan, EK Thomas, KS Irwin, MR AF O'Connor, Mary-Frances Bower, Julie E. Cho, Hyong Jin Creswell, J. David Dimitrov, Stoyan Hamby, Mary E. Hoyt, Michael A. Martin, Jennifer L. Robles, Theodore F. Sloan, Erica K. Thomas, KaMala S. Irwin, Michael R. TI To assess, to control, to exclude: Effects of biobehavioral factors on circulating inflammatory markers SO BRAIN BEHAVIOR AND IMMUNITY LA English DT Review DE Inflammation; Exclusion criteria; Biobehavioral; SES; Exercise; Body mass index; Interleukin ID C-REACTIVE PROTEIN; TUMOR-NECROSIS-FACTOR; CARDIOVASCULAR RISK-FACTORS; MODERATE ALCOHOL-CONSUMPTION; HORMONE REPLACEMENT THERAPY; MAJOR-DEPRESSIVE-DISORDER; INTERLEUKIN-1 RECEPTOR ANTAGONIST; HEALTHY POSTMENOPAUSAL WOMEN; RANDOMIZED CROSSOVER TRIAL; LOW SOCIOECONOMIC-STATUS AB Behavioral scientists have increasingly included inflammatory biology as mechanisms in their investigation of psychosocial dynamics on the pathobiology of disease. However, a lack of standardization of inclusion and exclusion criteria and assessment of relevant control variables impacts the interpretation of these studies. The present paper reviews and discusses human biobehavioral factors that can affect the measurement of circulating markers of inflammation. Keywords relevant to inflammatory biology and biobehavioral factors were searched through PubMed. Age, sex, and hormonal status, socioeconomic status, ethnicity and race, body mass index, exercise, diet, caffeine, smoking, alcohol, sleep disruption, antidepressants, aspirin, and medications for cardiovascular disease are all reviewed. A tiered set of recommendations as to whether each variable should be assessed, controlled for, or used as an exclusion criteria is provided. These recommendations provide a framework for observational and intervention studies investigating linkages between psychosocial and behavioral factors and inflammation. (C) 2009 Elsevier Inc. All rights reserved. C1 [O'Connor, Mary-Frances; Bower, Julie E.; Cho, Hyong Jin; Dimitrov, Stoyan; Hamby, Mary E.; Sloan, Erica K.; Thomas, KaMala S.; Irwin, Michael R.] Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Dept Psychiat & Biobehav Sci, Cousins Ctr Psychoneuroimmunol, Los Angeles, CA 90095 USA. [Bower, Julie E.; Hoyt, Michael A.; Robles, Theodore F.] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA. [Creswell, J. David] Carnegie Mellon Univ, Pittsburgh, PA 15213 USA. [Martin, Jennifer L.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. [Martin, Jennifer L.] Vet Adm Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, North Hills, CA 91343 USA. RP O'Connor, MF (reprint author), Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Dept Psychiat & Biobehav Sci, Cousins Ctr Psychoneuroimmunol, 300 Med Plaza,Room 3140, Los Angeles, CA 90095 USA. EM mfoconnor@mednet.ucla.edu RI Cho, Hyong Jin/B-9934-2014; Irwin, Michael/H-4870-2013 OI Cho, Hyong Jin/0000-0002-8629-8500; Irwin, Michael/0000-0002-1502-8431 FU NIA [K01 AG028404, K23 AG028452, NIMH T32-MH19925]; Cousins Center for Psychoneuroimmunology FX This work was supported by NIA Grants K01 AG028404 and K23 AG028452, NIMH T32-MH19925 and the Cousins Center for Psychoneuroimmunology. NR 174 TC 143 Z9 144 U1 0 U2 14 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0889-1591 J9 BRAIN BEHAV IMMUN JI Brain Behav. Immun. PD OCT PY 2009 VL 23 IS 7 BP 887 EP 897 DI 10.1016/j.bbi.2009.04.005 PG 11 WC Immunology; Neurosciences SC Immunology; Neurosciences & Neurology GA 540PV UT WOS:000273348600003 PM 19389469 ER PT J AU Hirata, H Hinoda, Y Nakajima, K Kikuno, N Yamamura, S Kawakami, K Suehiro, Y Tabatabai, ZL Ishii, N Dahiya, R AF Hirata, Hiroshi Hinoda, Yuji Nakajima, Koichi Kikuno, Nobuyuki Yamamura, Soichiro Kawakami, Kazumori Suehiro, Yutaka Tabatabai, Z. Laura Ishii, Nobuhisa Dahiya, Rajvir TI Wnt Antagonist Gene Polymorphisms and Renal Cancer SO CANCER LA English DT Article DE polymorphism; wingless-type mouse mammary tumor virus integration site; Dickkopf; secreted frizzled-related protein; renal cell carcinoma ID FREQUENT EPIGENETIC INACTIVATION; SINGLE-NUCLEOTIDE POLYMORPHISMS; CELL CARCINOMA; PROMOTER-HYPERMETHYLATION; SIGNALING PATHWAY; FAMILY GENES; LUNG-CANCER; COLORECTAL-CANCER; DICKKOPF FAMILY; PROSTATE-CANCER AB BACKGROUND: Epigenetic silencing of several wingless-type mouse mammary tumor virus integration site (Wnt) pathway-related genes has been reported in renal cancer. Except for the T-cell factor 4 gene TCF4, there are no reports regarding Writ pathway gene polymorphisms in renal cancer. Therefore, the authors of this report hypothesized that the polymorphisms in Wnt signaling genes may be risk factors for renal cancer. METHODS: In total, 210 patients (145 men and 65 women) with pathologically confirmed renal cell carcinoma (RCC) and 200 age-matched and sex-matched control individuals were enrolled in this study. We genotyped 14 single nucleotide polymorphisms (SNPs) in 6 genes. including Dickkopf 2 (DKK2) (reference SNP identification number 17037102 [rs17037102], rs419558, and rs447372), DKK3 (rs3206824, rs11022095, rs1472189, rs7396187, and rs2291599), DKK4 (rs2073664), secreted frizzled-related protein 4 (sFRP4) (rs1802073 and rs1802074), mothers against decapentaplegic homolog (SMAD) family member 7 or SMAD7 (rs12953717), and disheveled associated activator of morphogenesis 2 or DAAM2 (rs6937133 and rs2504106) using polymerase chain reaction-restriction fragment length polymorphism analysis and direct sequencing in the patients with RCC and in the healthy, age-matched control group. The relations also were tested between these polymorphisms and clinicopathologic data, including sex, tumor grade, tumor stage, lymph node involvement, distant metastasis, and overall survival. RESULTS: A significant decrease in the frequency of the guanine/adenine (G/A)+A/A genotypes in the DKK3 codon 335 rs3206824 was observed in the patients with RCC compared with the control group. The frequency of the rs3206824 (G/ A) A-rs7396187 (guanine/cytosine [G/C]) C haplotype was significantly lower in patients with RCC compared with other haplotypes. In addition, DKK3 rs1472189 cytosine/thymine (C/T) was associated with distant metastasis, and, DKK2 rs17037102 G-homozygous patients had a decreased risk for death in multivariate Cox regression analysis. CONCLUSIONS: To the authors' knowledge, this is the first report documenting that DKK3 polymorphisms are associated with RCC and that the DKK2 rs17037102 polymorphism may be a predictor for survival in patients with RCC after radical nephrectomy. Cancer 2009;115:4488-503. (C) 2009 American Cancer Society. C1 [Hirata, Hiroshi; Kikuno, Nobuyuki; Yamamura, Soichiro; Kawakami, Kazumori; Dahiya, Rajvir] Univ Calif San Francisco, Dept Urol, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. [Hinoda, Yuji; Suehiro, Yutaka] Yamaguchi Univ, Grad Sch Med, Dept Oncol & Lab Med, Yamaguchi, Japan. [Nakajima, Koichi; Ishii, Nobuhisa] Toho Univ, Dept Urol, Fac Med, Tokyo, Japan. [Tabatabai, Z. Laura] Univ Calif San Francisco, Dept Pathol, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. RP Dahiya, R (reprint author), Vet Affairs Med Ctr, Urol Res Ctr 112F, 4150 Clement St, San Francisco, CA 94121 USA. EM rdahiya@urology.ucsf.edu FU National InstitUteS of Health [RO1CA130860, RO1CA111470, RO1CA108612, T32-DKO7790] FX Supported by grants RO1CA130860, RO1CA111470, RO1CA108612, and T32-DKO7790 from the National InstitUteS of Health; by the Veterans Affairs Research Enhancement Award Program; Merit Review grants; and the Yamada Science Foundation. NR 50 TC 31 Z9 31 U1 0 U2 4 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER JI Cancer PD OCT 1 PY 2009 VL 115 IS 19 BP 4488 EP 4503 DI 10.1002/cncr.24491 PG 16 WC Oncology SC Oncology GA 501IS UT WOS:000270375700010 PM 19562778 ER PT J AU Kennedy, JP Bridges, TM Gentry, PR Brogan, JT Kane, AS Jones, CK Brady, AE Shirey, JK Conn, PJ Lindsley, CW AF Kennedy, J. Phillip Bridges, Thomas M. Gentry, Patrick R. Brogan, John T. Kane, Alexander S. Jones, Carrie K. Brady, Ashley E. Shirey, Jana K. Conn, P. Jeffrey Lindsley, Craig W. TI Synthesis and Structure-Activity Relationships of Allosteric Potentiators of the M-4 Muscarinic Acetylcholine Receptor SO CHEMMEDCHEM LA English DT Article DE allosteric; muscarinic; potentiators; receptors; schizophrenia; structure-activity relationships ID HISTAMINE H-3 RECEPTOR; KNOCKOUT MICE; ANTAGONISTS; DISORDERS; SYSTEM; GENES; RATS C1 [Kennedy, J. Phillip; Brogan, John T.; Lindsley, Craig W.] Vanderbilt Univ, Dept Chem, Nashville, TN 37232 USA. [Bridges, Thomas M.; Gentry, Patrick R.; Kane, Alexander S.; Jones, Carrie K.; Brady, Ashley E.; Shirey, Jana K.; Conn, P. Jeffrey; Lindsley, Craig W.] Vanderbilt Univ, Vanderbilt Program Drug Discovery, Dept Pharmacol, Med Ctr, Nashville, TN 37232 USA. [Jones, Carrie K.] TVHS, US Dept Vet Affairs, Nashville, TN 37212 USA. RP Kennedy, JP (reprint author), Vanderbilt Univ, Dept Chem, 12475 MRB4, Nashville, TN 37232 USA. EM craig.lindsley@vanderbilt.edu RI Conn, Peter/D-7848-2012 FU NIH; NIMH [1801 MH082867-01, 5801 MH073673]; ITTD [T90-DA022873] FX The authors warmly thank the NIH and NIMH for support of our programs in drug discovery. We specifically acknowledge the NIMH (1801 MH082867-01 and 5801 MH073673). TMA acknowledges an ITTD predoctoral training grant (T90-DA022873). NR 21 TC 19 Z9 19 U1 0 U2 1 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1860-7179 J9 CHEMMEDCHEM JI ChemMedChem PD OCT PY 2009 VL 4 IS 10 BP 1600 EP 1607 DI 10.1002/cmdc.200900231 PG 8 WC Chemistry, Medicinal; Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 506IG UT WOS:000270767900005 PM 19705385 ER PT J AU Kleeman, CR Levine, BS Felsenfeld, AJ AF Kleeman, Charles R. Levine, Barton S. Felsenfeld, Arnold J. TI Fuller Albright: The Consummate Clinical Investigator SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID OSTEITIS FIBROSA CYSTICA; PARATHYROID-GLANDS; HYPERPARATHYROIDISM; PHYSIOLOGY; OSTEOPOROSIS; THERAPY; HYPOPARATHYROIDISM; COMPLICATIONS; DIAGNOSIS C1 Univ Calif Los Angeles, Dept Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Felsenfeld, AJ (reprint author), W Los Angeles Vet Affairs Med Ctr, Nephrol Sect 111L, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Arnold.Felsenfeld@va.gov NR 36 TC 2 Z9 2 U1 0 U2 1 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1555-9041 J9 CLIN J AM SOC NEPHRO JI Clin. J. Am. Soc. Nephrol. PD OCT PY 2009 VL 4 IS 10 BP 1541 EP 1546 DI 10.2215/CJN.03030509 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 504LI UT WOS:000270617900001 PM 19808238 ER PT J AU Sugawara, M Geffner, DL Martinez, D Hershman, JM AF Sugawara, Masahiro Geffner, David L. Martinez, Dorothy Hershman, Jerome M. TI Novel treatment of medullary thyroid cancer SO CURRENT OPINION IN ENDOCRINOLOGY DIABETES AND OBESITY LA English DT Article DE indomethacin; medullary thyroid cancer; target chemotherapy; treatment of medullary thyroid cancer ID PHASE-II TRIAL; CARCINOMA-CELLS; CARCINOEMBRYONIC-ANTIGEN; VALPROIC ACID; TUMOR-GROWTH; APOPTOSIS; CAPECITABINE; THERAPY; INTERLEUKIN-12; INDOMETHACIN AB Purpose of review Metastatic medullary thyroid cancer (MTC) is an incurable disease once metastasis becomes unresectable. Many therapeutic drugs and methods have been tried to circumvent this difficulty. We review currently published treatments and hope for future developments of more effective treatment methods. Recent findings Motesanib, vandetanib, axitinib (tyrosine kinase inhibitors), and XL184 (multikinase inhibitor) have been shown to achieve partial response or stable disease state of metastatic MTC. Sunitinib and sorafenib, currently available tyrosine kinase inhibitors, can also be tried for patients with MTC. However, these medications are not curative and do not improve survival rate. Only carcinoembryonic antigen-I-131-iodine-based radioimmunotherapy improved survival of a subset of patients with a very aggressive type of MTC. Drugs currently available for possible use of MTC treatment include bortezomib (proteasome inhibitor), valproic acid (histone deacetylase inhibitor), capecitabine (5-fluorouracil prodrug), and indomethacin (NSAID), although clinical studies have yet to be done. Cardiac natriuretic hormones and an extract of the plant Cautleya gracilis are new agents to be studied for MTC. Summary Kinase inhibitors are the first drugs showing some efficacy in MTC. To improve survival, unconventional drugs or other therapies with or without kinase inhibitors need to be considered. C1 [Sugawara, Masahiro; Hershman, Jerome M.] Univ Calif Los Angeles, Endocrinol & Diabet Div, Greater Los Angeles VA Med Ctr, Dept Med, Los Angeles, CA 90073 USA. [Geffner, David L.; Martinez, Dorothy] Univ Calif Los Angeles, Div Endocrinol, David Geffen Sch Med, Los Angeles, CA 90073 USA. RP Sugawara, M (reprint author), Univ Calif Los Angeles, Endocrinol & Diabet Div, Greater Los Angeles VA Med Ctr, Dept Med, 111M,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM msugawar@ucla.edu FU VA Merit Review Research Grant FX The present publication was supported by VA Merit Review Research Grant (to M. S.). NR 48 TC 16 Z9 17 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1752-296X EI 1752-2978 J9 CURR OPIN ENDOCRINOL JI Curr. Opin. Endocrinol. Diabetes Obes. PD OCT PY 2009 VL 16 IS 5 BP 367 EP 372 DI 10.1097/MED.0b013e3283304f0c PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 691CF UT WOS:000285057200007 PM 19633548 ER PT J AU Pott, GB Beard, KS Regulski, M Shapiro, L AF Pott, Gregory B. Beard, K. Scott Regulski, Matthew Shapiro, Leland TI Activated collagen accelerates wound repair and modulates cytokine production in whole blood and PBMC cultures SO CYTOKINE LA English DT Meeting Abstract CT Tri-Society Annual Conference of the International-Cytokine-Society/International-Society-of-Interferon-and-C ytokine-Research/Society-of-Leukocyte-Biology CY OCT 17-21, 2009 CL Lisbon, PORTUGAL SP Int Cytokine Soc, Int Soc Interferon & Cytokin Res, Soc Leukocyte Biol C1 [Pott, Gregory B.; Beard, K. Scott; Shapiro, Leland] Denver Vet Affairs Med Ctr, Dept Med, Denver, CO USA. [Pott, Gregory B.; Beard, K. Scott; Shapiro, Leland] Univ Colorado Denver, Dept Med, Aurora, CO USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1043-4666 J9 CYTOKINE JI Cytokine PD OCT-NOV PY 2009 VL 48 IS 1-2 BP 93 EP 93 DI 10.1016/j.cyto.2009.07.390 PG 1 WC Biochemistry & Molecular Biology; Cell Biology; Immunology SC Biochemistry & Molecular Biology; Cell Biology; Immunology GA 507LN UT WOS:000270855100325 ER PT J AU Bauman, WA AF Bauman, William A. TI The potential metabolic consequences of cerebral palsy: inferences from the general population and persons with spinal cord injury SO DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY LA English DT Article; Proceedings Paper CT 62nd Annual Meeting of the American-Academy-for-Cerebral-Palsy-and-Developmental-Medicine CY SEP 17-20, 2008 CL Atlanta, GA SP Amer Acad Cerebral Palsy & Dev Med ID HIGH-DENSITY-LIPOPROTEIN; DEPENDENT DIABETES-MELLITUS; CORONARY-HEART-DISEASE; CHOLESTEROL-EDUCATION-PROGRAM; CHRONIC ELECTRICAL-STIMULATION; RESIDUAL NEUROLOGICAL DEFICIT; MOTOR FUNCTION CLASSIFICATION; CARDIOVASCULAR RISK-FACTORS; INVIVO INSULIN RESISTANCE; PHYSICAL-ACTIVITY LEVEL AB The metabolic consequences of cerebral palsy (CP) have not been reported. The observations and suggestions presented in this article are based on our current knowledge of physiology in the general population and on information on the known metabolic consequences of disability in persons with spinal cord injury. Because of pain, fatigue, and other secondary consequences of CP, adolescents with CP who are ambulatory may become less physically active with age. This phenomenon would be expected to be associated with deconditioning and adverse changes in body composition including atrophy of muscles and an absolute or relative increase in adiposity. Insulin resistance, hyperinsulinemia, and associated adverse metabolic changes may develop. In an unfavorable metabolic milieu, the ability of the pancreas to compensate for mild elevations of circulating glucose may diminish. The combination of reduced fitness and conventional risk factors for cardiovascular disease would be expected to increase the risk for coronary heart disease (CHD); however, there has been no assessment of the risk factors for CHD in adults with CP. Once subgroups with modifiable risk factors for cardiovascular disease have been identified, risk factors for CHD should be aggressively treated, according to current standards of care. C1 [Bauman, William A.] James J Peters Vet Affairs Med Ctr, Spinal Cord Injury & Med Serv, Ctr Excellence Med Consequences Spinal Cord Injur, Bronx, NY USA. [Bauman, William A.] Mt Sinai Sch Med, Dept Med, New York, NY USA. [Bauman, William A.] Mt Sinai Sch Med, Dept Rehabil Med, New York, NY USA. RP Bauman, WA (reprint author), James J Peters Vet Affairs Med Ctr, Spinal Cord Injury & Med Serv, Ctr Excellence Med Consequences Spinal Cord Injur, Bronx, NY USA. EM william.bauman@va.gov NR 136 TC 13 Z9 13 U1 1 U2 3 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0012-1622 EI 1469-8749 J9 DEV MED CHILD NEUROL JI Dev. Med. Child Neurol. PD OCT PY 2009 VL 51 SU 4 BP 64 EP 78 DI 10.1111/j.1469-8749.2009.03430.x PG 15 WC Clinical Neurology; Pediatrics SC Neurosciences & Neurology; Pediatrics GA 490WS UT WOS:000269539400010 PM 19740212 ER PT J AU de Boer, IH Katz, R Cao, JJ Fried, LF Kestenbaum, B Mukamal, K Rifkin, DE Sarnak, MJ Shlipak, MG Siscovick, DS AF de Boer, Ian H. Katz, Ronit Cao, Jie J. Fried, Linda F. Kestenbaum, Bryan Mukamal, Ken Rifkin, Dena E. Sarnak, Mark J. Shlipak, Michael G. Siscovick, David S. TI Cystatin C, Albuminuria, and Mortality Among Older Adults With Diabetes SO DIABETES CARE LA English DT Article ID GLOMERULAR-FILTRATION-RATE; ALL-CAUSE MORTALITY; KIDNEY-FUNCTION; CARDIOVASCULAR MORTALITY; SERUM CREATININE; FUNCTION DECLINE; ELDERLY PERSONS; RISK-FACTORS; DISEASE; PROTEINURIA AB OBJECTIVE - Albuminuria and impaired glomerular filtration rate (GFR) are each associated with poor health Outcomes among individuals with diabetes. joint associations of albuminuria and impaired GFR with mortality have not been comprehensively evaluated in this population. RESEARCH DESIGN AND METHODS - This is a cohort study among Cardiovascular Health Study participants with diabetes, mean age 78 years. GFR was estimated using serum cystatin C and serum creatinine. Albumin-to-creatinine ratio (ACR) was measured in single-voided urine samples. RESULTS - Of 691 participants, 378 died over 1.0 years of follow-up. Cystatin C-estimated GFR <60 ml/min per 1.73 m(2), creatinine-based estimated GFR <60 ml/min per 1.73 m(2), and urine ACR >= 30 mg/g were each associated with increased mortality risk with hazard ratios of 1.73 (95% CI 1.37-2.18), 1.54 (1.21-1.97), and 1.73 (1.39-2.17), respectively, adjusting for age, sex, race, diabetes duration, hypoglycemic medications, hypertension, BMI, smoking, cholesterol, lipid-lowering medications, prevalent cardiovascular disease (CVD), and prevalent heart failure. Cystatin C-estimated GFR and urine ACR were additive in terms of mortality risk. Cystatin C-estimated GFR predicted mortality more strongly than creatinine-based estimated GFR. CONCLUSIONS - Albuminuria and impaired GFR were independent, additive risk factors for mortality among older adults with diabetes. These Findings support current recommendations to regularly assess both albuminuria and GFR in the clinical care of patients with diabetes a focus on interventions to prevent or treat CVD in the presence of albuminuria, impaired GFR, or both; and further consideration of cystatin C use in clinical care. C1 [de Boer, Ian H.; Katz, Ronit; Kestenbaum, Bryan; Siscovick, David S.] Univ Washington, Seattle, WA 98195 USA. [Cao, Jie J.] NHLBI, Bethesda, MD 20892 USA. [Fried, Linda F.] Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Mukamal, Ken] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. [Rifkin, Dena E.; Sarnak, Mark J.] Tufts Med Ctr, Boston, MA USA. [Shlipak, Michael G.] Univ Calif San Francisco, San Francisco, CA 94143 USA. RP de Boer, IH (reprint author), Univ Washington, Seattle, WA 98195 USA. EM deboer@u.washington.edu FU National Heart, Lung, and Blood Institute [N01-HC-85079, N01-HC-85086, N01-HC-35129, N01 HC-15103, N01 HC-55222, N01-HC-75150, N01-HC-45133, U01-HL-080295]; National Institute of Neurological Disorders and Stroke; National Institutes of Health [R01-AG-027002, 1KL2-RR-025015-01] FX The research reported in this article was supported by the National Heart, Lung, and Blood Institute (contracts N01-HC-85079 through N01-HC-85086, N01-HC-35129, N01 HC-15103, N01 HC-55222, N01-HC-75150, and N01-HC-45133 and Grant U01-HL-080295), with additional contribution from the National Institute of Neurological Disorders and Stroke. Additional support came from National Institutes of Health grants R01-AG-027002 and 1KL2-RR-025015-01. NR 25 TC 51 Z9 51 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD OCT PY 2009 VL 32 IS 10 BP 1833 EP 1838 DI 10.2337/dc09-0191 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 509HE UT WOS:000271004900013 PM 19587367 ER PT J AU Rosenstock, J Yang, F Reusch, J Stewart, M Bush, M AF Rosenstock, Julio Yang, Fred Reusch, Jane Stewart, Murray Bush, Mark CA Albiglutide Study Grp TI Potential of Albiglutide, a Long-Acting GLP-1 Receptor Agonist, in Type 2 Diabetes A randomized controlled trial exploring weekly, biweekly, and monthly dosing SO DIABETES CARE LA English DT Article ID GLUCAGON-LIKE PEPTIDE-1; BLOOD-GLUCOSE CONTROL; EXENATIDE EXENDIN-4; GLYCEMIC CONTROL; TREATED PATIENTS; HOMEOSTASIS; METFORMIN; SULFONYLUREA; OUTCOMES; PROTEIN AB OBJECTIVE - To evaluate the efficacy, safety, and tolerability of incremental doses of albiglutide, a long-acting glucagon-like peptide-1 receptor agonist, administered with three dosing schedules in patients with type 2 diabetes inadequately controlled with diet and exercise or metformin monotherapy. RESEARCH DESIGN AND METHODS - In this randomized multicenter double-blind parallel-group study, 356 type 2 diabetic subjects With similar mean baseline characteristics (age 54 years, diabetes duration 4.9 years, BMI 32.1 kg/m(2), AlC 8.0%) received subcutaneous placebo or albiglutide (weekly [4, 15, or 30 mg], biweekly [15, 30, or 50 mg], or monthly [50 or 100 mg]) or exenatide twice daily as an open-label active reference (per labeling in metformin subjects only) over 16 weeks followed by an 11-week washout period. The main outcome measure was change from baseline AlC of albiglutide groups versus placebo at week 16. RESULTS - Dose-dependent reductions in AlC were observed within all albiglutide schedules. Mean AlC was similarly reduced from baseline by albiglutide 30 mg weekly, 50 mg biweekly (every 2 weeks), and 100 mg monthly (-0.87, -0.79, and -0.87%, respectively) versus placebo (-0.17%, P < 0.004) and exenatide (-0.54%). Weight loss (-1.1 to -1.7 kg) was observed with these three albiglutide doses with no significant between-group effects. The incidence of gastrointestinal adverse events in subjects receiving albiglutide 30 mg weekly was less than that observed for the highest biweekly and monthly doses of albiglutide or exenatide. CONCLUSIONS - Weekly albiglutide administration significantly improved glycemic control and elicited weight loss in type 2 diabetic patients, with a favorable safety and tolerability profile. C1 [Rosenstock, Julio] Dallas Diabet & Endocrine Ctr Med City, Dallas, TX USA. [Reusch, Jane] Univ Colorado Denver AMC, Div Endocrinol Metab & Diabet, Denver, CO USA. [Reusch, Jane] Denver Vet Affairs Med Ctr, Denver, CO USA. [Bush, Mark] GlaxoSmithKline Inc, Res Triangle Pk, NC USA. [Yang, Fred; Stewart, Murray] GlaxoSmithKline Inc, King Of Prussia, PA USA. RP Rosenstock, J (reprint author), Dallas Diabet & Endocrine Ctr Med City, Dallas, TX USA. EM juliorosenstock@dallasdiabetes.com FU GlaxoSmithKline FX This study was sponsored by GlaxoSmithKline, Middlesex, U.K. J.Ro. has received research grants and consulting honoraria for serving on scientific advisory boards from GlaxoSmithKline. J.Re. has received research grants from and acted as a consultant for GlaxoSmithKline. M.B., F.Y., and M.S. are employees/Stockholders of GlaxoSmithKline. No other Potential conflicts of interest relevant to this article were reported. NR 25 TC 120 Z9 125 U1 1 U2 10 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD OCT PY 2009 VL 32 IS 10 BP 1880 EP 1886 DI 10.2337/dc09-0366 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 509HE UT WOS:000271004900022 PM 19592625 ER PT J AU Mizumori, M Akiba, Y Kaunitz, JD AF Mizumori, Misa Akiba, Yasutada Kaunitz, Jonathan D. TI Lubiprostone Stimulates Duodenal Bicarbonate Secretion in Rats SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE ClC-2; EP receptor; Water secretion; CFTR; Prostaglandin ID TRANSMEMBRANE CONDUCTANCE REGULATOR; CHLORIDE CHANNEL ACTIVATOR; IRRITABLE-BOWEL-SYNDROME; SMALL-INTESTINE; CLINICAL-TRIAL; CLC-2; CELLS; CONSTIPATION; BARRIER; MUCOSA AB Lubiprostone, a bicyclic fatty acid, is used for the treatment of chronic constipation. No published study has addressed the effect of lubiprostone on intestinal ion secretion in vivo. The aim of this study was to test the hypothesis that lubiprostone augments duodenal HCO(3) (-) secretion (DBS). Rat proximal duodenal loops were perfused with pH 7.0 Krebs, control vehicle (medium-chain triglycerides), or lubiprostone (0.1-10 mu M). We measured DBS with flow-through pH and CO(2) electrodes, perfusate [Cl(-)] with a Cl(-) electrode, and water flux using a non-absorbable ferrocyanide marker. Some rats were pretreated with a potent, selective CFTR antagonist, CFTR(inh)-172 (1 mg/kg, ip), 1 h before experiments. Perfusion of lubiprostone concentration dependently increased DBS, whereas net Cl(-) output and net water output were only increased at 0.1 mu M, compared with vehicle. CFTR(inh)-172 reduced lubiprostone (10 mu M)-induced DBS increase, whereas net Cl(-) output was also unchanged. Nevertheless, CFTR(inh)-172 reduced basal net water output, which was reversed by lubiprostone. Furthermore, lubiprostone-induced DBS was inhibited by EP4 receptor antagonist, not by an EP1/2 receptor antagonist or by indomethacin pretreatment. In this first study of the effect of lubiprostone on intestinal ion secretion in vivo, lubiprostone stimulated CFTR-dependent DBS without changing net Cl(-) secretion. This effect supports the hypothesis that Cl(-) secreted by CFTR is recycled across the apical membrane by anion exchangers. Recovery of water output during CFTR inhibition suggests that lubiprostone may improve the intestinal phenotype in CF patients. Furthermore, increased DBS suggests that lubiprostone may protect the duodenum from acid-induced injury via EP4 receptor activation. C1 [Akiba, Yasutada; Kaunitz, Jonathan D.] W Los Angeles VA Med Ctr, Los Angeles, CA 90073 USA. [Mizumori, Misa; Akiba, Yasutada; Kaunitz, Jonathan D.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. [Akiba, Yasutada; Kaunitz, Jonathan D.] Brentwood Biomed Res Inst, Los Angeles, CA 90073 USA. RP Kaunitz, JD (reprint author), W Los Angeles VA Med Ctr, 11301 Wilshire Blvd,Bldg 114,Suite 217, Los Angeles, CA 90073 USA. EM jake@ucla.edu FU Takeda North America [07-014L]; Department of Veterans Affairs Merit Review Award; NIH-NIDDK [R01 DK54221, P30 DK0413] FX We thank Jenifer Kugler for her assistance with manuscript preparation. This work was supported by a research grant from Takeda North America No. 07-014L, Department of Veterans Affairs Merit Review Award, NIH-NIDDK R01 DK54221 (J. Kaunitz), and the animal core of NIH-NIDDK P30 DK0413 (J.E. Rozengurt). NR 27 TC 17 Z9 17 U1 0 U2 2 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD OCT PY 2009 VL 54 IS 10 BP 2063 EP 2069 DI 10.1007/s10620-009-0907-0 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 490UK UT WOS:000269531900003 PM 19657734 ER PT J AU Wasterlain, CG Suchomelova, L Matagne, A Klitgaard, H Niquet, J Baldwin, R AF Wasterlain, C. G. Suchomelova, L. Matagne, A. Klitgaard, H. Niquet, J. Baldwin, R. TI SHORT-TERM AND LONG-TERM EFFECTS OF BRIVARACETAM IN AN ANIMAL MODEL OF STATUS SO EPILEPSIA LA English DT Meeting Abstract CT 28th International Epilespy Congress CY 2009 CL Budapest, HUNGARY C1 [Wasterlain, C. G.; Suchomelova, L.; Niquet, J.; Baldwin, R.] VA Greater Angeles Hlth Care Syst, Epilepsy Res Lab, Los Angeles, CA USA. [Wasterlain, C. G.; Suchomelova, L.; Niquet, J.; Baldwin, R.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. NR 0 TC 5 Z9 5 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD OCT PY 2009 VL 50 BP 13 EP 13 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 502DB UT WOS:000270433800043 ER PT J AU Nguyen, V Tran, H Makhijani, V Nguyen, C Shah, N Kaunitz, J Dergalust, S AF Nguyen, V. Tran, H. Makhijani, V. Nguyen, C. Shah, N. Kaunitz, J. Dergalust, S. TI ANTIEPILEPTIC DRUG MONOTHERAPY IN A VETERAL POPULATION SO EPILEPSIA LA English DT Meeting Abstract CT 28th International Epilespy Congress CY 2009 CL Budapest, HUNGARY C1 [Nguyen, V.; Tran, H.; Makhijani, V.; Nguyen, C.; Shah, N.; Kaunitz, J.; Dergalust, S.] Vet Affairs Greater Los Angeles, Los Angeles, CA USA. [Nguyen, V.] Univ So Calif, Los Angeles, CA 90089 USA. [Tran, H.] Univ Calif Los Angeles, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD OCT PY 2009 VL 50 BP 110 EP 111 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 502DB UT WOS:000270433800401 ER PT J AU Parko, K Thurman, DJ AF Parko, Karen Thurman, David J. TI Prevalence of epilepsy and seizures in the Navajo Nation 1998-2002 SO EPILEPSIA LA English DT Article DE Epidemiology; Health disparities; Native American; Global health AB P>Purpose: To determine the prevalence of epilepsy and seizures in the Navajo. Methods: We studied 226,496 Navajo residing in the Navajo Reservation who had at least one medical encounter between October 1, 1998 and September 30, 2002. We ascertained and confirmed cases in two phases. First, we identified patients with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes signifying epilepsy or seizures using Indian Health Service (IHS) administrative data. Second, we reviewed medical charts of a geographic subpopulation of identified patients to confirm diagnoses and assess the positive predictive value of the ICD-9-CM codes in identifying patients with active epilepsy. Results: Two percent of Navajo receiving IHS care were found to have an ICD-9-CM code consistent with epilepsy or seizures. Based on confirmed cases, the crude prevalence for the occurrence of any seizure (including febrile seizures and recurrent seizures that may have been provoked) in the geographic subpopulation was 13.5 per 1,000 and the crude prevalence of active epilepsy was 9.2 per 1,000. Prevalence was higher among males, children under 5 years of age, and older adults. Discussion: The estimated prevalence of active epilepsy in the Navajo Nation is above the upper limit of the range of reported estimates from other comparable studies of U.S. communities. C1 [Parko, Karen] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. [Parko, Karen] San Francisco VA Med Ctr, San Francisco, CA USA. [Thurman, David J.] Ctr Dis Control & Prevent, Div Adult & Community Hlth, Epilepsy Program, Atlanta, GA USA. RP Parko, K (reprint author), 4150 Clement St 127, San Francisco, CA 94121 USA. EM Karen.Parko@ucsf.edu OI Thurman, David/0000-0002-0533-7062 FU CDC National Center for Chronic Disease Prevention and Health Promotion; Indian Health Service Information Technology; Shiprock Service Unit Health Board; Richard Champany DDS; CEO; Northern Navajo Medical Center; National IHS IRB; Navajo Nation Human Research Review Board FX The authors thank the following for their direct assistance: Indian Health Service Information Technology Support Center; Anne Butman, management analyst, DataCom Sciences; Yolinda Cadman; Dr. Nathanial Cobb; Navajo Area medical records department; Northern Navajo Medical Center in Shiprock: Gary Russell-King, in Kayenta: Lorraine Dohi, in Crownpoint: Cynthia Begaye; Clinical pharmacists in the NNMC seizure clinic: Tom Duran, Lauren Dolence, Melissa Stahlecker, Dr. David Labiner, Karla Lindquist, Peter Taylor, and Elena Cherkasova. This work could not have been undertaken without the support from: Duane H. Yazzie and the Shiprock Chapter House; Manuel Morgan and the Shiprock Service Unit Health Board; Richard Champany DDS, CEO, Northern Navajo Medical Center; Phillip Smith, MD, MPH and the National IHS IRB; and Beverly Pigman and the Navajo Nation Human Research Review Board. NR 0 TC 20 Z9 20 U1 0 U2 2 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD OCT PY 2009 VL 50 IS 10 BP 2180 EP 2185 DI 10.1111/j.1528-1167.2009.02140.x PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 498GW UT WOS:000270126300002 PM 19490040 ER PT J AU Vandenbark, A AF Vandenbark, A. TI Results of a phase I safety study of RTL1000, a recombinant T-Cell receptor ligand specific for an immunodominant MOG peptide, in multiple sclerosis SO EUROPEAN JOURNAL OF NEUROLOGY LA English DT Meeting Abstract CT 13th Congress of the European-Federation-of-Neurological-Societies CY SEP 12-15, 2009 CL Florence, ITALY SP European Federat Neurol Soc C1 [Vandenbark, A.] Portland VA Med Ctr, Portland, OR USA. [Vandenbark, A.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1351-5101 J9 EUR J NEUROL JI Eur. J. Neurol. PD OCT PY 2009 VL 16 BP 249 EP 249 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 494IC UT WOS:000269804100523 ER PT J AU Offner, H AF Offner, H. TI Cytokine switch and bystander suppression of autoimmune responses to multiple antigens in EAE by a single recombinant TCR ligand (RTL) SO EUROPEAN JOURNAL OF NEUROLOGY LA English DT Meeting Abstract CT 13th Congress of the European-Federation-of-Neurological-Societies CY SEP 12-15, 2009 CL Florence, ITALY SP European Federat Neurol Soc C1 [Offner, H.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Offner, H.] Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1351-5101 J9 EUR J NEUROL JI Eur. J. Neurol. PD OCT PY 2009 VL 16 BP 570 EP 570 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 494IC UT WOS:000269804101162 ER PT J AU Seetharaman, SV Prudencio, M Karch, C Holloway, SP Borchelt, DR Hart, PJ AF Seetharaman, Sai V. Prudencio, Mercedes Karch, Celeste Holloway, Stephen P. Borchelt, David R. Hart, P. John TI Immature Copper-Zinc Superoxide Dismutase and Familial Amyotrophic Lateral Sclerosis SO EXPERIMENTAL BIOLOGY AND MEDICINE LA English DT Review DE superoxide dismutase; SOD1; amyotrophic lateral sclerosis; motor neuron disease; protein misfolding; protein aggregation; protofibrils; amyloid ID MOTOR-NEURON DISEASE; SOD1 GENE MUTATION; INTRACYTOPLASMIC HYALINE INCLUSIONS; POSTERIOR COLUMN INVOLVEMENT; MISSENSE POINT MUTATION; BASE-PAIR DELETION; CU,ZN-SUPEROXIDE DISMUTASE; TRANSGENIC MICE; MUTANT SOD1; WILD-TYPE AB Mutations in human copper-zinc superoxide dismutase (SOD1) cause an inherited form of amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease, motor neuron disease). Insoluble forms of mutant SOD1 accumulate in neural tissues of human ALS patients and in spinal cords of transgenic mice expressing these polypeptides, suggesting that SOD1-linked ALS is a protein misfolding disorder. Understanding the molecular basis for how the pathogenic mutations give rise to SOD1 folding intermediates, which may themselves be toxic, is therefore of keen interest. A critical step on the SOD1 folding pathway occurs when the copper chaperone for SOD1 (CCS) modifies the nascent SOD1 polypeptide by inserting the catalytic copper cofactor and oxidizing its intrasubunit disulfide bond. Recent studies reveal that pathogenic SOD1 proteins coming from cultured cells and from the spinal cords of transgenic mice tend to be metal-deficient and/or lacking the disulfide bond, raising the possibility that the disease-causing mutations may enhance levels of SOD1-folding intermediates by preventing or hindering CCS-mediated SOD1 maturation. This mini-review explores this hypothesis by highlighting the structural and biophysical properties of the pathogenic SOD1 mutants in the context of what is currently known about CCS structure and action. Other hypotheses as to the nature of toxicity inherent in pathogenic SOD1 proteins are not covered. Exp Biol Med 234:1140-1154, 2009 C1 [Seetharaman, Sai V.; Holloway, Stephen P.; Hart, P. John] Univ Texas Hlth Sci Ctr San Antonio, Dept Biochem, San Antonio, TX 78229 USA. [Seetharaman, Sai V.; Holloway, Stephen P.; Hart, P. John] Univ Texas Hlth Sci Ctr San Antonio, Xray Crystallog Core Lab, San Antonio, TX 78229 USA. [Prudencio, Mercedes; Karch, Celeste; Borchelt, David R.] Univ Florida, McKnight Brain Inst, Dept Neurosci, Gainesville, FL 32610 USA. [Hart, P. John] Univ Texas Hlth Sci Ctr San Antonio, S Texas Vet Hlth Care Syst, Dept Vet Affairs, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Hart, PJ (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Biochem, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM pjhart@biochem.uthscsa.edu OI Karch, Celeste/0000-0002-6854-5547; Prudencio, Mercedes/0000-0002-4894-4858 FU NIH/NINDS; ALS Association; Welch Foundation; Packard Foundation; William and Ella C. Owens Medical Research Foundation; Judith and Jean Pape Adams Charitable Foundation FX This work has been supported over the years by the NIH/NINDS (PJH/DRB), the ALS Association (P.J.H./D.R.B.). the Robert A. Welch Foundation (P.J.H.), the Packard Foundation (D.R.B.), the William and Ella C. Owens Medical Research Foundation (P.J.H.), and the Judith and Jean Pape Adams Charitable Foundation (P.J.H.). Support for the X-ray Crystallography Core Laboratory by the Executive Research Council at the University of Texas Health Science Center is gratefully acknowledged. NR 138 TC 45 Z9 47 U1 1 U2 5 PU SOC EXPERIMENTAL BIOLOGY MEDICINE PI MAYWOOD PA 195 WEST SPRING VALLEY AVE, MAYWOOD, NJ 07607-1727 USA SN 1535-3702 J9 EXP BIOL MED JI Exp. Biol. Med. PD OCT PY 2009 VL 234 IS 10 BP 1140 EP 1154 DI 10.3181/0903-MR-104 PG 15 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 501AC UT WOS:000270347800004 PM 19596823 ER PT J AU Hayes, TG AF Hayes, Teresa G. TI Pharmacologic treatment of male breast cancer SO EXPERT OPINION ON PHARMACOTHERAPY LA English DT Review DE aromatase; chemotherapy; hormonal therapy; male breast cancer; orchiectomy; tamoxifen ID FIRST-LINE THERAPY; ADJUVANT CHEMOTHERAPY; AROMATASE INHIBITOR; PROGNOSTIC-FACTORS; HORMONAL-THERAPY; BRCA2 MUTATIONS; POSTMENOPAUSAL WOMEN; COMPLETE REMISSION; POSTOPERATIVE RADIOTHERAPY; KLINEFELTERS-SYNDROME AB Male breast cancer is an uncommon condition. It often occurs in settings in which there is an imbalance between androgens and oestrogens. Genetics plays an important role, as many cases are associated with mutations in BRCA2 or other genes. Male breast cancer occurs at an older age than female breast cancer and is frequently diagnosed at a later stage. Tumors are predominantly oestrogen and progesterone positive. Prognosis is approximately equivalent to that of breast cancer in females when matched for age, stage and hormonal receptors. The recommended treatment for male breast cancer is similar to that for breast cancer in postmenopausal females. However, the presence of androgens in males has a strong effect on the hormonal milieu and the ability of male patients to respond to hormonal agents. When pharmacologic treatment is required, tamoxifen is effective for first-line therapy. Other hormonal approaches such as orchiectomy, aromatase inhibitors and androgen ablation may be useful in later lines of therapy. C1 Baylor Coll Med, Hematol Oncol Sect, Dept Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Hayes, TG (reprint author), Baylor Coll Med, Hematol Oncol Sect, Dept Vet Affairs Med Ctr, VA 111H,2002 Holcombe Blvd, Houston, TX 77030 USA. EM thayes@bcm.edu FU Michael E DeBakey Veterans Administration Medical Center FX This material is the result of work supported with resources and the use of facilities at the Michael E DeBakey Veterans Administration Medical Center. NR 201 TC 6 Z9 8 U1 0 U2 3 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1465-6566 EI 1744-7666 J9 EXPERT OPIN PHARMACO JI Expert Opin. Pharmacother. PD OCT PY 2009 VL 10 IS 15 BP 2499 EP 2510 DI 10.1517/14656560903200634 PG 12 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 509IQ UT WOS:000271009200009 PM 19708850 ER PT J AU Salmon, AB Perez, VI Bokov, A Jernigan, A Kim, G Zhao, H Levine, RL Richardson, A AF Salmon, Adam B. Perez, Viviana I. Bokov, Alex Jernigan, Amanda Kim, Geumsoo Zhao, Hang Levine, Rodney L. Richardson, Arlan TI Lack of methionine sulfoxide reductase A in mice increases sensitivity to oxidative stress but does not diminish life span SO FASEB JOURNAL LA English DT Article DE longevity; free radical; stress resistance; aging; antioxidant ID FIBROBLAST CELL-LINES; ANTIOXIDANT ENZYMES; MULTIPLE FORMS; KNOCKOUT MOUSE; DWARF MICE; RESISTANCE; MSRA; DAMAGE; GENE; OVEREXPRESSION AB Methionine sulfoxide reductase A (MsrA) repairs oxidized methionine residues within proteins and may also function as a general antioxidant. Previous reports have suggested that modulation of MsrA in mice and mammalian cell culture can affect the accumulation of oxidized proteins and may regulate resistance to oxidative stress. Thus, under the oxidative stress theory of aging, these results would predict that MsrA regulates the aging process in mammals. We show here that MsrA(-/-) mice are more susceptible to oxidative stress induced by paraquat. Skin-derived fibroblasts do not express MsrA, but fibroblasts cultured from MsrA(-/-) mice were, nevertheless, also more susceptible to killing by various oxidative stresses. In contrast to previous reports, we find no evidence for neuromuscular dysfunction in MsrA(-/-) mice in either young adult or in older animals. Most important, we found no difference between MsrA(-/-) and control mice in either their median or maximum life span. Thus, our results show that MsrA regulates sensitivity to oxidative stress in mice but has no effect on aging, as determined by life span.-Salmon, A. B., Perez, V. I., Bokov, A., Jernigan, A., Kim, G., Zhao, H., Levine, R. L., Richardson, A. Lack of methionine sulfoxide reductase A in mice increases sensitivity to oxidative stress but does not diminish life span. FASEB J. 23, 3601-3608 (2009). www.fasebj.org C1 [Richardson, Arlan] Univ Texas Hlth Sci Ctr San Antonio, Dept Cellular & Struct Biol, Sam & Ann Barshop Inst Longev & Aging Studies, San Antonio, TX 78245 USA. [Kim, Geumsoo; Zhao, Hang; Levine, Rodney L.] NHLBI, Biochem Lab, NIH, Bethesda, MD 20892 USA. [Richardson, Arlan] S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Richardson, A (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Cellular & Struct Biol, Sam & Ann Barshop Inst Longev & Aging Studies, 15355 Lambda Dr, San Antonio, TX 78245 USA. EM richardsona@uthscsa.edu RI Zhao, Hang/A-2558-2012; Levine, Rodney/D-9885-2011 FU National Institutes of Health (NIH) [T32 AG021890-05, R37AG026557]; San Antonio Nathan Shock Center for Excellence in the Basic Biology of Aging; National Heart, Lung, and Blood Institute FX We thank Jay Cox, Marian Sabia, and Quy Fung for assistance in animal care. We also thank Dr. James Harper for statistical analysis assistance and intellectual discourse. This study was supported by National Institutes of Health (NIH) training grant T32 AG021890-05 (A. B. S.), NIH MERIT grant R37AG026557 (A. R.), the San Antonio Nathan Shock Center for Excellence in the Basic Biology of Aging (A.R.), and the Intramural Research Program of the National Heart, Lung, and Blood Institute (G.K., H.Z., and R.L.L.). NR 44 TC 63 Z9 65 U1 0 U2 4 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD OCT PY 2009 VL 23 IS 10 BP 3601 EP 3608 DI 10.1096/fj.08-127415 PG 8 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 501BQ UT WOS:000270354300036 PM 19487311 ER PT J AU Byers, AL Bruce, ML Yaffe, K AF Byers, A. L. Bruce, M. L. Yaffe, K. TI PREVALENCE AND CORRELATES OF SUICIDALITY IN COMMUNITY-DWELLING OLDER ADULTS: THE NATIONAL COMORBIDITY SURVEY REPLICATION SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Byers, A. L.; Yaffe, K.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Byers, A. L.; Yaffe, K.] San Francisco VA Med Ctr, San Francisco, CA USA. [Bruce, M. L.] Weill Cornell Med Coll, White Plains, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 41 EP 41 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UI UT WOS:000271793900188 ER PT J AU Clemens, P Sae-Chew, P Niizawa, G AF Clemens, P. Sae-Chew, P. Niizawa, G. TI MOLECULAR PATHOGENESIS OF AND NOVEL TREATMENT APPROACHES TO CANCER CACHEXIA IN MURINE MODELS SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Clemens, P.; Sae-Chew, P.; Niizawa, G.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Clemens, P.; Sae-Chew, P.; Niizawa, G.] Univ Pittsburgh, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 64 EP 65 PG 2 WC Gerontology SC Geriatrics & Gerontology GA 519UI UT WOS:000271793900305 ER PT J AU Bamman, MM AF Bamman, M. M. TI ROLE OF SATELLITE CELLS IN AGE-RELATED MUSCLE REGENERATION IMPAIRMENT SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Bamman, M. M.] Birmingham VA Med Ctr, GRECC & Physiol & Biophys, Birmingham, AL USA. [Bamman, M. M.] Univ Alabama, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 65 EP 65 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UI UT WOS:000271793900307 ER PT J AU Leggett, AN Zarit, SH Duda, JE Galvin, JE Kaufer, DI Lippa, CF Taylor, A AF Leggett, A. N. Zarit, S. H. Duda, J. E. Galvin, J. E. Kaufer, D. I. Lippa, C. F. Taylor, A. TI ROLE STRAIN, PERSONAL STRAIN, AND WORRY ABOUT PERFORMANCE AMONG CAREGIVERS OF PEOPLE WITH LEWY BODY DEMENTIA SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Leggett, A. N.; Zarit, S. H.] Penn State Univ, State Coll, PA USA. [Duda, J. E.] Univ Penn, Philadelphia, PA 19104 USA. [Duda, J. E.] Vet Affairs Med Ctr, Philadelphia, PA USA. [Galvin, J. E.] Washington Univ, St Louis, MO USA. [Kaufer, D. I.] Univ N Carolina, Chapel Hill, NC USA. [Lippa, C. F.] Drexel Univ, Coll Med, Philadelphia, PA 19104 USA. [Taylor, A.] Lewy Body Dementia Assoc, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 80 EP 80 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UI UT WOS:000271793900377 ER PT J AU Weston, AL Costa, P Simonsick, E Ayonayon, HN Harris, T Rosano, C Satterfield, S Yaffe, K AF Weston, A. L. Costa, P. Simonsick, E. Ayonayon, H. N. Harris, T. Rosano, C. Satterfield, S. Yaffe, K. TI THE ASSOCIATION OF PERSONALITY DOMAINS AND COGNITIVE FUNCTION: FINDINGS FROM THE HEALTH ABC STUDY SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Weston, A. L.; Yaffe, K.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Costa, P.; Simonsick, E.; Harris, T.] NIA, Baltimore, MD 21224 USA. [Rosano, C.] Univ Pittsburgh, Sch Publ Hlth, Pittsburgh, PA 15260 USA. [Satterfield, S.] Univ Tennessee, Ctr Hlth Sci, Memphis, TN 38163 USA. [Weston, A. L.] San Francisco VA Med Ctr, San Francisco, CA USA. [Ayonayon, H. N.; Yaffe, K.] Univ Calif San Francisco Epidemiol & Biostat, San Francisco, CA USA. [Yaffe, K.] Univ Calif San Francisco Neurol, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 92 EP 92 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UI UT WOS:000271793900433 ER PT J AU Espinoza, S Jung, I Hazuda, H AF Espinoza, S. Jung, I. Hazuda, H. TI IS THERE AN ETHNIC DISPARITY IN MORTALITY BETWEEN OLDER MEXICAN AMERICANS AND EUROPEAN AMERICANS? SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Espinoza, S.; Jung, I.; Hazuda, H.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Espinoza, S.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 166 EP 166 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UI UT WOS:000271793900785 ER PT J AU Crowe, M Clay, OJ Sartori, AC Wadley, VG Andel, R Sawyer, P Allman, R AF Crowe, M. Clay, O. J. Sartori, A. C. Wadley, V. G. Andel, R. Sawyer, P. Allman, R. TI DIABETES AND COGNITIVE DECLINE IN OLDER AFRICAN AMERICANS AND WHITES SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Wadley, V. G.; Sawyer, P.; Allman, R.] Univ Alabama, Div Gerontol Geriatr & Palliat Care, Birmingham, AL USA. [Allman, R.] Birmingham VA Med Ctr, Birmingham, AL USA. [Andel, R.] Univ S Florida, Tampa, FL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 192 EP 192 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UI UT WOS:000271793900908 ER PT J AU Clay, OJ Crowe, M Crowther, M Sawyer, P Allman, R AF Clay, O. J. Crowe, M. Crowther, M. Sawyer, P. Allman, R. TI USE OF THE GERIATRIC DEPRESSION SCALE IN AFRICAN AMERICAN AND CAUCASIAN MEDICARE BENEFICIARIES SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Clay, O. J.; Crowe, M.] Univ Alabama, Dept Psychol, Birmingham, AL 35294 USA. [Crowther, M.] Univ Alabama, Dept Psychol, Tuscaloosa, AL 35487 USA. [Sawyer, P.; Allman, R.] UAB, Div Gerontol Geriatr & Palliat Care, Birmingham, AL USA. [Allman, R.] Birmingham VA Med Ctr, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 235 EP 235 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UK UT WOS:000271794100142 ER PT J AU Faulkner, K Studenski, S Scheier, M Morse, J Coday, M Simonsick, E Yaffe, K Cauley, JA AF Faulkner, K. Studenski, S. Scheier, M. Morse, J. Coday, M. Simonsick, E. Yaffe, K. Cauley, J. A. TI DOES CONSCIENTIOUSNESS PROTECT AGAINST RECURRING FALLS IN OLDER MEN? SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Faulkner, K.; Studenski, S.; Morse, J.; Cauley, J. A.] Univ Pittsburgh, Pittsburgh, PA USA. [Scheier, M.] Carnegie Mellon Univ, Pittsburgh, PA 15213 USA. [Coday, M.] Univ Tennessee, Ctr Hlth Sci, Memphis, TN 38163 USA. [Simonsick, E.] NIA, Clin Res Branch, Baltimore, MD 21224 USA. [Yaffe, K.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Yaffe, K.] San Francisco VA Med Ctr, San Francisco, CA USA. RI Cauley, Jane/N-4836-2015 OI Cauley, Jane/0000-0003-0752-4408 NR 0 TC 0 Z9 0 U1 1 U2 1 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 244 EP 244 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UK UT WOS:000271794100188 ER PT J AU White, AR Snow, A Kunik, ME Beck, C Karner, T AF White, A. R. Snow, A. Kunik, M. E. Beck, C. Karner, T. TI BARRIERS TO PAIN MANAGEMENT FOR PERSONS WITH SEVERE DEMENTIA IN THE NURSING HOME SO GERONTOLOGIST LA English DT Meeting Abstract C1 [White, A. R.] Birmingham VA Med Ctr, Birmingham, AL USA. [White, A. R.] Univ Alabama, Birmingham, AL USA. [Snow, A.] Univ Alabama, Tuscaloosa, AL USA. [Snow, A.] Tuscaloosa VA Med Ctr, Tuscaloosa, AL USA. [Karner, T.] Univ Houston, Houston, TX USA. [Kunik, M. E.] Michael E DeBakey VA Med Ctr, Houston, TX USA. [Snow, A.; Kunik, M. E.] Baylor Coll Med, Houston, TX 77030 USA. [Beck, C.] Univ Arkansas Med Sci, Little Rock, AR 72205 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 267 EP 267 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UK UT WOS:000271794100296 ER PT J AU Buracchio, T Mattek, NC Hayes, T Kaye, J AF Buracchio, T. Mattek, N. C. Hayes, T. Kaye, J. TI WALKING CHARACTERISTICS ON THE 5 DAYS BEFORE AND AFTER A FALL: NO HARM, NO FOUL, NO CHANGE? SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Buracchio, T.; Mattek, N. C.; Hayes, T.; Kaye, J.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Buracchio, T.; Kaye, J.] Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 274 EP 275 PG 2 WC Gerontology SC Geriatrics & Gerontology GA 519UK UT WOS:000271794100330 ER PT J AU Harvath, TA Young, HM Lee, L AF Harvath, T. A. Young, H. M. Lee, L. TI POST-MASTERS CERTIFICATE OPTION IN ADVANCED PRACTICE GERONTOLOGICAL NURSING SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Harvath, T. A.] Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR 97201 USA. [Lee, L.] Portland VA Med Ctr, Portland, OR USA. [Young, H. M.] Univ Calif Davis, Davis, CA 95616 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 SU 2 BP 316 EP 316 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UK UT WOS:000271794100528 ER PT J AU Huang, A Moore, E Boyko, E Scholes, D Lin, F Vittinghoff, E Fihn, S AF Huang, A. Moore, E. Boyko, E. Scholes, D. Lin, F. Vittinghoff, E. Fihn, S. TI VAGINAL ATROPHY SYMPTOMS: NATURAL HISTORY AND PREDICTORS IN OLDER WOMEN SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Huang, A.; Lin, F.; Vittinghoff, E.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Moore, E.] Royal Childrens Hosp, Parkville, Vic 3052, Australia. [Boyko, E.] Univ Washington, Seattle, WA 98195 USA. [Boyko, E.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Scholes, D.] Grp Hlth Ctr Hlth Studies, Seattle, WA USA. [Fihn, S.] Dept Vet Affairs, Washington, DC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 BP 420 EP 420 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UL UT WOS:000271794200069 ER PT J AU Wieland, G Boland, R Kinosian, B AF Wieland, G. Boland, R. Kinosian, B. TI THE PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY [PACE]: LENGTH OF ENROLLMENT [LOE] AND REASONS FOR DISENROLLMENT SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Wieland, G.; Boland, R.] Palmetto Hlth Richland, Geriatr Serv, Columbia, SC USA. [Kinosian, B.] CHERP, Philadelphia, PA USA. [Wieland, G.] Univ S Carolina, Sch Med, Columbia, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 BP 425 EP 425 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UL UT WOS:000271794200092 ER PT J AU Williams, BR Sawyer, P Allman, R AF Williams, B. R. Sawyer, P. Allman, R. TI TIL DEATH DO US PART: SOCIODEMOGRAPHIC, HEALTH AND FUNCTION CORRELATES OF TIME SINCE SPOUSAL LOSS SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Williams, B. R.; Sawyer, P.; Allman, R.] UAB, Birmingham, AL USA. [Williams, B. R.; Allman, R.] Birmingham VAMC, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 BP 437 EP 438 PG 2 WC Gerontology SC Geriatrics & Gerontology GA 519UL UT WOS:000271794200149 ER PT J AU Mavandadi, S Oslin, DW AF Mavandadi, S. Oslin, D. W. TI SOCIAL EXCHANGES AND SUICIDAL IDEATION AMONG OLDER VETERANS WITH BEHAVIORAL HEALTH ISSUES SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Mavandadi, S.; Oslin, D. W.] Philadelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. [Oslin, D. W.] Univ Penn, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 BP 486 EP 486 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UL UT WOS:000271794200382 ER PT J AU Kramer, B Vivrette, R Martin, J Rubenstein, LZ AF Kramer, B. Vivrette, R. Martin, J. Rubenstein, L. Z. TI DEVELOPMENT OF A FALL RISK SELF-ASSESSMENT FOR SENIORS SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Kramer, B.; Vivrette, R.; Martin, J.; Rubenstein, L. Z.] VA Greater Angeles Healthcare Syst, Los Angeles, CA USA. [Kramer, B.; Martin, J.; Rubenstein, L. Z.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Kramer, B.; Rubenstein, L. Z.] Fall Prevent Ctr Excellence, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 BP 497 EP 497 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UL UT WOS:000271794200432 ER PT J AU Espinoza, S Pierce, A Shamsi, K Halade, D Richardson, A AF Espinoza, S. Pierce, A. Shamsi, K. Halade, D. Richardson, A. TI A COMPARATIVE GLYCOPROTEOMICS APPROACH TO FRAILTY USING LECTIN AFFINITY CHROMATOGRAPHY: A PILOT STUDY SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Espinoza, S.; Pierce, A.; Shamsi, K.; Halade, D.; Richardson, A.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Espinoza, S.; Pierce, A.; Richardson, A.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. RI Pierce, Anson/D-1079-2012 OI Pierce, Anson/0000-0002-1383-0180 NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 BP 499 EP 499 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UL UT WOS:000271794200439 ER PT J AU Hanlon, JT Castle, N Stone, RA Handler, S Semla, T Pugh, M Berlowitz, D Dysken, M AF Hanlon, J. T. Castle, N. Stone, R. A. Handler, S. Semla, T. Pugh, M. Berlowitz, D. Dysken, M. TI POTENTIAL UNDERUSE OF ANTIDEPRESSANTS IN OLDER VETERAN NURSING HOME PATIENTS SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Hanlon, J. T.; Castle, N.; Stone, R. A.; Handler, S.] UPITT, Pittsburgh, PA USA. [Hanlon, J. T.; Stone, R. A.; Handler, S.] Pittsburgh VA, Pittsburgh, PA USA. [Pugh, M.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Semla, T.] VA PBM, Hines, IL USA. [Berlowitz, D.] Edith Nourse Rogers VA Mem Hospital, Bedford, MA USA. [Dysken, M.] Minneapolis VA, Minneapolis, MN USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD OCT PY 2009 VL 49 BP 500 EP 500 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 519UL UT WOS:000271794200443 ER PT J AU Chapko, MK Liu, CF Perkins, M Li, YF Fortney, JC Maciejewski, ML AF Chapko, Michael K. Liu, Chuan-Fen Perkins, Mark Li, Yu-Fang Fortney, John C. Maciejewski, Matthew L. TI EQUIVALENCE OF TWO HEALTHCARE COSTING METHODS: BOTTOM-UP AND TOP-DOWN SO HEALTH ECONOMICS LA English DT Article DE economics; cost; measurement; activity-based costing; relative value units ID DECISION-SUPPORT-SYSTEM; AVERAGE COST; VA; EXPENDITURES; AGREEMENT; HOSPITALS; STAYS AB This paper compares two quite different approaches to estimating costs: a 'bottom-up' approach. represented by the US Department of Veterans Affairs' (VA) Decision Support System that uses local costs of specific inputs; and a 'top-down' approach, represented by the costing system created by the VA Health Economics Resource Center. which assigns the VA national healthcare budget to specific products using various weighting systems. Total annual costs per patient plus the cost for specific services (e.g. clinic visit, radiograph, laboratory, inpatient admission) were compared using scatterplots, correlations. mean difference, and standard deviation of individual differences. Analysis are based upon 2001 costs for 14915 patients at 72 facilities. Correlations ranged from 0.24 for the cost of outpatient encounters to 0.77 for the cost of inpatient admissions. and 0.85 for total annual cost. The mean difference between costing methods was $707 ($4168 versus $3461) for total annual cost. The standard deviation of the individual differences was $5934. Overall, the agreement between the two costing systems varied by the specific cost being measured and increased with aggregation. Administrators and researchers conducting cost analyses need to carefully consider the purpose, methods, characteristics, strengths. and weaknesses when selecting a method for assessing cost. Copyright (C) 2008 John Wiley & Sons, Ltd. C1 [Chapko, Michael K.; Liu, Chuan-Fen; Perkins, Mark; Li, Yu-Fang] VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98108 USA. [Chapko, Michael K.; Liu, Chuan-Fen] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. [Li, Yu-Fang] Univ Washington, Sch Nursing, Seattle, WA 98195 USA. [Fortney, John C.] Cent Arkansas Vet Healthcare Syst, Hlth Serv Res & Dev, Ctr Mental Hlth & Outcomes Res, N Little Rock, AR USA. [Fortney, John C.] Univ Arkansas Med Sci, Dept Psychiat, Div Hlth Serv Res, Coll Med, Little Rock, AR 72205 USA. [Maciejewski, Matthew L.] Durham VA Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC USA. [Maciejewski, Matthew L.] Univ N Carolina, Sch Pharm, Div Pharmaceut Outcomes & Policy, Chapel Hill, NC USA. RP Chapko, MK (reprint author), VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev 152, 1660 S Columbian Way, Seattle, WA 98108 USA. EM michael.chapko@va.gov FU Health Services Research and Development Services; Department of Veterans Affairs [IIR 20-005]; Department of Veterans Affairs; University of Washington; University of Arkansas for Medical Sciences; University of North Carolina FX This study was funded by Health Services Research and Development Services, Department of Veterans Affairs (IIR 20-005). The views expressed herein are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs, the University of Washington, the University of Arkansas for Medical Sciences, or the University of North Carolina. NR 29 TC 42 Z9 43 U1 1 U2 18 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1057-9230 J9 HEALTH ECON JI Health Econ. PD OCT PY 2009 VL 18 IS 10 BP 1188 EP 1201 DI 10.1002/hec.1422 PG 14 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 496BD UT WOS:000269942100007 PM 19097041 ER PT J AU Xu, J Verlinsky, A Lugea, A She, HY Mkrtchyan, H Ueno, A Cooper, M Tsukamoto, H AF Xu, Jun Verlinsky, Alla Lugea, Aurelia She, Hongyun Mkrtchyan, Hasmik Ueno, Akiko Cooper, Marcus Tsukamoto, Hidekazu TI MODERATE OBESITY AND ALCOHOL, TWO HITS ON MITOCHONDRIA AGGRAVATE STEATOHEPATITIS IN MICE SO HEPATOLOGY LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY OCT 30-NOV 03, 2009 CL Boston, MA SP Amer Assoc Study Liver Dis C1 [Xu, Jun; Verlinsky, Alla; She, Hongyun; Mkrtchyan, Hasmik; Ueno, Akiko; Tsukamoto, Hidekazu] Univ So Calif, Keck Sch Med, So Calif Res Ctr ALPD & Cirrhosis, Los Angeles, CA 90033 USA. [Cooper, Marcus] Univ Massachusetts, Sch Med, Div Cardiovasc Med, Worcester, MA USA. [Lugea, Aurelia; Tsukamoto, Hidekazu] Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2009 VL 50 IS 4 MA 52 BP 326A EP 327A PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502JV UT WOS:000270456000053 ER PT J AU Zhu, NL Wang, JH Lai, KK Asahina, K Tsukamoto, H AF Zhu, Nian-Ling Wang, Jiaohong Lai, Keane K. Asahina, Kinji Tsukamoto, Hidekazu TI NECDIN CROSS-TALKS WITH CANONICAL WNT AND SHH PATHWAYS AND CONTRIBUTES TO ANTI-ADIPOGENIC TRANS-DIFFERENTIATION OF HEPATIC STELLATE CELLS SO HEPATOLOGY LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY OCT 30-NOV 03, 2009 CL Boston, MA SP Amer Assoc Study Liver Dis C1 [Zhu, Nian-Ling; Wang, Jiaohong; Lai, Keane K.; Asahina, Kinji; Tsukamoto, Hidekazu] Univ So Calif, Keck Sch Med, So Calif Res Ctr ALPD & Cirrhosis, Los Angeles, CA 90033 USA. [Tsukamoto, Hidekazu] Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2009 VL 50 IS 4 MA 127 BP 364A EP 364A PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502JV UT WOS:000270456000128 ER PT J AU Ryan, JC Lehil, M Kim, MS Duh, FM Martin, M George, S Kennedy, AE Yee, RM Tracy, D Cozen, M Carrington, M Monto, A AF Ryan, James C. Lehil, Mandeep Kim, Michael S. Duh, Fuh-Mei Martin, Maureen George, Sally Kennedy, Alan E. Yee, Russell M. Tracy, Daniel Cozen, Myrna Carrington, Mary Monto, Alexander TI NK CELL KIR CONTROL DIVERGENT OUTCOMES IN HEPATITIS C VIRUS INFECTION SO HEPATOLOGY LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY OCT 30-NOV 03, 2009 CL Boston, MA SP Amer Assoc Study Liver Dis C1 [Ryan, James C.; Lehil, Mandeep; Kim, Michael S.; George, Sally; Kennedy, Alan E.; Yee, Russell M.; Tracy, Daniel; Cozen, Myrna; Monto, Alexander] San Francisco VA Med Ctr, San Francisco, CA USA. [Ryan, James C.; Kim, Michael S.; Cozen, Myrna; Monto, Alexander] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Duh, Fuh-Mei; Martin, Maureen; Carrington, Mary] NCI, Frederick, MD 21701 USA. NR 0 TC 0 Z9 0 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 OCT PY 2009 VL 50 IS 4 MA 176 BP 386A EP 386A PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502JV UT WOS:000270456000177 ER PT J AU Groessl, EJ Weingart, KR Gifford, AL Asch, S Ho, SB AF Groessl, Erik J. Weingart, Kimberly R. Gifford, Allen L. Asch, Steven Ho, Samuel B. TI SELF-MANAGEMENT INTERVENTIONS FOR VETERANS WITH HEPATITIS C SO HEPATOLOGY LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY OCT 30-NOV 03, 2009 CL Boston, MA SP Amer Assoc Study Liver Dis C1 [Groessl, Erik J.; Weingart, Kimberly R.; Ho, Samuel B.] VA San Diego, HSR&D, San Diego, CA USA. [Groessl, Erik J.; Ho, Samuel B.] Univ Calif San Diego, La Jolla, CA 92093 USA. [Asch, Steven] W Los Angeles VA, Los Angeles, CA USA. [Gifford, Allen L.] Bedford VA, Bedford, MA USA. [Gifford, Allen L.] Boston Univ, Boston, MA 02215 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2009 VL 50 IS 4 MA 734 BP 648A EP 649A PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502JV UT WOS:000270456000733 ER PT J AU Naugler, WE Sonnenberg, A AF Naugler, Willscott E. Sonnenberg, Amnon TI MODELS OF INFLUENCE IN CHRONIC LIVER DISEASE SO HEPATOLOGY LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY OCT 30-NOV 03, 2009 CL Boston, MA SP Amer Assoc Study Liver Dis C1 [Naugler, Willscott E.; Sonnenberg, Amnon] Oregon Hlth & Sci Univ, Med GI & Hepatol, Portland, OR 97201 USA. [Sonnenberg, Amnon] Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2009 VL 50 IS 4 MA 746 BP 654A EP 654A PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502JV UT WOS:000270456000745 ER PT J AU Utzschneider, KM Kowdley, KV Yeh, MM Kahn, SE AF Utzschneider, Kristina M. Kowdley, Kris V. Yeh, Matthew M. Kahn, Steven E. TI SITES OF INSULIN RESISTANCE IN OBESE NON-DIABETIC SUBJECTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) SO HEPATOLOGY LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY OCT 30-NOV 03, 2009 CL Boston, MA SP Amer Assoc Study Liver Dis C1 [Utzschneider, Kristina M.; Kahn, Steven E.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Utzschneider, Kristina M.; Kowdley, Kris V.; Yeh, Matthew M.; Kahn, Steven E.] Univ Washington, Seattle, WA 98195 USA. [Kowdley, Kris V.] Virginia Mason Med Ctr, Benaroya Res Inst, Seattle, WA 98101 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2009 VL 50 IS 4 MA 989 BP 769A EP 769A PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502JV UT WOS:000270456000987 ER PT J AU Davis, GL Alter, MJ El-Serag, HB Poynard, T Jennings, LW AF Davis, Gary L. Alter, Miriam J. El-Serag, Hashem B. Poynard, Thierry Jennings, Linda W. TI AGING OF HEPATITIS C INFECTED PERSONS IN THE UNITED STATES: A MULTIPLE COHORT MODEL OF HCV PREVALENCE AND DISEASE PROGRESSION SO HEPATOLOGY LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY OCT 30-NOV 03, 2009 CL Boston, MA SP Amer Assoc Study Liver Dis C1 [Davis, Gary L.; Jennings, Linda W.] Baylor Univ Hosp Dallas, Div Hepatol Liver Transplant, Dallas, TX USA. [Alter, Miriam J.] Univ Texas Med Branch, Infect Dis Epidemiol Program, Galveston, TX USA. [El-Serag, Hashem B.] Baylor Coll Med, Dept Med, Houston, TX 77030 USA. [El-Serag, Hashem B.] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. [Poynard, Thierry] Hepato Gastro Grp Hosp, Paris, France. NR 0 TC 0 Z9 0 U1 2 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 OCT PY 2009 VL 50 IS 4 MA 1613 BP 1050A EP 1051A PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502JV UT WOS:000270456001608 ER PT J AU Rodriguez-Torres, M Brau, N Rodriguez-Orengo, JF Ortiz-Lasanta, G Segarra-Alonso, O Marxuach, AM AF Rodriguez-Torres, Maribel Brau, Norbert Rodriguez-Orengo, Jose F. Ortiz-Lasanta, Grisell Segarra-Alonso, Omar Marxuach, Acisclo M. TI SEVERITY OF LIVER STEATOSIS AFFECTS PROGRESSION OF DISEASE IN MONOINFECTED PATIENTS BUT NOT IN HCV/HIV CO-INFECTED PATIENTS SO HEPATOLOGY LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY OCT 30-NOV 03, 2009 CL Boston, MA SP Amer Assoc Study Liver Dis C1 [Rodriguez-Torres, Maribel; Rodriguez-Orengo, Jose F.; Ortiz-Lasanta, Grisell; Segarra-Alonso, Omar; Marxuach, Acisclo M.] Fdn Invest Diego, Santurce, PR USA. [Rodriguez-Torres, Maribel] Ponce Sch Med, Ponce, PR USA. [Brau, Norbert] Bronx Vet Affairs Med Ctr, New York, NY USA. [Brau, Norbert] Mt Sinai Sch Med, New York, NY USA. [Rodriguez-Orengo, Jose F.] UPR Sch Med, Dept Biochem, San Juan, PR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2009 VL 50 IS 4 MA 1633 BP 1060A EP 1060A PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502JV UT WOS:000270456001628 ER PT J AU Gastaldelli, A Harrison, SA Belfort-Aguilar, R Hardies, LJ Balas, B Schenker, S Cusi, K AF Gastaldelli, Amalia Harrison, Stephen A. Belfort-Aguilar, Renata Hardies, Lou Jean Balas, Bogdan Schenker, Steven Cusi, Kenneth TI Importance of Changes in Adipose Tissue Insulin Resistance to Histological Response During Thiazolidinedione Treatment of Patients with Nonalcoholic Steatohepatitis SO HEPATOLOGY LA English DT Article ID FATTY LIVER-DISEASE; PLACEBO-CONTROLLED TRIAL; PPAR-GAMMA; NONDIABETIC SUBJECTS; DIABETES-MELLITUS; HEPATIC STEATOSIS; HEALTHY-SUBJECTS; ACID METABOLISM; GENE-EXPRESSION; IN-VIVO AB Pioglitazone treatment improves insulin resistance (IR), glucose metabolism, hepatic steatosis, and necroinflammation in patients with nonalcoholic steatohepatitis (NASH). Because abnormal lipid metabolism/elevated plasma free fatty acids (FFAs) are important to the pathophysiology of NASH, we examined the impact of pioglitazone therapy on adipose tissue insulin resistance (Adipo-IR) during the treatment of patients with NASH. To this end, we assessed glucose/lipid metabolism in 47 patients with impaired glucose tolerance/type 2 diabetes mellitus and NASH and 20 nondiabetic controls. All individuals underwent a 75-g oral glucose tolerance test (OGTT) in which we measured glucose tolerance, IR, and suppression of plasma FFAs. We also measured Adipo-IR index (fasting, FFAs X insulin), hepatic fat by magnetic resonance spectroscopy, and liver histology (liver biopsy). Patients were randomized (double-blind) to diet plus pioglitazone (45 mg/day) or placebo for 6 months, and all measurements were repeated. We found that patients with NASH had severe Adipo-IR and low adiponectin levels. Fasting FFAs were increased and their suppression during the OGTT was impaired. Adipo-IR was strongly associated with hepatic fat (r=0.54) and reduced glucose clearance both fasting (r=0.34) and during the OGTT (r=0.40, all P<0.002). Pioglitazone significantly improved glucose tolerance and glucose clearance, steatosis and necroinflammation (all P<0.01-0.001 versus placebo). Fasting/postprandial plasma FFAs decreased to levels of controls with pioglitazone (P<0.02 versus placebo). Adipo-IR decreased by 47% and correlated with the reduction of hepatic fat (r=0.46, P=0.009) and with the reduction in hepatic necroinflammation (r=0.47, P=0.0007). Conclusion: Patients with NASH have severe Adipo-IR independent of the degree of obesity. Amelioration of Adipo-IR by pioglitazone is closely related to histological improvement and plays an important role during treatment of patients with NASH. (HEPATOLOGY 2009;50:1087-1093.) C1 [Gastaldelli, Amalia] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Diabet Div, Audie L Murphy Vet Adm Med Ctr, San Antonio, TX 78248 USA. [Hardies, Lou Jean] Univ Texas Hlth Sci Ctr San Antonio, Dept Radiol, Res Imaging Ctr, San Antonio, TX 78248 USA. [Schenker, Steven] Univ Texas Hlth Sci Ctr San Antonio, Div Gastroenterol, San Antonio, TX 78248 USA. [Gastaldelli, Amalia] CNR, Fdn G Monasterio, Pisa, Italy. [Harrison, Stephen A.] Brooke Army Med Ctr, Div Gastroenterol, San Antonio, TX USA. RP Cusi, K (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Diabet Div, Audie L Murphy Vet Adm Med Ctr, San Antonio, TX 78248 USA. EM cusi@uthscsa.edu RI Hardies, Lou /F-2102-2010; Gastaldelli, Amalia/H-3319-2014 OI Gastaldelli, Amalia/0000-0003-2594-1651 FU NCATS NIH HHS [UL1 TR000149]; NCRR NIH HHS [UL 1RR025767, UL1 RR025767] NR 50 TC 99 Z9 102 U1 0 U2 3 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2009 VL 50 IS 4 BP 1087 EP 1093 DI 10.1002/hep.23116 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502JU UT WOS:000270455800015 PM 19670459 ER PT J AU Malandraki, GA Sutton, BP Perlman, AL Karampinos, DC Conway, C AF Malandraki, Georgia A. Sutton, Bradley P. Perlman, Adrienne L. Karampinos, Dimitrios C. Conway, Charles TI Neural Activation of Swallowing and Swallowing-Related Tasks in Healthy Young Adults: An Attempt to Separate the Components of Deglutition SO HUMAN BRAIN MAPPING LA English DT Review DE neuroimaging; swallowing; fMRI; deglutition; neurophysiology ID SUPPLEMENTARY MOTOR AREA; CEREBRAL CORTICAL REPRESENTATION; POSITRON-EMISSION-TOMOGRAPHY; PRIMARY SOMATOSENSORY CORTEX; ANTERIOR CINGULATE CORTEX; EVENT-RELATED FMRI; FUNCTIONAL NEUROANATOMY; TONGUE MOVEMENT; COUGH REFLEX; INTERINDIVIDUAL VARIABILITY AB Understanding the underlying neural pathways that govern the highly complex neuromuscular action of swallowing is considered crucial in the process of correctly identifying and treating swallowing disorders. The aim of the present investigation was to identify the neural activations of the different components of deglutition in healthy young adults using functional magnetic resonance imaging (fMRI). Ten right-handed young healthy individuals were scanned in a 3-Tesla Siemens Allegra MRI scanner. Participants were visually cued for both a "Swallow" task and for component/control tasks ("Prepare to swallow", "Tap Your tongue", and "Clear Your throat") in a randomized order (event-related design). Behavioral interleaved gradient (BIG) methodology was used to address movement-related artifacts. Areas activated during each of the three component tasks enabled a partial differentiation of the neural localization for various components of the swallow. Areas that were more activated during throat clearing than other components included the posterior insula and small portions of the post- and pre-central gyri bilaterally. Tongue tapping showed higher activation in portions of the primary sensorimotor and premotor cortices and the parietal lobules. Planning did not show any areas that were more activated than in the other component tasks. When swallowing was compared with all other tasks, there was significantly more activation in the cerebellum, thalamus, cigulate gyrus, and all areas of the primary sensorimotor cortex bilaterally. Hum Brain Mapp 30:3209-3226, 2009. (C) 2009 Wiley-Liss, Inc. C1 [Malandraki, Georgia A.; Perlman, Adrienne L.] Univ Illinois, Dept Speech & Hearing Sci, Urbana, IL 61801 USA. [Sutton, Bradley P.; Conway, Charles] Univ Illinois, Dept Bioengn, Urbana, IL 61801 USA. [Karampinos, Dimitrios C.] Univ Illinois, Dept Mech Engn, Urbana, IL 61801 USA. RP Malandraki, GA (reprint author), William S Middleton Mem Vet Adm Med Ctr, Madison 2500 Overlook Terrace,GRECC-11G, Madison, WI 53705 USA. EM gmaland@medicine.wisc.edu RI Sutton, Bradley/A-4801-2008; Karampinos, Dimitrios/A-5994-2011 OI Sutton, Bradley/0000-0002-8443-0408; Karampinos, Dimitrios/0000-0003-4922-3662 FU Biomedical Imaging Center of the Beckman Institute at UIUC FX The authors thank the staff and management of the Biomedical Imaging Center of the Beckman Institute at UIUC. NR 102 TC 47 Z9 51 U1 0 U2 4 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1065-9471 EI 1097-0193 J9 HUM BRAIN MAPP JI Hum. Brain Mapp. PD OCT PY 2009 VL 30 IS 10 BP 3209 EP 3226 DI 10.1002/hbm.20743 PG 18 WC Neurosciences; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging GA 507LB UT WOS:000270853700011 PM 19247994 ER PT J AU Sieh, W Choi, Y Chapman, NH Craig, UK Steinbart, EJ Rothstein, JH Oyanagi, K Garruto, RM Bird, TD Galasko, DR Schellenberg, GD Wijsman, EM AF Sieh, Weiva Choi, Yoonha Chapman, Nicola H. Craig, Ulla-Katrina Steinbart, Ellen J. Rothstein, Joseph H. Oyanagi, Kiyomitsu Garruto, Ralph M. Bird, Thomas D. Galasko, Douglas R. Schellenberg, Gerard D. Wijsman, Ellen M. TI Identification of novel susceptibility loci for Guam neurodegenerative disease: challenges of genome scans in genetic isolates SO HUMAN MOLECULAR GENETICS LA English DT Article ID AMYOTROPHIC-LATERAL-SCLEROSIS; PARKINSONISM-DEMENTIA COMPLEX; MULTIPOINT LINKAGE ANALYSIS; MULTILOCUS GENOTYPE DATA; SIB-PAIR METHOD; NEUROFIBRILLARY TANGLES; ISOLATED POPULATIONS; CLINICAL-FEATURES; ALZHEIMER-DISEASE; LOCATION SCORES AB Amyotrophic lateral sclerosis/parkinsonism-dementia complex (ALS/PDC) is a fatal neurodegenerative disease found in the Chamorro people of Guam and other Pacific Island populations. The etiology is unknown, although both genetic and environmental factors appear important. To identify loci for ALS/PDC, we conducted both genome-wide linkage and association analyses, using approximately 400 microsatellite markers, in the largest sample assembled to date, comprising a nearly complete sample of all living and previously sampled deceased cases. A single, large, complex pedigree was ascertained from a village on Guam, with smaller families and a case-control sample ascertained from the rest of Guam by population-based neurological screening and archival review. We found significant evidence for two regions with novel ALS/PDC loci on chromosome 12 and supportive evidence for the involvement of the MAPT region on chromosome 17. D12S1617 on 12p gave the strongest evidence of linkage (maximum LOD score, Z(max) = 4.03) in our initial scan, with additional support in the complete case-control sample in the form of evidence of allelic association at this marker and another nearby marker. D12S79 on 12q also provided significant evidence of linkage (Z(max) = 3.14) with support from flanking markers. Our results suggest that ALS/PDC may be influenced by as many as three loci, while illustrating challenges that are intrinsic in genetic analyses of isolated populations, as well as analytical strategies that are useful in this context. Elucidation of the genetic basis of ALS/PDC should improve our understanding of related neurodegenerative disorders including Alzheimer disease, Parkinson disease, frontotemporal dementia and ALS. C1 [Sieh, Weiva; Chapman, Nicola H.; Rothstein, Joseph H.; Bird, Thomas D.; Wijsman, Ellen M.] Univ Washington, Div Med Genet, Dept Med, Seattle, WA 98195 USA. [Choi, Yoonha; Wijsman, Ellen M.] Univ Washington, Dept Biostat, Seattle, WA 98195 USA. [Steinbart, Ellen J.; Bird, Thomas D.; Schellenberg, Gerard D.] Univ Washington, Dept Neurol, Seattle, WA 98195 USA. [Schellenberg, Gerard D.] Univ Washington, Dept Med, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. [Schellenberg, Gerard D.] Univ Washington, Dept Pharmacol, Seattle, WA 98195 USA. [Wijsman, Ellen M.] Univ Washington, Dept Genome Sci, Seattle, WA 98195 USA. [Sieh, Weiva] Stanford Univ, Dept Hlth Res & Policy, Div Epidemiol, Stanford, CA 94305 USA. [Craig, Ulla-Katrina] Univ Guam, Micronesian Hlth & Aging Study, Mangilao, GU 96923 USA. [Steinbart, Ellen J.; Bird, Thomas D.; Schellenberg, Gerard D.] Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Seattle, WA 98108 USA. [Oyanagi, Kiyomitsu] Tokyo Metropolitan Inst Neurosci, Dept Neuropathol, Tokyo, Japan. [Garruto, Ralph M.] SUNY Binghamton, Dept Anthropol, Lab Biomed Anthropol & Neurosci, Binghamton, NY 13902 USA. [Galasko, Douglas R.] Univ Calif San Diego, Dept Neurosci, La Jolla, CA 92093 USA. [Schellenberg, Gerard D.] Univ Penn, Dept Pathol & Lab Med, Philadelphia, PA 19104 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 National Institutes of Health [AG14382, AG11762, AG05136, GM46255]; Department of Veterans Affairs FX This work was funded by the National Institutes of Health (AG14382; AG11762; AG05136; and GM46255) and by the Department of Veterans Affairs. NR 95 TC 13 Z9 13 U1 0 U2 0 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 OCT 1 PY 2009 VL 18 IS 19 BP 3725 EP 3738 DI 10.1093/hmg/ddp300 PG 14 WC Biochemistry & Molecular Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Genetics & Heredity GA 505PZ UT WOS:000270707900017 PM 19567404 ER PT J AU Morales, SA Mareninov, S Coulam, P Wadehra, M Goodglick, L Braun, J Gordon, LK AF Morales, Shawn A. Mareninov, Sergey Coulam, Paige Wadehra, Madhuri Goodglick, Lee Braun, Jonathan Gordon, Lynn K. TI Functional Consequences of Interactions between FAK and Epithelial Membrane Protein 2 (EMP2) SO INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE LA English DT Article ID FOCAL ADHESION KINASE; COLLAGEN GEL CONTRACTION; TYROSINE PHOSPHORYLATION; PROLIFERATIVE VITREORETINOPATHY; SURFACE EXPRESSION; GROWTH-FACTOR; TETRASPANIN FUNCTIONS; ADJUNCTIVE TREATMENT; SIGNALING PATHWAYS; SWISS 3T3-CELLS AB PURPOSE. Collagen gel contraction by ARPE-19 is controlled by epithelial membrane protein 2 (EMP2) through focal adhesion kinase (FAK) activation. The purpose of this study was to test the role of EMP2 in the cellular context of FAK activation. METHODS. The ARPE-19 cell line was recombinantly modified to increase the expression of EMP2 and was used in this study. Quantification of FAK and Src phosphorylation was determined with Western blot analysis of whole cell lysates with the use of specific antibodies for different target sites of phosphorylation. Coimmunoprecipitation of whole cell lysates with an antibody against EMP2, followed by Western blot analysis and identification of FAK, was performed. Focal adhesions and their relationship to EMP2 were identified with immunofluorescence and confocal microscopy. F-actin distribution was identified using fluorescence microscopy, and alpha-smooth muscle actin (alpha-SMA) expression was quantified with Western blot analysis and specific antibodies. Adhesion to collagen type I was determined with a binding assay. RESULTS. EMP2 overexpression led to increased FAK phosphorylation at all measured phosphorylation sites. Coimmunoprecipitation and confocal microscopy provided evidence for a physical association between EMP2 and FAK. Increased EMP2 was also associated with altered distribution of focal adhesions, changes in actin organization, increased alpha-SMA expression, and increased adherence to a collagen-coated surface. CONCLUSIONS. The EMP2-FAK association represents a novel protein-protein interaction, not previously reported, that demonstrates significant functional cellular responses in the context of in vitro models of proliferative vitreoretinopathy (PVR). (Invest Ophthalmol Vis Sci. 2009;50:4949-4956) DOI: 10.1167/iovs.08-3315 C1 [Gordon, Lynn K.] Univ Calif Los Angeles, David Geffen Sch Med, Jules Stein Eye Inst, Dept Ophthalmol, Los Angeles, CA 90095 USA. [Morales, Shawn A.; Coulam, Paige; Wadehra, Madhuri; Goodglick, Lee; Braun, Jonathan] Univ Calif Los Angeles, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. [Gordon, Lynn K.] Greater Los Angeles Vet Affairs Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP Gordon, LK (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Jules Stein Eye Inst, Dept Ophthalmol, 100 Stein Plaza, Los Angeles, CA 90095 USA. EM lgordon@ucla.edu OI Braun, Jonathan/0000-0003-1646-2974 FU Veterans Administration Merit Grant; American Health Assistance Foundation; NIH [AI52031, HD48540, EY007026]; Ruzic Foundation FX Supported by Veterans Administration Merit Grant (LKG), the American Health Assistance Foundation (LKG), NIH Grants AI52031 (SAM), HD48540 (JB), and EY007026 (SAM), and the Ruzic Foundation (JB). NR 44 TC 14 Z9 17 U1 0 U2 2 PU ASSOC RESEARCH VISION OPHTHALMOLOGY INC PI ROCKVILLE PA 12300 TWINBROOK PARKWAY, ROCKVILLE, MD 20852-1606 USA SN 0146-0404 EI 1552-5783 J9 INVEST OPHTH VIS SCI JI Invest. Ophthalmol. Vis. Sci. PD OCT PY 2009 VL 50 IS 10 BP 4949 EP 4956 DI 10.1167/iovs.08-3315 PG 8 WC Ophthalmology SC Ophthalmology GA 497XE UT WOS:000270097200056 PM 19494199 ER PT J AU Bedimo, RJ McGinnis, KA Dunlap, M Rodriguez-Barradas, MC Justice, AC AF Bedimo, Roger J. McGinnis, Kathleen A. Dunlap, Melinda Rodriguez-Barradas, Maria C. Justice, Amy C. TI Incidence of Non-AIDS-Defining Malignancies in HIV-Infected Versus Noninfected Patients in the HAART Era: Impact of Immunosuppression SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article; Proceedings Paper CT 17th International AIDS Conference CY AUG 03-08, 2008 CL Mexico City, MEXICO DE AIDS-defining malignancies; HAART; Incidence; non-AIDS-defining malignancies ID HUMAN-IMMUNODEFICIENCY-VIRUS; ACTIVE ANTIRETROVIRAL THERAPY; HUMAN-PAPILLOMAVIRUS INFECTION; NEGATIVE WOMEN; UNITED-STATES; LUNG-CANCER; RISK; COHORT; VETERANS; TRENDS AB Background: The incidence of non-AIDS-defining malignancies (non-ADMs) is reported as unchanged or increasing in the highly active antiretroviral therapy era. Whether incidence of non-ADM is significantly higher in HIV-infected than in HIV-uninfected patients remains unclear. Methods: Incidence rates of malignancies were calculated in a cohort of veterans in care for HIV-infected and age, race, and gender-matched uninfected patients from 1997 to 2004. For HIV-infected patients, CD4 counts closest to first observation date were compared between those with and without cancer. Results: Thirty three thousand four hundred twenty HIV-infected and 66,840 HIV-uninfected patients were followed for a median of 5.1 and 6.4 years. The incidence rate ratio of HIV infected to HIV uninfected was 1.6 (1260 vs. 841 per 100,000 person-years; 95% confidence interval: 1.5 to 1.7). Incidence rate ratio for individual cancers was highest for anal cancer (14.9; confidence interval: 10.1 to 22.1). Among H W-infected patients, median CD4 counts were lower for those with non-ADM (249 vs. 270, P = 0.02), anal cancer (156 vs. 270; P < 0.001), and Hodgkin lymphoma (217 vs. 269; P = 0.03). Prostate cancer was associated with a higher CD4 count (311 vs. 266; P < 0.001). Conclusions: In the highly active antiretroviral therapy era, the incidence of non-ADMs is higher among HIV-infected than HIV-uninfected patients, adjusting for age, race, and gender. Some non-ADMs do not seem to be associated with significantly lower CD4 counts. C1 [Bedimo, Roger J.] UT SW Med Ctr, Dept Med, Vet Affairs N Texas Hlth Care Syst, Dallas, TX 75216 USA. [McGinnis, Kathleen A.] Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Rodriguez-Barradas, Maria C.] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Justice, Amy C.] VA Connecticut Healthcare Syst, Dept Med, West Haven, CT USA. [Justice, Amy C.] Yale Univ, Sch Med, West Haven, CT 06516 USA. [Justice, Amy C.] Yale Univ, Sch Publ Hlth, West Haven, CT 06516 USA. RP Bedimo, RJ (reprint author), UT SW Med Ctr, Dept Med, Vet Affairs N Texas Hlth Care Syst, 4500 S Lancaster Rd, Dallas, TX 75216 USA. EM roger.bedimo@va.gov FU NIAAA NIH HHS [U10 AA013566, 52U10 AA 13566, U10 AA013566-09] NR 33 TC 85 Z9 85 U1 4 U2 7 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 OCT 1 PY 2009 VL 52 IS 2 BP 203 EP 208 PG 6 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 499GQ UT WOS:000270206500006 PM 19617846 ER PT J AU Mularski, RA Munjas, BA Lorenz, KA Sun, S Robertson, SJ Schmelzer, W Kim, AC Shekelle, PG AF Mularski, Richard A. Munjas, Brett A. Lorenz, Karl A. Sun, Su Robertson, Sandra J. Schmelzer, Wendy Kim, Adina C. Shekelle, Paul G. TI Randomized Controlled Trial of Mindfulness-Based Therapy for Dyspnea in Chronic Obstructive Lung Disease SO JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE LA English DT Article ID GEORGES RESPIRATORY QUESTIONNAIRE; STRESS REDUCTION PROGRAM; QUALITY-OF-LIFE; PULMONARY-DISEASE; ALTERNATIVE MEDICINE; UNITED-STATES; MANAGEMENT; HEALTH; SCALES; CANCER AB Objectives: Patients with chronic obstructive lung disease (COPD) suffer from significant dyspnea and may benefit from complementary and alternative medicine (CAM) therapies aimed at mitigating symptoms. The objective of this study was to test the efficacy of a mindfulness-based breathing therapy (MBBT) on improving symptoms and health-related quality of life in those with COPD. Design: We conducted a randomized controlled trial of 8-week mindfulness-based breathing therapy (MBBT) compared to support groups to test efficacy on improving symptoms and health-related quality of life in those with COPD. Setting: The setting for this study was an academic-affiliated veterans healthcare system. Subjects: The subjects consisted of 86 patients with COPD. Interventions: MBBT included weekly meetings practicing mindfulness mediation and relaxation response. Outcome measures: The main outcome measure was a post 6-minute-walk test (6MWT) Borg dyspnea assessment. Other outcome measures included health-related quality of life measures, 6MWT distance, symptom scores, exacerbation rates, and measures of stress and mindfulness. Analysis of covariance compared differences in outcomes between groups; paired t test evaluated changes within groups. Results: Participants were predominantly elderly men with moderate to severe COPD. We found no improvements in dyspnea (post 6MWT Borg difference between the MBBT and support group was 0.3 (95% confidence interval [CI]: -1.1, 1.7). We found no differences between groups in almost all other outcome measures by either intention-to-treat analysis or within the subset that completed assigned group sessions. For the physical summary scale of the generic Short Form-36 for Veterans, the difference between outcomes favored the support group (4.3, 95% CI: 0.4, 8.1). Participant retention was low compared to mind-body trials that randomize from CAM wait lists. Conclusions: This trial found no measurable improvements in patients with COPD receiving a mindfulness-based breathing CAM therapy compared to a support group, suggesting that this intervention is unlikely to be an important therapeutic option for those with moderate-to-severe COPD. C1 [Mularski, Richard A.] Kaiser Permanente NW, Ctr Hlth Res, Portland, OR 97227 USA. [Mularski, Richard A.; Munjas, Brett A.; Lorenz, Karl A.; Sun, Su; Robertson, Sandra J.; Schmelzer, Wendy; Kim, Adina C.; Shekelle, Paul G.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Mularski, RA (reprint author), Kaiser Permanente NW, Ctr Hlth Res, 3800 N Interstate,WIN 1060, Portland, OR 97227 USA. EM Richard.A.Mularski@kpchr.org FU VA HSR&D Career Development Award FX ClinicalTrials.gov Identifier NCT00243282 NR 54 TC 24 Z9 24 U1 2 U2 13 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1075-5535 J9 J ALTERN COMPLEM MED JI J. Altern. Complement Med. PD OCT PY 2009 VL 15 IS 10 BP 1083 EP 1090 DI 10.1089/acm.2009.0037 PG 8 WC Integrative & Complementary Medicine SC Integrative & Complementary Medicine GA 509OP UT WOS:000271027700008 PM 19848546 ER PT J AU Anello, A Reichenberg, A Luo, XD Schmeidler, J Hollander, E Smith, CJ Puleo, CM Kryzak, LA Silverman, JM AF Anello, Alene Reichenberg, Abraham Luo, Xiaodong Schmeidler, James Hollander, Eric Smith, Christopher J. Puleo, Connor M. Kryzak, Lauren A. Silverman, Jeremy M. TI Brief Report: Parental Age and the Sex Ratio in Autism SO JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS LA English DT Article DE Paternal age; Maternal age; Sex ratio; Genetics; Genomic anomalies; Copy number variants ID PERVASIVE DEVELOPMENTAL DISORDERS; PATERNAL-AGE; SPECTRUM DISORDER; RISK; CHROMOSOME; LINKAGE; BIRTH; DAMAGE; LOCI AB The male-to-female (M:F) ratio for autism spectrum disorders (ASD), typically about 4:1, appears to decrease with increasing paternal age, but this relationship has not been systematically tested. With 393 ASD cases from families with two or more ASD cases, we categorized paternal age into five age groups (< 30, 30-34, 35-39, 40-44, 45+) and found that the M:F ratio was significantly decreased with increasing paternal age groups and remained so after also adjusting for maternal age. No significant relationship between maternal age group and the M:F ratio was observed. This study suggests that the M:F ratio is reduced with increasing paternal age consistent with de novo genetic or genomic anomalies arising more frequently as men age and then conceive children. C1 [Reichenberg, Abraham; Luo, Xiaodong; Schmeidler, James; Hollander, Eric; Smith, Christopher J.; Puleo, Connor M.; Kryzak, Lauren A.; Silverman, Jeremy M.] Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. [Silverman, Jeremy M.] James J Peters Vet Affairs Med Ctr, Bronx, NY USA. [Anello, Alene] Harvard Univ, Cambridge, MA 02138 USA. RP Silverman, JM (reprint author), Mt Sinai Sch Med, Dept Psychiat, 1 Gustave L Levy Pl,Box 1230, New York, NY 10029 USA. EM jeremy.silverman@mssm.edu FU NIMH NIH HHS [U54 MH066673-05, MH-066673, MH64547, U54 MH066673, R01 MH064547-05, R01 MH064547] NR 28 TC 19 Z9 19 U1 1 U2 11 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0162-3257 J9 J AUTISM DEV DISORD JI J. Autism Dev. Disord. PD OCT PY 2009 VL 39 IS 10 BP 1487 EP 1492 DI 10.1007/s10803-009-0755-y PG 6 WC Psychology, Developmental SC Psychology GA 495TM UT WOS:000269917900011 PM 19452267 ER PT J AU Watts, NB Lewiecki, EM Bonnick, SL Laster, AJ Binkley, N Blank, RD Geusens, PP Miller, PD Petak, SM Recker, RR Saag, KG Schousboe, J Siris, ES Bilezikian, JP AF Watts, Nelson B. Lewiecki, E. Michael Bonnick, Sydney L. Laster, Andrew J. Binkley, Neil Blank, Robert D. Geusens, Piet P. Miller, Paul D. Petak, Steven M. Recker, Robert R. Saag, Kenneth G. Schousboe, John Siris, Ethel S. Bilezikian, John P. TI Clinical Value of Monitoring BMD in Patients Treated With Bisphosphonates for Osteoporosis SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Article ID BONE-MINERAL DENSITY; FRACTURE INTERVENTION TRIAL; POSTMENOPAUSAL OSTEOPOROSIS; VERTEBRAL FRACTURES; RANDOMIZED-TRIAL; TURNOVER MARKERS; WOMEN; ALENDRONATE; THERAPY; RISK C1 [Watts, Nelson B.] Univ Cincinnati, Bone Hlth & Osteoporosis Ctr, Cincinnati, OH 45219 USA. [Lewiecki, E. Michael] Univ New Mexico, Sch Med, New Mexico Clin Res & Osteoporosis Ctr, Albuquerque, NM 87131 USA. [Bonnick, Sydney L.] Clin Res Ctr N Texas, Denton, TX USA. [Laster, Andrew J.] Univ N Carolina, Sch Med, Chapel Hill, NC USA. [Blank, Robert D.] Univ Wisconsin, Sch Med & Publ Hlth, Dept Med, Sect Endocrinol Diabet & Metab, Madison, WI USA. [Blank, Robert D.] William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI USA. [Geusens, Piet P.] Maastricht Univ, Med Ctr, Dept Internal Med, Subdiv Rheumatol, Maastricht, Netherlands. [Geusens, Piet P.] Univ Hasselt, Biomed Res Inst, Hasselt, Belgium. [Miller, Paul D.] Colorado Ctr Bone Res, Lakewood, CO USA. [Petak, Steven M.] Texas Inst Reprod Med & Endocrinol, Houston, TX USA. [Recker, Robert R.] Creighton Univ, Sch Med, Osteoporosis Res Ctr, Omaha, NE USA. [Saag, Kenneth G.] Univ Alabama Birmingham, Ctr Educ & Res Therapeut Musculoskeletal Disorder, Birmingham, AL USA. [Saag, Kenneth G.] Univ Alabama Birmingham, Div Clin Immunol & Rheumatol, Ctr Outcomes Effectiveness Res & Educ, Birmingham, AL 35294 USA. [Schousboe, John] Univ Minnesota, Div Hlth Pol & Management, Pk Nicollet Hlth Serv, Minneapolis, MN USA. [Siris, Ethel S.] Columbia Univ, Med Ctr, Tony Stabile Osteoporosis Ctr, New York, NY USA. [Bilezikian, John P.] Columbia Univ, Coll Phys & Surg, Dept Med, Div Endocrinol, New York, NY USA. RP Watts, NB (reprint author), Univ Cincinnati, Bone Hlth & Osteoporosis Ctr, 222 Piedmont Rd,Suite 6300, Cincinnati, OH 45219 USA. EM nelson.watts@uc.edu OI Blank, Robert Daniel/0000-0003-2950-1944 FU AHRQ HHS [U18 HS016956] NR 31 TC 29 Z9 30 U1 1 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0884-0431 EI 1523-4681 J9 J BONE MINER RES JI J. Bone Miner. Res. PD OCT PY 2009 VL 24 IS 10 BP 1643 EP 1646 DI 10.1359/JBMR.090818 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 503HC UT WOS:000270523300002 PM 19712042 ER PT J AU Nicosia, RF AF Nicosia, R. F. TI The aortic ring model of angiogenesis: a quarter century of search and discovery SO JOURNAL OF CELLULAR AND MOLECULAR MEDICINE LA English DT Review DE neovascularization; endothelial cells; mural cells; angiogenic factors; integrins; proteolytic enzymes; fibronectin; laminin; collagen; fibrin ID ENDOTHELIAL GROWTH-FACTOR; SMOOTH-MUSCLE-CELLS; ARG-GLY-ASP; 3-DIMENSIONAL EXTRACELLULAR-MATRIX; VASCULAR-PERMEABILITY FACTOR; RECEPTOR TYROSINE KINASES; FACTOR INDUCE EXPRESSION; TOLL-LIKE RECEPTORS; COLLAGEN TYPE-I; RAT AORTA AB The aortic ring model has become one of the most widely used methods to study angiogenesis and its mechanisms. Many factors have contributed to its popularity including reproducibility, cost effectiveness, ease of use and good correlation with in vivo studies. In this system aortic rings embedded in biomatrix gels and cultured under chemically defined conditions generate arborizing vascular outgrowths which can be stimulated or inhibited with angiogenic regulators. Originally based on the rat aorta, the aortic ring model was later adapted to the mouse for the evaluation of specific molecular alterations in genetically modified animals. Viral transduction of the aortic rings has enabled investigators to overexpress genes of interest in the aortic cultures. Experiments on angiogenic mechanisms have demonstrated that formation of neovessels in aortic cultures is regulated by macrophages, pericytes and fibroblasts through a complex molecular cascade involving growth factors, inflammatory cytokines, axonal guidance cues, extracellular matrix (ECM) molecules and matrix-degrading proteolytic enzymes. These studies have shown that endothelial sprouting can be effectively blocked by depleting the aortic explants of macrophages or by interfering with the angiogenic cascade at multiple levels including growth factor signalling, cell adhesion and proteolytic degradation of the ECM. In this paper, we review the literature in this field and retrace the journey from our first morphological descriptions of the aortic outgrowths to the latest breakthroughs in the cellular and molecular regulation of aortic vessel growth and regression. C1 [Nicosia, R. F.] VA Puget Sound Hlth Care Syst, Pathol & Lab Med Serv, Seattle, WA 98108 USA. [Nicosia, R. F.] Univ Washington, Dept Pathol, Seattle, WA 98195 USA. RP Nicosia, RF (reprint author), VA Puget Sound Hlth Care Syst, Pathol & Lab Med Serv S 113, 1660 S Columbian Way, Seattle, WA 98108 USA. EM roberto.nicosia@va.gov RI Perez , Claudio Alejandro/F-8310-2010; Xiao, Yang/B-5668-2012 OI Perez , Claudio Alejandro/0000-0001-9688-184X; FU Smith Charitable Trust; National Institutes of Health [HL52585]; Department of Veterans affairs FX I wish to thank all the postdoctoral fellows, technicians and collaborators who over the years have contributed to our studies on the aortic ring model and whose names are cited in the reference list. I am particularly grateful to Alfred C. Aplin, whose molecular expertise has been essential for the advances we made in recent years and who has graciously helped me with the references and the figures of this paper. I am also indebted to the W.W. Smith Charitable Trust, which funded my first studies, and the National Institutes of Health (HL52585) and the Department of Veterans affairs for their continuous support. NR 247 TC 42 Z9 42 U1 0 U2 7 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1582-1838 J9 J CELL MOL MED JI J. Cell. Mol. Med. PD OCT PY 2009 VL 13 IS 10 BP 4113 EP 4136 DI 10.1111/j.1582-4934.2009.00891.x PG 24 WC Cell Biology; Medicine, Research & Experimental SC Cell Biology; Research & Experimental Medicine GA 551BX UT WOS:000274181900004 PM 19725916 ER PT J AU Stetler, R Cao, G Yanqin, G Zhang, F Wang, S Weng, Z Vosler, P Zhang, L Chen, J AF Stetler, R. Cao, G. Yanqin, G. Zhang, F. Wang, S. Weng, Z. Vosler, P. Zhang, L. Chen, J. TI Critical role of serine-specific phosphorylation in the activation of HSP27 and its neuroprotective effect against ischemic neuronal injury SO JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM LA English DT Meeting Abstract CT 24th International Symposium on Cerebral Blood Flow and Metabolism/9th International Conference on Quantification of Brain Function with PET CY JUN 29-JUL 03, 2009 CL Chicago, IL SP Int Soc Cerebral Blood Flow & Metabolism C1 [Stetler, R.; Cao, G.; Zhang, F.; Wang, S.; Weng, Z.; Vosler, P.; Zhang, L.; Chen, J.] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. [Stetler, R.; Cao, G.; Zhang, F.; Wang, S.; Chen, J.] Vet Affairs Pittsburgh Hlth Care Syst, Educ & Clin Ctr, Pittsburgh, PA USA. [Stetler, R.; Cao, G.; Yanqin, G.; Chen, J.] Fudan Univ, Sch Med, State Key Lab Med Neurobiol, Shanghai 200433, Peoples R China. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0271-678X J9 J CEREBR BLOOD F MET JI J. Cereb. Blood Flow Metab. PD OCT PY 2009 VL 29 BP S440 EP S441 PG 2 WC Endocrinology & Metabolism; Hematology; Neurosciences SC Endocrinology & Metabolism; Hematology; Neurosciences & Neurology GA 500UB UT WOS:000270329900533 ER PT J AU Zhang, F Wang, S Luo, Y Ji, X Memoto, EM Chen, J AF Zhang, F. Wang, S. Luo, Y. Ji, X. Memoto, E. M. Chen, J. TI When hypothermia meets hypotension and hyperglycemia: the diverse effects of adenosine 5 '-monophosphate on cerebral ischemia in rats SO JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM LA English DT Meeting Abstract CT 24th International Symposium on Cerebral Blood Flow and Metabolism/9th International Conference on Quantification of Brain Function with PET CY JUN 29-JUL 03, 2009 CL Chicago, IL SP Int Soc Cerebral Blood Flow & Metabolism ID MILD HYPOTHERMIA C1 [Zhang, F.; Wang, S.; Chen, J.] Univ Pittsburgh, Ctr Cerebrovasc Dis Res, Pittsburgh, PA USA. [Zhang, F.; Chen, J.] Vet Affairs Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. [Luo, Y.; Ji, X.] Capital Med Univ, Xuanwu Hosp, Cerebrovasc Dis Res Inst, Beijing, Peoples R China. [Luo, Y.; Ji, X.] Minist Educ, Key Lab Neurodegenerat Dis, Beijing, Peoples R China. NR 4 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0271-678X J9 J CEREBR BLOOD F MET JI J. Cereb. Blood Flow Metab. PD OCT PY 2009 VL 29 BP S181 EP S182 PG 2 WC Endocrinology & Metabolism; Hematology; Neurosciences SC Endocrinology & Metabolism; Hematology; Neurosciences & Neurology GA 500UB UT WOS:000270329900213 ER PT J AU Wright, MJ Woo, E Schmitter-Edgecombe, M Hinkin, CH Miller, EN Gooding, AL AF Wright, Matthew J. Woo, Ellen Schmitter-Edgecombe, Maureen Hinkin, Charles H. Miller, Eric N. Gooding, Amanda L. TI The Item-Specific Deficit Approach to evaluating verbal memory dysfunction: Rationale, psychometrics, and application SO JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY LA English DT Article DE Memory; Psychometrics; Brain injury; Traumatic brain injury; Human immunodeficiency virus ID TRAUMATIC BRAIN-INJURY; NEUROPSYCHOLOGICAL TEST-PERFORMANCE; HIV-ASSOCIATED DEMENTIA; TEMPORAL-LOBE EPILEPSY; CLOSED-HEAD INJURY; EPISODIC MEMORY; PARKINSONS-DISEASE; LEARNING TEST; LONG-TERM; RETRIEVAL DEFICITS AB In the current study, we introduce the Item-Specific Deficit Approach (ISDA), a novel method for characterizing memory process deficits in list-learning data. To meet this objective, we applied the ISDA to California Verbal Learning Test (CVLT) data collected from a sample of 132 participants (53 healthy participants and 79 neurologically compromised participants). Overall, the ISDA indices measuring encoding, consolidation, and retrieval deficits demonstrated advantages over some traditional indices and indicated acceptable reliability and validity. Currently, the ISDA is intended for experimental use, although further research may support its utility for characterizing memory impairments in clinical assessments. C1 [Wright, Matthew J.; Woo, Ellen; Hinkin, Charles H.; Miller, Eric N.] Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Los Angeles, CA USA. [Woo, Ellen] Univ Calif Los Angeles, Alzheimers Dis Res Ctr, Los Angeles, CA USA. [Schmitter-Edgecombe, Maureen] Washington State Univ, Pullman, WA 99164 USA. [Hinkin, Charles H.; Gooding, Amanda L.] Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Miller, Eric N.] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. RP Wright, MJ (reprint author), Harbor UCLA Med Ctr, 1000 W Carson St,D-2 Annex,5,Box 495, Torrance, CA 90509 USA. EM mwright@labiomed.org OI Miller, Eric/0000-0002-0650-714X FU Marchionne Memorial Doctoral Fellowship (Washington State University); National Institutes of Health [R03 HD35838, R01 NS47690, R01 MH585522, T32 MH019535] FX Special thanks go to Anna Curren and for her assistance. This work was supported by a Marchionne Memorial Doctoral Fellowship (Washington State University) as well as National Institutes of Health funding (R03 HD35838, R01 NS47690, R01 MH585522, and T32 MH019535). Profitable use of the item-specific deficit approach (ISDA) is under the protection of U.S. Patent No. 60/862,837. NR 68 TC 11 Z9 11 U1 3 U2 5 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1380-3395 J9 J CLIN EXP NEUROPSYC JI J. Clin. Exp. Neuropsychol. PD OCT PY 2009 VL 31 IS 7 BP 790 EP 802 DI 10.1080/13803390802508918 PG 13 WC Psychology, Clinical; Clinical Neurology; Psychology SC Psychology; Neurosciences & Neurology GA 500AS UT WOS:000270270000002 PM 19142773 ER PT J AU Richards, JS Peng, J Amdur, RL Mikuls, TR Hooker, RS Michaud, K Reimold, AM Cannon, GW Caplan, L Johnson, D Hines, AE Kerr, GS AF Richards, J. Steuart Peng, Justin Amdur, Richard L. Mikuls, Ted R. Hooker, Roderick S. Michaud, Kaleb Reimold, Andreas M. Cannon, Grant W. Caplan, Liron Johnson, Dannette Hines, Anne E. Kerr, Gail S. TI Dual-Energy X-Ray Absorptiometry and Evaluation of the Osteoporosis Self-Assessment Tool in Men With Rheumatoid Arthritis SO JOURNAL OF CLINICAL DENSITOMETRY LA English DT Article DE Dual-energy X-ray absorptiometry; osteoporosis; Osteoporosis Self-Assessment Tool; rheumatoid arthritis ID ASSESSMENT SCREENING TOOL; AFRICAN-AMERICAN MEN; BONE DENSITOMETRY; BODY-COMPOSITION; RISK; WOMEN; ASSOCIATION; PERFORMANCE; VALIDATION; VETERANS AB Males with rheumatoid arthritis (RA) are at risk for osteoporosis but. infrequently undergo dual-energy X-ray absorptiometry (DXA). We examined the frequency of DXA in males enrolled in the Veterans Affairs Rheumatoid Arthritis Registry. The Osteoporosis Self-Assessment Tool (OST) index, a formula using a-e and weight, was calculated for all subjects. DXA was performed on 282 (35.5%) of the males who were younger (p < 0.01), had lower mean OST index score (p < 0.05), and were more likely to have been prescribed prednisone (p < 0.01) than subjects without DXA. Low bone mass (T-score < -1) was present in 73% of subjects with DXA; 37% of subjects with low-risk OST index scores had normal bone mineral density (BMD) compared with 5.6% of those with high-risk OST index scores (p < 0.01). There was a significant but modest correlation between BMD and the OST index (r = 0.17, p < 0.01). No OST score had a sensitivity and specificity of more than 80%. Association between OST index and BMD was strongest in non-Hispanic whites, subjects older than 60 yr, and smokers. DXA was underutilized in males with RA. The OST index correlated with low bone mass but could not reliably predict osteoporosis in this population. C1 [Richards, J. Steuart; Peng, Justin; Kerr, Gail S.] Washington DC VA Med Ctr, Rheumatol Sect, Washington, DC USA. [Richards, J. Steuart; Peng, Justin; Kerr, Gail S.] Georgetown Univ, Dept Med, Washington, DC USA. [Amdur, Richard L.] Washington DC VA Med Ctr, Res Serv, Washington, DC USA. [Amdur, Richard L.] Georgetown Univ, Dept Psychiat, Washington, DC USA. [Mikuls, Ted R.; Michaud, Kaleb] Omaha VA Med Ctr, Rheumatol Sect, Omaha, NE USA. [Mikuls, Ted R.] Univ Nebraska, Rheumatol Sect, Omaha, NE 68182 USA. [Hooker, Roderick S.; Reimold, Andreas M.] Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA. [Hooker, Roderick S.; Reimold, Andreas M.] VA N Texas Hlth Care Syst, Rheumatol Sect, Dallas, TX USA. [Cannon, Grant W.] Univ Utah, Salt Lake City, UT USA. [Cannon, Grant W.] George E Wahlen VA Med Ctr, Rheumatol Sect, Salt Lake City, UT USA. [Caplan, Liron; Hines, Anne E.] Univ Colorado, Denver, CO 80202 USA. [Caplan, Liron; Hines, Anne E.] Denver VA Med Ctr, Rheumatol Sect, Denver, CO USA. [Johnson, Dannette] Univ Mississippi, Jackson, MI USA. [Johnson, Dannette] MS VA Med Ctr, Jackson, MI USA. RP Richards, JS (reprint author), Vet Affairs Med Ctr, Rheumatol Sect, 151K,50 Irving St NW, Washington, DC 20422 USA. EM john.richards1@va.gov FU Veterans Health Administration; Abbott Laboratories; Bristol-Myers Squibb FX This work and the VARA project are also supported in part by the Health Services Research and Development Program of the Veterans Health Administration and unrestricted support front Abbott Laboratories and Bristol-Myers Squibb. NR 24 TC 4 Z9 4 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1094-6950 J9 J CLIN DENSITOM JI J. Clin. Densitom. PD OCT-DEC PY 2009 VL 12 IS 4 BP 434 EP 440 DI 10.1016/j.jocd.2009.06.003 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 519UG UT WOS:000271793600004 PM 19775920 ER PT J AU Gerchman, F Tong, J Utzschneider, KM Zraika, S Udayasankar, J McNeely, MJ Carr, DB Leonetti, DL Young, BA de Boer, IH Boyko, EJ Fujimoto, WY Kahn, SE AF Gerchman, Fernando Tong, Jenny Utzschneider, Kristina M. Zraika, Sakeneh Udayasankar, Jayalakshmi McNeely, Marguerite J. Carr, Darcy B. Leonetti, Donna L. Young, Bessie A. de Boer, Ian H. Boyko, Edward J. Fujimoto, Wilfred Y. Kahn, Steven E. TI Body Mass Index Is Associated with Increased Creatinine Clearance by a Mechanism Independent of Body Fat Distribution SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID CHRONIC KIDNEY-DISEASE; IMPAIRED GLUCOSE-TOLERANCE; GLOMERULAR-FILTRATION-RATE; JAPANESE-AMERICAN MEN; STAGE RENAL-DISEASE; VISCERAL ADIPOSITY; METABOLIC SYNDROME; INSULIN-RESISTANCE; SEVERE OBESITY; SURFACE AREA AB Context: Although obesity has been, in general, associated with glomerular hyperfiltration, visceral adiposity has been suggested to be associated with reduced glomerular filtration. Objective: The aim of the study was to evaluate the differential effects of obesity and body fat distribution on glomerular filtration. Design and Setting: We conducted a cross-sectional study of the Japanese-American community in Seattle, Washington. Participants: We studied a representative sample of second-generation Japanese-American men and women with normal glucose tolerance (n = 124) and impaired glucose metabolism (impaired fasting glucose and/or impaired glucose tolerance) (n = 144) residing in King County, Washington. Main Outcome Measures: Glomerular filtration rate was estimated by 24-h urinary creatinine clearance, body size by body mass index (BMI), and intra-abdominal fat (IAF), sc fat (SCF), and lean thigh areas by CT scan. Results: Creatinine clearance was positively correlated with BMI (r = 0.429; P < 0.001), fasting glucose (r = 0.198; P < 0.001), and insulin levels (r = 0.125; P < 0.042), as well as IAF (r = 0.239; P < 0.001), SCF (r = 0.281; P < 0.001), and lean thigh (r = 0.353; P < 0.001) areas. The association between creatinine clearance and BMI remained significant after adjustments for IAF, SCF areas, and fasting insulin levels (r = 0.337; P < 0.001); whereas IAF and SCF areas were not independently associated with creatinine clearance after adjusting for BMI. Creatinine clearance increased with increasing BMI after adjusting for fasting insulin, fasting glucose, IAF and SCF areas in subjects with normal glucose tolerance (r = 0.432; P < 0.001) and impaired glucose metabolism (r = 0.471; P < 0.001). Conclusions: BMI rather than body fat distribution is an independent determinant of creatinine clearance in nondiabetic subjects. Lean body mass, rather than adiposity, may explain this association. (J Clin Endocrinol Metab 94: 3781-3788, 2009) C1 [Gerchman, Fernando; Tong, Jenny; Utzschneider, Kristina M.; Zraika, Sakeneh; Udayasankar, Jayalakshmi; Fujimoto, Wilfred Y.; Kahn, Steven E.] VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. [Gerchman, Fernando; Tong, Jenny; Utzschneider, Kristina M.; Zraika, Sakeneh; Udayasankar, Jayalakshmi; Fujimoto, Wilfred Y.; Kahn, Steven E.] Univ Washington, Seattle, WA 98108 USA. [McNeely, Marguerite J.; Boyko, Edward J.] Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA 98195 USA. [Carr, Darcy B.] Univ Washington, Div Maternal Fetal Med, Dept Obstet & Gynecol, Seattle, WA 98195 USA. [Leonetti, Donna L.] Univ Washington, Dept Anthropol, Seattle, WA 98195 USA. [Young, Bessie A.; Boyko, Edward J.] VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. [Young, Bessie A.; de Boer, Ian H.] Univ Washington, Dept Med, Div Nephrol, Seattle, WA 98195 USA. RP Kahn, SE (reprint author), VA Puget Sound Hlth Care Syst 151, 1660 S Columbian Way, Seattle, WA 98108 USA. EM skahn@u.washington.edu OI Kahn, Steven/0000-0001-7307-9002; Boyko, Edward/0000-0002-3695-192X FU Department of Veterans Affairs; National Institutes of Health [DK-55460, DK02860, DK-02654, DK-35816, RR-37]; Coordination of Higher Education and Graduate Training (CAPES) in Brazil; International Scholarship Program of The Endocrine Society FX This work was supported by the Department of Veterans Affairs and National Institutes of Health Grants DK-55460, DK02860, DK-02654, DK-35816, and RR-37. F. G. was supported by a scholarship from Coordination of Higher Education and Graduate Training (CAPES) in Brazil and by the International Scholarship Program of The Endocrine Society. NR 40 TC 20 Z9 22 U1 0 U2 1 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD OCT PY 2009 VL 94 IS 10 BP 3781 EP 3788 DI 10.1210/jc.2008-2508 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 503IE UT WOS:000270526500022 PM 19584179 ER PT J AU Balajee, SA Kano, R Baddley, JW Moser, SA Marr, KA Alexander, BD Andes, D Kontoyiannis, DP Perrone, G Peterson, S Brandt, ME Pappas, PG Chiller, T AF Balajee, S. Arunmozhi Kano, Rui Baddley, John W. Moser, Stephen A. Marr, Kieren A. Alexander, Barbara D. Andes, David Kontoyiannis, Dimitrios P. Perrone, Giancarlo Peterson, Stephen Brandt, Mary E. Pappas, Peter G. Chiller, Tom TI Molecular Identification of Aspergillus Species Collected for the Transplant-Associated Infection Surveillance Network SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID HEMATOPOIETIC STEM-CELL; INVASIVE ASPERGILLOSIS; SP NOV.; FUMIGATUS; LENTULUS; PCR AB A large aggregate collection of clinical isolates of aspergilli (n = 218) from transplant patients with proven or probable invasive aspergillosis was available from the Transplant-Associated Infection Surveillance Network, a 6-year prospective surveillance study. To determine the Aspergillus species distribution in this collection, isolates were subjected to comparative sequence analyses by use of the internal transcribed spacer and beta-tubulin regions. Aspergillus fumigatus was the predominant species recovered, followed by A. flavus and A. niger. Several newly described species were identified, including A. lentulus and A. calidoustus; both species had high in vitro MICs to multiple antifungal drugs. Aspergillus tubingensis, a member of the A. niger species complex, is described from clinical specimens; all A. tubingensis isolates had low in vitro MICs to antifungal drugs. C1 [Balajee, S. Arunmozhi; Kano, Rui; Brandt, Mary E.; Chiller, Tom] Ctr Dis Control & Prevent, Mycot Dis Branch, Atlanta, GA 30333 USA. [Baddley, John W.; Pappas, Peter G.] Univ Alabama, Dept Med, Birmingham, AL 35294 USA. [Moser, Stephen A.] Univ Alabama, Dept Pathol, Birmingham, AL 35294 USA. [Baddley, John W.] Birmingham Vet Affairs Med Ctr, Dept Med, Birmingham, AL USA. [Marr, Kieren A.] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. [Marr, Kieren A.] Johns Hopkins Univ, Baltimore, MD USA. [Alexander, Barbara D.] Duke Univ, Durham, NC USA. [Andes, David] Univ Wisconsin, Madison, WI USA. [Kontoyiannis, Dimitrios P.] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA. [Perrone, Giancarlo] CNR, Inst Sci Food Prod, Bari, Italy. [Peterson, Stephen] USDA, Natl Ctr Agr Utilizat Res, Peoria, IL USA. RP Balajee, SA (reprint author), Ctr Dis Control & Prevent, Mycot Dis Branch, Mail Stop G 11,1600 Clifton Rd, Atlanta, GA 30333 USA. EM fir3@cdc.gov RI Moser, Stephen/A-1168-2008; Perrone, Giancarlo/O-7475-2014 OI Perrone, Giancarlo/0000-0002-3841-6066 FU Nihon University in Japan; NIH [K23AI064613] FX The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. NR 18 TC 93 Z9 97 U1 1 U2 4 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 OCT PY 2009 VL 47 IS 10 BP 3138 EP 3141 DI 10.1128/JCM.01070-09 PG 4 WC Microbiology SC Microbiology GA 501BC UT WOS:000270351700009 PM 19675215 ER PT J AU Jung, SW Sugimoto, M Graham, DY Yamaoka, Y AF Jung, Sung Woo Sugimoto, Mitsushige Graham, David Y. Yamaoka, Yoshio TI homB Status of Helicobacter pylori as a Novel Marker To Distinguish Gastric Cancer from Duodenal Ulcer SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID GASTRODUODENAL DISEASES; CLINICAL-RELEVANCE; PROMOTING GENE; INFECTION; STRAINS; CAGA; DUPA; RISK; PATHOGENESIS; INFLAMMATION AB The hom family of Helicobacter pylori outer-membrane proteins, especially the homB gene, has been suggested as a novel virulence factor; however, the clinical association and function of this gene are still unclear. We evaluated the presence of the homA, homB, and cagA genes in 286 strains isolated from patients in the U. S. and Colombian populations (126 with gastritis, 96 with duodenal ulcer, and 64 with gastric cancer) by PCR. The results were compared with the clinical presentation and gastric injury. The prevalence of the homB gene was significantly higher in strains isolated from gastric-cancer patients (71.9%) than in those from duodenal ulcer patients (52.1%) (P = 0.012). In a multivariate analysis, the presence of the cagA gene significantly increased the risk for developing gastric cancer and duodenal ulcer, with the presence of the homB gene acting as a factor that could distinguish gastric cancer from duodenal ulcer (adjusted odds ratio, 3.033; 95% confidence interval, similar to 1.37 to similar to 6.73). cagA status was correlated with homB status (r = 0.323; P < 0.01). A histological analysis showed that cagA status was associated with inflammation and atrophy both in the antrum and in the corpus, while homB status was associated with inflammation and atrophy in the corpus. homB gene status might be susceptible to gastric-cancer development such that the homB gene is used as a factor for discriminating the risk of gastric cancer from that of duodenal ulcer. C1 [Jung, Sung Woo; Sugimoto, Mitsushige; Graham, David Y.; Yamaoka, Yoshio] Michael E DeBakey Vet Affairs Med Ctr, Dept Med Gastroenterol, Houston, TX 77030 USA. [Jung, Sung Woo; Sugimoto, Mitsushige; Graham, David Y.; Yamaoka, Yoshio] Baylor Coll Med, Houston, TX 77030 USA. [Jung, Sung Woo] Korea Univ, Coll Med, Dept Internal Med, Div Gastroenterol, Seoul 136705, South Korea. [Yamaoka, Yoshio] Oita Univ, Fac Med, Dept Environm & Prevent Med, Yufu, Japan. RP Yamaoka, Y (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med, 111D,Rm 3A-320,2002 Holcombe Blvd, Houston, TX 77030 USA. EM yyamaoka@bcm.tmc.edu FU Office of Research and Development Medical Research Service Department of Veterans Affairs (VA) by Public Health Service [DK56338]; NIH [DK 62813] FX This material is based upon work supported in part by the Office of Research and Development Medical Research Service Department of Veterans Affairs (VA) by Public Health Service grant DK56338, which funds the Texas Gulf Coast Digestive Diseases Center. The project was also supported by grant number DK 62813 from the NIH. NR 27 TC 19 Z9 20 U1 0 U2 2 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 OCT PY 2009 VL 47 IS 10 BP 3241 EP 3245 DI 10.1128/JCM.00293-09 PG 5 WC Microbiology SC Microbiology GA 501BC UT WOS:000270351700024 PM 19710266 ER PT J AU Baddley, JW Marr, KA Andes, DR Walsh, TJ Kauffman, CA Kontoyiannis, DP Ito, JI Balajee, SA Pappas, PG Moser, SA AF Baddley, John W. Marr, Kieren A. Andes, David R. Walsh, Thomas J. Kauffman, Carol A. Kontoyiannis, Dimitrios P. Ito, James I. Balajee, S. Arunmozhi Pappas, Peter G. Moser, Stephen A. TI Patterns of Susceptibility of Aspergillus Isolates Recovered from Patients Enrolled in the Transplant-Associated Infection Surveillance Network SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID AMPHOTERICIN-B; IN-VITRO; INVASIVE ASPERGILLOSIS; CROSS-RESISTANCE; AZOLE RESISTANCE; FUMIGATUS; ITRACONAZOLE; VORICONAZOLE; TERREUS; RAVUCONAZOLE AB We analyzed antifungal susceptibilities of 274 clinical Aspergillus isolates from transplant recipients with proven or probable invasive aspergillosis collected as part of the Transplant-Associated Infection Surveillance Network (TRANSNET) and examined the relationship between MIC and mortality at 6 or 12 weeks. Antifungal susceptibility testing was performed by the Clinical and Laboratory Standards Institute (CLSI) M38-A2 broth dilution method for amphotericin B (AMB), itraconazole (ITR), voriconazole (VOR), posaconazole (POS), and ravuconazole (RAV). The isolate collection included 181 Aspergillus fumigatus, 28 Aspergillus niger, 27 Aspergillus flavus, 22 Aspergillus terreus, seven Aspergillus versicolor, five Aspergillus calidoustus, and two Aspergillus nidulans isolates and two isolates identified as Aspergillus spp. Triazole susceptibilities were <= 4 mu g/ml for most isolates (POS, 97.6%; ITR, 96.3%; VOR, 95.9%; RAV, 93.5%). The triazoles were not active against the five A. calidoustus isolates, for which MICs were >= 4 mu g/ml. AMB inhibited 93.3% of isolates at an MIC of 1 mu g/ml. The exception was A. terreus, for which 15 (68%) of 22 isolates had MICs of >1 mu g/ml. One of 181 isolates of A. fumigatus showed resistance (MIC > 4 mu g/ml) to two of three azoles tested. Although there appeared to be a correlation of higher VOR MICs with increased mortality at 6 weeks, the relationship was not statistically significant (R(2) = 0.61; P = 0.065). Significant relationships of in vitro MIC to all-cause mortality at 6 and 12 weeks for VOR or AMB were not found. C1 [Baddley, John W.; Pappas, Peter G.] Univ Alabama, Dept Med, Div Infect Dis, Birmingham, AL 35294 USA. [Baddley, John W.] Birmingham Vet Affairs Med Ctr, Infect Dis Sect, Dept Med, Birmingham, AL USA. [Marr, Kieren A.] Johns Hopkins Univ, Sch Med, Dept Med, Div Infect Dis, Baltimore, MD 21205 USA. [Andes, David R.] Univ Wisconsin, Dept Med, Div Infect Dis, Madison, WI USA. [Walsh, Thomas J.] NCI, Pediat Oncol Branch, Bethesda, MD 20892 USA. [Kauffman, Carol A.] Univ Michigan, Dept Med, Ann Arbor, MI 48109 USA. [Kauffman, Carol A.] Vet Affairs Ann Arbor Healthcare Syst, Ann Arbor, MI USA. [Kontoyiannis, Dimitrios P.] Univ Texas MD Anderson Canc Ctr, Dept Med, Houston, TX 77030 USA. [Ito, James I.] City Hope Natl Med Ctr, Dept Med, Div Infect Dis, Duarte, CA 91010 USA. [Balajee, S. Arunmozhi] Ctr Dis Control & Prevent, Div Mycot Dis, Atlanta, GA USA. [Moser, Stephen A.] Univ Alabama, Dept Pathol, Birmingham, AL 35294 USA. RP Baddley, JW (reprint author), Univ Alabama, Dept Med, Div Infect Dis, 1900 Univ Blvd,229 Tinsley Harrison Tower, Birmingham, AL 35294 USA. EM jbaddley@uab.edu RI Moser, Stephen/A-1168-2008 FU NIH [K23AI064613] FX J.W.B. is sponsored in part by NIH grant K23AI064613. NR 30 TC 87 Z9 89 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD OCT PY 2009 VL 47 IS 10 BP 3271 EP 3275 DI 10.1128/JCM.00854-09 PG 5 WC Microbiology SC Microbiology GA 501BC UT WOS:000270351700029 PM 19692558 ER PT J AU Mahlen, SD Clarridge, JE AF Mahlen, Steven D. Clarridge, Jill E., III TI Site and Clinical Significance of Alloscardovia omnicolens and Bifidobacterium Species Isolated in the Clinical Laboratory SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID HUMAN DENTAL-CARIES; GEN. NOV.; DENTICOLENS AB Most of the members of the genus Bifidobacterium, including the related organism Alloscardovia omnicolens, are inhabitants of the gastrointestinal tract and oral cavity of humans and animals and have been considered nonpathogenic for humans. However, the actual site of isolation and the clinical significance of A. omnicolens and of Bifidobacterium species are unclear. This may be due in part to the difficulties in distinguishing these organisms from other genera such as Actinomyces. To determine the potential disease-causing role of these organisms, we analyzed the clinical significance of 15 A. omnicolens and Bifidobacterium isolates identified by 16S rRNA gene sequencing from a clinical laboratory. All of the organisms in this study were isolated from sterile sites or in significant numbers by standard clinical microbiological culture methods. Our 15 clinical strains fit into only four species: A. omnicolens (five isolates), Bifidobacterium scardovii (four isolates), B. longum (two isolates), and B. breve (four isolates). All five A. omnicolens isolates, one of the B. breve isolates, and three of the four B. scardovii isolates were cultured from urine at 105 CFU/ml. One B. scardovii isolate was from a patient with a genitourinary tract wound infection, two B. longum isolates were from abdominal wounds, and three B. breve isolates were from blood cultures. This study enlarges the spectrum of diseases and clinical sources associated with A. omnicolens and Bifidobacterium species and addresses identification problems. C1 [Mahlen, Steven D.] Univ Washington, Dept Lab Med, USA, Seattle, WA 98195 USA. [Clarridge, Jill E., III] Vet Affairs Puget Sound Hlth Care Syst, Pathol & Lab Med Serv, Seattle, WA 98108 USA. RP Clarridge, JE (reprint author), VA PSHCS, Pathol & Lab Med Serv 113, 1660 S Columbian Way, Seattle, WA 98108 USA. EM jill.clarridge@va.gov NR 13 TC 17 Z9 17 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD OCT PY 2009 VL 47 IS 10 BP 3289 EP 3293 DI 10.1128/JCM.00555-09 PG 5 WC Microbiology SC Microbiology GA 501BC UT WOS:000270351700032 PM 19641056 ER PT J AU Lundstrom, BN Famulare, M Sorensen, LB Spain, WJ Fairhall, AL AF Lundstrom, Brian Nils Famulare, Michael Sorensen, Larry B. Spain, William J. Fairhall, Adrienne L. TI Sensitivity of firing rate to input fluctuations depends on time scale separation between fast and slow variables in single neurons SO JOURNAL OF COMPUTATIONAL NEUROSCIENCE LA English DT Article DE Noise; Gain; f-I curve; Stimulus fluctuations; Single neuron; Time scales; Dynamical systems; Phase portrait; Hodgkin-Huxley; Slow adaptation; Slow AHP ID NEOCORTICAL NEURONS; IN-VIVO; GAIN MODULATION; NEURAL CODE; CONDUCTANCE; ADAPTATION; NOISE; OSCILLATIONS; DYNAMICS; DETECTOR AB Neuronal responses are often characterized by the firing rate as a function of the stimulus mean, or the f-I curve. We introduce a novel classification of neurons into Types A, B-, and B+ according to how f-I curves are modulated by input fluctuations. In Type A neurons, the f-I curves display little sensitivity to input fluctuations when the mean current is large. In contrast, Type B neurons display sensitivity to fluctuations throughout the entire range of input means. Type B- neurons do not fire repetitively for any constant input, whereas Type B+ neurons do. We show that Type B+ behavior results from a separation of time scales between a slow and fast variable. A voltage-dependent time constant for the recovery variable can facilitate sensitivity to input fluctuations. Type B+ firing rates can be approximated using a simple "energy barrier" model. C1 [Lundstrom, Brian Nils; Spain, William J.; Fairhall, Adrienne L.] Univ Washington, Dept Physiol & Biophys, Seattle, WA 98195 USA. [Famulare, Michael; Sorensen, Larry B.] Univ Washington, Dept Phys, Seattle, WA 98195 USA. [Spain, William J.] Vet Affairs Puget Sound Hlth Care Syst, Neurol Sect, Seattle, WA 98108 USA. RP Lundstrom, BN (reprint author), Univ Washington, Dept Physiol & Biophys, Seattle, WA 98195 USA. EM lundbr@u.washington.edu FU Burroughs-Wellcome Careers at the Scientific Interface; McKnight Scholar Award; National Institute of Neurological Disorders and Stroke [F30NS055650]; Medical Scientist Training Program; National Institute of General Medical Sciences; ARCS fellowship; VA Merit Review FX This work was supported by a Burroughs-Wellcome Careers at the Scientific Interface grant and a McKnight Scholar Award; BNL was supported by grant number F30NS055650 from the National Institute of Neurological Disorders and Stroke, the Medical Scientist Training Program at UW supported by the National Institute of General Medical Sciences, and an ARCS fellowship; WJS was supported by a VA Merit Review. NR 40 TC 28 Z9 28 U1 0 U2 5 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0929-5313 J9 J COMPUT NEUROSCI JI J. Comput. Neurosci. PD OCT PY 2009 VL 27 IS 2 BP 277 EP 290 DI 10.1007/s10827-009-0142-x PG 14 WC Mathematical & Computational Biology; Neurosciences SC Mathematical & Computational Biology; Neurosciences & Neurology GA 488AG UT WOS:000269320300008 PM 19353260 ER PT J AU Choi, KD Kim, N Jang, IJ Park, YS Cho, JY Kim, JR Shin, JM Jung, HC Song, IS AF Choi, Kee Don Kim, Nayoung Jang, In-Jin Park, Young Soo Cho, Joo Youn Kim, Jung-Ryul Shin, Jai Moo Jung, Hyun Chae Song, In Sung TI Optimal dose of intravenous pantoprazole in patients with peptic ulcer bleeding requiring endoscopic hemostasis in Korea SO JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article DE CYP2C19; Helicobacter pylori; intravenous infusions; peptic ulcer bleeding; proton pump inhibitor ID PROTON-PUMP INHIBITOR; HELICOBACTER-PYLORI INFECTION; INTRAGASTRIC PH; EXTENSIVE METABOLIZERS; ATROPHIC GASTRITIS; GENOTYPE STATUS; OMEPRAZOLE; RABEPRAZOLE; ACID; POLYMORPHISM AB Background and Aim: The lowest effective dose of proton pump inhibitors (PPI) for prevention of peptic ulcer rebleeding remains unclear. The objective of the present study was to evaluate whether low-dose PPI has a similar efficacy to high-dose i.v. administration for maintaining intragastric pH above 6. Methods: Sixty-one patients with bleeding ulcers were randomized into one of three groups after endoscopic hemostasis: pantoprazole 80 mg bolus followed by 8 mg/h; 40 mg, 4 mg/h infusion; and bolus injection of 40 mg every 24 h. Intragastric pH values and rebleeding rates were measured. In addition, pharmacokinetic parameters and association with CYP2C19 polymorphisms and H. pylori infection were assessed. Results: Mean percentage of time with intragastric pH > 6, and the proportion of patients with pH > 6 for more than 60% of the time were significantly higher in the 40 mg, 4 mg/h infusion group compared to the 40 mg bolus injection. There was no significant difference between the 80 mg, 8 mg/h and the 40 mg, 4 mg/h groups. In the H. pylori (-) group, only 40% of patients that received continuous infusion reached the target pH > 6 for more than 60% of the time; this was significantly lower than the H. pylori (+) group, 87.5% (P = 0.026). Conclusions: A continuous infusion, regardless of high or low dose, was more effective for acid suppression than a 40 mg bolus PPI injection in Korea. H. pylori infection was an important factor for the maintenance of an intragastric pH > 6. C1 [Choi, Kee Don; Kim, Nayoung; Park, Young Soo; Jung, Hyun Chae; Song, In Sung] Seoul Natl Univ, Coll Med, Dept Internal Med, Seoul 151, South Korea. [Choi, Kee Don; Kim, Nayoung; Park, Young Soo; Jung, Hyun Chae; Song, In Sung] Seoul Natl Univ, Coll Med, Liver Res Inst, Seoul, South Korea. [Jang, In-Jin; Cho, Joo Youn; Kim, Jung-Ryul] Seoul Natl Univ, Coll Med, Dept Pharmacol, Seoul, South Korea. [Choi, Kee Don] Univ Ulsan, Coll Med, Dept Internal Med, Asan Med Ctr, Ulsan, South Korea. [Kim, Nayoung; Park, Young Soo] Seoul Natl Univ, Dept Internal Med, Bundang Hosp, Seognam, Gyeonggi Do, South Korea. [Shin, Jai Moo] Univ Calif Los Angeles, Dept Physiol & Med, Digest Res Ctr, Los Angeles, CA USA. [Shin, Jai Moo] VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. RP Kim, N (reprint author), Seoul Natl Univ, Dept Internal Med, Bundang Hosp, 300 Gumi Dong, Seognam Si 463707, Gyeonggi Do, South Korea. EM nayoungkim49@empal.com RI Kim, Nayoung/J-5387-2012; Cho, Joo-Youn/J-5672-2012; Jung, Hyun Chae/J-5654-2012; Park, Young Soo/J-5491-2012 OI Kim, Nayoung/0000-0002-9397-0406 FU Seoul National University Bundang Hospital Research fund [2006-04-027] FX We appreciate the skillful assistance of Ji Suk Park. This work was supported by grant no. 2006-04-027 from the Seoul National University Bundang Hospital Research fund. NR 32 TC 13 Z9 14 U1 0 U2 2 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0815-9319 J9 J GASTROEN HEPATOL JI J. Gastroenterol. Hepatol. PD OCT PY 2009 VL 24 IS 10 BP 1617 EP 1624 DI 10.1111/j.1440-1746.2009.05939.x PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 499AM UT WOS:000270188800008 PM 19686407 ER PT J AU Mak, KM Leo, MA AF Mak, Ki M. Leo, Maria A. TI How reproducible are rat steatosis models using high-fat diets? Reply SO JOURNAL OF HEPATOLOGY LA English DT Letter C1 [Mak, Ki M.] Mt Sinai Sch Med, New York, NY 10029 USA. [Leo, Maria A.] James J Peters VA Med Ctr, New York, NY USA. RP Mak, KM (reprint author), Mt Sinai Sch Med, 1 Gustave Levy Pl, New York, NY 10029 USA. EM ki.mak@mssm.edu NR 3 TC 1 Z9 1 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-8278 J9 J HEPATOL JI J. Hepatol. PD OCT PY 2009 VL 51 IS 4 BP 824 EP 824 DI 10.1016/j.jhep.2009.05.019 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 506BV UT WOS:000270749000032 ER PT J AU Rosenbach, M Murrell, DF Bystryn, JC Dulay, S Dick, S Fakharzadeh, S Hall, R Korman, NJ Lin, J Okawa, J Pandya, AG Payne, AS Rose, M Rubenstein, D Woodley, D Vittorio, C Werth, BB Williams, EA Taylor, L Troxel, AB Werth, VP AF Rosenbach, Misha Murrell, Dedee F. Bystryn, Jean-Claude Dulay, Sam Dick, Sarah Fakharzadeh, Steve Hall, Russell Korman, Neil J. Lin, Julie Okawa, Joyce Pandya, Amit G. Payne, Aimee S. Rose, Mathew Rubenstein, David Woodley, David Vittorio, Carmela Werth, Benjamin B. Williams, Erik A. Taylor, Lynne Troxel, Andrea B. Werth, Victoria P. TI Reliability and Convergent Validity of Two Outcome Instruments for Pemphigus SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Article ID DISEASE; SEVERITY; SYMPTOMS; IMPACT; AREA AB A major obstacle in performing multicenter controlled trials for pemphigus is the lack of a validated disease activity scoring system. Here, we assess the reliability and convergent validity of the PDAI (pemphigus disease area index). A group of 10 dermatologists scored 15 patients with pemphigus to estimate the inter- and intra-rater reliability of the PDAI and the recently described ABSIS (autoimmune bullous skin disorder intensity score) instrument. To assess convergent validity, these tools were also correlated with the Physician's Global Assessment (PGA). Reliability studies demonstrated an intra-class correlation coefficient (ICC) for inter-rater reliability of 0.76 (95% confirdence interval (CI) = 0.61-0.91) for the PDAI and 0.77 (0.63-0.91) for the ABSIS. The tools differed most in reliability of assessing skin activity, with an ICC of 0.39 (0.17-0.60) for the ABSIS and 0.86 (0.76-0.95) for the PDAI. Intra-rater test-retest reliability demonstrated an ICC of 0.98 (0.96-1.0) for the PDAI and 0.80 (0.65-0.96) for the ABSIS. The PDAI also correlated more closely with the PGA. We conclude that the PDAI is more reproducible and correlates better with physician impression of extent. Subset analysis suggests that for this population of mild-to-moderate disease activity, the PDAI captures more variability in cutaneous disease than the ABSIS. C1 [Rosenbach, Misha; Dulay, Sam; Dick, Sarah; Fakharzadeh, Steve; Lin, Julie; Okawa, Joyce; Payne, Aimee S.; Rose, Mathew; Vittorio, Carmela; Werth, Benjamin B.; Williams, Erik A.; Werth, Victoria P.] Univ Penn, Dept Dermatol, Philadelphia, PA 19119 USA. [Murrell, Dedee F.] Univ NSW, Dept Dermatol, St George Hosp, Sydney, NSW, Australia. [Bystryn, Jean-Claude] NYU, Med Ctr, Dept Dermatol, New York, NY 10016 USA. [Hall, Russell] Duke Med Ctr, Dept Dermatol, Div Dermatol, Durham, NC USA. [Korman, Neil J.] Univ Hosp Cleveland, Dept Dermatol, Case Western Med Ctr, Cleveland, OH 44106 USA. [Pandya, Amit G.] Univ Texas SW Med Ctr Dallas, Div Dermatol, Dept Dermatol, Dallas, TX 75390 USA. [Rubenstein, David] Univ N Carolina, Dept Dermatol, Chapel Hill, NC 27514 USA. [Woodley, David] Univ So Calif, Keck Sch Med, Dept Dermatol, Los Angeles, CA 90033 USA. [Taylor, Lynne; Troxel, Andrea B.] Univ Penn, Dept Biostat & Epidemiol, Philadelphia, PA 19119 USA. [Werth, Victoria P.] Philadelphia VA Med Ctr, Dept Dermatol, Philadelphia, PA USA. RP Werth, VP (reprint author), Univ Penn, Dept Dermatol, 2 Rhodes Pavil,3600 Spruce St, Philadelphia, PA 19119 USA. EM werth@mail.med.upenn.edu OI Troxel, Andrea/0000-0002-1393-3075 FU International Pemphigus and Pemphigoid Foundation; National Institutes of Health [NIH K24-AR 02207] FX This study was supported by a grant to VPW from the International Pemphigus and Pemphigoid Foundation. We acknowledge specific assistance from Janet Segall, William J. Zrnchik II, John Frew, and David Sirois, and the National Institutes of Health to VPW (NIH K24-AR 02207). This work was presented at the Society of Investigative Dermatology in May 2008, and was published in abstract form in the Journal of Investigative Dermatology (abstract) 43: S75, 2008. NR 11 TC 73 Z9 77 U1 0 U2 2 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD OCT PY 2009 VL 129 IS 10 BP 2404 EP 2410 DI 10.1038/jid.2009.72 PG 7 WC Dermatology SC Dermatology GA 498SL UT WOS:000270163300015 PM 19357707 ER PT J AU Gee, RE Shacter, HE Long, JA AF Gee, Rebekah E. Shacter, Hannah E. Long, Judith A. TI Coverage of the Human Papillomavirus Vaccine by US and Canadian Medical Schools SO JOURNAL OF LOWER GENITAL TRACT DISEASE LA English DT Article DE human papilloma virus; HPV vaccine; student health; hepatitis B vaccine AB Objective. This study evaluates the degree to which medical school health insurance covers the costs of the human papillomavirus (HPV) vaccine for medical students in the United States and in Canada. Methods. A telephone survey was conducted in November 2007 of every accredited medical school in the United States and in Canada. Results. Thirty-one percent of schools fully covered the vaccine, 18% partially covered it, and the majority, 51%, provided no coverage. In the United States, the Northeast had the highest level of full coverage (61%). In the adjusted model, regional differences were no longer significant. However, private schools (odds ratio [OR] = 4.7; 95% confidence interval [CI] = 1.5-15.3)] and those that covered the hepatitis B vaccine (OR = 19.4; 95% CI = 5.5-68.6) remained more likely to cover the HPV vaccine. For medical schools that provided no HPV vaccine coverage, the average out-of-pocket cost for students was $434. Conclusions. This study shows that most medical students are not being offered health insurance coverage for the HPV vaccine, but that the vaccine was adopted relatively quickly into the armamentarium of medical student health centers. C1 [Gee, Rebekah E.] Robert Wood Johnson Fdn, Clin Scholars Program, Philadelphia, PA USA. [Gee, Rebekah E.; Long, Judith A.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Shacter, Hannah E.] Univ Minnesota, Sch Med, Minneapolis, MN 55455 USA. [Long, Judith A.] Philadelphia Vet Affairs Ctr Hlth Equ Res & Promo, Philadelphia, PA USA. [Long, Judith A.] Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. RP Gee, RE (reprint author), 423 Guardian Dr,13th Floor Blockley Hall, Philadelphia, PA 19104 USA. EM rebekahgeemd@gmail.com FU Robert Wood Johnson Clinical Scholars Program FX The authors thank the Robert Wood Johnson Clinical Scholars Program for providing funding for the study. NR 8 TC 0 Z9 0 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1089-2591 J9 J LOW GENIT TRACT DI JI J. Low. Genit. Tract. Dis. PD OCT PY 2009 VL 13 IS 4 BP 207 EP 209 PG 3 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 507DO UT WOS:000270831600004 ER PT J AU Maguen, S Metzler, TJ McCaslin, SE Inslicht, SS Henn-Haase, C Neylan, TC Marmar, CR AF Maguen, Shira Metzler, Thomas J. McCaslin, Shannon E. Inslicht, Sabra S. Henn-Haase, Clare Neylan, Thomas C. Marmar, Charles R. TI Routine Work Environment Stress and PTSD Symptoms in Police Officers SO JOURNAL OF NERVOUS AND MENTAL DISEASE LA English DT Article DE Work environment; traumatic stress; police officers ID EMERGENCY SERVICES PERSONNEL; MALE VIETNAM VETERANS; WAR-ZONE STRESSORS; MENTAL-HEALTH; PSYCHOLOGICAL STRESS; CHILDHOOD TRAUMA; RISK-FACTORS; DISORDER; FEMALE; IMPACT AB This study examined the relationship between routine work environment stress and posttraumatic stress disorder (PTSD) symptoms in a sample of police officers (N = 180) who were first assessed during academy training and reassessed I-year later. In a model that included gender, ethnicity, traumatic exposure prior to entering the academy, current negative life events, and critical incident exposure over the last year, routine work environment stress was most strongly associated with PTSD symptoms. We also found that routine work environment stress mediated the relationship between critical incident exposure and PTSD symptoms and between current negative life events and PTSD symptoms. Ensuring that the work environment is functioning optimally protects against the effects of duty-related critical incidents and negative life events outside police service. C1 [Maguen, Shira; Metzler, Thomas J.; McCaslin, Shannon E.; Inslicht, Sabra S.; Henn-Haase, Clare; Neylan, Thomas C.; Marmar, Charles R.] San Francisco VA Med Ctr, San Francisco, CA USA. [Maguen, Shira; Metzler, Thomas J.; McCaslin, Shannon E.; Inslicht, Sabra S.; Henn-Haase, Clare; Neylan, Thomas C.; Marmar, Charles R.] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. RP Maguen, S (reprint author), San Francisco VA Med Ctr, PTSD Program 116-P,4150 Clement St, San Francisco, CA USA. EM Shira.Maguen@va.gov FU NIMH NIH HHS [R01 MH056350] NR 38 TC 28 Z9 28 U1 0 U2 19 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-3018 J9 J NERV MENT DIS JI J. Nerv. Ment. Dis. PD OCT PY 2009 VL 197 IS 10 BP 754 EP 760 DI 10.1097/NMD.0b013e3181b975f8 PG 7 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 507CZ UT WOS:000270829900007 PM 19829204 ER PT J AU Raggio, CL Giampietro, PF Dobrin, S Zhao, C Dorshorst, D Ghebranious, N Weber, JL Blank, RD AF Raggio, Cathleen L. Giampietro, Philip F. Dobrin, Seth Zhao, Chengfeng Dorshorst, Donna Ghebranious, Nader Weber, James L. Blank, Robert D. TI A Novel Locus for Adolescent Idiopathic Scoliosis on Chromosome 12p SO JOURNAL OF ORTHOPAEDIC RESEARCH LA English DT Article DE AIS; axial skeletal growth; chromosome 12p; genetic heterogeneity; susceptibility locus ID LINKAGE ANALYSIS; CURVE PROGRESSION; CANDIDATE REGIONS; SUSCEPTIBILITY; IDENTIFICATION; GENE; DEGRADATION; ASSIGNMENT; SYSTEM; TYPE-1 AB Adolescent idiopathic scoliosis (AIS) is a common disorder with strong evidence for genetic predisposition. Quantitative trait loci (QTLs) for AIS susceptibility have been identified on chromosomes. We performed a genome-wide genetic linkage scan in seven multiplex families using 400 marker loci with a mean spacing of 8.6 cM. We used Genehunter Plus to generate linkage statistics, expressed as homogeneity (HLOD) scores, under dominant and recessive genetic models. We found a significant linkage signal on chromosome 12p, whose support interval extends from near 12pter, spanning approximately 10 million bases or 31 cM. Fine mapping within the region using 20 additional markers reveals maximum HLOD = 3.7 at 5 cM under a dominant inheritance model, and a split peak maximum HLOD = 3.2 at 8 and 18 cM under a recessive inheritance model. The linkage support interval contains 95 known genes. We found evidence suggestive of linkage on chromosomes 1, 6, 7, 8, and 14. This study is the first to find evidence of an AIS susceptibility locus on chromosome 12. Detection of AIS susceptibility OTLs on multiple chromosomes in this and other studies demonstrate that the condition is genetically heterogeneous. (C) 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:1366-1372, 2009 C1 [Giampietro, Philip F.] Marshfield Clin Fdn Med Res & Educ, Med Genet Serv, Marshfield, WI 54449 USA. [Raggio, Cathleen L.] Hosp Special Surg, Dept Pediat Orthoped, New York, NY 10021 USA. [Giampietro, Philip F.] Univ Wisconsin, Dept Pediat, Madison, WI 53701 USA. [Dobrin, Seth; Zhao, Chengfeng; Dorshorst, Donna; Ghebranious, Nader] Marshfield Clin Res Fdn, Ctr Human Genet, Marshfield, WI 54449 USA. [Blank, Robert D.] Univ Wisconsin, Madison, WI 53705 USA. [Blank, Robert D.] William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Giampietro, PF (reprint author), Marshfield Clin Fdn Med Res & Educ, Med Genet Serv, 1000 N Oak Ave, Marshfield, WI 54449 USA. EM pfgiampietro@pediatrics.wisc.edu OI Blank, Robert Daniel/0000-0003-2950-1944 FU National Heart, Lung, and Blood Institute, Mammalian Genotyping Service [N01-HV-48141]; Beatrice and Samuel A. Seaver Foundation; Marshfield Clinic Research Foundation FX C.L.R., P.F.G., and R.D.B. contributed equally to this work. This work was supported by grants from the National Heart, Lung, and Blood Institute, Mammalian Genotyping Service N01-HV-48141, Beatrice and Samuel A. Seaver Foundation, and Marshfield Clinic Research Foundation. The authors thank Marshfield Clinic Research Foundation for its support through the assistance of Alice Stargardt in the preparation of this manuscript. This paper is Madison GRECC manuscript 2007-04. All authors state that there are no conflicts of interest. NR 41 TC 24 Z9 28 U1 1 U2 4 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0736-0266 J9 J ORTHOP RES JI J. Orthop. Res. PD OCT PY 2009 VL 27 IS 10 BP 1366 EP 1372 DI 10.1002/jor.20885 PG 7 WC Orthopedics SC Orthopedics GA 498NJ UT WOS:000270147600016 PM 19340878 ER PT J AU Dobscha, SK Soleck, GD Dickinson, KC Burgess, DJ Lasarev, MR Lee, ES McFarland, BH AF Dobscha, Steven K. Soleck, Geoffrey D. Dickinson, Kathryn C. Burgess, Diana J. Lasarev, Michael R. Lee, Eun Sul McFarland, Bentson H. TI Associations Between Race and Ethnicity and Treatment for Chronic Pain in the VA SO JOURNAL OF PAIN LA English DT Article DE Veterans; pain; race/ethnicity ID HEALTH-CARE UTILIZATION; AFRICAN-AMERICANS; JOINT REPLACEMENT; KNEE ARTHROPLASTY; OLDER PATIENTS; DISPARITIES; OSTEOARTHRITIS; MANAGEMENT; ACCESS; PERCEPTIONS AB The purpose of this study was to identify racial and ethnic differences in patient-reported rates of treatment for chronic pain and ratings of pain-treatment effectiveness among veterans treated in Veterans Affairs(VA) facilities. This was a cross-sectional analysis of data from 255,522 veterans who participated in the VA Survey of the Healthcare Experiences of Patients (SHEP) in Fiscal Year 2005. Measures included demographics, the Veterans Rand Health Survey-12, a single item inquiring if the patient received treatment for chronic pain in the VA within the prior 12 months, and a single item asking the patient to rate the effectiveness of chronic pain care. in a logistic model adjusting for demographics, pain interference, and mental health status, male and female veterans who were Hispanic (OR 1.39 [95%CI 1.26-1.53] and OR 1.57 [1.02-2.43], respectively) or nonHispanic black (OR 1.43 [1.33-1.54] and OR 1.35 [1.02-1.78], respectively) were more likely to report receiving treatment for chronic pain in the prior 12 months compared to nonHispanic white veterans. Among veterans who reported receiving treatment for chronic pain, nonHispanic black men were less likely to rate pain-treatment effectiveness as very good or excellent, compared to nonHispanic white men (OR .809 [.720-.910]). Perspective: in our study, Hispanic and nonHispanic black veterans reported receiving chronic pain treatment more frequently than white veterans. Among veterans reporting pain treatment, nonHispanic black men were somewhat less likely to report receiving highly effective treatment than white men. Further research is needed to understand the reasons for these differences and their potential clinical implications. (c) 2009 by the American Pain Society C1 [Dobscha, Steven K.; Soleck, Geoffrey D.; Dickinson, Kathryn C.; Lasarev, Michael R.; Lee, Eun Sul] Portland VA Med Ctr, Portland Ctr Study Chron Comorbid Phys & Mental D, Portland, OR 97207 USA. [Dobscha, Steven K.; McFarland, Bentson H.] Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA. [Lee, Eun Sul; McFarland, Bentson H.] Oregon Hlth & Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USA. [Lasarev, Michael R.] Oregon Hlth & Sci Univ, Ctr Res Occupat & Environm Toxicol, Portland, OR 97201 USA. [Burgess, Diana J.] Minneapolis Vet Affairs Med Ctr, Ctr Chron Dis Outcomes Res, Minneapolis, MN USA. [Burgess, Diana J.] Univ Minnesota, Dept Med, Minneapolis, MN 55455 USA. RP Dobscha, SK (reprint author), Portland VA Med Ctr, Portland Ctr Study Chron Comorbid Phys & Mental D, POB 1034 P3MHADM, Portland, OR 97207 USA. EM steven.dobscha@va.gov RI Burgess, Diana/A-1946-2016 OI McFarland, Bentson/0000-0001-9149-5616 FU Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service [PMI 03-195, RCD 04129, REA 06-174] FX Supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service Projects PMI 03-195, RCD 04129 and REA 06-174. NR 47 TC 17 Z9 17 U1 2 U2 10 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 1526-5900 J9 J PAIN JI J. Pain PD OCT PY 2009 VL 10 IS 10 BP 1078 EP 1087 DI 10.1016/j.jpain.2009.04.018 PG 10 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 508GM UT WOS:000270917700010 PM 19800567 ER PT J AU Stern, SL Dhanda, R Hazuda, HP AF Stern, Stephen L. Dhanda, Rahul Hazuda, Helen P. TI Helplessness predicts the development of hypertension in older Mexican and European Americans SO JOURNAL OF PSYCHOSOMATIC RESEARCH LA English DT Article DE Depression; Elderly; Ethnicity; Helplessness; Hypertension ID AMBULATORY BLOOD-PRESSURE; DEPRESSIVE SYMPTOMS; SOCIOCULTURAL STATUS; RISK-FACTORS; DISEASE; HEALTH; POPULATION; ANXIETY; WOMEN; SCALE AB Objective: The mechanisms by which depression is associated with an elevated risk of cardiovascular disease remain unclear. It is possible that depressive symptoms could increase the risk of hypertension, which in turn could predispose to cardiovascular disease. The goal of this study was to explore whether individual depressive symptoms might predict the incidence of hypertension in a cohort of 240 initially normotensive Mexican-American and European-American elders. Methods: Subjects were 65-78 years old on entering the San Antonio Longitudinal Study of Aging, an epidemiologic survey, at which time they completed the 30-item Geriatric Depression Scale in English or Spanish. Their blood pressure was reassessed a mean of 7.0 years later. Responses to six key scale items (depressed mood, decreased interest, worthlessness, hopelessness, helplessness, and fatigue) were evaluated for the ability to predict incident hypertension. Results: In univariate analyses, only helplessness significantly predicted incident hypertension (chi-square 13.5, df=1, P=.0003). In a Cox proportional hazards model adjusted for sex, education, number of comorbid diseases, current drinking, social well-being, and marital status, helplessness remained a very strong predictor [hazard ratio (HR) 4.99: 95% confidence interval (CI) 1.90-13.12, P=.0011]. Total depression score also predicted incident hypertension, but less strongly (HR 1.08, CI 1.00-1.17, P=.0339). Conclusion: Helplessness may predict the development of hypertension in the elderly. Further research into this relationship might lead to interventions to reduce the risk of cardiovascular disease. (C) 2009 Elsevier Inc. All rights reserved. C1 [Stern, Stephen L.] S Texas Vet Hlth Care Syst, Psychiat Serv, San Antonio, TX USA. [Stern, Stephen L.] Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat, San Antonio, TX 78229 USA. [Dhanda, Rahul] Ikaria, Clinton, NJ USA. [Hazuda, Helen P.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. RP Stern, SL (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, Psychiat Serv 116A, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM stephen.stern@va.gov FU NIA [R01-AG10444, R01-AG16518]; NIH [MO1-RR-01346] FX This work was supported by NIA Grant R01-AG10444 (San Antonio Longitudinal Study of Aging), NIA Grant R01-AG16518 (Disablement in an Aging, Bi-ethnic Cohort), and NIH Grant MO1-RR-01346 (Frederic C. Barrier Clinical Research Center). NR 32 TC 8 Z9 8 U1 1 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0022-3999 EI 1879-1360 J9 J PSYCHOSOM RES JI J. Psychosomat. Res. PD OCT PY 2009 VL 67 IS 4 BP 333 EP 337 DI 10.1016/j.jpsychores.2009.04.007 PG 5 WC Psychiatry SC Psychiatry GA 503VA UT WOS:000270567700008 PM 19773026 ER PT J AU Schumacher, HR Taylor, W Edwards, L Grainger, R Schlesinger, N Dalbeth, N Sivera, F Singh, J Evans, R Waltrip, RW Diaz-Torne, C Macdonald, P Mcqueen, F Perez-Ruiz, F AF Schumacher, H. Ralph Taylor, William Edwards, Lawrence Grainger, Rebecca Schlesinger, Naomi Dalbeth, Nicola Sivera, Francisca Singh, Jasvinder Evans, Robert Waltrip, Royce W. Diaz-Torne, Cesar Macdonald, Patricia Mcqueen, Fiona Perez-Ruiz, Fernando TI Outcome Domains for Studies of Acute and Chronic Gout SO JOURNAL OF RHEUMATOLOGY LA English DT Article; Proceedings Paper CT 9th International Consensus Conference on Outcome Measures in Rheumatology Clinical Trials (OMERACT 9) CY MAY 27-31, 2008 CL Kananaskis, CANADA DE GOUT; OUTCOME MEASURES; CLINICAL TRIALS; OMERACT ID HYPERURICEMIA AB Discussion and voting at OMERACT 9 confirmed 5 essential domains for outcomes of acute gout: pain, joint swelling, joint tenderness, patient global assessment and activity limitations. For studies in chronic gout 7 essential domains are: serum urate, acute gout attacks, tophus burden, health-related quality of life. activity limitations, pain, and patient global assessment. Implications of patient perspectives, discretionary domains for specific studies, measurement instruments and a possible responder index are under study. (J Rheumatol 2009:36:2342-5; doi: 10.3899/jrheum.090370) C1 [Taylor, William] Univ Otago, Wellington Sch Med & Hlth Sci, Rehabil Teaching & Res Unit, Wellington, New Zealand. [Edwards, Lawrence] Univ Florida, Dept Med, Gainesville, FL USA. [Grainger, Rebecca] Malaghan Inst Med Res, Wellington, New Zealand. [Schlesinger, Naomi] Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Dept Med, New Brunswick, NJ 08903 USA. [Dalbeth, Nicola; Mcqueen, Fiona] Univ Auckland, Dept Med, Auckland, New Zealand. [Sivera, Francisca] Gen Hosp Univ Alicante, Secc Reumatol, E-03080 Alicante, Spain. [Singh, Jasvinder] Vet Affairs Med Ctr, Rheumatol Sect, Minneapolis, MN USA. [Singh, Jasvinder] Vet Affairs Med Ctr, Ctr Chron Dis Outcomes Res, Minneapolis, MN USA. [Evans, Robert] Regeneron Pharmaceut Inc, Tarrytown, NY 10591 USA. [Waltrip, Royce W.] Savient Pharmaceut, E Brunswick, NJ USA. [Diaz-Torne, Cesar] Hosp Santa Creu & Sant Pau, Barcelona, Spain. Takeda Pharmaceut Prod Inc, Lake Forest, IL USA. [Perez-Ruiz, Fernando] Hosp Cruces, Secc Reumatol, Vizcaya, Spain. [Schumacher, H. Ralph] Vet Affairs Med Ctr, Rheumatol Sect, Philadelphia, PA 19104 USA. RP Schumacher, HR (reprint author), Vet Affairs Med Ctr, Rheumatol Sect, Univ & Woodland Ave, Philadelphia, PA 19104 USA. EM schumacr@mail.med.upenn.edu; fperez@hcru.osakidetza.net RI PEREZ-RUIZ, FERNANDO/E-4844-2012 OI singh, jasvinder/0000-0003-3485-0006; Cesar, Diaz-Torne/0000-0001-6275-7699; Perez-Ruiz, Fernando/0000-0002-5268-1894 NR 12 TC 52 Z9 55 U1 0 U2 2 PU J RHEUMATOL PUBL CO PI TORONTO PA 365 BLOOR ST E, STE 901, TORONTO, ONTARIO M4W 3L4, CANADA SN 0315-162X EI 1499-2752 J9 J RHEUMATOL JI J. Rheumatol. PD OCT PY 2009 VL 36 IS 10 BP 2342 EP 2345 DI 10.3899/jrheum.090370 PG 4 WC Rheumatology SC Rheumatology GA 505KB UT WOS:000270691200035 PM 19820223 ER PT J AU Grainger, R Taylor, WJ Dalbeth, N Perez-Ruiz, F Singh, JA Waltrip, RW Schlesinger, N Evans, R Edwards, NL Sivera, F Diaz-Torne, C Macdonald, PA Mcqueen, FM Schumacher, HR AF Grainger, Rebecca Taylor, William J. Dalbeth, Nicola Perez-Ruiz, Fernando Singh, Jasvinder A. Waltrip, Royce W. Schlesinger, Naomi Evans, Robert Edwards, N. Lawrence Sivera, Francisca Diaz-Torne, Cesar Macdonald, Patricia A. Mcqueen, Fiona M. Schumacher, H. Ralph TI Progress in Measurement Instruments for Acute and Chronic Gout Studies SO JOURNAL OF RHEUMATOLOGY LA English DT Article; Proceedings Paper CT 9th International Consensus Conference on Outcome Measures in Rheumatology Clinical Trials (OMERACT 9) CY MAY 27-31, 2008 CL Kananaskis, CANADA DE GOUT; OUTCOME MEASURES; INSTRUMENTS ID QUALITY-OF-LIFE; DOUBLE-BLIND; ASSESSMENT QUESTIONNAIRE; PHYSICAL MEASUREMENT; OUTCOME MEASURES; CONTROLLED-TRIAL; ARTHRITIS; INDOMETHACIN; ETORICOXIB; FEBUXOSTAT AB Consensus exercises have identified and prioritized domains of measurement for studies in acute and chronic gout. In parallel, the technical properties of instruments for measurement in many of these domains have been assessed, with the main objective to consider the instruments in the context of the OMERACT filter of truth, discrimination, and feasibility. These data were presented and discussed at OMERACT 9 in the Gout workshop, in breakout groups, and at informal meetings of the gout group. In acute gout, instruments for domains of pain, joint swelling. joint tenderness, and patient and physician global assessment have been assessed. In chronic gout, some validation exercises have been performed in instruments for domains serum urate, tophus measurement, health-related quality of life (HRQOL). In voting at OMERACT 9, the Medical Outcomes Study Short-Form 36 was endorsed as a valid instrument for measurement of HRQOL. Methods of tophus measurement were considered to have met some criteria of the OMERACT filter, but these require further work, particularly regarding sensitivity to change over shorter time periods. Priorities for future research include measurement of joint inflammation in acute gout and disability in acute and chronic gout. (J Rheumatol 2009;36:2346-55; doi: 10.3899/jrheum.090371) C1 [Grainger, Rebecca] Univ Otago, Dept Med, Wellington 6242, New Zealand. Univ Otago, Malaghan Inst Med Res, Rehabil Teaching & Res Unit, Wellington 6242, New Zealand. [Dalbeth, Nicola; Mcqueen, Fiona M.] Univ Auckland, Dept Med, Auckland, New Zealand. [Perez-Ruiz, Fernando] Hosp Cruces, Secc Reumatol, Vizcaya, Spain. [Singh, Jasvinder A.] Vet Affairs Med Ctr, Rheumatol Sect, Minneapolis, MN USA. [Singh, Jasvinder A.] Vet Affairs Med Ctr, Ctr Chron Dis Outcomes Res, Minneapolis, MN USA. [Waltrip, Royce W.] Savient Pharmaceut, E Brunswick, NJ USA. [Schlesinger, Naomi] Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Dept Med, New Brunswick, NJ 08903 USA. [Evans, Robert] Regeneron Pharmaceut Inc, Tarrytown, NY 10591 USA. [Edwards, N. Lawrence] Univ Florida, Dept Med, Miami, FL USA. [Sivera, Francisca] Gen Hosp Univ Alicante, Secc Reumatol, E-03080 Alicante, Spain. [Diaz-Torne, Cesar] Hosp Santa Creu & Sant Pau, Barcelona, Spain. [Macdonald, Patricia A.] TAP Pharmaceut Prod Inc, Lake Forest, IL USA. [Schumacher, H. Ralph] Vet Affairs Med Ctr, Philadelphia, PA USA. RP Taylor, WJ (reprint author), Univ Otago, Dept Med, POB 7343, Wellington 6242, New Zealand. EM will.taylor@otago.ac.nz RI PEREZ-RUIZ, FERNANDO/E-4844-2012; Grainger, Rebecca/I-1866-2012 OI singh, jasvinder/0000-0003-3485-0006; Cesar, Diaz-Torne/0000-0001-6275-7699; Perez-Ruiz, Fernando/0000-0002-5268-1894 NR 39 TC 33 Z9 36 U1 0 U2 4 PU J RHEUMATOL PUBL CO PI TORONTO PA 365 BLOOR ST E, STE 901, TORONTO, ONTARIO M4W 3L4, CANADA SN 0315-162X EI 1499-2752 J9 J RHEUMATOL JI J. Rheumatol. PD OCT PY 2009 VL 36 IS 10 BP 2346 EP 2355 DI 10.3899/jrheum.090371 PG 10 WC Rheumatology SC Rheumatology GA 505KB UT WOS:000270691200036 PM 19820224 ER PT J AU Kelz, RR Tran, TT Hosokawa, P Henderson, W Paulson, EC Spitz, F Hamilton, BH Hall, BL AF Kelz, Rachel R. Tran, Timothy T. Hosokawa, Patrick Henderson, William Paulson, E. Carter Spitz, Francis Hamilton, Barton H. Hall, Bruce L. TI Time-of-Day Effects on Surgical Outcomes in the Private Sector: A Retrospective Cohort Study SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Article ID 30-DAY POSTOPERATIVE MORTALITY; UNIVERSITY MEDICAL-CENTERS; VETERANS-AFFAIRS HOSPITALS; MYOCARDIAL-INFARCTION; EMERGENCY-SURGERY; INTENSIVE-CARE; MORBIDITY; RISK; OPERATIONS; SURVIVAL AB BACKGROUND: Surgical care is delivered around the clock. Elective cases within the Veterans Affairs health system starting after 4 Pm appear to have an elevated risk of morbidity, but not mortality, compared with earlier cases. The relationship between operation start time and patient outcomes is not described in private-sector patients or for emergency cases. STUDY DESIGN: We performed a retrospective cohort study of 56,920 general and vascular surgical procedures performed from October 2001 through September 2004, and entered into the National Surgical Quality Improvement Program database. Operation start time was the independent variable of interest. Random effects, hierarchical logistic regression models adjusted for patient, operative, and facility characteristics. Two independent models determined associations between start time and morbidity or mortality. Subset analysis was performed for emergency and nonemergency cases. RESULTS: After adjustment for patient and procedure characteristics, mortality had a moderately strong association with start time, but only for nonemergency cases starting 9:30 PM to 7:30 Am (odds ratio = 1.752; P = 0.028; reference 7:30 Am to 9:30 AM). As for morbidity, after adjustment, operations starting 9:30 AM to 1:30 PM mid 5:30 PM to 9:30 Pm were associated with a weakly elevated risk of morbidity, but those starting 9:30 PM to 7:30 AM demonstrated a strong effect on morbidity (odds ratio = 1.32; p < 0.0001). Subgroup analysis showed this effect was largely a result of elevated risk of morbidity in emergency cases from this overnight time period (odds ratio = 1.48; p = 0.001). CONCLUSIONS: Surgical start times are associated with risk-adjusted patient outcomes. In terms of facility operations management and resource allocation, consideration should be given to the capacity to accommodate cases with differences in risk during different time periods. (J Am Coll Surg 2009;209:434-445. (C) 2009 by the American College of Surgeons) C1 [Kelz, Rachel R.; Paulson, E. Carter; Spitz, Francis] Univ Penn, Sch Med, Dept Surg, Philadelphia, PA 19104 USA. [Kelz, Rachel R.; Spitz, Francis] Philadelphia VA Med Ctr, Dept Surg, Philadelphia, PA USA. [Tran, Timothy T.; Hall, Bruce L.] Washington Univ, Sch Med, Dept Surg, St Louis, MO 63110 USA. [Hosokawa, Patrick; Henderson, William] Univ Colorado, Hlth Outcomes Program, Denver, CO 80202 USA. [Hamilton, Barton H.; Hall, Bruce L.] Washington Univ, John M Olin Sch Business, St Louis, MO 63130 USA. [Hall, Bruce L.] John Cochran Vet Affairs Med Ctr, Dept Surg, St Louis, MO USA. [Hall, Bruce L.] Washington Univ, Ctr Hlth Policy, St Louis, MO USA. RP Kelz, RR (reprint author), Univ Penn, Sch Med, Dept Surg, 3400 Spruce St,4 Silverstein, Philadelphia, PA 19104 USA. EM rachel.kelz@uphs.upenn.edu RI Hamilton, Barton/P-5187-2015 FU Office of Research and Development; Department of Veterans Affairs [693/11]; Center for Health Policy; Agency for Healthcare Research and Quality [5U18HS011913] FX This study does not represent the views of the ACS or the ACS NSQIP. This material is based upon work supported by the Office of Research and Development, competitive pilot project fund, Department of Veterans Affairs 693/11. Dr Hall was supported by the Center for Health Policy under the direction of Dr William Peck, Washington University in St Louis, St Louis, MO. This article is partially derived from the Patient Safety in Surgery Study, and partially supported by the Agency for Healthcare Research and Quality, grant number 5U18HS011913, entitled "Reporting System to Improve Patient Safety in Surgery." NR 21 TC 23 Z9 23 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1072-7515 J9 J AM COLL SURGEONS JI J. Am. Coll. Surg. PD OCT PY 2009 VL 209 IS 4 BP 434 EP 445 DI 10.1016/j.jamcollsurg.2009.05.022 PG 12 WC Surgery SC Surgery GA 506CD UT WOS:000270749900003 PM 19801316 ER PT J AU Zhu, CW Penrod, JD Ross, JS Dellenbaugh, C Sano, M AF Zhu, Carolyn W. Penrod, Joan D. Ross, Joseph S. Dellenbaugh, Cornelia Sano, Mary TI Use of Medicare and Department of Veterans Affairs Health Care by Veterans with Dementia: A Longitudinal Analysis SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE dementia; health services use; Medicare; veterans; longitudinal models ID ACUTE MYOCARDIAL-INFARCTION; ALZHEIMERS-DISEASE; UNITED-STATES; VA; COST; PREVALENCE; DISTANCE; SERVICES; SYSTEM AB The objectives of this study were to examine longitudinal patterns of Department of Veterans Affairs (VA)-only use, dual VA and Medicare use, and Medicare-only use by veterans with dementia. Data on VA and Medicare use were obtained from VA administrative datasets and Medicare claims (1998-2001) for 2,137 male veterans who, in 1997, used some VA services, had a formal diagnosis of Alzheimer's disease or vascular dementia in the VA, and were aged 65 and older. Generalized ordered logit models were used to estimate the effects of patient characteristics on use group over time. In 1998, 41.7% of the sample were VA-only users, 55.4% were dual users, and 2.9% were Medicare-only users. By 2001, 30.4% were VA-only users, 51.5% were dual users, and 18.1% were Medicare-only users. Multivariate results show that greater likelihood of Medicare use was associated with older age, being white, being married, having higher education, having private insurance or Medicaid, having low VA priority level, and living in a nursing home or dying during the year. Higher comorbidities were associated with greater likelihood of dual use as opposed to any single system use. Alternatively, number of functional limitations was associated with greater likelihood of Medicare-only use and less likelihood of VA-only use. These results imply that different aspects of veterans' needs have differential effects on where they seek care. Efforts to coordinate care between VA and Medicare providers are necessary to ensure that patients receive high-quality care, especially patients with multiple comorbidities. C1 [Zhu, Carolyn W.; Penrod, Joan D.; Ross, Joseph S.; Dellenbaugh, Cornelia; Sano, Mary] James J Peters Vet Affairs Med Ctr, Res Enhancement Award Program, Hlth Serv Res & Dev Serv, Bronx, NY 10468 USA. [Zhu, Carolyn W.; Penrod, Joan D.; Ross, Joseph S.; Dellenbaugh, Cornelia] Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY USA. [Sano, Mary] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. [Zhu, Carolyn W.; Penrod, Joan D.; Ross, Joseph S.; Dellenbaugh, Cornelia; Sano, Mary] James J Peters Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Hlth Serv Res & Dev Serv, Bronx, NY 10468 USA. RP Zhu, CW (reprint author), James J Peters Vet Affairs Med Ctr, Res Enhancement Award Program, Hlth Serv Res & Dev Serv, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM carolyn.zhu@mssm.edu FU VA HSRD [IIR 05-114, TRP-02-149] FX This project was supported by VA HSR&D IIR 05-114 (PI Zhu). Drs. Zhu, Penrod, and Ross also are supported by VA HSR&D TRP-02-149. NR 33 TC 7 Z9 7 U1 3 U2 4 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2009 VL 57 IS 10 BP 1908 EP 1914 DI 10.1111/j.1532-5415.2009.02405.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 503PV UT WOS:000270551300025 PM 19682132 ER PT J AU Feng, XB Lu, TC Chuang, PY Fang, W Ratnam, K Xiong, HB Ouyang, XS Shen, YH Levy, DE Hyink, D Klotman, M D'Agati, V Iyengar, R Klotman, PE He, JC AF Feng, Xiaobei Lu, Ting-Chi Chuang, Peter Y. Fang, Wei Ratnam, Krishna Xiong, Huabao Ouyang, Xinshou Shen, Yuhong Levy, David E. Hyink, Deborah Klotman, Mary D'Agati, Vivette Iyengar, Ravi Klotman, Paul E. He, John C. TI Reduction of Stat3 Activity Attenuates HIV-Induced Kidney Injury SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID JAK/STAT SIGNALING PATHWAY; AIDS-LIKE DISEASE; TRANSGENIC MICE; DIABETIC-NEPHROPATHY; CELL DEVELOPMENT; NEF; EXPRESSION; PODOCYTES; PROLIFERATION; ACTIVATION AB HIV-1 Nef induces podocyte proliferation and dedifferentiation by activating the Stat3 and MAPK1,2 pathways. Activation of Stat3 also occurs in human kidneys affected by HIV-associated nephropathy (HIVAN), but its contribution to the development of HIVAN is unknown. Here, we generated HIV-1 transgenic mice (Tg26) with either 75% Stat3 activity (Tg26-SA/+) or 25% Stat3 activity (Tg26-SA/-). The kidneys of Tg26-SA/+ mice, but not Tg26-SA/- mice, showed increased Stat3 phosphorylation. The Tg26-SA/+ phenotype was not different from Tg26 mice, but Tg26-SA/- mice developed significantly less proteinuria, glomerulosclerosis, and tubulointerstitial injury. Tg26-SA/+ mice exhibited reduced expression of podocyte differentiation markers and increased expression of VEGF and proliferation markers as compared to Tg26-SA/- mice. Primary podocytes isolated from Tg26-SA/+ mice showed increased Stat3 phosphorylation and reduced expression of podocyte differentiation markers. The tubulointerstitial compartment and isolated tubules of Tg26-SA/+ mice also had increased Stat3 phosphorylation and expression of Stat3 target genes. We confirmed that the expression of the HIV-1 transgene and reduction of Stat3 activity did not affect T and B cell development. In conclusion, Stat3 plays a critical role in the pathogenesis of HIVAN. C1 [He, John C.] Mt Sinai Sch Med, Dept Med, Div Nephrol, New York, NY 10029 USA. [Iyengar, Ravi; He, John C.] Mt Sinai Sch Med, Dept Pharmacol & Syst Therapeut, New York, NY 10029 USA. [Xiong, Huabao; Ouyang, Xinshou] Mt Sinai Sch Med, Immunobiol Ctr, New York, NY 10029 USA. [Feng, Xiaobei] Shanghai Jiao Tong Univ, Sch Med, RuiJin Hosp, Dept Nephrol, Shanghai 200030, Peoples R China. [Shen, Yuhong] Rockefeller Univ, Mol Cell Biol Lab, New York, NY 10021 USA. [Levy, David E.] NYU, Dept Pathol, New York, NY 10016 USA. [D'Agati, Vivette] Columbia Univ, Dept Pathol, New York, NY USA. [Lu, Ting-Chi; He, John C.] James J Peters VA Med Ctr, Bronx, NY USA. RP He, JC (reprint author), Mt Sinai Sch Med, Dept Med, Div Nephrol, Box 1243,1 Gustave L Levy Pl, New York, NY 10029 USA. EM cijiang.he@mssm.edu RI klotman, mary/A-1921-2016 FU NIH [R01 DK078897, P01 DK056492, R01 GM54508] FX J.C.H. is supported by NIH R01 DK078897. This work was also supported by NIH Grants P01 DK056492 to P.K. and R01 GM54508 to R.I. NR 44 TC 25 Z9 26 U1 0 U2 2 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD OCT PY 2009 VL 20 IS 10 BP 2138 EP 2146 DI 10.1681/ASN.2008080879 PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 510ST UT WOS:000271112700011 PM 19608706 ER PT J AU Putzki, N Kinkel, RP Dontchev, M Tanner, JP Kollman, C Simon, J O'Connor, P Hyde, R AF Putzki, N. Kinkel, R. P. Dontchev, M. Tanner, J. P. Kollman, C. Simon, J. O'Connor, P. Hyde, R. TI CHAMPIONS extension: 10-year outcomes in interferon beta-1a-treated patients at high risk for developing multiple sclerosis after a clinically isolated syndrome SO JOURNAL OF THE NEUROLOGICAL SCIENCES LA English DT Meeting Abstract CT 19th World Congress of Neurology CY OCT 24-30, 2009 CL Bangkok, THAILAND C1 [Putzki, N.] Cantonal Hosp, St Gallen, Switzerland. [Putzki, N.] Univ Duisburg Essen, Dept Neurol, Essen, Germany. [Kinkel, R. P.] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. [Dontchev, M.; Tanner, J. P.; Kollman, C.] Hlth Res Fdn Inc, Jaeb Ctr, Tampa, FL USA. [Simon, J.] Portland VA Med Ctr, Portland, OR USA. [O'Connor, P.] St Michaels Hosp, Toronto, ON M5B 1W8, Canada. [Hyde, R.] Biogen Idec Inc, Cambridge, MA USA. NR 0 TC 0 Z9 0 U1 0 U2 6 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 OCT PY 2009 VL 285 SU 1 BP S119 EP S120 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 529ML UT WOS:000272521300412 ER PT J AU Yehuda, R Bierer, LA AF Yehuda, Rachel Bierer, Linda A. TI The Relevance of Epigenetics to PTSD: Implications for the DSM-V SO JOURNAL OF TRAUMATIC STRESS LA English DT Article; Proceedings Paper CT 24th Annual Meeting of the International-Society-for-Traumatic-Stress-Studies CY NOV, 2008 CL Chicago, IL SP Int Soc Traumat Stress Studies ID POSTTRAUMATIC-STRESS-DISORDER; MATERNAL-CARE; ANIMAL-MODEL; HOLOCAUST SURVIVORS; GLUCOCORTICOID-RECEPTOR; CHILDHOOD ABUSE; RISK-FACTORS; RESPONSES; GENE; CORTISOL AB Epigenetic modifications, such as DNA methylation, can occur in response to environmental influences to alter the functional expression of genes in an enduring and potentially, intergenerationally transmissible manner. As such, they may explain interindividual variation, as well as the long-lasting effects of trauma exposure. Although there are currently no findings that suggest epigenetic modifications that are specific to posttraumatic stress disorder (PTSD) or PTSD risk, many recent observations are compatible with epigenetic explanations. These include recent findings of stress-related gene expression, in utero contributions to infant biology, the association of PTSD risk with maternal PTSD, and the relevance of childhood adversity to the development of PTSD. The relevance of epigenetic mechanisms to formulations of PTSD for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is described. C1 James J Peters VAMC, PTSD Clin & Res Program, Bronx, NY USA. Mt Sinai Sch Med, Traumat Stress Studies Div, New York, NY USA. RP Yehuda, R (reprint author), Bronx VA OOMH, 116-A,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Rachel.Yehuda@va.gov FU NCRR NIH HHS [M01 RR000071-430595, M01 RR000071, M01 RR000071-447234, M01 RR000071-458256]; NIMH NIH HHS [R56 MH077321, R56 MH077321-01] NR 57 TC 74 Z9 77 U1 9 U2 28 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0894-9867 J9 J TRAUMA STRESS JI J. Trauma Stress PD OCT PY 2009 VL 22 IS 5 BP 427 EP 434 DI 10.1002/jts.20448 PG 8 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 515SK UT WOS:000271493000011 PM 19813242 ER PT J AU Heller, JC Prochazka, AV Everson, GT Forman, LM AF Heller, J. Christie Prochazka, Allan V. Everson, Gregory T. Forman, Lisa M. TI Long-Term Management After Liver Transplantation: Primary Care Physician Versus Hepatologist SO LIVER TRANSPLANTATION LA English DT Article ID METABOLIC SYNDROME; DIABETES-MELLITUS; PREVALENCE; OBESITY AB As long-term survival after liver transplantation increases, metabolic complications are becoming increasingly prevalent. Given concerns about which group of providers should be managing liver recipients and how well metabolic complications are managed, we administered a postal survey to 280 transplant hepatologists to determine attitudes, perceptions, and practice patterns in the management of metabolic complications after transplantation. The response rate was 68.2%. There was great variation in patterns of practice across the United States with respect to the number of posttransplant clinics, clinic format, and number of recipients cared for per week. Hepatologists, primary care physicians (PCPs), and surgeons were primarily responsible for the overall care of liver recipients 1 year or more after liver transplantation according to 66%, 24%, and 8% of respondents, respectively. Hepatologists felt that metabolic complications were common, but few strongly agreed that hypertension (33.3%), chronic renal insufficiency (3.8%), diabetes mellitus (8.8%), dyslipidemia (111.1%), and bone disease (12.8%) were well controlled. The majority of hepatologists indicated that ideally PCPs should be managing recipients' hypertension, diabetes mellitus, dyslipidemia, and bone disease (78.8%, 63.1%, 78.3%, and 72.5%), but they felt that in actuality, PCPs were managing these conditions less frequently (45.4%, 51.4%, 44.6%, and 38%). In conclusion, metabolic complications are perceived to be common but not well controlled post-transplant, and most hepatologists feel that PCPs should take a more active role in the management of these complications. Future studies are needed to identify barriers to care in the treatment of metabolic complications post-transplant with the goal of improving long-term morbidity and mortality. Liver Transpl 15:1330-1335, 2009. (C) 2009 AASLD. C1 [Heller, J. Christie; Everson, Gregory T.; Forman, Lisa M.] Univ Colorado, Hlth Sci Ctr, Div Gastroenterol & Hepatol, Denver, CO USA. [Prochazka, Allan V.] Univ Colorado, Hlth Sci Ctr, Div Gen Internal Med, Denver, CO 80262 USA. [Prochazka, Allan V.] Denver VA Hosp, Div Ambulatory Care, Denver, CO USA. RP Forman, LM (reprint author), Univ Colorado, Hlth Sci Ctr, Div Gastroenterol & Hepatol, 1635 Aurora Court,B-154, Aurora, CO 80045 USA. EM lisa.forman@ucdenver.edu FU American Society of Transplantation/Schering Plough Women; Minority Career Development Faculty FX This study was funded in part by an American Society of Transplantation/Schering Plough Women and Minority Career Development Faculty Grant. NR 14 TC 11 Z9 11 U1 0 U2 1 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1527-6465 J9 LIVER TRANSPLANT JI Liver Transplant. PD OCT PY 2009 VL 15 IS 10 BP 1330 EP 1335 DI 10.1002/lt.21786 PG 6 WC Gastroenterology & Hepatology; Surgery; Transplantation SC Gastroenterology & Hepatology; Surgery; Transplantation GA 508LB UT WOS:000270931500026 PM 19790168 ER PT J AU Yu, L Koepsell, T Manhart, L Ioannou, G AF Yu, Lei Koepsell, Thomas Manhart, Lisa Ioannou, George TI Survival After Orthotopic Liver Transplantation: The Impact of Antibody Against Hepatitis B Core Antigen in the Donor SO LIVER TRANSPLANTATION LA English DT Article ID HBC POSITIVE DONORS; VIRUS INFECTION; GRAFT-SURVIVAL; ISCHEMIA TIME; ALLOGRAFTS; TRANSMISSION; RECIPIENTS; LAMIVUDINE; RISK; REACTIVATION AB Liver transplantation using grafts from donors with antibody against hepatitis B core antigen (anti-HBc) increases the recipients' risk of developing hepatitis B virus (HBV) infection post-transplantation. Our aim was to assess whether using such grafts was associated with reduced posttransplantation survival and whether this association depended on recipients' prior exposure to HBV on the basis of their pretransplantation serological patterns. Data were derived from the United Network for Organ Sharing on adult, cadaveric, first-time liver transplants performed between 1994 and 2006. Among recipients who did not have HBV infection before transplantation, those with anti-HBc-positive donors had significantly worse unadjusted posttransplantation patient survival than recipients with anti-HBc-negative donors [hazard ratio, 1.35; 95% confidence interval (CI), 1.21-1.50). However, after adjustments for other predictors of posttransplantation survival, including donor age, donor race, and recipient underlying liver diseases, patient survival was not significantly different between the 2 groups (hazard ratio, 1.09; 95% CI, 0.97-1.24). Among recipients without antibody against hepatitis B surface antigen (anti-HBs), use of anti-HBc-positive donor grafts was associated with a trend toward worse survival (adjusted hazard ratio, 1.18; 95% CI, 0.95-1.46), whereas no such trend was observed among recipients positive for anti-HBs. In conclusion, in patients without HBV infection before transplantation, using anti-HBc-positive donors was not independently associated with worse posttransplantation survival. Matching these donors to recipients with anti-HBs pre-transplantation may be especially safe. Liver Transpl 15:1343-1350, 2009. (C) 2009 AASLD. C1 [Yu, Lei] Univ Washington, Dept Med, Div Gastroenterol, Sch Med, Seattle, WA 98195 USA. [Yu, Lei; Ioannou, George] Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Gastroenterol, Seattle, WA USA. [Yu, Lei; Ioannou, George] Vet Affairs Puget Sound Hlth Care Syst, Res Enhancement Award Program, Seattle, WA USA. [Yu, Lei; Koepsell, Thomas; Manhart, Lisa] Univ Washington, Dept Epidemiol, Sch Publ Hlth & Community Med, Seattle, WA 98195 USA. RP Yu, L (reprint author), Univ Washington, Dept Med, Div Gastroenterol, Sch Med, 1959 NE Pacific St,Box 356424, Seattle, WA 98195 USA. EM leiy@medicine.washington.edu FU American Liver Foundation; American Association for the Study of Liver Diseases through the Jan Albrecht Award; National Institutes of Health; Health Resources and Services Administration [231-00-0115] FX This research was supported by the American Liver Foundation and American Association for the Study of Liver Diseases through the Jan Albrecht Award (to G. Ioannou), by the Veterans Affairs Puget Sound Health Care System through the Research Enhancement Award Program (to L. Yu), by the National Institutes of Health through a T32 training grant (to L. Yu), and by the Health Resources and Services Administration (contract 231-00-0115). NR 30 TC 25 Z9 25 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1527-6465 J9 LIVER TRANSPLANT JI Liver Transplant. PD OCT PY 2009 VL 15 IS 10 BP 1343 EP 1350 DI 10.1002/lt.21788 PG 8 WC Gastroenterology & Hepatology; Surgery; Transplantation SC Gastroenterology & Hepatology; Surgery; Transplantation GA 508LB UT WOS:000270931500028 PM 19790164 ER PT J AU Namjou, B Scofield, RH Kelly, JA Goodmon, EL Aberle, T Bruner, GR Harley, JB AF Namjou, B. Scofield, R. H. Kelly, J. A. Goodmon, E. L. Aberle, T. Bruner, G. R. Harley, J. B. TI The effects of previous hysterectomy on lupus SO LUPUS LA English DT Article DE anti-DNA antibodies; nephritis; systemic lupus erythematosus ID UNITED-STATES; ERYTHEMATOSUS; SEX; PREVALENCE; WOMEN; AGE AB Hysterectomy is one of the most common surgical procedures performed in United States, and currently, one in three women in United States has had a hysterectomy by the age of 60 years. Systemic lupus erythematosus (SLE) is a common autoimmune disease and especially targets women of childbearing age at least 10 times higher than men, which reflects the major role of female sex hormones. In this retrospective study, we evaluate the potential effects of previous hysterectomy in our lupus cohort. Data collected from study subject questionnaires were obtained from the Lupus Family Registry and Repository (LFRR) at the Oklahoma Medical Research Foundation. Hysterectomy data were available from 3389 subjects. SLE patients with a positive history of hysterectomy have been selected and compared with matched lupus patients with a negative history of hysterectomy and healthy controls. Association analyses were performed, and the P values and adjusted odds ratios (ORs) were calculated. SLE patients with a negative history of hysterectomy more likely had kidney nephritis or positive anti-dsDNA than age-matched SLE patients with a history of hysterectomy before disease onset. This effect was independent of ethnicity with an OR of 6.66 (95% CI = 3.09-14.38, P = 1.00 x 10(-8)) in European patients and 2.74 (95% CI = 1.43-5.25, P = 0.001) in African-Americans. SLE patients with a positive history of hysterectomy before disease onset also had a later age of disease onset (P = 0.0001) after adjustment for age and race. Our findings support the notion that the influence of female sex hormones in SLE and various clinical findings are tremendous and that surgical menopause such as this could significantly affect the outcome of disease and clinical manifestations. Lupus (2009) 18, 1000-1005. C1 [Namjou, B.; Scofield, R. H.; Kelly, J. A.; Goodmon, E. L.; Aberle, T.; Bruner, G. R.; Harley, J. B.] Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. [Harley, J. B.] US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. [Harley, J. B.] Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA. RP Harley, JB (reprint author), Oklahoma Med Res Fdn, 825 NE 13th St, Oklahoma City, OK 73104 USA. EM john-harley@omrf.org FU NIH [AR42460, RR015577, AI31584, AR12253, AR48940, DE015223, RR020143, AI062629, AI24717, AI07633, AR62277]; U.S. Department of Veterans Affairs FX This work was supported by the NIH (AR42460, RR015577, AI31584, AR12253, AR48940, DE015223, RR020143, AI062629, AI24717, AI07633 and AR62277) and the U.S. Department of Veterans Affairs. NR 15 TC 4 Z9 4 U1 0 U2 0 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 0961-2033 J9 LUPUS JI Lupus PD OCT PY 2009 VL 18 IS 11 BP 1000 EP 1005 DI 10.1177/0961203309104315 PG 6 WC Rheumatology SC Rheumatology GA 495AW UT WOS:000269862600010 PM 19762402 ER PT J AU Thameem, F Puppala, S He, X Arar, NH Stern, MP Blangero, J Duggirala, R Abboud, HE AF Thameem, Farook Puppala, Sobha He, Xin Arar, Nedal H. Stern, Michael P. Blangero, John Duggirala, Ravindranath Abboud, Hanna E. TI Evaluation of gremlin 1 (GREM1) as a candidate susceptibility gene for albuminuria-related traits in Mexican Americans with type 2 diabetes mellitus SO METABOLISM-CLINICAL AND EXPERIMENTAL LA English DT Article ID GLOMERULAR-FILTRATION-RATE; MEASURED GENOTYPE; NEPHROPATHY; LINKAGE; EXPRESSION; DISEASE; GLUCOSE; SEARCH; KIDNEY; LIMB AB Several novel genes that are up-regulated in the kidney in diabetes have been identified including GREM1, which encodes gremlin 1. GREM1 maps to human chromosome 15q12, a region previously found to be linked to albumin to creatinine ratio (ACR) in Mexican Americans. The objective of this study is to investigate whether genetic variants in GREM1, a positional candidate gene, contribute to variation in ACR. By sequencing 32 individuals for both exons and 2-kilobase putative promoter region of GREM1, we identified 19 genetic variants including 5 in the promoter region and 13 in the 3' Untranslated region. Of 19 polymorphisms identified, 13 polymorphisms were genotyped in the entire cohort (N = 670, 39 large families) either by restriction fragment length polymorphism or by TaqMan (Applied Biosystems, Foster City, CA) assays. Association analyses between the genotypes and ACR, type 2 diabetes mellitus, and related phenotypes were carried out using a measured genotype approach as implemented in the variance component analytical tools (SOLAR). of the variants examined for association, none exhibited statistically significant association with ACR after accounting for the effects of covariates such as age, sex, diabetes, duration of diabetes, systolic blood pressure, and antihypertensive medications. However, 2 novel variants at the 31 untranslated region showed significant association with estimated glomerular filtration rate (P = .010 and P = .049) and body mass index (P = .013 and P = .019) after accounting for trait-specific covariate influences. Furthermore, a novel variant located in the promoter exhibited a significant association with systolic (P = .038) and diastolic blood pressure (P = .005) after adjusting for the effects of age, sex, diabetes, and antihypertensive medications. In conclusion, the variants examined at GREM1 are not significant contributors to variation in ACR in Mexican Americans, although they appear to minimally influence risk factors related to ACR. (c) 2009 Elsevier Inc. All rights reserved. C1 [Thameem, Farook] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Div Nephrol, San Antonio, TX 78229 USA. [Thameem, Farook; Arar, Nedal H.; Abboud, Hanna E.] Univ Texas Hlth Sci Ctr San Antonio, George OBrien Kidney Res Ctr, San Antonio, TX 78229 USA. [Puppala, Sobha; Blangero, John; Duggirala, Ravindranath] SW Fdn Biomed Res, Dept Genet, San Antonio, TX 78227 USA. [Arar, Nedal H.; Abboud, Hanna E.] S Texas Vet Healthcare Syst, San Antonio, TX 78229 USA. [Stern, Michael P.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Div Clin Epidemiol, San Antonio, TX 78229 USA. RP Thameem, F (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Div Nephrol, San Antonio, TX 78229 USA. EM thameem@uthscsa.edu FU American Heart Association; Diabetes Action Research and Education Foundation; Satellite HealthCare; George O'Brien Kidney Research Center [P50 DK061597]; VA-Merit Review; National Institute of Diabetes, Digestive, and Kidney Diseases [DK42273, DK47482, DK53889]; National Center for Research Resources [UL1 RR025767, KL2 RR025766] FX We thank members of the SAFDGS for their participation and cooperation. This Study was Supported by a Scientist Development Grant from the American Heart Association (FT), Diabetes Action Research and Education Foundation (FT), Satellite HealthCare (FT), George O'Brien Kidney Research Center (P50 DK061597; HEA, FT), VA-Merit Review (HEA, NHA), and grants from the National Institute of Diabetes, Digestive, and Kidney Diseases (NIPS: DK42273, DK47482; RD: DK53889). This work was also Supported by the National Center for Research Resources contracts UL1 RR025767 and KL2 RR025766 for the Institute for Integration of Medicine and Science. We also thank the General Clinical Research Center, South Texas Healthcare System. NR 22 TC 5 Z9 5 U1 0 U2 4 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0026-0495 J9 METABOLISM JI Metab.-Clin. Exp. PD OCT PY 2009 VL 58 IS 10 BP 1496 EP 1502 DI 10.1016/j.metabol.2009.04.039 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 500TF UT WOS:000270327100020 PM 19577778 ER PT J AU Brown, M AF Brown, Mark TI Military Chemical Warfare Agent Human Subjects Testing: Part 1-History of Six-Decades of Military Experiments With Chemical Warfare Agents SO MILITARY MEDICINE LA English DT Article AB Military chemical warfare agent testing from World War I to 1975 produced thousands of veterans with concerns of possible long-term health consequences. Clinical and research evaluation of potential long-term health effects has been difficult because the exposures occurred decades ago, the identity of troops exposed and exposure magnitudes are uncertain, and acute effects during experiments poorly documented. In contrast, a companion article describes the large amount of information available about the specific agents tested and their long-term health effects. This short history describes U.S. military chemical-agent experiments with human subjects and identifies tested agents. Finally, the demonstrated need to anticipate future health concerns from military personnel involved in such military testing suggests current and future military researchers should be required, by law and regulation, to fully record the identity of those exposed, relevant exposure magnitude, and complete medical information for all subjects. New study protocols and institutional review board approvals for research involving military personnel should reflect this need. C1 US Dept Vet Affairs, Environm Agents Serv, Washington, DC 20420 USA. RP Brown, M (reprint author), US Dept Vet Affairs, Environm Agents Serv, 810 Vermont Ave NW, Washington, DC 20420 USA. NR 10 TC 4 Z9 4 U1 0 U2 1 PU ASSOC MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 J9 MIL MED JI Milit. Med. PD OCT PY 2009 VL 174 IS 10 BP 1041 EP 1048 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 601LI UT WOS:000278060500006 PM 19891215 ER PT J AU Brown, M AF Brown, Mark TI Military Chemical Warfare Agent Human Subjects Testing: Part 2-Long-Term Health Effects Among Participants of US Military Chemical Warfare Agent Testing SO MILITARY MEDICINE LA English DT Article ID CHLOROBENZYLIDENE MALONONITRILE CS; POSTTRAUMATIC-STRESS-DISORDER; MUSTARD GAS; TOKYO SUBWAY; TEAR GAS; VETERANS; SARIN; EXPOSURE AB Military chemical warfare agent testing from World War I to 1975 produced thousands of veterans with concerns about how their participation affected their health. A companion article describes the history of these experiments, and how the lack of clinical data hampers evaluation of long-term health consequences. Conversely, much information is available about specific agents tested and their long-term health effects in other populations, which may be invaluable for helping clinicians respond effectively to the health care and other needs of affected veterans. The following review describes tested agents and their known long-term health consequences. Although hundreds of chemicals were tested, they fall into only about a half-dozen pharmaceutical classes, including common pharmaceuticals; anticholinesterase agents including military nerve agents and pesticides; anticholinergic glycolic acid esters such as atropine; acetylcholine reactivators such as 2-PAM; psychoactive compounds including cannabinoids, phencyclidine, and LSD; and irritants including tear gas and riot control agents. C1 US Dept Vet Affairs, Environm Agents Serv, Washington, DC 20420 USA. RP Brown, M (reprint author), US Dept Vet Affairs, Environm Agents Serv, 810 Vermont Ave, Washington, DC 20420 USA. NR 25 TC 2 Z9 2 U1 0 U2 10 PU ASSOC MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 J9 MIL MED JI Milit. Med. PD OCT PY 2009 VL 174 IS 10 BP 1049 EP 1054 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 601LI UT WOS:000278060500007 PM 19891216 ER PT J AU He, WJ Kulkarni, H Castiblanco, J Shimizu, C Aluyen, U Maldonado, R Carrillo, A Griffin, M Lipsitt, A Beachy, L Shostakovich-Koretskaya, L Mangano, A Sen, L Nibbs, RJB Tiemessen, CT Bolivar, H Bamshad, MJ Clark, RA Burns, JC Dolan, MJ Ahuja, SK AF He, Weijing Kulkarni, Hemant Castiblanco, John Shimizu, Chisato Aluyen, Una Maldonado, Robert Carrillo, Andrew Griffin, Madeline Lipsitt, Amanda Beachy, Lisa Shostakovich-Koretskaya, Ludmila Mangano, Andrea Sen, Luisa Nibbs, Robert J. B. Tiemessen, Caroline T. Bolivar, Hector Bamshad, Michael J. Clark, Robert A. Burns, Jane C. Dolan, Matthew J. Ahuja, Sunil K. TI Experimental aspects of copy number variant assays at CCL3L1 Reply SO NATURE MEDICINE LA English DT Letter ID ACTIVE ANTIRETROVIRAL THERAPY; GENE; SUSCEPTIBILITY C1 [He, Weijing; Kulkarni, Hemant; Castiblanco, John; Aluyen, Una; Maldonado, Robert; Carrillo, Andrew; Griffin, Madeline; Lipsitt, Amanda; Beachy, Lisa; Clark, Robert A.; Ahuja, Sunil K.] S Texas Vet Hlth Care Syst, Vet Adm Res Ctr AIDS & HIV Infect 1, San Antonio, TX USA. [He, Weijing; Kulkarni, Hemant; Castiblanco, John; Aluyen, Una; Maldonado, Robert; Carrillo, Andrew; Griffin, Madeline; Lipsitt, Amanda; Beachy, Lisa; Clark, Robert A.; Ahuja, Sunil K.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. [Shimizu, Chisato; Burns, Jane C.] Univ Calif San Diego, Sch Med, Dept Pediat, La Jolla, CA 92093 USA. [Shostakovich-Koretskaya, Ludmila] Dnepropetrovsk State Med Acad, Dept Gen Pediat & Pediat Infect Dis, Dnepropetrovsk, Ukraine. [Mangano, Andrea; Sen, Luisa] Hosp Pediat JP Garrahan, Lab Biol Celular & Retrovirus, Buenos Aires, DF, Argentina. [Nibbs, Robert J. B.] Univ Glasgow, Glasgow Biomed Res Ctr, Glasgow, Lanark, Scotland. [Tiemessen, Caroline T.] Natl Hlth Lab Serv, Natl Inst Communicable Diseases, AIDS Virus Res Unit, Johannesburg, South Africa. [Tiemessen, Caroline T.] Univ Witwatersrand, Johannesburg, South Africa. [Bolivar, Hector] Univ Miami, Miller Sch Med, AIDS Clin Res Unit, Miami, FL 33136 USA. [Bamshad, Michael J.] Univ Washington, Dept Pediat, Seattle, WA 98195 USA. [Bamshad, Michael J.] Univ Washington, Dept Genome Sci, Seattle, WA 98195 USA. [Bamshad, Michael J.] Seattle Childrens Hosp, Seattle, WA USA. [Dolan, Matthew J.] Wilford Hall USAF Med Ctr, Henry M Jackson Fdn, Lackland AFB, TX 78236 USA. [Dolan, Matthew J.] Brooke Army Med Ctr, San Antonio Mil Med Ctr, Infect Dis Serv, Ft Sam Houston, TX 78234 USA. RP He, WJ (reprint author), S Texas Vet Hlth Care Syst, Vet Adm Res Ctr AIDS & HIV Infect 1, San Antonio, TX USA. EM ahujas@uthscsa.edu RI CASTIBLANCO, JOHN/B-6599-2009; Shimizu, Chisato/J-6516-2015 OI CASTIBLANCO, JOHN/0000-0002-7965-9822; NR 18 TC 22 Z9 22 U1 0 U2 3 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 1078-8956 J9 NAT MED JI Nat. Med. PD OCT PY 2009 VL 15 IS 10 BP 1117 EP 1120 DI 10.1038/nm1009-1117 PG 5 WC Biochemistry & Molecular Biology; Cell Biology; Medicine, Research & Experimental SC Biochemistry & Molecular Biology; Cell Biology; Research & Experimental Medicine GA 504EC UT WOS:000270596400015 PM 19812563 ER PT J AU de Nijs, L Leon, C Nguyen, L LoTurco, JJ Delgado-Escueta, AV Grisar, T Lakaye, B AF de Nijs, Laurence Leon, Christine Nguyen, Laurent LoTurco, Joseph J. Delgado-Escueta, Antonio V. Grisar, Thierry Lakaye, Bernard TI EFHC1 interacts with microtubules to regulate cell division and cortical development SO NATURE NEUROSCIENCE LA English DT Article ID JUVENILE MYOCLONIC EPILEPSY; NEURONAL MIGRATION; RNA INTERFERENCE; MITOTIC SPINDLE; CEREBRAL-CORTEX; GENERALIZED EPILEPSY; CYTOPLASMIC DYNEIN; NEOCORTEX; MUTATIONS; PROTEIN AB Mutations in the EFHC1 gene are linked to juvenile myoclonic epilepsy (JME), one of the most frequent forms of idiopathic generalized epilepsies. JME is associated with subtle alterations of cortical and subcortical architecture, but the underlying pathological mechanism remains unknown. We found that EFHC1 is a microtubule-associated protein involved in the regulation of cell division. In vitro, EFHC1 loss of function disrupted mitotic spindle organization, impaired M phase progression, induced microtubule bundling and increased apoptosis. EFHC1 impairment in the rat developing neocortex by ex vivo and in utero electroporation caused a marked disruption of radial migration. We found that this effect was a result of cortical progenitors failing to exit the cell cycle and defects in the radial glia scaffold organization and in the locomotion of postmitotic neurons. Therefore, we propose that EFHC1 is a regulator of cell division and neuronal migration during cortical development and that disruption of its functions leads to JME. C1 [de Nijs, Laurence; Leon, Christine; Nguyen, Laurent; Grisar, Thierry; Lakaye, Bernard] Univ Liege, GIGA Neurosci, Liege, Belgium. [LoTurco, Joseph J.] Univ Connecticut, Dept Physiol & Neurobiol, Storrs, CT 06269 USA. [Delgado-Escueta, Antonio V.] Univ Calif Los Angeles, David Geffen Sch Med, Epilepsy Genet Genom Labs, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Grisar, T (reprint author), Univ Liege, GIGA Neurosci, Liege, Belgium. EM tgrisar@ulg.ac.be OI Delgado-Escueta, Antonio V./0000-0002-1581-6999 FU FNRS (Fonds de la Recherche Scientifique Medicale) [3.4565.03]; Leon Fredericq Foundation FX We thank B. Coumans for skillful technical assistance, J. Bai for help with in utero electroporation processing and S. Ormenese from the GIGA-Imaging and Flow Cytometry platform for support with flow cytometry. We are also grateful to A. Adamantidis for critical reading of the manuscript. We thank F. Polleux for the NeuroD-IRES-GFP plasmid. This work was supported by grants from the F. R. S.- FNRS (Fonds de la Recherche Scientifique Medicale 3.4565.03 to T. G. and B. L.) and the Leon Fredericq Foundation (to L. d. N.). L. N. and B. L. are research associates at the F. R. S.- FNRS. NR 50 TC 37 Z9 37 U1 0 U2 8 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 1097-6256 J9 NAT NEUROSCI JI Nat. Neurosci. PD OCT PY 2009 VL 12 IS 10 BP 1266 EP U84 DI 10.1038/nn.2390 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 498US UT WOS:000270170200015 PM 19734894 ER PT J AU Siegel, JM AF Siegel, Jerome M. TI SLEEP - OPINION Sleep viewed as a state of adaptive inactivity SO NATURE REVIEWS NEUROSCIENCE LA English DT Review ID EYE-MOVEMENT SLEEP; SLOW-WAVE SLEEP; CONTINUOUS AUDITORY VIGILANCE; CEREBRAL GLUCOSE-UTILIZATION; LIZARD CTENOSAURA-PECTINATA; MAMMALIAN SLEEP; REM-SLEEP; PHYLOGENETIC ANALYSIS; PARADOXICAL SLEEP; GROWTH-HORMONE AB Sleep is often viewed as a vulnerable state that is incompatible with behaviours that nourish and propagate species. This has led to the hypothesis that sleep has survived because it fulfills some universal, but as yet unknown, vital function. I propose that sleep is best understood as a variant of dormant states seen throughout the plant and animal kingdoms and that it is itself highly adaptive because it optimizes the timing and duration of behaviour. Current evidence indicates that ecological variables are the main determinants of sleep duration and intensity across species. C1 [Siegel, Jerome M.] Univ Calif Los Angeles, Dept Psychiat, Sch Med, Los Angeles, CA 90095 USA. [Siegel, Jerome M.] Vet Affairs Greater Los Angeles Healthcare Syst, North Hills, CA 91343 USA. RP Siegel, JM (reprint author), Univ Calif Los Angeles, Dept Psychiat, Sch Med, Los Angeles, CA 90095 USA. EM JSiegel@ucla.edu FU Medical Research Service of the Veterans Affairs Greater Los Angeles Healthcare System [NS14610, HL41370, MH64109, NSF0234687] FX The author's work is supported by the Medical Research Service of the Veterans Affairs Greater Los Angeles Healthcare System, grants NS14610, HL41370, MH64109 and NSF0234687. I thank G. Barber and W. Domhoff for helpful comments. NR 121 TC 102 Z9 104 U1 8 U2 56 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1471-003X J9 NAT REV NEUROSCI JI Nat. Rev. Neurosci. PD OCT PY 2009 VL 10 IS 10 BP 747 EP 753 DI 10.1038/nrn2697 PG 7 WC Neurosciences SC Neurosciences & Neurology GA 496MQ UT WOS:000269978800013 PM 19654581 ER PT J AU Suntsova, N Kumar, S Guzman-Marin, R Alam, MN Szymusiak, R McGinty, D AF Suntsova, N. Kumar, S. Guzman-Marin, R. Alam, M. N. Szymusiak, R. McGinty, D. TI A role for the preoptic sleep-promoting system in absence epilepsy SO NEUROBIOLOGY OF DISEASE LA English DT Article DE Absence epilepsy; Spike-wave discharges; Sleep; Median preoptic nucleus; Ventrolateral preoptic nucleus; GABAergic neurons; c-Fos; Neuronal activity; WAG/Rij rats ID IDIOPATHIC GENERALIZED EPILEPSY; WAKING DISCHARGE PATTERNS; SPIKE-WAVE DISCHARGES; C-FOS; GALANINERGIC NEURONS; SUBUNIT EXPRESSION; GABAERGIC NEURONS; GENETIC MODEL; WAG/RIJ RATS; SEIZURES AB Absence epilepsy (AE) in humans and the genetic AE model in WAG/Rij rats are both associated with abnormalities in sleep architecture that suggest insufficiency of the sleep-promoting mechanisms. In this study we compared the functionality of sleep-active neuronal groups within two well-established sleep-promoting sites, the ventrolateral and median preoptic nuclei (VLPO and MnPN, respectively), in WAG/Rij and control rats. Neuronal activity was assessed using c-Fos immunoreactivity and chronic single-unit recording techniques. We found that WAG/Rij rats exhibited a lack of sleep-associated c-Fos activation of GABAergic MnPN and VLPO neurons, a lower percentage of MnPN and VLPO cells increasing discharge during sleep and reduced firing rates of MnPN sleep-active neurons, compared to non-epileptic rats. The role of sleep-promoting mechanisms in pathogenesis of absence seizures was assessed in non-epileptic rats using electrical stimulation and chemical manipulations restricted to the MnPN. We found that fractional activation of the sleep-promoting system in waking was sufficient to elicit absence-like seizures. Given that reciprocally interrelated sleep-promoting and arousal neuronal groups control thalamocortical excitability, we hypothesize that malfunctioning of sleep-promoting system results in impaired ascending control over thalamocortical rhythmogenic mechanisms during wake-sleep transitions thus favoring aberrant thalamocortical oscillations. Our findings suggest a pathological basis for AE-associated sleep abnormalities and a mechanism underlying association of absence seizures with wake-sleep transitions. Published by Elsevier Inc. C1 [Suntsova, N.; Kumar, S.; Alam, M. N.; Szymusiak, R.; McGinty, D.] VA Greater Los Angeles Healthcare Syst, Res Serv, North Hills, CA 91343 USA. [Suntsova, N.; Alam, M. N.; McGinty, D.] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA. [Kumar, S.; Szymusiak, R.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. [Guzman-Marin, R.] Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90095 USA. [Suntsova, N.] So Fed Univ, AB Kogan Res Inst Neurocybernet, Rostov Na Donu 344091, Russia. [Kumar, S.] Univ Patna, Dept Zool, Patna 800005, Bihar, India. RP Suntsova, N (reprint author), VA Greater Los Angeles, Res Serv 151A3, Healthcare Syst, 16111 Plummer St, North Hills, CA 91343 USA. EM suntsova@ucla.edu; dmcginty@ucla.edu FU Medical Research Service of the Department of Veterans Affairs; NIH [MH075076, HL60296, NS-50939]; Sleep Research Society Foundation FX This research was supported by the Medical Research Service of the Department of Veterans Affairs, NIH grants MH075076, HL60296, NS-50939 and the J. Christian Gillin Research Grant from the Sleep Research Society Foundation (N.S.) We thank Dr. M.N. Shouse for helpful comments on the work and Keng-Tee Chew for technical assistance. References NR 62 TC 15 Z9 16 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 0969-9961 J9 NEUROBIOL DIS JI Neurobiol. Dis. PD OCT PY 2009 VL 36 IS 1 BP 126 EP 141 DI 10.1016/j.nbd.2009.07.005 PG 16 WC Neurosciences SC Neurosciences & Neurology GA 536BJ UT WOS:000273016900013 PM 19631751 ER PT J AU Mata, IF Hutter, CM Gonzalez-Fernandez, MC de Pancorbo, MM Lezcano, E Huerta, C Blazquez, M Ribacoba, R Guisasola, LM Salvador, C Gomez-Esteban, JC Zarranz, JJ Infante, J Jankovic, J Deng, H Edwards, KL Alvarez, V Zabetian, CP AF Mata, Ignacio F. Hutter, Carolyn M. Gonzalez-Fernandez, Maria C. de Pancorbo, Marian M. Lezcano, Elena Huerta, Cecilia Blazquez, Marta Ribacoba, Renee Guisasola, Luis M. Salvador, Carlos Gomez-Esteban, Juan C. Zarranz, Juan J. Infante, Jon Jankovic, Joseph Deng, Hao Edwards, Karen L. Alvarez, Victoria Zabetian, Cyrus P. TI Lrrk2 R1441G-related Parkinson's disease: evidence of a common founding event in the seventh century in Northern Spain SO NEUROGENETICS LA English DT Article DE Parkinson disease; LRRK2; R1441G; Founder effect; Basques ID CLINICAL-FEATURES; SPANISH PATIENTS; GENETIC-ANALYSIS; G2019S MUTATION; ASHKENAZI JEWS; BASQUES; DIVERSITY; LINKAGE; IDENTIFICATION; FREQUENCY AB Mutations in the leucine-rich repeat kinase 2 (LRRK2) gene together represent the most common genetic determinant of Parkinson's disease (PD) identified to date. The vast majority of patients with LRRK2-related PD reported in the literature carry one of three pathogenic substitutions: G2019S, R1441C, or R1441G. While G2019S and R1441C are geographically widespread, R1441G is most prevalent in the Basque Country and is rare outside of Northern Spain. We sought to better understand the processes that have shaped the current distribution of R1441G. We performed a haplotype analysis of 29 unrelated PD patients heterozygous for R1441G and 85 wild-type controls using 20 markers that spanned 15.1 Mb across the LRRK2 region. Nine of the patients were of Basque origin and 20 were non-Basques. We inferred haplotypes using a Bayesian approach and utilized a maximum-likelihood method to estimate the age of the most recent common ancestor. Significant but incomplete allele sharing was observed over a distance of 6.0 Mb and a single, rare ten-marker haplotype 5.8 Mb in length was seen in all mutation carriers. We estimate that the most recent common ancestor lived 1,350 (95% CI, 1,020-1,740) years ago in approximately the seventh century. We hypothesize that R1441G originated in the Basque population and that dispersion of the mutation then occurred through short-range gene flow that was largely limited to nearby regions in Spain. C1 [Mata, Ignacio F.; Zabetian, Cyrus P.] Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr S 182, Seattle, WA 98108 USA. [Mata, Ignacio F.; Zabetian, Cyrus P.] Univ Washington, Dept Neurol, Seattle, WA 98195 USA. [Hutter, Carolyn M.; Edwards, Karen L.] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. [Gonzalez-Fernandez, Maria C.; de Pancorbo, Marian M.] Univ Basque Country, Serv Gen Invest Genom Banco ADN, Vitoria, Spain. [Lezcano, Elena; Gomez-Esteban, Juan C.; Zarranz, Juan J.] Hosp Cruces, Unidad Trastornos Movimiento, Baracaldo, Spain. [Huerta, Cecilia; Alvarez, Victoria] Hosp Univ Cent Asturias, Genet Mol Inst Invest Nefrol, Oviedo, Spain. [Blazquez, Marta; Guisasola, Luis M.; Salvador, Carlos] Hosp Univ Cent Asturias, Serv Neurol, Oviedo, Spain. [Ribacoba, Renee] Hosp Alvarez Buylla, Serv Neurol, Mieres, Spain. [Infante, Jon] Univ Cantabria, Serv Neurol, Hosp Univ Marques de Valdecilla, E-39005 Santander, Spain. [Jankovic, Joseph; Deng, Hao] Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. [Deng, Hao] Cent S Univ, Ctr Med Expt, Xiangya Hosp 3, Changsha, Hunan, Peoples R China. RP Zabetian, CP (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr S 182, 1660 S Columbian Way, Seattle, WA 98108 USA. EM zabetian@u.washington.edu RI Zarranz, Juan Jose/E-2955-2012; Gomez, Juan Carlos/E-3020-2012; SGIKER, Cienciometria/A-5759-2012 OI Fernandez Mata, Ignacio/0000-0003-1198-0633; Zabetian, Cyrus/0000-0002-7739-4306; MARTINEZ DE PANCORBO, MARIA DE LOS ANGELES/0000-0002-7408-6068 FU Basque Government and University of the Basque Country [S-PE07UN44]; NIH [NINDS, K08 NS044138]; Department of Veterans Affairs; Parkinson's Disease Foundation; Spanish Fondo de Investigacion Sanitaria [FIS PI070014, 05/008]; Veterans Integrated Service Network 20 Geriatric, Mental Illness, and Parkinson's Disease Research, Education, and Clinical Centers FX We dedicate this paper to our dear colleague, Dr. Luis M. Guisasola, a superb clinician, researcher, and educator, who recently passed away. We thank the individuals who participated in the study. This work was supported by the Basque Government and University of the Basque Country (grant S-PE07UN44, M. M. P. and M. C. G-F.); the NIH (NINDS, K08 NS044138, C. P. Z.); the Department of Veterans Affairs (Merit Review Award, C. P. Z.); the Parkinson's Disease Foundation (Fellowship Award, I. F. M.); the Spanish Fondo de Investigacion Sanitaria (grant FIS PI070014, J. I; grant 05/008, V. A.); and the Veterans Integrated Service Network 20 Geriatric, Mental Illness, and Parkinson's Disease Research, Education, and Clinical Centers. NR 44 TC 15 Z9 15 U1 0 U2 2 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1364-6745 J9 NEUROGENETICS JI Neurogenetics PD OCT PY 2009 VL 10 IS 4 BP 347 EP 353 DI 10.1007/s10048-009-0187-z PG 7 WC Genetics & Heredity; Clinical Neurology SC Genetics & Heredity; Neurosciences & Neurology GA 501MM UT WOS:000270386000010 PM 19308469 ER PT J AU Bar-Shira, A Hutter, CM Giladi, N Zabetian, CP Orr-Urtreger, A AF Bar-Shira, Anat Hutter, Carolyn M. Giladi, Nir Zabetian, Cyrus P. Orr-Urtreger, Avi TI Ashkenazi Parkinson's disease patients with the LRRK2 G2019S mutation share a common founder dating from the second to fifth centuries SO NEUROGENETICS LA English DT Article DE Parkinson's disease; Haplotype; Ashkenazi Jews; LRRK2 G2019S mutation; Founder mutation ID 185DELAG BRCA1 MUTATION; FAMILIES; JEWS; IDENTIFICATION; PENETRANCE; PREVALENCE; PORTUGAL; EUROPE; AGE AB The LRRK2 G2019S mutation is a major genetic determinant of Parkinson's disease (PD) across the world that occurs at an elevated frequency in Ashkenazi Jews. We determined the LRRK2 haplotypes in 77 G2019S carriers, mostly Ashkenazi Jews, and in 50 noncarrier Ashkenazi PD patients, using 16 genetic markers. A single haplotype was detected in all mutation carriers, indicating that these individuals share a common founder. Using a maximum-likelihood method, we estimate that Ashkenazi Jews with G2019S share a common ancestor who lived similar to 1,830 (95% CI 1,560-2,160) years ago, around the second century, after the second Jewish Diaspora. C1 [Bar-Shira, Anat; Orr-Urtreger, Avi] Tel Aviv Sourasky Med Ctr, Genet Inst, IL-64239 Tel Aviv, Israel. [Giladi, Nir] Tel Aviv Sourasky Med Ctr, Movement Disorders Unit, Parkinson Ctr, Dept Neurol, IL-64239 Tel Aviv, Israel. [Giladi, Nir; Orr-Urtreger, Avi] Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel. [Hutter, Carolyn M.] Univ Washington, Sch Publ Hlth & Community Med, Dept Epidemiol, Seattle, WA 98195 USA. [Zabetian, Cyrus P.] Univ Washington, Sch Med, Geriatr Res Educ & Clin Ctr, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. [Zabetian, Cyrus P.] Univ Washington, Dept Neurol, Sch Med, Seattle, WA USA. RP Orr-Urtreger, A (reprint author), Tel Aviv Sourasky Med Ctr, Genet Inst, 6 Weizmann St, IL-64239 Tel Aviv, Israel. EM aviorr@tasmc.health.gov.il OI Zabetian, Cyrus/0000-0002-7739-4306 FU National Parkinson Foundation, Miami, USA; Tel Aviv Sourasky Medical Center Grant of Excellence; Wolfson and Kahn Foundations FX The assistance of Dr. Helena Yagev-More is gratefully acknowledged. This work was supported by grants from National Parkinson Foundation, Miami, USA, Tel Aviv Sourasky Medical Center Grant of Excellence, and Wolfson and Kahn Foundations. NR 29 TC 16 Z9 16 U1 0 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1364-6745 J9 NEUROGENETICS JI Neurogenetics PD OCT PY 2009 VL 10 IS 4 BP 355 EP 358 DI 10.1007/s10048-009-0186-0 PG 4 WC Genetics & Heredity; Clinical Neurology SC Genetics & Heredity; Neurosciences & Neurology GA 501MM UT WOS:000270386000011 PM 19283415 ER PT J AU Lo, AC Guarino, P Krebs, HI Volpe, BT Bever, CT Duncan, PW Ringer, RJ Wagner, TH Richards, LG Bravata, DM Haselkorn, JK Wittenberg, GF Federman, DG Corn, BH Maffucci, AD Peduzzi, P AF Lo, Albert C. Guarino, Peter Krebs, Hermano I. Volpe, Bruce T. Bever, Christopher T. Duncan, Pamela W. Ringer, Robert J. Wagner, Todd H. Richards, Lorie G. Bravata, Dawn M. Haselkorn, Jodie K. Wittenberg, George F. Federman, Daniel G. Corn, Barbara H. Maffucci, Alysia D. Peduzzi, Peter TI Multicenter Randomized Trial of Robot-Assisted Rehabilitation for Chronic Stroke: Methods and Entry Characteristics for VA ROBOTICS SO NEUROREHABILITATION AND NEURAL REPAIR LA English DT Article DE Stroke; Rehabilitation; Robotics; Randomized clinical trial; Health economics ID HEALTH UTILITIES INDEX; CLINICAL-TRIALS; RECOVERY; THERAPY; ARM; INFORMATION; IMPACT; NEUROREHABILITATION; STIMULATION; PERFORMANCE AB Background. Chronic upper extremity impairment due to stroke has significant medical, psychosocial, and financial consequences, but few studies have examined the effectiveness of rehabilitation therapy during the chronic stroke period. Objective. To test the safety and efficacy of the MIT-Manus robotic device for chronic upper extremity impairment following stroke. Methods. The VA Cooperative Studies Program initiated a multicenter, randomized, controlled trial in November 2006 (VA ROBOTICS). Participants with upper extremity impairment >= 6 months poststroke were randomized to robot-assisted therapy (RT), intensive comparison therapy (ICT), or usual care (UC). RT and ICT consisted of three 1-hour treatment sessions per week for 12 weeks. The primary outcome was change in the Fugl-Meyer Assessment upper extremity motor function score at 12 weeks relative to baseline. Secondary outcomes included the Wolf Motor Function Test and the Stroke Impact Scale. Results. A total of 127 participants were randomized: 49 to RT, 50 to ICT, and 28 to UC. The majority of participants were male (96%), with a mean age of 65 years. The primary stroke type was ischemic (85%), and 58% of strokes occurred in the anterior circulation. Twenty percent of the participants reported a stroke in addition to their index stroke. The average time from the index stroke to enrollment was 56 months (range, 6 months to 24 years). The mean Fugl-Meyer score at entry was 18.9. Conclusions. VA ROBOTICS demonstrates the feasibility of conducting multicenter clinical trials to rigorously test new rehabilitative devices before their introduction to clinical practice. The results are expected in early 2010. C1 [Lo, Albert C.] Brown Univ, Providence VA Med Ctr, VA RR&D Ctr Excellence, Ctr Restorat & Regenerat Med, Providence, RI 02909 USA. [Guarino, Peter; Corn, Barbara H.; Maffucci, Alysia D.; Peduzzi, Peter] VA Connecticut Healthcare Syst, Coordinating Ctr, VA Cooperat Studies Program, West Haven, CT USA. [Krebs, Hermano I.] MIT, Cambridge, MA 02139 USA. [Volpe, Bruce T.] Cornell Univ, Weill Med Coll, Burke Med Res Inst, White Plains, NY USA. [Bever, Christopher T.] Univ Maryland, Sch Med, VA Maryland Healthcare Syst, Baltimore, MD 21201 USA. [Bever, Christopher T.; Wittenberg, George F.] Univ Maryland, Sch Med, Dept Neurol, Baltimore, MD 21201 USA. [Duncan, Pamela W.] Duke Univ, Duke Ctr Clin Hlth Policy Res, Durham, NC USA. [Ringer, Robert J.] Clin Res Pharm Coordinating Ctr, VA Cooperat Studies Program, Albuquerque, NM USA. [Wagner, Todd H.] VA Palo Alto Healthcare Syst, Hlth Econ Resource Ctr, Menlo Pk, CA USA. [Richards, Lorie G.] N Florida S Georgia Vet Hlth Syst, Gainesville, FL USA. [Richards, Lorie G.] Univ Florida, Gainesville, FL USA. [Bravata, Dawn M.] Richard L Roudebush VAMC, Indianapolis, IN USA. [Haselkorn, Jodie K.] VA Puget Sound Healthcare Syst, Seattle, WA USA. [Haselkorn, Jodie K.] Univ Washington, Seattle, WA 98195 USA. [Wittenberg, George F.] Univ Maryland, Sch Med, Vet Affairs Med Ctr Baltimore Geriatr Res, Educ & Clin Ctr, Baltimore, MD 21201 USA. [Federman, Daniel G.] Yale Univ, New Haven, CT USA. RP Lo, AC (reprint author), Brown Univ, Providence VA Med Ctr, VA RR&D Ctr Excellence, Ctr Restorat & Regenerat Med, 830 Chalkstone Ave,111N, Providence, RI 02909 USA. EM Albert.Lo@va.gov OI Volpe, Bruce/0000-0002-1098-1848 FU Department of Veterans Affairs Cooperative Studies Program; Department of Veterans Affairs Rehabilitation Research and Development Service FX VA ROBOTICS was supported by the Department of Veterans Affairs Cooperative Studies Program and the Department of Veterans Affairs Rehabilitation Research and Development Service. Dr H. I. Krebs is a coinventor in the MIT-held patent for the robotic device used in this study. He holds equity positions in Interactive Motion Technologies, Inc, the company that manufactures this type of technology under license to MIT. NR 51 TC 35 Z9 36 U1 0 U2 11 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1545-9683 EI 1552-6844 J9 NEUROREHAB NEURAL RE JI Neurorehabil. Neural Repair PD OCT PY 2009 VL 23 IS 8 BP 775 EP 783 DI 10.1177/1545968309338195 PG 9 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 494YV UT WOS:000269856900001 PM 19541917 ER PT J AU Keyhani, S Federman, A AF Keyhani, Salomeh Federman, Alex TI Doctors on Coverage -- Physicians' Views on a New Public Insurance Option and Medicare Expansion. SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material C1 [Keyhani, Salomeh] James J Peters Vet Adm Med Ctr, Bronx, NY USA. [Keyhani, Salomeh] Mt Sinai Sch Med, Dept Hlth Policy, New York, NY USA. [Keyhani, Salomeh; Federman, Alex] Mt Sinai Sch Med, Div Gen Internal Med, New York, NY USA. RP Keyhani, S (reprint author), James J Peters Vet Adm Med Ctr, Bronx, NY USA. NR 3 TC 16 Z9 16 U1 0 U2 1 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 OCT 1 PY 2009 VL 361 IS 14 DI 10.1056/NEJMp0908239 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 500KZ UT WOS:000270300000005 PM 19752465 ER PT J AU Cook, J Jakupcak, M Rosenheck, R Fontana, A McFall, M AF Cook, Jessica Jakupcak, Matthew Rosenheck, Robert Fontana, Alan McFall, Miles TI Influence of PTSD symptom clusters on smoking status among help-seeking Iraq and Afghanistan veterans SO NICOTINE & TOBACCO RESEARCH LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER; CONFIRMATORY FACTOR-ANALYSIS; SCRIPT-DRIVEN IMAGERY; MAJOR DEPRESSION; COMBAT VETERANS; NEGATIVE AFFECT; TWIN REGISTRY; WAR VETERANS; PRIMARY-CARE; NICOTINE AB Despite the strong association between smoking and posttraumatic stress disorder (PTSD), mechanisms influencing smoking in this population remain unclear. Previous smoking research has largely examined PTSD as a homogenous syndrome despite the fact that PTSD is composed of four distinct symptom clusters (i.e., reexperiencing, effortful avoidance, emotional numbing, and hyperarousal). Examination of the relationship between smoking and PTSD symptom clusters may increase understanding of mechanisms influencing comorbidity between smoking and PTSD. The goals of the present study were to (a) examine the influence of overall PTSD symptom severity on likelihood of smoking and smoking heaviness and (b) examine the influence of each PTSD symptom cluster on smoking. Participants (N = 439) were Operation Iraqi Freedom/Operation Enduring Freedom combat veterans referred to VA mental health services. Multinomial logistic regression was chosen to accommodate a three-level outcome, in which the likelihood of being a nonsmoker was compared with (a) light smoking (1-9 cigarettes/day), (b) moderate smoking (10-19 cigarettes/day), and (c) heavy smoking (>= 20 cigarettes/day). Results showed that veterans with higher levels of overall PTSD symptomatology were more likely to endorse heavy smoking (Wald = 4.56, p = .03, odds ratio [OR] = 1.65). Veterans endorsing high levels of emotional numbing were also more likely to endorse heavy smoking (Wald = 6.49, p = .01, OR = 1.81); all other PTSD symptom clusters were unrelated to smoking. The association between emotional numbing and heavy daily smoking suggests that veterans with PTSD may smoke to overcome emotional blunting following trauma exposure. C1 [Cook, Jessica] Univ Wisconsin, Ctr Tobacco Res & Intervent, Sch Med & Publ Hlth, Madison, WI 53711 USA. [Jakupcak, Matthew; McFall, Miles] Univ Washington, Dept Psychiat & Behav Sci, VA Puget Sound Hlth Care Syst, Sch Med, Seattle, WA 98195 USA. [Rosenheck, Robert; Fontana, Alan] Yale Univ, Sch Med, NE Evaluat Program, VA Natl Ctr PTSD,Evaluat Ctr, New Haven, CT USA. RP Cook, J (reprint author), Univ Wisconsin, Ctr Tobacco Res & Intervent, Sch Med & Publ Hlth, 1930 Monroe St,Suite 200, Madison, WI 53711 USA. EM jwcook@ctri.medicine.wisc.edu FU VA Puget Sound Health Care System, Seattle, WA [K08DA021311] FX This work is supported by K08DA021311 to Dr. Cook. This material is supported by resources from the VA Puget Sound Health Care System, Seattle, WA. NR 41 TC 23 Z9 23 U1 3 U2 7 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1462-2203 J9 NICOTINE TOB RES JI Nicotine Tob. Res. PD OCT PY 2009 VL 11 IS 10 BP 1189 EP 1195 DI 10.1093/ntr/ntp123 PG 7 WC Substance Abuse; Public, Environmental & Occupational Health SC Substance Abuse; Public, Environmental & Occupational Health GA 496VX UT WOS:000270008900009 PM 19648174 ER PT J AU Sharifi, E Porco, TC Naseri, A AF Sharifi, Emile Porco, Travis C. Naseri, Ayman TI Cost-Effectiveness Analysis of Intracameral Cefuroxime Use for Prophylaxis of Endophthalmitis after Cataract Surgery SO OPHTHALMOLOGY LA English DT Article ID ANTERIOR SEGMENT SYNDROME; VIGAMOX(R) MOXIFLOXACIN 0.5-PERCENT; PENICILLIN-ALLERGIC PATIENTS; OCULAR SURFACE FLUID; OCCULT-BLOOD TESTS; POSTOPERATIVE ENDOPHTHALMITIS; PREVENTING ENDOPHTHALMITIS; INCISION TYPE; RABBIT MODEL; RISK-FACTORS AB Objective: To evaluate the cost-effectiveness of intracameral cefuroxime for postoperative endophthalmitis prophylaxis, and to determine the efficacy threshold necessary for alternative antibiotics to attain cost-effective equivalence with intracameral cefuroxime. Design: Cost-effectiveness analysis. Participants: We study a hypothetical cohort of 100 000 patients undergoing cataract surgery as a part of the cost analysis. Methods: A cost-effectiveness model was constructed to analyze different antibiotic prophylactic regimens for postoperative endophthalmitis with intracameral cefuroxime as our base case. Efficacy was defined as the absolute reduction in rate of infection from background rate of infection, which was sourced from the literature. Antibiotic cost data were derived from the Red Book 2007 edition, and salary data were taken from the United States Bureau of Labor Statistics. Multivariate sensitivity analysis assessed the performance of antibiotic options under different scenarios. Main Outcome Measures: Cost per case of endophthalmitis prevented; theoretical maximal cost-effectiveness; efficacy threshold necessary to achieve cost-effective equivalence with intracameral cefuroxime; ratio indicating how many times more effective or less expensive alternative antibiotics would have to be to achieve cost-effective equivalence with intracameral cefuroxime. Results: The cost-effectiveness ratio for intracameral cefuroxime is $1403 per case of postoperative endophthalmitis prevented. By comparison, the least expensive topical fluoroquinolone in our study, ciprofloxacin, would have to be >8 times more effective than intracameral cefuroxime to achieve cost-effective equivalence. The most expensive topical fluoroquinolones studied, gatifloxacin and moxifloxacin, would have to be >= 19 times more effective than intracameral cefuroxime to achieve cost-effective equivalence. A sensitivity analysis reveals that even in the worst case scenario for intracameral cefuroxime efficacy and with a 50% reduction in the cost of 4th-generation fluoroquinolones, gatifloxacin and moxifloxacin would have to be >= 9 times more effective than intracameral cefuroxime to achieve cost-effective equivalence. Conclusions: Administration of intracameral cefuroxime is relatively cost-effective in preventing endophthalmitis after cataract surgery. Owing to their high costs, many commonly used topical antibiotics are not cost-effective compared with intracameral cefuroxime, even under optimistic assumptions about their efficacy. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. Ophthalmology 2009;116:1887-1896 (C) 2009 by the American Academy of Ophthalmology. C1 [Sharifi, Emile; Porco, Travis C.; Naseri, Ayman] Univ Calif San Francisco, Dept Ophthalmol, San Francisco, CA 94143 USA. [Naseri, Ayman] San Francisco Vet Adm Med Ctr, Dept Ophthalmol, San Francisco, CA 94121 USA. [Porco, Travis C.] Univ Calif San Francisco, Dept Epidemiol & Biostat, Div Prevent Med & Publ Hlth, Francis I Proctor Fdn Res Ophthalmol, San Francisco, CA 94143 USA. RP Naseri, A (reprint author), San Francisco Vet Adm Med Ctr, Dept Ophthalmol, 4150 Clement St, San Francisco, CA 94121 USA. EM ayman.naseri@va.gov FU That Man May See, San Francisco, CA; Research to Prevent Blindness, New York, NY; NIH [P30 EY002162] FX Supported in part by an unrestricted grant from That Man May See, San Francisco, CA, an unrestricted grant from Research to Prevent Blindness, New York, NY, and by a Core Grant For Vision Research (NIH P30 EY002162). NR 59 TC 26 Z9 28 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0161-6420 J9 OPHTHALMOLOGY JI Ophthalmology PD OCT PY 2009 VL 116 IS 10 BP 1887 EP 1896 DI 10.1016/j.ophtha.2009.03.014 PG 10 WC Ophthalmology SC Ophthalmology GA 506RX UT WOS:000270794600009 PM 19560825 ER PT J AU Hekiert, AM Kofonow, JM Doghramji, L Kennedy, DW Chiu, AG Palmer, JN Leid, JG Cohen, NA AF Hekiert, Adrianna M. Kofonow, Jennifer M. Doghramji, Laurel Kennedy, David W. Chiu, Alexander G. Palmer, James N. Leid, Jeffery G. Cohen, Noam A. TI Biofilms correlate with T(H)1 inflammation in the sinonasal tissue of patients with chronic rhinosinusitis SO OTOLARYNGOLOGY-HEAD AND NECK SURGERY LA English DT Article ID BACTERIAL BIOFILMS; CHRONIC SINUSITIS; PSEUDOMONAS-AERUGINOSA; STAPHYLOCOCCUS-AUREUS; NASAL POLYPOSIS; MODEL; INTERLEUKIN-5; PROFILES; HEALTH; CARE AB OBJECTIVE: Determine the prevalence of bacterial biofilms in surgical chronic rhinosinusitis (CRS) patients and characterize the inflammatory response associated with biofilm CRS. STUDY DESIGN: Cross-sectional. SETTING: Tertiary care academic center. SUBJECTS AND METHODS: Sinonasal mucosa and peripheral blood were collected from 60 CRS patients. Mucosal biofilms were demonstrated by scanning electron microscopy. Leukocyte subpopulations were determined by flow cytometry. Cytokines were identified with a luminex-based assay on the lysate of homogenized tissue or plasma. RESULTS: Of the 60 samples, 17 were determined to be positive for the presence of biofilms. Oral steroid-naive CRS patients with biofilm demonstrated a local T(H)1 inflammatory response with significantly elevated levels of interferon-gamma (INF-gamma), granulocyte colony-stimulating factor, macrophage inflammatory protein-1 beta, and neutrophils in the sinonasal mucosa. No differences were present at the systemic level. CONCLUSION: Sinonasal bacterial biofilms correlate to a T(H)1 skewed local but not systemic inflammatory response in CRS. This difference is abrogated by the use of oral steroids. (C) 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved. C1 [Hekiert, Adrianna M.; Kofonow, Jennifer M.; Doghramji, Laurel; Kennedy, David W.; Chiu, Alexander G.; Palmer, James N.; Cohen, Noam A.] Univ Penn, Sch Med, Dept Otorhinolaryngol, Philadelphia, PA 19104 USA. [Kofonow, Jennifer M.; Cohen, Noam A.] Philadelphia VA Med Ctr, Dept Otorhinolaryngol, Philadelphia, PA USA. [Leid, Jeffery G.] No Arizona Univ, Ctr Microbial Genet & Genom, Flagstaff, AZ 86011 USA. RP Cohen, NA (reprint author), Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, Div Rhinol, Ravdin Bldg,5th Flr, Philadelphia, PA 19104 USA. EM cohenn@uphs.upenn.edu RI Chiu, Alexander/J-1230-2014 OI Chiu, Alexander/0000-0002-7592-6575; Cohen, Noam/0000-0002-9462-3932 FU American Academy of Otolaryngic Allergy; Sinus and Allergy Health Partnership FX This project was funded by a CORE resident grant from the American Academy of Otolaryngic Allergy to A.M.H. and a Young Investigator Award from the Sinus and Allergy Health Partnership to N.A.C. NR 22 TC 34 Z9 36 U1 0 U2 3 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 0194-5998 J9 OTOLARYNG HEAD NECK JI Otolaryngol. Head Neck Surg. PD OCT PY 2009 VL 141 IS 4 BP 448 EP 453 DI 10.1016/j.otohns.2009.06.090 PG 6 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 502GK UT WOS:000270443800003 PM 19786211 ER PT J AU Haskell, SG Brandt, CA Krebs, EE Skanderson, M Kerns, RD Goulet, JL AF Haskell, Sally G. Brandt, Cynthia A. Krebs, Erin E. Skanderson, Melissa Kerns, Robert D. Goulet, Joseph L. TI Pain among Veterans of Operations Enduring Freedom and Iraqi Freedom: Do Women and Men Differ? SO PAIN MEDICINE LA English DT Article DE Pain Assessment; Veterans; Sex Differences ID POSTTRAUMATIC-STRESS-DISORDER; RECEIVING PRIMARY-CARE; PERSIAN-GULF-WAR; HEALTH-CARE; GENERAL-POPULATION; GENDER-DIFFERENCES; FEMALE VETERANS; UNITED-STATES; PREVALENCE; AGE AB Objective. To evaluate sex differences in the prevalence of overall pain, moderate-severe pain, and persistent pain among Veterans of Operations Enduring Freedom and Iraqi Freedom seen at VA outpatient clinics, and to evaluate sex differences in pain assessment. Design. The observational cohort consisted of Veterans discharged from the U.S. military from October 1, 2001 to November 30, 2007 that enrolled for Veterans Administration (VA) services or received VA care before January 1, 2008. We limited the sample to the 153,212 Veterans (18,481 female, 134,731 male) who had 1 year of observation after their last deployment. Results. Pain was assessed in 59.7% (n = 91,414) of Veterans in this sample. Among those assessed, 43.3% (n = 39,591) reported any pain, 63.2% (n = 25,028) of whom reported moderate-severe pain. Over 20% (n = 3,427) of Veterans with repeated pain measures reported persistent pain. We found no significant difference in the probability of pain assessment by sex (RR = 0.98, 95% CI 0.96, 1.00). Female Veterans were less likely to report any pain (RR 0.89, 95% CI 0.86, 0.92). Among those with any pain, female Veterans were more likely to report moderate-severe pain (RR 1.05, 95% CI 1.01, 1.09) and less likely to report persistent pain (RR 0.90, 95% CI 0.81, 0.99). Conclusions. As the VA plans care for the increasing numbers of female Veterans returning from Iraq and Afghanistan, a better understanding of the prevalence of pain, as well as sex-specific variations in the experience and treatment of pain, is important for policy makers and providers who seek to improve identification and management of diverse pain disorders. C1 [Haskell, Sally G.; Brandt, Cynthia A.; Kerns, Robert D.; Goulet, Joseph L.] VA Connecticut Healthcare Syst, West Haven, CT 06516 USA. [Krebs, Erin E.] Roudebush VA Ctr Implementing Evidence Based Prac, Indianapolis, IN USA. [Krebs, Erin E.] Indiana Univ, Sch Med, Indianapolis, IN USA. [Krebs, Erin E.] Regenstrief Inst Inc, Indianapolis, IN USA. [Skanderson, Melissa] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Haskell, Sally G.; Brandt, Cynthia A.; Kerns, Robert D.; Goulet, Joseph L.] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA. [Haskell, Sally G.; Brandt, Cynthia A.; Kerns, Robert D.; Goulet, Joseph L.] Yale Univ, Sch Med, Dept Neurol, New Haven, CT 06510 USA. [Haskell, Sally G.; Brandt, Cynthia A.; Kerns, Robert D.; Goulet, Joseph L.] Yale Univ, Sch Med, Dept Psychol, New Haven, CT 06510 USA. RP Goulet, JL (reprint author), VA Connecticut Healthcare Syst, 950 Campbell Ave, West Haven, CT 06516 USA. EM Joseph.Goulet@VA.gov OI Goulet, Joseph/0000-0002-0842-804X FU VA [DHI 07-065-1]; VA HSR&D Research Enhancement Award Program (REAP) PRIME Project [CD207215-2] FX Financial support: VA grants DHI 07-065-1 (Brandt PI, Haskell, Skanderson); VA HSR&D Research Enhancement Award Program (REAP) PRIME Project (Kerns PI; Goulet); CD207215-2 (Krebs PI). NR 48 TC 35 Z9 35 U1 1 U2 1 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1526-2375 J9 PAIN MED JI Pain Med. PD OCT PY 2009 VL 10 IS 7 BP 1167 EP 1173 DI 10.1111/j.1526-4637.2009.00714.x PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 504BT UT WOS:000270589100003 PM 19818028 ER PT J AU Helfand, M Freeman, M AF Helfand, Mark Freeman, Michele TI Assessment and Management of Acute Pain in Adult Medical Inpatients: A Systematic Review SO PAIN MEDICINE LA English DT Article DE Pain Management; Hospital Medicine; Systematic Reviews ID PATIENT-CONTROLLED ANALGESIA; ACUTE ABDOMINAL-PAIN; EMERGENCY-DEPARTMENT; OLDER-ADULTS; COGNITIVE IMPAIRMENT; EPIDURAL ANALGESIA; ACUTE APPENDICITIS; OPIOID ANALGESIA; SELF-ASSESSMENT; EFFICACY AB Objective. To review the literature addressing effective care for acute pain in inpatients on medical wards. Methods. We searched Medline, PubMed Clinical Queries, and the Cochrane Database for systematic reviews published in 1996 through April 2007 on the assessment and management of acute pain in inpatients, including patients with impaired self-report or chemical dependencies. We conducted a focused search for studies on the timing and frequency of assessment, and on the use of patient-controlled analgesia (PCA) for nonsurgical pain. Two investigators performed a critical analysis of the literature and compiled narrative summaries to address the key questions. Results. We found no evidence that directly linked the timing, frequency, or method of pain assessment with outcomes or safety in medical inpatients. There is good evidence that treating abdominal pain does not compromise timely diagnosis and treatment of the surgical abdomen. Pain management teams and other systemwide interventions improve assessment and use of analgesics, but do not clearly affect pain outcomes. The safety and effectiveness of PCA in medical patients have not been studied. There is weak evidence that most cognitively impaired individuals can understand at least one self-assessment measure. Almost no evidence is available to guide management of pain in delirium. Evidence for managing pain in patients with substance abuse disorders or chronic opioid use is weak, being derived from case reports, retrospective studies, and expert opinion. Conclusions. Pain is a prevalent problem for medical inpatients. Clinical research is needed to guide the assessment and management of pain in this setting. C1 Oregon Hlth & Sci Univ, Vet Affairs Med Ctr, Evidence Based Synth Program, Portland, OR 97201 USA. Oregon Evidence Based Practice Ctr, Portland, OR USA. RP Helfand, M (reprint author), Portland VA Med Ctr, Mailcode RD71,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM mark.helfand@va.gov FU Department of Veterans Affairs, VHA [01-0206] FX The research reported here was supported by the Department of Veterans Affairs, VHA Project ESP 05-225, VA #01-0206. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. We gratefully acknowledge the assistance of research librarians Andrew Hamilton and Rose Campbell, and the participation of Robert D. Kerns, PhD, Jack Rosenberg, MD, Karl Lorenz, MD, and Roger Chou, MD, in helping us identify and refine key questions, and critically reviewing drafts of the findings. NR 92 TC 27 Z9 27 U1 1 U2 8 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1526-2375 J9 PAIN MED JI Pain Med. PD OCT PY 2009 VL 10 IS 7 BP 1183 EP 1199 DI 10.1111/j.1526-4637.2009.00718.x PG 17 WC Medicine, General & Internal SC General & Internal Medicine GA 504BT UT WOS:000270589100005 PM 19818030 ER PT J AU Dobscha, SK Clark, ME Morasco, BJ Freeman, M Campbell, R Helfand, M AF Dobscha, Steven K. Clark, Michael E. Morasco, Benjamin J. Freeman, Michele Campbell, Rose Helfand, Mark TI Systematic Review of the Literature on Pain in Patients with Polytrauma Including Traumatic Brain Injury SO PAIN MEDICINE LA English DT Article DE Pain; Multiple Trauma; Blast Injuries; Traumatic Brain Injury; Veterans ID PERIPHERAL-NERVE LESIONS; LONG-TERM OUTCOMES; INTRATHECAL BACLOFEN THERAPY; HEAD-INJURY; MULTIPLE TRAUMA; MAJOR TRAUMA; FOLLOW-UP; FUNCTIONAL CONSEQUENCES; SPASTIC HYPERTONIA; RISK-FACTORS AB Objective. To review the literature addressing the assessment and management of pain in patients with polytraumatic injuries including traumatic brain injury (TBI) and blast-related headache, and to identify patient, clinician and systems factors associated with pain-related outcomes. Design. Systematic review. Methods. We conducted searches in MEDLINE of literature published from 1950 through July 2008. Due to a limited number of studies using controls or comparators, we included observational and rigorous qualitative studies. We systematically rated the quality of systematic reviews, cohort, and case-control design studies. Results. One systematic review, 93 observational studies, and one qualitative research study met inclusion criteria. The literature search yielded no published studies that assessed measures of pain intensity or pain-related functional interference among patients with cognitive deficits due to TBI, that compared patients with blast-related headache with patients with other types of headache, or that assessed treatments for blast-related headache pain. Studies on the association between TBI severity and pain reported mixed findings. There was limited evidence that the following factors are associated with pain among TBI patients: severity, location, and multiplicity of injuries; insomnia; fatigue; depression; and post-traumatic stress disorder. Conclusions. Very little evidence is currently available to guide pain assessment and treatment approaches in patients with polytrauma. Further research employing systematic observational as well as controlled intervention designs is clearly indicated. C1 [Dobscha, Steven K.] Portland VA Med Ctr, Portland Ctr Study Chron Comorbid Phys & Mental D, Portland, OR 97207 USA. [Dobscha, Steven K.; Morasco, Benjamin J.] Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA. [Dobscha, Steven K.; Morasco, Benjamin J.] Portland VA Med Ctr, Mental Hlth & Clin Neurosci Div, Portland, OR 97207 USA. [Clark, Michael E.] James A Haley Vet Affairs Hosp, Psychol Serv, Tampa, FL USA. [Clark, Michael E.] Univ S Florida, Coll Med, Dept Psychol, Jacksonville, FL USA. [Clark, Michael E.] Univ S Florida, Coll Med, Dept Neurol, Jacksonville, FL USA. [Freeman, Michele; Campbell, Rose] Oregon Hlth & Sci Univ, Oregon Evidence Based Practice Ctr, Portland, OR 97201 USA. [Helfand, Mark] Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97201 USA. [Helfand, Mark] Oregon Hlth & Sci Univ, Vet Affairs Med Ctr, Portland, OR 97201 USA. RP Dobscha, SK (reprint author), Portland VA Med Ctr, Portland Ctr Study Chron Comorbid Phys & Mental D, Box 1034 P3MHADM, Portland, OR 97207 USA. EM steven.dobscha@va.gov FU Department of Veterans Affairs; Veterans Health Administration, Health Services Research and Development Service [RCD 04129]; National Institutes of Health [K23DA023467-01A1]; Agency for Healthcare Research and Quality FX The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service Project RCD 04129 (Dobscha), National Institutes of Health K23DA023467-01A1 (Morasco) and Evidence-based Practice Center funding which is supported by the Agency for Healthcare Research and Quality. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. NR 90 TC 48 Z9 49 U1 1 U2 10 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1526-2375 J9 PAIN MED JI Pain Med. PD OCT PY 2009 VL 10 IS 7 BP 1200 EP 1217 DI 10.1111/j.1526-4637.2009.00721.x PG 18 WC Medicine, General & Internal SC General & Internal Medicine GA 504BT UT WOS:000270589100006 PM 19818031 ER PT J AU Lorenz, KA Krebs, EE Bentley, TGK Sherbourne, CD Goebel, JR Zubkoff, L Lanto, AB Asch, SM AF Lorenz, Karl A. Krebs, Erin E. Bentley, Tanya G. K. Sherbourne, Cathy D. Goebel, Joy R. Zubkoff, Lisa Lanto, Andy B. Asch, Steven M. TI Exploring Alternative Approaches to Routine Outpatient Pain Screening SO PAIN MEDICINE LA English DT Article DE Ambulatory Care; Veterans; Pain; Measurement ID 5TH VITAL SIGN; PRIMARY-CARE; IMPACT; VALIDITY; INFORMATION; IMPAIRMENT; INVENTORY; QUALITY AB Objective. To evaluate potential alternatives to the numeric rating scale (NRS) for routine pain screening. Design. Cross-sectional. Setting. Nineteen Veterans Affairs outpatient clinics in Southern California at two hospitals and six community sites. Patients. Five hundred twenty-eight veterans from primary care, cardiology, and oncology clinics sampled in proportion to the total number of visits made to each clinic during the previous year. Methods. Veterans were approached following clinic visits to complete researcher-administered surveys about their clinic experience. Using the Brief Pain Inventory (BPI) interference scale of >= 5 as a reference standard for important unrelieved pain, we evaluated potential alternative pain screening items and item combinations by analyzing sensitivity and specificity, area under the receiver operating curve (AUC), and likelihood ratios. Results. Of the veterans, 43.6% had unrelieved pain as measured by the reference standard. Approximately half had painful musculoskeletal diagnoses and one-third had comorbid mental health or substance use disorders. The fifth vital sign detected pain less accurately than did an NRS with a 1-week timeframe and an item assessing pain-related bother over the past week. AUCs were 0.79, 0.86, and 0.86, respectively. A sequential approach combining the pain-related bother and NRS with a 1-week timeframe items had good discriminatory ability. Conclusions. Alternative single or combined pain screening strategies assessing pain-related bother may improve routine pain detection. C1 [Lorenz, Karl A.; Zubkoff, Lisa; Lanto, Andy B.; Asch, Steven M.] Vet Adm Greater Los Angeles Healthcare Syst, Div Gen Internal Med, Los Angeles, CA 90073 USA. [Lorenz, Karl A.; Bentley, Tanya G. K.; Asch, Steven M.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Lorenz, Karl A.; Sherbourne, Cathy D.; Asch, Steven M.] Univ Calif Los Angeles, Ctr Hlth Policy Res, Los Angeles, CA USA. [Krebs, Erin E.] Richard L Roudebush Vet Adm Med Ctr, Ctr Implementing Evidence Based Practice, Indianapolis, IN 46202 USA. [Krebs, Erin E.] Indiana Univ, Sch Med, Indianapolis, IN USA. [Krebs, Erin E.] Regenstrief Inst Inc, Indianapolis, IN USA. [Goebel, Joy R.] Calif State Univ Long Beach, Dept Nursing, Long Beach, CA 90840 USA. RP Lorenz, KA (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, Div Gen Internal Med, 11301 Wilshire Blvd,Code 111-G, Los Angeles, CA 90073 USA. EM Karl.lorenz@med.va.gov FU VA Health Services Research and Development (HSRD) Service [IIR 03-150] FX This study was supported by a grant from the VA Health Services Research and Development (HSRD) Service (IIR 03-150). Dr. Erin Krebs is supported by a VA HSRD Career Development Award. NR 35 TC 8 Z9 8 U1 2 U2 6 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1526-2375 J9 PAIN MED JI Pain Med. PD OCT PY 2009 VL 10 IS 7 BP 1291 EP 1299 DI 10.1111/j.1526-4637.2009.00709.x PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 504BT UT WOS:000270589100014 PM 19818039 ER PT J AU Crowley-Matoka, M Saha, S Dobscha, SK Burgess, DJ AF Crowley-Matoka, Megan Saha, Somnath Dobscha, Steven K. Burgess, Diana J. TI Problems of Quality and Equity in Pain Management: Exploring the Role of Biomedical Culture SO PAIN MEDICINE LA English DT Review DE Pain Management; Disparities; Biomedical Culture ID CHRONIC NONCANCER PAIN; CLINICAL-PRACTICE GUIDELINE; PRIMARY-CARE PHYSICIANS; OPIOID ANALGESICS; CANCER PAIN; ETHNIC DISPARITIES; POSTOPERATIVE PAIN; AMERICAN ACADEMY; PATIENT; MEDICINE AB Objectives. To explore how social scientific analyses of the culture of biomedicine may contribute to advancing our understanding of ongoing issues of quality and equity in pain management. Design. Drawing upon the rich body of social scientific literature on the culture of biomedicine, we identify key features of biomedical culture with particular salience for pain management. We then examine how these cultural features of biomedicine may shape key phases of the pain management process in ways that have implications not just for quality, but for equity in pain management as well. Setting and Patients. We bring together a range of literatures in developing our analysis, including literatures on the culture of biomedicine, pain management and health care disparities. Measures. We surveyed the relevant literatures to identify and inter-relate key features of biomedical culture, key phases of the pain management process, and key dimensions of identified problems with suboptimal and inequitable treatment of pain. Results. We identified three key features of biomedical culture with critical implications for pain management: 1) mind-body dualism; 2) a focus on disease vs illness; and 3) a bias toward cure vs care. Each of these cultural features play a role in the key phases of pain management, specifically pain-related communication, assessment and treatment decision-making, in ways that may hinder successful treatment of pain in general-and of pain patients from disadvantaged groups in particular. Conclusions. Deepening our understanding of the role of biomedical culture in pain management has implications for education, policy and research as part of ongoing efforts to ameliorate problems in both quality and equity in managing pain. In particular, we suggest that building upon the existing the cultural competence movement in medicine to include fostering a deeper understanding of biomedical culture and its impact on physicians may be useful. From a policy perspective, we identify pain management as an area where the need for a shift to a more biopsychosocial model of health care is particularly pressing, and suggest prioritization of inter-disciplinary, multimodal approaches to pain as one key strategy in realizing this shift. Finally, in terms of research, we identify the need for empirical research to assess aspects of biomedical culture that may influence physician's attitudes and behaviors related to pain management, as well as to explore how these cultural values and their effects may vary across different settings within the practice of medicine. C1 [Crowley-Matoka, Megan] Univ Pittsburgh, Pittsburgh, PA USA. [Crowley-Matoka, Megan] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Saha, Somnath; Dobscha, Steven K.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Saha, Somnath; Dobscha, Steven K.] Portland VA Med Ctr, Portland, OR USA. [Burgess, Diana J.] Univ Minnesota, Minneapolis, MN USA. [Burgess, Diana J.] Minneapolis Vet Affairs Med Ctr, Ctr Chron Dis Outcomes Res, Minneapolis, MN USA. RP Crowley-Matoka, M (reprint author), VA Pittsburgh Healthcare Syst 646, CHERP, 7180 Highland Dr 151C-H, Pittsburgh, PA 15206 USA. EM Megan.Matoka@med.va.gov RI Burgess, Diana/A-1946-2016 FU VA HSRD Merit Review [VA IIR 05-210-01] FX The authors have no relevant financial relationships to declare. Dr. Crowley-Matoka's work on this manuscript was supported by a VA HSR&D Merit Review award (VA IIR 05-210-01). NR 116 TC 29 Z9 30 U1 1 U2 8 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1526-2375 J9 PAIN MED JI Pain Med. PD OCT PY 2009 VL 10 IS 7 BP 1312 EP 1324 DI 10.1111/j.1526-4637.2009.00716.x PG 13 WC Medicine, General & Internal SC General & Internal Medicine GA 504BT UT WOS:000270589100016 PM 19818041 ER PT J AU Reeve, JR Liddle, RA AF Reeve, Joseph R., Jr. Liddle, Rodger A. TI A Tribute to Gary M. Green (1940-2008) IN MEMORIAM SO PANCREAS LA English DT Biographical-Item C1 [Reeve, Joseph R., Jr.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. [Liddle, Rodger A.] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. RP Reeve, JR (reprint author), VA Greater Los Angeles Healthcare Syst, Digest Dis Res Ctr, Bldg 115 Room 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jreeve@ucla.edu NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0885-3177 J9 PANCREAS JI Pancreas PD OCT PY 2009 VL 38 IS 7 BP 719 EP 720 DI 10.1097/MPA.0b013e3181b13795 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 500BL UT WOS:000270271900001 ER PT J AU Parchman, ML Flannagan, D Ferrer, RL Matamoras, M AF Parchman, Michael L. Flannagan, Dorothy Ferrer, Robert L. Matamoras, Mike TI Communication competence, self-care behaviors and glucose control in patients with type 2 diabetes SO PATIENT EDUCATION AND COUNSELING LA English DT Article DE Diabetes mellitus, Type 2; Communication; Blood glucose; Physician-patient relations ID PARTICIPATORY DECISION-MAKING; PHYSICIAN COMMUNICATION; HEALTH-CARE; DISPARITIES; MANAGEMENT; OUTCOMES; QUALITY; MODEL AB Objective: To examine the relationship between physician communication competence and A1c control among Hispanics and non-Hispanics seen in primary care practices. Study design: Observational. Methods: Direct observation and audio-recording of patient-physician encounters by 155 Hispanic and non-Hispanic white patients seen by 40 physicians in 20 different primary care clinics. Audio-recordings were transcribed and coded to derive an overall communication competence score for the physician. An exit survey was administered to each patient to assess self-care activities and their medical record was abstracted for the most recent glycosylated hemoglobin (A1c) level. Results: Higher levels of communication competence were associated with lower levels of A1c for Hispanics, but not non-Hispanic white patients. Although communication competence was associated with better self-reported diet behaviors, diet was not associated with A1c control. Across all patients, higher levels of communication competence were associated with improved A1c control after controlling for age, ethnicity and diet adherence. Conclusions: Physician's communication competence may be more important for promoting clinical success in disadvantaged patients. Practice implications: Acquisition of communication competence skills may be an important component in interventions to eliminate Hispanic disparities in glucose control. Published by Elsevier Ireland Ltd. C1 [Parchman, Michael L.; Ferrer, Robert L.] Univ Texas Hlth Sci Ctr San Antonio, Dept Family & Community Med, San Antonio, TX 78229 USA. [Flannagan, Dorothy; Matamoras, Mike] Univ Texas San Antonio, Dept Psychol, San Antonio, TX USA. RP Parchman, ML (reprint author), S Texas Vet Hlth Care Syst, VERDICT 11C6, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM parchman@uthscsa.edu OI Parchman, Michael/0000-0001-7129-2889 FU Agency for Healthcare Research and Quality [K08 HS013008-02]; Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service FX This research was supported by the Agency for Healthcare Research and Quality (Grant #K08 HS013008-02) and the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. We would like to express our appreciation to the physicians and offices staff in the South Texas Ambulatory Research Network (STARNet) for their participation in this study. NR 30 TC 11 Z9 11 U1 0 U2 7 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0738-3991 J9 PATIENT EDUC COUNS JI Patient Educ. Couns. PD OCT PY 2009 VL 77 IS 1 BP 55 EP 59 DI 10.1016/j.pec.2009.03.006 PG 5 WC Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary SC Public, Environmental & Occupational Health; Social Sciences - Other Topics GA 500UW UT WOS:000270332000011 PM 19359125 ER PT J AU Villa-Bellosta, R Levi, M Sorribas, V AF Villa-Bellosta, Ricardo Levi, Moshe Sorribas, Victor TI Vascular smooth muscle cell calcification and SLC20 inorganic phosphate transporters: effects of PDGF, TNF-alpha, and Pi SO PFLUGERS ARCHIV-EUROPEAN JOURNAL OF PHYSIOLOGY LA English DT Article DE Vascular calcification; Phosphate transport; Pit-1; Endoplasmic reticulum; PDGF ID CHRONIC KIDNEY-DISEASE; NECROSIS-FACTOR-ALPHA; MATRIX GLA PROTEIN; IN-VITRO; COTRANSPORTER; OSTEOPONTIN; EXPRESSION; KINASE; ARTERY; PIT-1 AB Pi transport by vascular smooth muscle cells (VSMC) has been proposed to play an important role in the pathogenesis of vascular calcification. In this study, we have determined the correlation between calcification induced by Pi, platelet-derived growth factor (PDGF)-BB, and tumor necrosis factor-alpha and Pi transport activity in primary cultures of rat aortic VSMC. These agents induced calcification and increased the expression of Cbfa1, Msx2, and Bmp2 osteogene messenger RNA in rat aortic VSMC, while Pi transport rate was not modified per milligram of protein. Only PDGF increased Pi transport when it was expressed per unit of DNA, as PDGF also increased total cell protein by 100%, while DNA content and number of cells were not modified. PDGF increased the expression of the Pi transporter, Pit-1, but membrane protein biotinylation showed that Pit-1 abundance was not modified in the cell surface. Immunofluorescence revealed that, under basal conditions, Pit-1 is only slightly expressed at the cell membrane, but strongly expressed inside the cell. The intracellular signal colocalizes with endoplasmic reticulum (ER) markers, and PDGF increases Pit-1 expression in the ER but not the cell membrane. In conclusion, Pi transport across the plasma membrane does not correlate directly with calcification, but the expression of Pit-1 in the ER opens new possibilities for the study of the pathogenesis of vascular calcification. C1 [Villa-Bellosta, Ricardo; Sorribas, Victor] Univ Zaragoza, Fac Vet, Mol Toxicol Lab, E-50013 Zaragoza, Spain. [Levi, Moshe; Sorribas, Victor] Univ Colorado Denver, Dept Med, Div Renal Dis & Hypertens, Aurora, CO 80045 USA. [Levi, Moshe; Sorribas, Victor] Denver VAMC, Aurora, CO 80045 USA. RP Sorribas, V (reprint author), Univ Zaragoza, Fac Vet, Mol Toxicol Lab, Calle Miguel Servet 177, E-50013 Zaragoza, Spain. EM sorribas@unizar.es FU Spanish Ministry of Education and Science [BFU200606284/BFI]; US National Institute of Health [1 R01 DK066029]; Government of Aragon (Spain) [B086/2007] FX This work was supported by grants BFU200606284/BFI from the Spanish Ministry of Education and Science to VS, 1 R01 DK066029 from the US National Institute of Health to ML, and predoctoral fellowship B086/2007 from the Government of Aragon (Spain) to RVB. NR 34 TC 34 Z9 36 U1 0 U2 14 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0031-6768 J9 PFLUG ARCH EUR J PHY JI Pflugers Arch. PD OCT PY 2009 VL 458 IS 6 BP 1151 EP 1161 DI 10.1007/s00424-009-0688-5 PG 11 WC Physiology SC Physiology GA 495UB UT WOS:000269919400013 PM 19506901 ER PT J AU Boudreau, RM Hanlon, JT Roumani, YF Studenski, SA Ruby, CM Wright, RM Hilmer, SN Shorr, RI Bauer, DC Simonsick, EM Newman, AB AF Boudreau, Robert M. Hanlon, Joseph T. Roumani, Yazan F. Studenski, Stephanie A. Ruby, Christine M. Wright, Rollin M. Hilmer, Sarah N. Shorr, Ronald I. Bauer, Douglas C. Simonsick, Eleanor M. Newman, Anne B. TI Central nervous system medication use and incident mobility limitation in community elders: the health, aging, and body composition study SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Article DE aged; mobility; central nervous system drugs ID LOWER-EXTREMITY FUNCTION; BENZODIAZEPINE USE; OLDER-ADULTS; PHYSICAL PERFORMANCE; DISABILITY; ASSOCIATION; MORTALITY; PEOPLE; DRUGS; WOMEN AB Purpose To evaluate whether CNS medication use in older adults was associated with a higher risk of future incident mobility limitation. Methods This 5-year longitudinal cohort study included 3055 participants from the health, aging and body composition (Health ABC) study who were well-functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, and antidepressants) was determined yearly (except year 4) during in-home or in-clinic interviews. Summated standardized daily doses (low, medium, and high) and duration of CNS drug use were computed. Incident mobility limitation was operationalized as two consecutive self-reports of having any difficulty walking 1/4 mile or climbing 10 steps without resting every 6 months after baseline. Multivariable Cox proportional hazard analyses were conducted adjusting for demographics, health behaviors, health status, and common indications for CNS medications. Results Each year at least 13.9% of participants used a CNS medication. By year 6, overall 49% had developed incident mobility limitation. In multivariable models, CNS medication users compared to never users showed a higher risk for incident mobility limitation (adjusted hazard ratio (Adj. HR) 1.28; 95% confidence interval (CI) 1.12-1.47). Similar findings of increased risk were seen in analyses examining dose- and duration-response relationships. Conclusions CNS medication use is independently associated with an increased risk of future incident mobility limitation in community dwelling elderly. Further studies are needed to determine the impact of reducing CNS medication exposure on mobility problems. Copyright (C) 2009 John Wiley & Sons, Ltd. C1 [Hanlon, Joseph T.; Roumani, Yazan F.; Studenski, Stephanie A.; Ruby, Christine M.; Wright, Rollin M.; Newman, Anne B.] Univ Pittsburgh, Dept Geriatr Med, Sch Med, Pittsburgh, PA 15213 USA. [Boudreau, Robert M.; Newman, Anne B.] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15213 USA. [Hanlon, Joseph T.; Ruby, Christine M.] Univ Pittsburgh, Dept Pharm & Therapeut, Sch Pharm, Pittsburgh, PA 15213 USA. [Hanlon, Joseph T.; Studenski, Stephanie A.] Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equ Res, Pittsburgh, PA USA. [Hanlon, Joseph T.; Studenski, Stephanie A.] Vet Affairs Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. [Hilmer, Sarah N.] Univ Sydney, Sydney, NSW 2006, Australia. [Hilmer, Sarah N.] Royal N Shore Hosp, Sydney, NSW, Australia. [Shorr, Ronald I.] N Florida S Georgia Vet Hlth Syst Geriatr Res Edu, Gainesville, FL USA. [Bauer, Douglas C.] Univ Calif San Francisco, Div Gen Internal Med, San Francisco, CA 94143 USA. [Simonsick, Eleanor M.] NIA, Intramural Res Program, Baltimore, MD 21224 USA. RP Hanlon, JT (reprint author), Univ Pittsburgh, Dept Geriatr Med, Sch Med, Kaufman Med Bldg Suite 514,3471 5th Ave, Pittsburgh, PA 15213 USA. EM hanlonj@dom.pitt.edu RI Newman, Anne/C-6408-2013 OI Newman, Anne/0000-0002-0106-1150; Hilmer, Sarah/0000-0002-5970-1501; Boudreau, Robert/0000-0003-0162-5187 FU NIH, National Institute of Aging [R01AG027017, P30AG024827, N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106] FX This study was primarily supported by National Institute of Aging grants and contracts (R01AG027017; P30AG024827, N01-AG-6-2101, N01-AG-6-2103, and N01-AG-6-2106). This research was also supported in part by the Intramural Research program of the NIH, National Institute on Aging. Dr Hanlon and Dr Boudreau have full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design was done by Bauer, Hanlon, Boudreau, Newman, Shorr, Simonsick, and Studenski. Data were accumulated by Hanlon, Boudreau, and Newman. Analysis and interpretation of the data were done by Hanlon, Boudreau, Newman, Shorr, Simonsick, Bauer, Ruby, Roumani, Studenski, Wright, and Hilmer. The manuscript was drafted by Hanlon, Boudreau, Roumani, Hilmer, Studenski, Wright, and Simonsick. Critical revision of the manuscript for important intellectual content was done by Hanlon, Boudreau, Newman, Roumani, Hilmer, Shorr, Bauer, Studenski, Ruby, Wright, and Simonsick. Statistical analysis was done by Boudreau, Roumani. Funding was obtained by Hanlon and Newman. The study was supervised by Hanlon and Newman. NR 28 TC 26 Z9 26 U1 2 U2 4 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1053-8569 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD OCT PY 2009 VL 18 IS 10 BP 916 EP 922 DI 10.1002/pds.1797 PG 7 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA 510GN UT WOS:000271076200006 PM 19585466 ER PT J AU Figoni, SF Kunkel, CF Scremin, AME Asher, A Banks, NL Rivera, A Tin, JK Cohen, B AF Figoni, Stephen F. Kunkel, Charles F. Scremin, A. M. Erika Asher, Arash Banks, Norman L. Rivera, Anthony Tin, John K. Cohen, Babak TI Effects of Exercise Training on Calf Tissue Oxygenation in Men With Intermittent Claudication SO PM&R LA English DT Article AB Objective: To determine the effects of exercise training on calf tissue oxygenation in men with peripheral arterial disease and intermittent calf claudication. Design: This pilot study was prospective and longitudinal and used a one-group, pretest-posttest design. Setting: Tertiary care medical center for veterans. Participants: Fifteen male veterans (mean age 69 years) with Fontaine stage Ila peripheral arterial disease and classic intermittent claudication. Main Outcome Measurements: Before and after intervention, participants performed graded treadmill exercise tests while medial calf tissue oxygenation (StO(2), % oxyhemoglobin saturation) was monitored continuously with near-infrared spectroscopy. Intervention: The intervention consisted of a 3-month exercise training program involving 3 sessions per week at the clinic (treadmill walking, calf ergometry) and 2 sessions per week at home (free walking, standing heel raises). Results: After completion of the intervention, participants significantly increased their maximal treadmill exercise time from 7.19 to 11.27 minutes. Mean exercise StO(2) decreased from 29% to 19% saturation, StO(2) X time area increased from 421% . mm to 730% . min StO(2) nadir, and StO(2) recovery time did not change significantly. Conclusions: After the exercise intervention, the improved treadmill walking performance was accompanied by greater calf tissue deoxygenation during exercise. Given the continued presence of ischemia, this finding may represent increased capillarization and diffusion-based enhancement of arteriovenous O-2 extraction. C1 [Figoni, Stephen F.; Kunkel, Charles F.; Scremin, A. M. Erika; Cohen, Babak] VA W Los Angeles Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Phys Med & Rehabil Serv, Los Angeles, CA USA. [Kunkel, Charles F.; Scremin, A. M. Erika] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. [Asher, Arash; Banks, Norman L.; Rivera, Anthony; Tin, John K.] Univ Calif Los Angeles, VA Greater Los Angeles Phys Med & Rehabil Residen, Los Angeles, CA USA. RP Figoni, SF (reprint author), VA W Los Angeles Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Phys Med & Rehabil Serv, 11301 Wilshire Blvd, Los Angeles, CA USA. EM sfigoni@gmail.com FU Rehabilitation Research and Development Service, Department of Veterans Affairs [B3644P] FX 8, Grant #B3644P from the Rehabilitation Research and Development Service, Department of Veterans Affairs NR 42 TC 5 Z9 7 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1934-1482 J9 PM&R JI PM&R PD OCT PY 2009 VL 1 IS 10 BP 932 EP 940 DI 10.1016/j.pmrj.2009.08.453 PG 9 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA V24LN UT WOS:000208412000005 PM 19854422 ER PT J AU Brekke, JS Hoe, M Green, MF AF Brekke, J. S. Hoe, M. Green, M. F. TI Neurocognitive change, functional change and service intensity during community-based psychosocial rehabilitation for schizophrenia SO PSYCHOLOGICAL MEDICINE LA English DT Article DE Functional change; neurocognitive change; psychosocial rehabilitation; schizophrenia ID SEVERE MENTAL-ILLNESS; CASE-MANAGEMENT; 1ST-EPISODE SCHIZOPHRENIA; MEASUREMENT INVARIANCE; COGNITIVE REMEDIATION; SUBJECTIVE EXPERIENCE; SOCIAL COGNITION; RATING-SCALE; FOLLOW-UP; DEFICITS AB Background. This study examined the magnitude of neurocognitive change during 1 year of community-based psychosocial intervention, whether neurocognitive change and functional change were linked, and how neurocognitive change combined with service intensity to facilitate functional change. Method. A total of 130 individuals diagnosed with schizophrenia were recruited upon admission to four community-based psychosocial rehabilitation programs. Subjects were assessed at baseline, 6 and 12 months oil role functioning and symptom measures. Neurocognition was measured at baseline and 12 months. Service intensity was the number of days of treatment attendance during the study period. Latent mean difference tests and Latent Growth Curve Models (LCGMs) were used to examine the Study hypotheses. Results. There was statistically and clinically significant functional improvement over 12 months. Neurocognition improved significantly over time. Seventy-six (58%) of the sample showed neurocognitive improvement and 54 (42%) did not. There was a significant rate of functional enhancement in the neurocognitive improver group. There was a non-significant rate of functional change in the neurocognitive non-improver group. Neurocognitive improvers showed functional improvement that was 350% greater than neurocognitive non-improvers. Service intensity did not vary between neurocognitive improvers and non-improvers but there was a strong interaction between neurocognitive improvement, service intensity and rate Of functional improvement Such that service intensity was strongly related to functional improvement for neurocognitive improvers but not for neurocognitive non-improvers. Medication usage and symptomatology did not confound these findings. Conclusions. These findings suggest that neurocognitive improvement may be a foundation for functional change and treatment responsiveness during COMM Unity-based psychosocial rehabilitation for individuals With schizophrenia. C1 [Brekke, J. S.; Hoe, M.] Univ So Calif, Sch Social Work, Los Angeles, CA 90089 USA. [Green, M. F.] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. RP Brekke, JS (reprint author), Univ So Calif, Sch Social Work, MC 0411, Los Angeles, CA 90089 USA. EM brekke@usc.edu FU National Institute of Mental Health [R-01 MH53282] FX This research was supported by grant no. R-01 MH53282 from the National Institute of Mental Health awarded to J.S.B. NR 65 TC 23 Z9 25 U1 1 U2 8 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA SN 0033-2917 EI 1469-8978 J9 PSYCHOL MED JI Psychol. Med. PD OCT PY 2009 VL 39 IS 10 BP 1637 EP 1647 DI 10.1017/S003329170900539X PG 11 WC Psychology, Clinical; Psychiatry; Psychology SC Psychology; Psychiatry GA 499XQ UT WOS:000270260500008 PM 19243648 ER PT J AU Yehuda, R Bierer, LM Sarapas, C Makotkine, I Andrew, R Seckl, JR AF Yehuda, Rachel Bierer, Linda M. Sarapas, Casey Makotkine, Iouri Andrew, Ruth Seckl, Jonathan R. TI Cortisol metabolic predictors of response to psychotherapy for symptoms of PTSD in survivors of the World Trade Center attacks on September 11, 2001 SO PSYCHONEUROENDOCRINOLOGY LA English DT Article DE Posttraumatic stress disorder; Cortisol; Cortisol metabolites; Glucocorticoid metabolism; Biological markers; Psychotherapy; 5 alpha-Reductase; 5 alpha-Tetrahydrocortisol (5 alpha-THF) ID POSTTRAUMATIC-STRESS-DISORDER; RANDOMIZED CONTROLLED-TRIAL; 11-BETA-HYDROXYSTEROID DEHYDROGENASE TYPE-1; COGNITIVE-BEHAVIORAL THERAPY; HOLOCAUST SURVIVORS; SALIVARY CORTISOL; PLASMA-CORTISOL; SEXUAL ABUSE; HPA-AXIS; IN-VIVO AB Background: A proportion of subjects with symptoms of posttraumatic stress disorder (PTSD) are unresponsive to specialized psychotherapy, but a biological basis for this has not been described. To observe whether differences in cortisol or its metabolites predict or correlate with response to therapy for PTSD symptoms, cortisol and its metabolites were measured from urine samples at pre-treatment, at the conclusion of psychotherapy, and at 3-month follow-up. Methods: 28 survivors of the World Trade Center attacks on September 11, 2001 seeking psychological treatment for PTSD symptoms received four sessions of either exposure therapy or supportive counseling, followed by up to 10 sessions of prolonged exposure in a specialized PTSD treatment program at a private hospital serving the New York City metropolitan area. 24-h mean integrated cortisol excretion was assessed by radioimmunoassay (RIA); urinary free cortisol and metabolites cortisone, 5 alpha-tetrahydrocortisol (5 alpha-THF), 5 beta-tetrahydrocortisol, and tetrahydrocortisone were assessed by gas chromatography-mass spectrometry (GC-MS); and indices of enzyme activity for 5 alpha- and 5 beta-reductase and for the 11 beta-hydroxysteroid dehydrogenases were derived from the metabolite and glucocorticoid measures. Results: 5 alpha-Reductase activity was significantly tower at pre-treatment among non-responders, whereas there were no significant pre-treatment differences between responders and non-responders in any other hormone or metabolite level. In repeated measures analyses across the three time points, 5 alpha-reductase activity, as well as 5 alpha-THF and total glucocorticoids, significantly differed between responders and non-responders. For urinary cortisol measured by RIA, there was a significant group x time interaction indicating that, although not different at pre-treatment, urinary cortisol levels declined over time in the non-responder group, such that by follow-up, towered cortisol significantly distinguished non-responders from responders. Indices of 5 alpha-reductase activity, including 5 alpha-THF and total glucocorticoids, were significantly negatively correlated with avoidance symptom severity at pre-treatment. At follow-up, indices of 5 alpha-reductase activity were significantly negatively correlated with severity of all three PTSD symptom clusters and with total PTSD severity scores. Conclusion: Lower 5 alpha-reductase activity is associated with avoidance severity and predicts non-responsiveness to psychological treatment for PTSD symptomatology. Relatively diminished 5 alpha-reductase activity may mark a state of primary vulnerability, perhaps via attenuated peripheral catabolism of cortisol resulting in the suppression of hypothalamic-pituitary-ad renal axis responsiveness. Lower cortisol levels appear later in the progression to chronic, treatment-resistant PTSD. Published by Elsevier Ltd. C1 [Yehuda, Rachel; Bierer, Linda M.; Sarapas, Casey; Makotkine, Iouri] Mt Sinai Sch Med, Traumat Stress Studies Div, Bronx, NY 10468 USA. [Yehuda, Rachel; Bierer, Linda M.; Sarapas, Casey; Makotkine, Iouri] James J Peters Vet Affairs Med Ctr, Bronx, NY 10468 USA. [Andrew, Ruth; Seckl, Jonathan R.] Univ Edinburgh, Queens Med Res Inst, Endocrinol Unit, Edinburgh EH16 4TJ, Midlothian, Scotland. RP Yehuda, R (reprint author), Mt Sinai Sch Med, Traumat Stress Studies Div, Psychiat 116-A OOMH,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM rachel.yehuda@va.gov RI Seckl, Jonathan/C-3555-2013; Andrew, Ruth/C-2727-2008 FU NCRR NIH HHS [M01 RR000071, M01 RR000071-458256]; NIMH NIH HHS [R01MH064104-01, R56 MH077321, R56 MH077321-01] NR 63 TC 52 Z9 54 U1 3 U2 10 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 OCT PY 2009 VL 34 IS 9 BP 1304 EP 1313 DI 10.1016/j.psyneuen.2009.03.018 PG 10 WC Endocrinology & Metabolism; Neurosciences; Psychiatry SC Endocrinology & Metabolism; Neurosciences & Neurology; Psychiatry GA 506LY UT WOS:000270777500005 PM 19411143 ER PT J AU Golier, JA Schmeidler, J Yehuda, R AF Golier, Julia A. Schmeidler, James Yehuda, Rachel TI Pituitary response to metyrapone in Gulf War veterans: Relationship to deployment, PTSD and unexplained health symptoms SO PSYCHONEUROENDOCRINOLOGY LA English DT Article DE Medically unexplained illness; Gulf War syndrome; Stress; ACTH; Cortisol; Metyrapone ID POSTTRAUMATIC-STRESS-DISORDER; OPERATION DESERT-STORM; MULTISYMPTOM ILLNESS; MILITARY SERVICE; CORTISOL; HORMONE; ACTH; SYMPTOMATOLOGY; DEXAMETHASONE; SPECTROSCOPY AB Objective: Gulf War deployment has been associated with a distinct neuroendocrine profile characterized by low 24 h basal ACTH levels and enhanced cortisol and ACTH suppression to low-dose dexamethasone. The metyrapone stimulation test was performed to further characterize hypothalamic-pituitary activity in Gulf War veterans (GWV) and its relationship to unexplained medical symptoms and post-traumatic stress disorder (PTSD). Method: Eleven GWV without PTSD, 18 GWV with PTSD and 15 healthy subjects not exposed to the Gulf War theater (non-exposed) underwent the metyrapone stimulation test, which inhibits cortisol synthesis, impairs cortisol-mediated negative feedback inhibition and in turn increases levels of ACTH and 11-deoxycortisol, a cortisol precursor. These hormones were measured at baseline (7:00 a.m.) and at intervals (from 8:00a.m. to 4:00 p.m.) following the administration of metyrapone 750 mg orally at 7:05 a.m. and at 10:05 a.m. Results: There were group differences in the ACTH response despite similar cortisol and 11-deoxycortisol responses to metyrapone. GWV without PTSD had a significantly attenuated ACTH response compared to non-exposed subjects; GWV with PTSD had a significantly higher ACTH response than GWV without PTSD but did not differ from non-exposed subjects. Among GWV, unexplained medical health symptoms (e.g., neurological, musculoskeletal, cardiac, and pulmonary symptoms) and PTSD symptoms were significantly positively associated with the ACTH response to metyrapone. Conclusion: Gulf War deployment is associated with a substantially lower ACTH response to metyrapone. In contrast, unexplained health symptoms and PTSD in Gulf War veterans are associated with relatively greater hypothalamic-pituitary activity which may reflect increased CRF activity and is evident only in consideration of deployment effects. This pattern of differences suggests either that Gulf War deployment and its associated exposures results in enduring changes in pituitary function or that reduced hypothalamic-pituitary activity protects against the development of PTSD and other deployment-related health problems. Published by Elsevier Ltd. C1 [Golier, Julia A.] James J Peters VA Med Ctr, OOMH, Dept Psychiat, Bronx, NY 10468 USA. [Golier, Julia A.; Schmeidler, James; Yehuda, Rachel] Mt Sinai Sch Med, New York, NY USA. RP Golier, JA (reprint author), James J Peters VA Med Ctr, OOMH, Dept Psychiat, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM julia.golier@va.gov FU VA/DoD; VA MERIT; National Institute of Health [5 M01 RR00071] FX This work was supported by a VA/DoD and VA MERIT award to Dr. Golier and by a grant (5 M01 RR00071) for the Mount Sinai General Clinical Research Center from the National Institute of Health. The authors also gratefully acknowledge the time and effort of the veterans who participated in this study. NR 51 TC 12 Z9 12 U1 2 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4530 J9 PSYCHONEUROENDOCRINO JI Psychoneuroendocrinology PD OCT PY 2009 VL 34 IS 9 BP 1338 EP 1345 DI 10.1016/j.psyneuen.2009.04.004 PG 8 WC Endocrinology & Metabolism; Neurosciences; Psychiatry SC Endocrinology & Metabolism; Neurosciences & Neurology; Psychiatry GA 506LY UT WOS:000270777500008 PM 19446401 ER PT J AU Bierer, GB Hoo, GWS AF Bierer, Gregory B. Hoo, Guy W. Soo TI Noninvasive Ventilation for Acute Respiratory Failure: A National Survey of Veterans Affairs Hospitals SO RESPIRATORY CARE LA English DT Article DE noninvasive ventilation; respiratory failure; hypercapnia; respiratory therapists ID POSITIVE-PRESSURE VENTILATION; OBSTRUCTIVE PULMONARY-DISEASE; MECHANICAL VENTILATION; ACUTE EXACERBATIONS; CONTROLLED-TRIAL; CARE; EDEMA; COPD; METAANALYSIS; STANDARDS AB BACKGROUND: The utilization of noninvasive ventilation (NIV) in the Veterans Affairs health-care system is not well characterized. A survey of physicians and respiratory therapists was conducted to better understand its use. METHODS: Three hospitals in each of 21 Veterans Affairs networks were selected based on severity of patient mix, level of staffing and workload. A request was sent via e-mail to Veterans Affairs respiratory therapists and critical care physicians at these hospitals to complete a 41-question survey using an Internet-based survey site. RESULTS: A total of 192/882 (22%) responses were received from a survey of about half (63/128) of the Veterans Affairs intensive care units (ICUs). Previous experience and training in NIV was limited. NIV is reported to be widely available and applied in both monitored (ICU, step-down, emergency department) and unmonitored (ward) settings. NIV was identified as a first-line option for COPD and CHF, but perceived use was less. Sixty-four percent of respiratory therapists felt NIV was used < 50% of the time when indicated, compared to 29% of physicians (P < .001). Reported NIV use varied, with 45% treating 0-4 patients a month and 23% with > 10 patients a month. Larger ICUs reported more frequent use of NIV (> 10 patients a month) than smaller ICUs (P = .02). Written guidelines were noted by 65%, but only 27% had titration guidelines. The perceived efficacy of NIV was low, with a success rate of > 50% noted by only 29% of respondents. CONCLUSIONS: The perception of NIV use in the Veterans Affairs hospitals varies significantly. This survey revealed a wide range of training and experience, location of use, presence of written guidelines, and methods of delivery. Notable perceptual differences exist between respiratory therapists and physicians. Underutilization of NIV and low rates of perceived efficacy are major findings. C1 [Hoo, Guy W. Soo] W Los Angeles Vet Affairs Healthcare Ctr, Pulm & Crit Care Sect, Los Angeles, CA 90073 USA. [Bierer, Gregory B.] Olive View UCLA Med Ctr, Sylmar, CA 91342 USA. [Hoo, Guy W. Soo] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Hoo, GWS (reprint author), W Los Angeles Vet Affairs Healthcare Ctr, Pulm & Crit Care Sect, 111Q,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM guy.soohoo@va.gov NR 38 TC 23 Z9 24 U1 0 U2 0 PU DAEDALUS ENTERPRISES INC PI IRVING PA 9425 N MAC ARTHUR BLVD, STE 100, IRVING, TX 75063-4706 USA SN 0020-1324 J9 RESP CARE JI Respir. Care PD OCT PY 2009 VL 54 IS 10 BP 1313 EP 1320 PG 8 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 509WZ UT WOS:000271051300005 PM 19796410 ER PT J AU Adams, SG Anzueto, A Briggs, DD Leimer, I Kesten, S AF Adams, Sandra G. Anzueto, Antonio Briggs, Dick D., Jr. Leimer, Inge Kesten, Steven TI Evaluation of withdrawal of maintenance tiotropium in COPD SO RESPIRATORY MEDICINE LA English DT Article DE COPD; Tiotropium; Spirometry; Peak expiratory flow rate; St. George's Respiratory Questionnaire; Transition dyspnea index ID OBSTRUCTIVE PULMONARY-DISEASE; AIR-FLOW; HEALTH OUTCOMES; DIAGNOSIS; DYSPNEA AB Introduction: In chronic diseases such as chronic obstructive pulmonary disease (COPD), patients may not perceive all of the benefits of drug therapy until withdrawal. Thus, we evaluated the effect of tiotropium withdrawal. on clinical variables. Methods: COPD subjects who participated in two identical 1-year, prospective, double-blind, placebo-controlled studies of tiotropium 18 mu g once daily who completed a 3-week visit following discontinuation of therapy were included in this analysis. Outcomes measured included dyspnea (transition dyspnea, index [TDI]), Peak Expiratory Flow Rate (PEFR), health status (St George's Respiratory Questionnaire [SGRQ]), and rescue beta(2)-agonist use. Results: Overall, the tiotropium group exhibited significant improvements in clinical. parameters at the end of therapy. Of the entire cohort of 921 patients, 713 patients (77%) completed 3-weeks post-withdrawal evaluation. Patients in the tiotropium group had 1.1 unit worsening in TDI, decreased in PEFR, health status and reduced beta(2)-agonist medication following treatment discontinuation, white the placebo group remained relatively stable. Conclusions: The withdrawal of tiotropium results in worsening of COPD over a three-week interval. There was no evidence of a rebound effect in response to tiotropium withdrawal. Published by Elsevier Ltd. C1 [Adams, Sandra G.; Anzueto, Antonio] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Adams, Sandra G.; Anzueto, Antonio] S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78229 USA. [Briggs, Dick D., Jr.] Univ Alabama, Birmingham, AL 35294 USA. [Leimer, Inge; Kesten, Steven] Boehringer Ingelheim Pharma GmbH & Co KG, D-55216 Ingelheim, Germany. RP Adams, SG (reprint author), Univ Texas Hlth Sci Ctr San Antonio, 7400 Merton Minter Blvd 111E, San Antonio, TX 78229 USA. EM adamssg@uthscsa.edu FU Boehringer Ingetheim Pharmaceuticals, Inc FX Boehringer Ingetheim Pharmaceuticals, Inc. provided funding and support for the clinical trials including collaborating with investigators regarding the original study design and statistical analyses. The authors of this manuscript were not given any compensation for writing or participating in the development of this manuscript. NR 18 TC 7 Z9 7 U1 0 U2 1 PU W B SAUNDERS CO LTD PI LONDON PA 32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND SN 0954-6111 J9 RESP MED JI Respir. Med. PD OCT PY 2009 VL 103 IS 10 BP 1415 EP 1420 DI 10.1016/j.rmed.2009.05.018 PG 6 WC Cardiac & Cardiovascular Systems; Respiratory System SC Cardiovascular System & Cardiology; Respiratory System GA 497IT UT WOS:000270053200004 PM 19523796 ER PT J AU Kennelly, MJ Lemack, GE Foote, JE Trop, CS AF Kennelly, Michael J. Lemack, Gary E. Foote, Jenelle E. Trop, Cynthia S. TI Efficacy and Safety of Oxybutynin Transdermal System in Spinal Cord Injury Patients With Neurogenic Detrusor Overactivity and Incontinence: An Open-label, Dose-titration Study SO UROLOGY LA English DT Article ID MIXED URINARY-INCONTINENCE; DOUBLE-BLIND; BLADDER; URGE; PHARMACOKINETICS; TOLTERODINE; MULTICENTER; BEHAVIOR; CHLORIDE AB OBJECTIVES To evaluate the efficacy and safety of oxybutynin transdermal system (oxybutynin-TDS) in spinal cord injury patients with neurogenic detrusor overactivity and incontinence despite use of clean intermittent catheterization (CIC). METHODS This multicenter, open-label, dose-titration study included patients >= 18 years old. During an 8-week dose-titration period, oxybutynin-TDS doses were adjusted every 2 weeks, depending on symptoms. The primary efficacy end point was a change in daily number of CIC periods without leakage, from baseline to 8 weeks or last observation. Outcome parameters included 3-day voiding diary, CIC volume, and urodynamic parameters. Changes from baseline were analyzed with paired t tests. RESULTS Of 24 study participants (mean age, 41.9 years), 18 (75.0%) completed the study. Final oxybutynin-TDS doses were 7.8, 9.1, and 11.7 mg/d for 4, 9, and I I patients, respectively. Daily number of CIC periods without leakage increased significantly (mean change, 1.5 +/- 2.2; P = .0036) from baseline (2-4 +/- 1.8) to 8 weeks (3.9 +/- 1.9). CIC volume (P = .0029), reflex volume (P = .0466), maximal cystometric bladder capacity (P = .0009), and residual urine volume (P = .0023) all increased significantly, whereas detrusor pressure at maximal bladder capacity decreased significantly (P = .0457). The most common adverse events were application site reaction (12.5% of patients), dry mouth (8.3%), and abnormal vision (8.3%). No patient discontinued treatment because of an adverse event. CONCLUSIONS Oxybutynin-TDS was efficacious in spinal cord injury patients with neurogenic detrusor overactivity and was well tolerated at up to 3 times the standard dose. UROLOGY 74: 741-745, 2009. (C) 2009 Elsevier Inc. C1 [Kennelly, Michael J.] Carolinas Healthcare Syst, Carolinas Rehabil, Charlotte, NC 28203 USA. Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA. James J Peters VA Med Ctr, Bronx, NY USA. Midtown Urol & Shepherd Ctr, Atlanta, GA USA. RP Kennelly, MJ (reprint author), Carolinas Healthcare Syst, Carolinas Rehabil, 1100 Blythe Blvd, Charlotte, NC 28203 USA. EM mkennelly@carolinas.org FU Watson Laboratories, Inc, Morristown, New Jersey FX This study was supported by Watson Laboratories, Inc, Morristown, New Jersey. Editorial assistance was provided by Scientific Cannexions, Newtown, Pennsylvania. Relevant financial disclosures and conflicts of interest: NR 25 TC 10 Z9 11 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0090-4295 J9 UROLOGY JI Urology PD OCT PY 2009 VL 74 IS 4 BP 741 EP 745 DI 10.1016/j.urology.2009.05.008 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 506TA UT WOS:000270797900008 PM 19628264 ER PT J AU Johnson, M Desai, R Morgan, R Ashton, CM Deswal, A Chen, H Aparasu, R AF Johnson, M. Desai, R. Morgan, R. Ashton, C. M. Deswal, A. Chen, H. Aparasu, R. TI A MARGINAL STRUCTURAL MODEL TO COMPARE THE EFFECTIVENESS OF INDIVIDUAL ANGIOTENSIN RECEPTOR BLOCKERS IN VETERANS WITH CHRONIC HEART FAILURE SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Johnson, M.; Desai, R.; Chen, H.; Aparasu, R.] Univ Houston, Houston, TX USA. [Morgan, R.] Univ Texas Houston, Houston, TX USA. [Ashton, C. M.] Methodist Inst Technol Innovat & Educ, Houston, TX USA. [Deswal, A.] Baylor Coll Med, Houston, TX 77030 USA. [Deswal, A.] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1098-3015 J9 VALUE HEALTH JI Value Health PD OCT PY 2009 VL 12 IS 7 BP A313 EP A313 DI 10.1016/S1098-3015(10)74537-X PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 495GH UT WOS:000269878100462 ER PT J AU Ramsey, SD McDermott, CL Zeliadt, SB Blough, DK Fedorenko, CR Arora, NK Penson, DF Oakley-Girvan, I Hamilton, AS Van den Eeden, SK Potosky, AL AF Ramsey, S. D. McDermott, C. L. Zeliadt, S. B. Blough, D. K. Fedorenko, C. R. Arora, N. K. Penson, D. F. Oakley-Girvan, I Hamilton, A. S. Van den Eeden, S. K. Potosky, A. L. TI COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) USE AMONG LOCAL STAGE PROSTATE CANCER PATIENTS: TYPES, FACTORS ASSOCIATED WITH USE AND PERCEIVED BENEFITS SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Ramsey, S. D.; McDermott, C. L.; Fedorenko, C. R.] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. [Zeliadt, S. B.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Blough, D. K.] Univ Washington, Seattle, WA 98195 USA. [Arora, N. K.] NCI, Bethesda, MD 20892 USA. [Penson, D. F.] Univ So Calif, Norris Canc Ctr, Los Angeles, CA USA. [Oakley-Girvan, I] No Calif Canc Ctr, Fremont, CA USA. [Hamilton, A. S.] USC, Kenneth Norris Jr Comprehens Canc Ctr, Los Angeles, CA USA. [Van den Eeden, S. K.] Kaiser Permanente, Oakland, CA USA. [Potosky, A. L.] Georgetown Univ, Med Ctr, Washington, DC 20007 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1098-3015 J9 VALUE HEALTH JI Value Health PD OCT PY 2009 VL 12 IS 7 BP A283 EP A283 DI 10.1016/S1098-3015(10)74386-2 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 495GH UT WOS:000269878100311 ER PT J AU Gensichen, J Von Korff, M Rutter, CM Seelig, MD Ludman, EJ Lin, EHB Ciechanowski, P Young, BA Wagner, EH Katon, WJ AF Gensichen, Jochen Von Korff, Michael Rutter, Carolyn M. Seelig, Michelle D. Ludman, Evette J. Lin, Elizabeth H. B. Ciechanowski, Paul Young, Bessie A. Wagner, Edward H. Katon, Wayne J. TI Physician support for diabetes patients and clinical outcomes SO BMC PUBLIC HEALTH LA English DT Article ID GLYCEMIC CONTROL; SELF-MANAGEMENT; CENTERED CARE; DEPRESSION; STRATEGIES; DISEASE; QUALITY; FUTURE AB Background: Physician practical support ( e. g. setting goals, pro-active follow-up) and communicative support ( e. g., empathic listening, eliciting preferences) have been hypothesized to influence diabetes outcomes. Methods: In a prospective observational study, patients rated physician communicative and practical support using a modified Health Care Climate Questionnaire. We assessed whether physicians' characteristic level of practical and communicative support ( mean across patients) and each patients' deviation from their physician's mean level of support was associated with glycemic control outcomes. Glycosylated haemoglobin (HbA1c) levels were measured at baseline and at follow-up, about 2 years after baseline. Results: We analysed 3897 patients with diabetes treated in nine primary care clinics by 106 physicians in an integrated health plan in Western Washington, USA. Physicians' average level of practical support ( based on patient ratings of their provider) was associated with significantly lower HbA1c at follow-up, controlling for baseline HbA1c (p=.0401). The percentage of patients with "optimal" and "poor" glycemic control differed significantly across different levels of practical support at follow (p=.022 and p=.028). Communicative support was not associated with differences in HbA1c at follow-up. Conclusion: This observational study suggests that, in community practice settings, physician differences in practical support may influence glycemic control outcomes among patients with diabetes. C1 [Gensichen, Jochen] Univ Hosp Jena, Inst Gen Practice, Jena, Germany. [Von Korff, Michael; Rutter, Carolyn M.; Seelig, Michelle D.; Ludman, Evette J.; Lin, Elizabeth H. B.; Wagner, Edward H.] Grp Hlth Cooperat Puget Sound, Grp Hlth Ctr Hlth Studies, Seattle, WA USA. [Ciechanowski, Paul; Katon, Wayne J.] Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Young, Bessie A.] Vet Affairs Puget Sound Healthcare Syst, Seattle, WA USA. RP Gensichen, J (reprint author), Univ Hosp Jena, Inst Gen Practice, Jena, Germany. EM jochen.gensichen@med.uni-jena.de; vonkorff.m@ghc.org; rutter.c@ghc.org; seelig.m@ghc.org; ludman.e@ghc.org; lin.e@ghc.org; pavelcie@u.washington.edu; youngb@u.washington.edu; wagner.e@ghc.org; wkaton@u.washington.edu FU National Institute of Mental Health (NIMH); Division of Services and Intervention Research [R01 MH4173917] FX The Pathway Study was funded by the National Institute of Mental Health (NIMH). Division of Services and Intervention Research [R01 MH4173917]. NR 29 TC 11 Z9 11 U1 1 U2 4 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1471-2458 J9 BMC PUBLIC HEALTH JI BMC Public Health PD SEP 29 PY 2009 VL 9 AR 367 DI 10.1186/1471-2458-9-367 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 513NL UT WOS:000271329100001 PM 19788726 ER PT J AU Singh, H Thomas, EJ Mani, S Sittig, D Arora, H Espadas, D Khan, MM Petersen, LA AF Singh, Hardeep Thomas, Eric J. Mani, Shrinidi Sittig, Dean Arora, Harvinder Espadas, Donna Khan, Myrna M. Petersen, Laura A. TI Timely Follow-up of Abnormal Diagnostic Imaging Test Results in an Outpatient Setting Are Electronic Medical Records Achieving Their Potential? SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID DECISION-SUPPORT-SYSTEMS; INFORMATION-TECHNOLOGY; PATIENT NAVIGATION; CLINICAL-PRACTICE; COMMUNICATION; ERRORS; CARE; ALERTS; SAFETY; CONSEQUENCES AB Background: Given the fragmentation of outpatient care, timely follow-up of abnormal diagnostic imaging results remains a challenge. We hypothesized that an electronic medical record (EMR) that facilitates the transmission and availability of critical imaging results through either automated notification (alerting) or direct access to the primary report would eliminate this problem. Methods: We studied critical imaging alert notifications in the outpatient setting of a tertiary care Department of Veterans Affairs facility from November 2007 to June 2008. Tracking software determined whether the alert was acknowledged (ie, health care practitioner/provider [HCP] opened the message for viewing) within 2 weeks of transmission; acknowledged alerts were considered read. We reviewed medical records and contacted HCPs to determine timely follow-up actions (eg, ordering a follow-up test or consultation) within 4 weeks of transmission. Multivariable logistic regression models accounting for clustering effect by HCPs analyzed predictors for 2 outcomes: lack of acknowledgment and lack of timely follow-up. Results: Of 123 638 studies (including radiographs, computed tomographic scans, ultrasonograms, magnetic resonance images, and mammograms), 1196 images (0.97%) generated alerts; 217 (18.1%) of these were unacknowledged. Alerts had a higher risk of being unacknowledged when the ordering HCPs were trainees (odds ratio [ OR], 5.58; 95% confidence interval [CI], 2.86-10.89) and when dual-alert (>1 HCP alerted) as opposed to single-alert communication was used (OR, 2.02; 95% CI, 1.22-3.36). Timely follow-up was lacking in 92 (7.7% of all alerts) and was similar for acknowledged and unacknowledged alerts (7.3% vs 9.7%; P = .22). Risk for lack of timely follow-up was higher with dual-alert communication (OR, 1.99; 95% CI, 1.06-3.48) but lower when additional verbal communication was used by the radiologist (OR, 0.12; 95% CI, 0.04-0.38). Nearly all abnormal results lacking timely follow-up at 4 weeks were eventually found to have measurable clinical impact in terms of further diagnostic testing or treatment. Conclusions: Critical imaging results may not receive timely follow-up actions even when HCPs receive and read results in an advanced, integrated electronic medical record system. A multidisciplinary approach is needed to improve patient safety in this area. C1 [Singh, Hardeep; Mani, Shrinidi; Espadas, Donna; Khan, Myrna M.; Petersen, Laura A.] Baylor Coll Med, Dept Vet Affairs Hlth Serv Res & Dev Serv, Ctr Excellence, Houston, TX 77030 USA. [Singh, Hardeep; Mani, Shrinidi; Espadas, Donna; Khan, Myrna M.; Petersen, Laura A.] Baylor Coll Med, Ctr Inquiry Improve Outpatient Safety Through Eff, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Singh, Hardeep; Mani, Shrinidi; Espadas, Donna; Khan, Myrna M.; Petersen, Laura A.] Baylor Coll Med, Sect Hlth Serv Res, Dept Med, Houston, TX 77030 USA. [Thomas, Eric J.] Univ Texas Houston, Sch Med, Dept Med,Div Gen Med, Mem Hermann Ctr Healthcare Qual & Safety, Houston, TX 77030 USA. [Sittig, Dean] Univ Texas Houston, Sch Hlth Informat Sci, Houston, TX 77030 USA. [Sittig, Dean] Univ Texas Mem Hermann Ctr Healthcare Qual & Safe, Houston, TX USA. RP Singh, H (reprint author), VA Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM hardeeps@bcm.tmc.edu FU NIH K23 [K23CA125585]; VA National Center of Patient Safety; Agency for Health Care Research and Quality; Houston VA HSR& D Center of Excellence [HFP90020] FX The study was supported by an NIH K23 career development award (K23CA125585) to Dr Singh, the VA National Center of Patient Safety, Agency for Health Care Research and Quality, and in part by the Houston VA HSR& D Center of Excellence (HFP90020). NR 43 TC 86 Z9 87 U1 9 U2 11 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD SEP 28 PY 2009 VL 169 IS 17 BP 1578 EP 1586 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 499TA UT WOS:000270247400008 PM 19786677 ER PT J AU Luck, J Hagigi, F Parker, LE Yano, EM Rubenstein, LV Kirchner, JE AF Luck, Jeff Hagigi, Fred Parker, Louise E. Yano, Elizabeth M. Rubenstein, Lisa V. Kirchner, JoAnn E. TI A social marketing approach to implementing evidence-based practice in VHA QUERI: the TIDES depression collaborative care model SO IMPLEMENTATION SCIENCE LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; RESEARCH INITIATIVE QUERI; LATE-LIFE DEPRESSION; QUALITY-IMPROVEMENT; PUBLIC-HEALTH; ORGANIZATIONS; EXPERIENCE; SERIES AB : Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U. S. Veterans Health Administration (VHA). Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. TIDES social marketing approach: The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN) regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Results: Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Discussion and conclusion: Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems. C1 [Luck, Jeff; Hagigi, Fred; Parker, Louise E.; Yano, Elizabeth M.; Rubenstein, Lisa V.] VA Greater Angeles Healthcare Syst, VA Greater Angeles HSR&D Ctr Excellence, Sepulveda, CA USA. [Luck, Jeff; Hagigi, Fred; Yano, Elizabeth M.; Rubenstein, Lisa V.] Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. [Rubenstein, Lisa V.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. [Parker, Louise E.; Kirchner, JoAnn E.] Ctr Mental Healthcare & Outcomes Res, N Little Rock, AR USA. [Kirchner, JoAnn E.] S Cent Mental Illness Res Educ & Clin Ctr MIRECC, Little Rock, AR USA. [Kirchner, JoAnn E.] Univ Arkansas Med Sci Ctr, Little Rock, AR USA. RP Luck, J (reprint author), VA Greater Angeles Healthcare Syst, VA Greater Angeles HSR&D Ctr Excellence, Sepulveda, CA USA. EM jluck@ucla.edu; hagigi@ucla.edu; parkerlouise@earthlnk.net; elizabeth.yano@va.gov; lisar@rand.org; kirchnerjoanne@uams.edu FU VHA HSR D [IMA 04-161]; VHA QUERI FX This work was funded through a VHA HSR& D supplemental grant for enhancing access to implementation research expertise (Project # IMA 04-161) and a VHA QUERI service-directed project, the Cost and Value of Translating Evidence-based Practices Study (COVES) (Project # MNT 02-029). We thank Jennifer L. Magnabosco, PhD, for her coordination and project management support of the joint marketing effort across these studies. Mona Ritchie, PhD, also has provided valuable support to TIDES implementation and evaluation. John Williams, MD, Ed Chaney, PhD, Jeff Smith, PhD(c), and Susan Vivell, PhD provided valuable information about the TIDES implementation effort. Cheryl Stetler, PhD, RN and Brian Mittman, PhD provided conceptual and structural suggestions that greatly improved the manuscript. NR 47 TC 26 Z9 26 U1 2 U2 9 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1748-5908 J9 IMPLEMENT SCI JI Implement. Sci. PD SEP 28 PY 2009 VL 4 AR 64 DI 10.1186/1748-5908-4-64 PG 13 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 507XO UT WOS:000270889300001 PM 19785754 ER PT J AU Hysong, SJ Sawhney, MK Wilson, L Sittig, DF Esquivel, A Watford, M Davis, T Espadas, D Singh, H AF Hysong, Sylvia J. Sawhney, Mona K. Wilson, Lindsey Sittig, Dean F. Esquivel, Adol Watford, Monica Davis, Traber Espadas, Donna Singh, Hardeep TI Improving outpatient safety through effective electronic communication: a study protocol SO IMPLEMENTATION SCIENCE LA English DT Article ID PHYSICIAN ORDER ENTRY; INFORMATION-TECHNOLOGY; MALPRACTICE CLAIMS; PRIMARY-CARE; ERRORS; SYSTEM; OUTCOMES; EVENTS AB potentially powerful systems-based interventions to facilitate diagnosis and treatment because they ensure the delivery of key new findings and other health related information to the practitioner. However, effective communication involves more than just information transfer; despite a state of the art EMR system, communication breakdowns can still occur. [1-3] In this project, we will adapt a model developed by the Systems Engineering Initiative for Patient Safety (SEIPS) to understand and improve the relationship between work systems and processes of care involved with electronic communication in EMRs. We plan to study three communication activities in the Veterans Health Administration's (VA) EMR: electronic communication of abnormal imaging and laboratory test results via automated notifications (i.e., alerts); electronic referral requests; and provider-to-pharmacy communication via computerized provider order entry (CPOE). Aim: Our specific aim is to propose a protocol to evaluate the systems and processes affecting outcomes of electronic communication in the computerized patient record system (related to diagnostic test results, electronic referral requests, and CPOE prescriptions) using a human factors engineering approach, and hence guide the development of interventions for work system redesign. Design: This research will consist of multiple qualitative methods of task analysis to identify potential sources of error related to diagnostic test result alerts, electronic referral requests, and CPOE; this will be followed by a series of focus groups to identify barriers, facilitators, and suggestions for improving the electronic communication system. Transcripts from all task analyses and focus groups will be analyzed using methods adapted from grounded theory and content analysis. C1 [Hysong, Sylvia J.; Sawhney, Mona K.; Wilson, Lindsey; Esquivel, Adol; Watford, Monica; Davis, Traber; Espadas, Donna; Singh, Hardeep] Baylor Coll Med, Houston VA HSR&D Ctr Excellence, Houston, TX 77030 USA. [Hysong, Sylvia J.; Sawhney, Mona K.; Wilson, Lindsey; Esquivel, Adol; Watford, Monica; Davis, Traber; Espadas, Donna; Singh, Hardeep] Baylor Coll Med, Ctr Inquiry Improve Outpatient Safety Effect Elec, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. [Hysong, Sylvia J.; Sawhney, Mona K.; Wilson, Lindsey; Esquivel, Adol; Watford, Monica; Davis, Traber; Espadas, Donna; Singh, Hardeep] Baylor Coll Med, Dept Med, Sect Hlth Serv Res, Houston, TX 77030 USA. [Sittig, Dean F.] Univ Texas Houston, Sch Hlth Informat Sci, Houston, TX USA. [Sittig, Dean F.] Univ Texas Houston, Mem Hermann Ctr Healthcare Qual & Safety, Houston, TX USA. RP Hysong, SJ (reprint author), Baylor Coll Med, Houston VA HSR&D Ctr Excellence, Houston, TX 77030 USA. EM Sylvia.Hysong@med.va.gov; monak.sawhney@va.gov; lindseya.wilson@va.gov; Dean.F.Sittig@uth.tmc.edu; adol.esquivel@va.gov; monica.watford@va.gov; traber.davis@va.gov; Donna.Espadas@va.gov; hardeep.singh@va.gov RI Hysong, Sylvia/B-8420-2008 OI Hysong, Sylvia/0000-0002-9063-5207; Davis Giardina, Traber/0000-0002-9184-6524 FU Department of Veterans Affairs, Veterans Health Administration, National Center for Patient Safety; AHRQ [T32 HS017586] FX The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration, National Center for Patient Safety. All authors' salaries (except for Sittig and Sawhney) were supported in part by the Department of Veterans Affairs. Mona Sawhney's salary was supported by a training fellowship from the AHRQ Training Program of the W. M. Keck Center for Interdisciplinary Bioscience Training of the Gulf Coast Consortia (AHRQ Grant No. T32 HS017586). The views expressed in this article are solely those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, Baylor College of Medicine, or the University of Texas. We would like to thank Dr. Laura Petersen for her support of this work and Ms. Rebecca Bryan for her assistance with technical writing. NR 33 TC 9 Z9 9 U1 1 U2 5 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1748-5908 J9 IMPLEMENT SCI JI Implement. Sci. PD SEP 25 PY 2009 VL 4 AR 62 DI 10.1186/1748-5908-4-62 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 507XN UT WOS:000270889200001 PM 19781075 ER PT J AU Kulkarni, H Marconi, VC He, WJ Landrum, ML Okulicz, JF Delmar, J Kazandjian, D Castiblanco, J Ahuja, SS Wright, EJ Weiss, RA Clark, RA Dolan, MJ Ahuja, SK AF Kulkarni, Hemant Marconi, Vincent C. He, Weijing Landrum, Michael L. Okulicz, Jason F. Delmar, Judith Kazandjian, Dickran Castiblanco, John Ahuja, Seema S. Wright, Edwina J. Weiss, Robin A. Clark, Robert A. Dolan, Matthew J. Ahuja, Sunil K. TI The Duffy-null state is associated with a survival advantage in leukopenic HIV-infected persons of African ancestry SO BLOOD LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; ACTIVE ANTIRETROVIRAL THERAPY; ETHNIC NEUTROPENIA; BLOOD-GROUP; AIDS SUSCEPTIBILITY; PLASMA-LEVELS; MALARIA; ANTIGEN; PATHOGENESIS; CHEMOKINES AB Persons of African ancestry, on average, have lower white blood cell (WBC) counts than those of European descent (ethnic leukopenia), but whether this impacts negatively on HIV-1 disease course remains unknown. Here, in a large natural history cohort of HIV-infected subjects, we show that, although leukopenia (< 4000 WBC/mm(3) during infection) was associated with an accelerated HIV disease course, this effect was more prominent in leukopenic subjects of European than African ancestry. The African-specific -46C/C genotype of Duffy Antigen Receptor for Chemokines (DARC) confers the malaria-resisting, Duffy-null phenotype, and we found that the recently described association of this genotype with ethnic leukopenia extends to HIV-infected African Americans (AAs). The association of Duffy-null status with HIV disease course differed according to WBC but not CD4(+) T-cell counts, such that leukopenic but not nonleukopenic HIV+ AAs with DARC -46C/C had a survival advantage compared with all Duffy-positive subjects. This survival advantage became increasingly pronounced in those with progressively lower WBC counts. These data highlight that the interaction between DARC genotype and the cellular milieu defined by WBC counts may influence HIV disease course, and this may provide a partial explanation of why ethnic leukopenia remains benign in HIV-infected AAs, despite immunodeficiency. (Blood. 2009;114:2783-2792) C1 [Kulkarni, Hemant; He, Weijing; Castiblanco, John; Ahuja, Seema S.; Clark, Robert A.; Ahuja, Sunil K.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. [Kulkarni, Hemant; He, Weijing; Castiblanco, John; Ahuja, Seema S.; Clark, Robert A.; Ahuja, Sunil K.] S Texas Vet Hlth Care Syst, Vet Adm Res Ctr AIDS & HIV Infect 1, San Antonio, TX USA. [Marconi, Vincent C.; Landrum, Michael L.; Okulicz, Jason F.; Delmar, Judith] Uniformed Serv Univ Hlth Sci, Infect Dis Clin Res Program, Bethesda, MD 20814 USA. [Marconi, Vincent C.; Landrum, Michael L.; Okulicz, Jason F.; Delmar, Judith; Dolan, Matthew J.] Brooke Army Med Ctr, San Antonio Mil Med Ctr, Infect Dis Serv, Ft Sam Houston, TX 78234 USA. [Landrum, Michael L.; Dolan, Matthew J.] Henry M Jackson Fdn, Lackland AFB, TX USA. [Kazandjian, Dickran] Wilford Hall USAF Med Ctr, Dept Med, Lackland AFB, TX 78236 USA. [Wright, Edwina J.] Monash Univ, Fac Med Nursing & Hlth Sci, Melbourne, Vic 3004, Australia. [Wright, Edwina J.] Alfred Hosp, Burnet Inst, Melbourne, Vic, Australia. [Weiss, Robin A.] UCL, Div Infect & Immun, London, England. [Ahuja, Sunil K.] Univ Texas Hlth Sci Ctr San Antonio, Dept Microbiol, San Antonio, TX 78229 USA. [Ahuja, Sunil K.] Univ Texas Hlth Sci Ctr San Antonio, Dept Immunol, San Antonio, TX 78229 USA. RP Ahuja, SK (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM ahujas@uthscsa.edu RI CASTIBLANCO, JOHN/B-6599-2009; Marconi, Vincent/N-3210-2014 OI CASTIBLANCO, JOHN/0000-0002-7965-9822; Marconi, Vincent/0000-0001-8409-4689; CASTIBLANCO, JOHN/0000-0003-2556-3697 FU Veterans Administration Center on AIDS and HIV infection of the South Texas Veterans Health Care System; MERIT [R37046326]; National Institutes of Health [AI043279, MH069270]; Veterans Administration MERIT; Elizabeth Glaser Scientist Award; Burroughs Wellcome Clinical Scientist Award in Translational Research; Doris Duke Distinguished Clinical Scientist Award; Department of Defense HIV Natural History Study cohort; Infectious Disease Clinical Research Program of the Uniformed Services University of the Health Sciences; Uniformed Services University of the Health Sciences; Henry M. Jackson Foundation for the Advancement of Military Medicine; Human Services/National Institutes of Health/National Institute of Allergy and Infectious Diseases/Division of Clinical Research [Y1-AI-5072] FX The authors thank Duane Hospenthal, Brian Agan, and the anonymous reviewers for their critical feedback. This work was supported by the Veterans Administration Center on AIDS and HIV infection of the South Texas Veterans Health Care System, and a MERIT (R37046326) and other awards (AI043279 and MH069270) from the National Institutes of Health (S.K.A.). S. K. A. is also supported by a Veterans Administration MERIT award and is a recipient of the Elizabeth Glaser Scientist Award, the Burroughs Wellcome Clinical Scientist Award in Translational Research, and the Doris Duke Distinguished Clinical Scientist Award. Support for the Department of Defense HIV Natural History Study cohort and staff involved in this work was provided by the Infectious Disease Clinical Research Program of the Uniformed Services University of the Health Sciences, of which the HIV Natural History Study is a component. The Infectious Disease Clinical Research Program is a Department of Defense tri-service program executed through Uniformed Services University of the Health Sciences and the Henry M. Jackson Foundation for the Advancement of Military Medicine, in collaboration with Department of Health and Human Services/National Institutes of Health/National Institute of Allergy and Infectious Diseases/Division of Clinical Research through Interagency Agreement Y1-AI-5072.; The content of this publication is the sole responsibility of the authors and does not necessarily reflect the views or policies of the National Institutes of Health or the Department of Health and Human Services, the Department of Defense or the Departments of the Army, Navy or Air Force. Mention of trade names, commercial products, or organizations does not imply endorsement by the US Government. NR 49 TC 22 Z9 22 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 2021 L ST NW, SUITE 900, WASHINGTON, DC 20036 USA SN 0006-4971 EI 1528-0020 J9 BLOOD JI Blood PD SEP 24 PY 2009 VL 114 IS 13 BP 2783 EP 2792 DI 10.1182/blood-2009-04-215186 PG 10 WC Hematology SC Hematology GA 498KK UT WOS:000270138600031 PM 19620399 ER PT J AU Asch, DA Nicholson, S Srinivas, S Herrin, J Epstein, AJ AF Asch, David A. Nicholson, Sean Srinivas, Sindhu Herrin, Jeph Epstein, Andrew J. TI Evaluating Obstetrical Residency Programs Using Patient Outcomes SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID MORTALITY-RATES; TRAINING-PROGRAMS; PROVIDER VOLUME; CARE; POLICY; HOSPITALS; SURGEONS; QUALITY AB Context Patient outcomes have been used to assess the performance of hospitals and physicians; in contrast, residency programs have been compared based on non-clinical measures. Objective To assess whether obstetrics and gynecology residency programs can be evaluated by the quality of care their alumni deliver. Design, Setting, and Patients A retrospective analysis of all Florida and New York obstetrical hospital discharges between 1992 and 2007, representing 4 906 169 deliveries performed by 4124 obstetricians from 107 US residency programs. Main Outcome Measures Nine measures of maternal complications from vaginal and cesarean births reflecting laceration, hemorrhage, and all other complications after vaginal delivery; hemorrhage, infection, and all other complications after cesarean delivery; and composites for vaginal and cesarean deliveries and for all deliveries regardless of mode. Results Obstetricians' residency program was associated with substantial variation in maternal complication rates. Women treated by obstetricians trained in residency programs in the bottom quintile for risk-standardized major maternal complication rates had an adjusted complication rate of 13.6%, approximately one-third higher than the 10.3% adjusted rate for women treated by obstetricians from programs in the top quintile (absolute difference, 3.3%; 95% confidence interval, 2.8%-3.8%). The rankings of residency programs based on each of the 9 measures were similar. Adjustment for medical licensure examination scores did not substantially alter the program ranking. Conclusions Obstetrics and gynecology training programs can be ranked by the maternal complication rates of their graduates' patients. These rankings are stable across individual types of complications and are not associated with residents' licensing examination scores. JAMA. 2009;302(12):1277-1283 C1 [Asch, David A.; Nicholson, Sean; Srinivas, Sindhu; Epstein, Andrew J.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Asch, David A.] Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. [Srinivas, Sindhu] Univ Penn, Dept Obstet & Gynecol, Philadelphia, PA 19104 USA. [Nicholson, Sean] Cornell Univ, Ithaca, NY USA. [Herrin, Jeph; Epstein, Andrew J.] Yale Univ, New Haven, CT USA. RP Asch, DA (reprint author), Univ Penn, Leonard Davis Inst Hlth Econ, 3641 Locust Walk, Philadelphia, PA 19104 USA. EM asch@wharton.upenn.edu RI Sandall, Jane/D-4146-2009 OI Sandall, Jane/0000-0003-2000-743X FU National Board of Medical Examiners FX This work was supported by a grant from the Stemmler Fund of the National Board of Medical Examiners (Drs Asch, Nicholson, and Epstein). NR 19 TC 86 Z9 86 U1 1 U2 5 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD SEP 23 PY 2009 VL 302 IS 12 BP 1277 EP 1283 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 497AR UT WOS:000270026000009 PM 19773562 ER PT J AU Jensen, BC Swigart, PM Laden, ME DeMarco, T Hoopes, C Simpson, PC AF Jensen, Brian C. Swigart, Philip M. Laden, Marie-Eve DeMarco, Teresa Hoopes, Charles Simpson, Paul C. TI The Alpha-1D Is the Predominant Alpha-1-Adrenergic Receptor Subtype in Human Epicardial Coronary Arteries SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE adrenergic; alpha and beta; arteries; coronary disease; receptors ID BENIGN PROSTATIC HYPERPLASIA; CARDIAC MYOCYTES; ALPHA(1)-ADRENERGIC RECEPTORS; KNOCKOUT MOUSE; MESSENGER-RNAS; SMOOTH-MUSCLE; ALPHA(1B); HEART; ALPHA(1B)-ADRENOCEPTOR; CONSTRICTION AB Objectives The goal was to identify alpha-1-adrenergic receptor (AR) subtypes in human coronary arteries. Background The alpha 1-ARs regulate human coronary blood flow. The alpha 1-ARs exist as 3 molecular subtypes, alpha 1A, alpha 1B,and alpha 1D, and the alpha 1D subtype mediates coronary vasoconstriction in the mouse. However, the alpha 1A is thought to be the only subtype in human coronary arteries. Methods We obtained human epicardial coronary arteries and left ventricular (LV) myocardium from 19 transplant recipients and 6 unused donors (age 19 to 70 years; 68% male; 32% with coronary artery disease). We cultured coronary rings and human coronary smooth muscle cells. We assayed alpha 1-and alpha-AR subtype messenger ribonucleic acid (mRNA) by quantitative real-time reverse transcription polymerase chain reaction and subtype proteins by radioligand binding and extracellular signal-regulated kinase (ERK) activation. Results The alpha 1D subtype was 85% of total coronary alpha 1-AR mRNA and 75% of total alpha 1-AR protein, and alpha 1D stimulation activated ERK. In contrast, the alpha 1D was low in LV myocardium. Total coronary alpha 1-AR le